bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical effect and contributing factors of acupuncture for knee osteoarthritis: a systematic review and pairwise and exploratory network meta-analysis
Authors: Liu Chuan-Yang , Duan Yan-Shan , Zhou Hang , Wang Yu , Tu Jian-Feng , Bao Xue-Ying , Yang Jing-Wen , Lee Myeong Soo , Wang Li-Qiong 
Published: November 2024

ObjectivesThis study aims to evaluate (1) the effect and safety of acupuncture in patients with knee osteoarthritis (KOA) and explore (2) whether the effect of acupuncture differed according to acupuncture type, acupuncture dose and follow-up time.DesignSystematic review and pairwise and exploratory network meta-analysis.SettingPubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals and Wanfang from inception to 13 November 2023.ParticipantsRandomised controlled trials comparing acupuncture with sham acupuncture, non-steroidal anti-inflammatory drugs (NSAIDs), usual care or waiting list groups, intra-articular (IA) injection and blank groups in patients with KOA.InterventionsEligible interventions included manual acupuncture (MA) and electroacupuncture (EA).Main outcomes measuresThe primary outcome was pain intensity at the end of treatment.Results80 trials (9933 participants) were included. Very low certainty evidence suggested that acupuncture may reduce pain intensity compared with sham acupuncture (standardised mean difference, SMD −0.74, 95% CI −1.08 to −0.39, corresponded to a difference in Visual Analogue Scale of −18.50 mm, −27.00 to −9.75), NSAIDs (SMD −0.86 –1.26 to −0.46, corresponded to −21.50 mm, −31.50 to −11.50), usual care or waiting list groups (SMD −1.01, –1.47 to −0.54, corresponded to −25.25 mm, −36.75 to −13.50) and blank groups (SMD −1.65, –1.99 to −1.32, corresponded to −41.25 mm, −49.75 to −33.00), but not IA injection. Similar results were also found in other outcomes. For most of the subgroup analyses, acupuncture type, acupuncture dose and follow-up time did not show a significant relative effect. Only when compared with NSAIDs, a higher dose of acupuncture may provide greater pain relief (interaction p<0.001). The network meta-analysis revealed that electroacupuncture (SMD −0.75, 95% CI −1.34 to −0.17) had a greater effect on pain relief in patients with KOA compared with manual acupuncture.ConclusionsThe findings suggest that acupuncture may provide clinically important effects in reducing pain and improving physical function in patients with KOA, but the certainty of evidence was very low. Electroacupuncture and higher dose of acupuncture probably are two potential contributing factors.PROSPERO registration numberCRD42021232177.
Exploring the feasibility of home-delivered capsule endoscopy with 5G support: innovations and carbon footprint insights
Authors: Jalayeri Nia Gohar , Conway Cassie , Ward Frances , Dungey Sheena , Streames Linda , Liu Bei Bei , Lei Ian Lo , Cameron James , Wenzek Hagen , Shekhar Chander , Eason Sally , Arasaradnam Ramesh P 
Published: November 2024

IntroductionColorectal cancer (CRC) poses a significant global health threat, necessitating early detection. Traditional diagnostic tools like optical colonoscopy have limitations prompting our ‘5G-SUCCEEDS’ initiative to explore a novel approach involving remote colon capsule endoscopy (CCE).MethodsThis prospective feasibility study was conducted at a single hospital in England. Between December 2022 and September 2023, we introduced a remote CCE service within the 5G-SUCCEEDS framework. We undertook a feasibility study of CCE in patients with low-risk/moderate-risk CRC stratified by faecal haemoglobin. Outcomes included carbon footprint analysis (outlined through three potential clinical pathways) and patient-reported outcomes through structured questionnaires and interviews.ResultsAmong 25 participants, 88% expressed satisfaction with remote CCE. 82% were willing to have remote CCE if clinically indicated in future. CCE findings included adenomatous polyps (58%), normal results (17%) and diverticulosis (21%), with no cancers identified in this pilot. Notably, we found that the carbon footprint associated with delivery of CCE at home (pathway 3) was lower compared with CCE delivered in a clinical setting (pathway 2). A fully optimised, automated scaled-up pathway would combine the delivery and collection of CCE equipment within a local area to reduce the carbon footprint of the travel element by 75%. Moreover, the conversion rate into a colonoscopy pathway is not static and clinicians acknowledge that this could be as low as 28%. Carbon footprint is more favourable for home-delivered CCE in the optimised scenario, while less so when considering the need for additional procedures (colonoscopy conversion).ConclusionThe 5G-SUCCEEDS initiative highlights the feasibility and advantages of home-based diagnostics using CCE.
Primary headache content on online community platforms: a scoping review protocol
Authors: Chaffin Kendall , Horvath Anna , Ahmad Sophie , Ahad Rooman , Batra Kavita 
Published: November 2024

IntroductionAs the usage of online platforms becomes increasingly prevalent to share information, it is essential to garner a better understanding of the content disseminated across the internet. Studies have found that patients are relying on online resources to gather medical information, potentially encountering misinformation. The sharing of information concerning primary headaches, despite affecting a large portion of the world’s population, has not been comprehensively analysed through the lens of online content. This scoping review seeks to explore the extent of available information, uncover existing gaps in knowledge, and to serve as a resource for healthcare providers to educate themselves to provide informed care to patients.Methods and analysisStudies considered for inclusion are those focused on primary headache (including migraines, tension headaches and cluster headaches) content posted on a community platform. Any online community forum will be eligible, including but not limited to TikTok, Twitter, Facebook, YouTube, Instagram, online forums and blogs. Studies will be limited to those published in English, with no geographic restriction. Five electronic databases, namely PubMed, Cochrane Library, Scopus, EMBASE, PsycInfo, will be searched for published reports. Two reviewers will independently screen titles and abstracts. The reviewers will then assess the full texts selected. In both cases, disagreements will be discussed with a third reviewer and consensus will be achieved. Data analysis will be descriptive with a narrative summary.Ethics and disseminationSince this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal.Trial Registration NumberThis protocol is registered on the Open Science Framework Repository (https://doi.org/10.17605/OSF.IO/2MAFN).
Health effects of selected environmental Exposomes Across the Life courSe in Indian populations using longitudinal cohort studies: GEOHealth HEALS Study protocol
Authors: Prabhakaran Dorairaj , Sieber Nancy Long , Jaganathan Suganthi , Mandal Siddhartha , Prabhakaran Poornima , Walia Gagandeep Kaur , Menon Jyothi S , Rajput Prashant , Gupta Tarun , Mohan Sailesh , Kondal Dimple , Rajiva Ajit , Dutta Anubrati , Krishna Bhargav , Yajnik Chittaranjan , Mohan Deepa , Ganguly Enakshi , Madhipatla Kishore , Sharma Praggya , Singh Sonal , Gupta Ruby , Ljungman Petter , Gupta Vipin , Mohan Viswanathan , Reddy KS , Schwartz Joel D 
Published: November 2024

IntroductionAir pollution presents a major public health threat to India, affecting more than three quarters of the country’s population. In the current project, GEOHealth Health Effects of Selected Environmental Exposomes Across the Life CourSe–India, we aim to study the effect of environmental exposomes—fine particulate matter (PM2.5), nitrogen dioxide (NO2), ozone (O3) and extremes of temperature—on multiple health outcomes using a modified life course approach. The associated training grant aims to build capacity in India to address the unique environmental health problems.Methods and analysisThe project aims to (A) Develop exposure assessments in seven cities, namely Delhi, Chennai, Sonipat, Vizag, Pune, Hyderabad and Bikaner, for: (1) A fine-scale spatiotemporal model for multiple pollutants (PM2.5, NO2, O3,temperature); (2) Combined ground monitoring and modelling for major chemical species of ambient PM2.5at seven cities; and (3) Personal exposure assessment in a subsample from the six cities, except Pune, and (B) Conduct health association studies covering a range of chronic non-communicable diseases and their risk factors leveraging a unique approach using interdigitating cohorts. We have assembled existing pregnancy, child, adolescent, adult and older adult cohorts across India to explore health effects of exposomes using causal analyses. We propose to use Bayesian kernel machine regression to assess the effects of mixtures of all pollutants including species of PM2.5on health while accounting for potential non-linearities and interactions between exposures. This builds on earlier work that constructed a fine spatiotemporal model for PM2.5exposure to study health outcomes in two Indian cities.Ethics and disseminationEthical clearance for conduct of the study was obtained from the Institutional Ethics Committee (IEC) of the Centre for Chronic Disease Control, and all the participating institutes and organisations. National-level permission was provided by the Indian Council of Medical Research. The research findings will be disseminated through peer-reviewed publications, policy briefs, print and social media, and communicating with the participating communities and stakeholders. Training of Indian scientists will build the capacity to undertake research on selected adverse environmental exposures on population health in India.
Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy
Authors: Li Hongxun , Li Jiagen , Zhang Lei , Yang Lihong , Zhao Yun , Zhao Hong , Pan Ye 
Published: November 2024

ObjectiveTo evaluate the effectiveness of dacryoendoscopic-assisted laser dacryoplasty with silicone intubation (DLDI) for the management of nasolacrimal duct obstruction (NLDO) or stenosis, and to identify the factors associated with DLDI failure.Methods and analysisThis study was designed as a prospective, single-centre cohort study. Patients with NLDO or stenosis who underwent DLDI from December 2019 to December 2021 at Tianjin Eye Hospital were considered for enrolment. The Kaplan-Meier estimator was used to assess the anatomical and functional success rate of DLDI within 2 years follow-up after removal of the silicone stent. Cox proportional hazards regression models were used to identify risk factors for treatment failure.Results170, 174 and 178 eyes were included in Groups A (proximal NLDO), B (distal NLDO) and C (nasolacrimal duct stenosis), respectively. The overall anatomical success rate was 84.8% for the entire cohort at the 2-year follow-up. The cumulative anatomical or functional success rate for Groups B and C was significantly higher than that for Group A. In the multivariable model, a higher risk of failed DLDI surgery was associated with a history of chronic dacryocystitis (HR=3.07; p<0.001) and a longer duration of epiphora than 1 year (HR=2.67; p<0.001). Of the 522 eyes, 37 patients (7.1%) had surgery-related complications.ConclusionsDLDI is an effective minimally invasive technique for treatment in patients with distal NLDO or stenosis. Factors associated with a higher risk of reoperation include a longer duration of epiphora and a history of chronic dacryocystitis.Trial registration numberNCT05999058.
Prevalence and factors associated with overweight and obesity among adolescents in Nagarjun municipality: a cross-sectional study
Authors: Gautam Laxmi , Thapa Milan , Pokhrel Poonam , Bhusal Sandesh , Paudel Kiran , Adhikari Tara Ballav 
Published: November 2024

IntroductionOverweight and obesity are a growing global public health threat increasingly prevalent among adolescents in low-income and middle-income countries such as Nepal. These conditions are influenced by multifaceted social, behavioural, and habitual factors. Adolescents are particularly at risk due to changing dietary and lifestyle patterns. Additionally, the current nutritional shift, economic progress and rapid urbanisation pose significant threats to nutrition-related health outcomes. This study aims to assess the prevalence and factors associated with overweight and obesity among adolescents in Nepal.MethodsA school-based cross-sectional study was conducted from September 2022 to January 2023 among 768 randomly selected adolescents from 10 schools in the Nagarjun municipality of Nepal. Anthropometric measurements of height and weight were assessed using standard tools, and the corresponding body mass index (BMI) was calculated. Factors associated with overweight/obesity were examined using the χ2tests, followed by logistic regression analyses. The statistical significance was set at p<0.05 and 95% Confidence Intervals (CIs).ResultsThe overall prevalence of overweight/obesity among adolescents was 6.38% (95% CI 4.64% to 8.11%). The mean weight, height and BMI of the participants were 50.22±9.37 kg, 160.17±9.14 cm and 19.56±3.24 kg/m2, respectively. Adolescents studying in higher grades (AOR 3.61, 95% CI 1.26 to 10.30), uninvolved in any kind of physical activity (AOR 4.97, 95% CI 2.38 to 10.34) and various games and extracurricular activities at school (AOR 2.49, 95% CI 1.16 to 5.28) and consuming high-calorie sugar-rich foods as lunch (AOR 3.02, 95% CI 1.31 to 6.94) were more likely of being overweight/obese than their respective counterparts.ConclusionOverweight and obesity are significantly influenced by lifestyles that involve minimal to no physical activity and by the dietary habits of adolescents. The findings warrant interventions in educational and home settings aiming to improve the lifestyles of adolescents.
Clinical outcomes in frail elderly patients undergoing small-bowel capsule endoscopy
Authors: Grant Rebecca K , Robertson Alexander R , Lennon Kirsty A , Gupta Eksha , Walton Ursula E , Porter Ross J , Burke Niall T , Ong Solomon , Anand Atul , Douglas Sarah , Corbett Alice , Brindle William M , Kalla Rahul , Plevris John N 
Published: November 2024

ObjectiveSmall-bowel capsule endoscopy (SBCE) is being used with increasing frequency. It is important, however, to ensure that the frail elderly in particular are undergoing investigations which have a positive impact on their ongoing management. We aimed to determine the SBCE rate in the elderly, the clinical outcomes, and if clinical frailty may be used to tailor SBCE.Design/methodsPatients aged ≥65 who had a SBCE performed at the Royal Infirmary of Edinburgh from 1 January 2016 to 1 December 2021 were identified. Demographic, clinical and SBCE results were collected and statistical analysis was performed.ResultsIn total, 189 patients aged ≥65 years underwent SBCE. Median age at SBCE was 72 years (IQR 68–76); 63.0% (n=119) were women. The most common indication for SBCE was iron-deficiency anaemia (n=174, 92.1%).A total of 15.9% (n=30) patients were clinically frail (Clinical Frailty Scale ≥5). Frail patients had reduced survival at 1 (p=0.003), 3 (p<0.001) and 5 (p<0.0001) years post-SBCE. The most common pathology in this group was angioectasia (33.3%, n=10). Double balloon enteroscopy was performed in 1 frail patient, compared with 11 non-frail patients (p=0.488).ConclusionsOur results indicate that small bowel bleeding in the frail elderly is most likely to be associated with angioectasia. Given the high mortality at follow-up and risks of subsequent investigations in this group, conservative treatment with oral or parenteral iron may be more appropriate. Investigating these patients with SBCE is unlikely to alter management and clinical outcome.
Hyperuricaemia elevates risk of short-term readmission and mortality in patients with heart failure
Authors: Rao Jiahuan , Lai Ruihui , Jiang Lingyan , Wen Wei , Chen Haibo 
Published: November 2024

BackgroundHeart failure (HF) is a leading cause of morbidity and mortality worldwide. Serum uric acid (SUA), a product of purine metabolism, has been implicated in HF progression. However, the association between hyperuricaemia and the short-term readmission and mortality in patients with HF remains controversial.MethodsIn this retrospective cohort study, we analysed data from a HF database specific to the Chinese population. The primary endpoint was short-term readmission or all-cause mortality within 90 days. Participants with HF were categorised into normouricaemia group (NUA) and hyperuricaemia group (HUA) based on a SUA threshold of 420 µmol/L. The association between SUA and primary endpoint was evaluated using Kaplan-Meier survival curves and Cox regression analysis.ResultsBaseline characteristics revealed significant differences between NUA and HUA groups, with the latter exhibiting a higher prevalence of males, chronic kidney disease (CKD) and elevated levels of various biomarkers. During a 90-day follow-up, 493 (26.6%) participants reached the primary endpoint, with a higher incidence observed in the HUA group at 31.2%, compared with 20.1% in the NUA group. When a threshold effect was identified at 420 µmol/L, a non-linear association was observed between SUA and the primary endpoint. After adjusting for gender, age, New York Heart Association class, CKD, systolic blood pressure (SBP) and potassium, the HUA group exhibited a higher risk for the primary endpoint compared with the NUA group (HR: 1.40, 95% CI: 1.14 to 1.72, p=0.001). Additionally, the risk increased across quartiles of SUA (P for trend=0.002). Furthermore, stratified analyses indicated a stronger association in patients without CKD (P interaction=0.033).ConclusionHyperuricaemia is independently associated with an increased risk of short-term readmission and mortality in patients with HF. Our findings suggest that monitoring and managing SUA could be crucial in improving patient with HF outcomes.
Hepatitis D Virus Status Among People With Hepatitis B Virus Infection: A Disconnect Between Guidelines and Practice
Authors: Jack Kathryn , Jackson Rachel , Irving William Lucien 
Published: November 2024

Background: Hepatitis D virus (HDV) infection is an important cause of chronic liver disease yet remains a poorly met clinical challenge. The current European and UK guidelines recommend that all patients with hepatitis B virus (HBV) are tested for HDV, but emerging UK data indicates that only approximately 20% have been tested. The World Health Organization viral hepatitis elimination strategy first requires the systematic testing of people with relevant risk factors, so there is a need to understand factors contributing to low anti‐HDV rates of testing.Methods: An audit was conducted to ascertain the perspectives of patients and healthcare professionals about identifying HDV infection. During a 4‐month period, 39 hepatology healthcare professionals and 70 patients with chronic HBV were recruited. The attitudes of healthcare professionals about HDV testing were surveyed according to the seven constructs of the theoretical framework of acceptability (TFA). Patients were surveyed by telephone about their knowledge of HDV and their own testing status.Results: Among the 39 healthcare professionals, only 66.6% and 53.8% were able to correctly cite EASL (European) HDV and NICE (UK) testing guidelines, respectively, although there were high levels of anti‐HDV testing acceptability according to the TFA. Among the patients, 95.7% (67/70) had been tested for anti‐HDV and all were seronegative. Only 23% (16/70) knew of the existence of HDV. There was extensive ethnic heterogeneity with 23 countries of birth and 24 different primary languages.Conclusion: Some clinicians lack familiarity with clinical guideline recommendations for universal testing of all HBsAg‐positive patients. Similarly, most patients lack knowledge about HDV. Staff and patient education are required to increase HDV diagnosis.
Monocyte CD36 Expression Predicts Disease Activity in Patients With Crohn’s Disease
Authors: Zhu Jiejie , Zhu Nannan , Wang Jiren , Liu Qiuyuan , Mei Qiao 
Published: November 2024

Background: Crohn’s disease (CD) is a chronic intestinal inflammatory disease associated with genetic, environmental, and other unknown factors. Cluster of differentiation 36 (CD36) plays an important role in cancer, inflammation, and metabolic diseases. Although CD36 has recently been implicated in various diseases, its role in CD is still unclear.Methods: Blood samples were collected from patients with CD and healthy volunteers. Peripheral blood mononuclear cells (PBMCs) were isolated by density gradient centrifugation over Ficoll–Paque and labeled with monoclonal antibodies (CD14‐APC and CD36‐PE). Flow cytometer CytoFlex is used for analysis.Results: Twenty‐nine patients with CD in remission, 42 patients with active CD, and 23 healthy volunteers were included in the study. Our results showed that the frequency of the CD14+CD36+ monocyte subset was increased in PBMCs from patients with active CD compared with patients in remission and healthy controls. However, CD36 on monocytes was lower in CD compared with the healthy controls. CD36 expression was decreased in patients with active CD compared with that of patients with CD in remission and healthy control subjects, but no difference was found between patients with CD in remission and healthy controls. Interestingly, we found negative correlations of CD36 with HBI, SES‐CD, C‐reactive protein, and neutrophil‐to‐lymphocyte ratio.Conclusions: These data indicate that monocyte CD36 associates with disease activity in CD and might be a potential biomarker for assessing the activity of CD.
The Context of Poverty and Cancer: Denying Human Potential
Authors: Doose Michelle , Kennedy Amy E. , Williams Shanita D. , Srinivasan Shobha 
Published: November 2024

Abstract
Poverty is a carcinogen and a leading cause of cancer disparities and overall mortality in the United States. Poverty is often viewed as an individual failure for “being poor,” but in fact, poverty is structurally driven, intergenerational, and place-based that socially deprives and denies human potential. Disparities in timely cancer prevention, diagnosis, treatment, survivorship, and survival disproportionally impact people living in poverty and especially in persistent poverty areas, an extreme form of place-based poverty that affects communities over multiple generations. There has been some progress made to address place-based conditions that exacerbate poverty, such as the NCI’s initiative on persistent poverty. However, gross inequality and cancer disparities continue to exist and persist. The time is now to accelerate the development of research-informed strategies and solutions with communities along with multisectoral collaborations with education, housing, occupation/workforce, foster care, criminal justice, transportation, and data collection systems. This commentary discusses the structural, place-based, and generational context of poverty, illustrates how entrenched inequities shape poor cancer outcomes, and describes opportunities for future research.