bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respiratory problems in rowers: outcomes from a systematic assessment of an elite squad
Authors: Hull James H , Williams Zander J , Jackson Anna R , Wootten Moses , Ranson Craig , Arnold Liz , Redgrave Ann 
Published: August 2024

ObjectivesTo characterise the respiratory health of elite rowers using a systematic screening approach to assess respiratory health (SARAH) and identify the associations between SARAH findings and acute respiratory illness (ARI) and chest wall injury (CWI).MethodsA systematic screening approach was conducted in a cohort of elite rowers. The assessment employed validated respiratory questionnaires and multiple physiological measures. An analysis of ARI and CWI incidence and burden from the 18 months before the SARAH assessment was conducted.ResultsFull respiratory surveillance was completed in 48 rowers (50% female, aged 27 [25–28] years). The incidence and burden of ARI were similar between male and female rowers. The incidence of CWI was greater in female rowers compared to males (1.6 versus 0.4 per 1000 athlete training days, respectively; incidence rate ratio of 4.3, 95% C.I. 1.5 to 12.2, p=0.005) and more common in younger rowers with greater lung function. SARAH detected at least one respiratory problem in 39 (81%) rowers, and two or more problems in 26 (54%). Sino-nasal problems (44%), allergy-related problems (42%) and breathing pattern disorder (42%) were the most prevalent problems identified. Exercise-associated cough was reported in 34 (71%) rowers, with objective evidence of asthma found in only five (10%).ConclusionsIn elite rowers, respiratory problems, including ARI and CWI, are common and impact health. A systematic screening approach identifies multiple underlying respiratory problems, presenting the opportunity to optimise athlete health and improve training availability.
Metabolic features of neutrophilic differentiation of HL-60 cells in hyperglycemic environments
Authors: Cázares-Preciado Jorge Andrés , López-Arredondo Alejandra , Cruz-Cardenas José Antonio , Luévano-Martínez Luis Alberto , García-Rivas Gerardo , Prado-Garcia Heriberto , Brunck Marion E. G. 
Published: August 2024

IntroductionChronic hyperglycemia affects neutrophil functions, leading to reduced pathogen killing and increased morbidity. This impairment has been directly linked to increased glycemia, however, how this specifically affects neutrophils metabolism and their differentiation in the bone marrow is unclear and difficult to study.Research design and methodsWe used high-resolution respirometry to investigate the metabolism of resting and activated donor neutrophils, and flow cytometry to measure surface CD15 and CD11b expression. We then used HL-60 cells differentiated towards neutrophil-like cells in standard media and investigated the effect of doubling glucose concentration on differentiation metabolism. We measured the oxygen consumption rate (OCR), and the enzymatic activity of carnitine palmitoyl transferase 1 (CPT1) and citrate synthase during neutrophil-like differentiation. We compared the surface phenotype, functions, and OCR of neutrophil-like cells differentiated under both glucose concentrations.ResultsDonor neutrophils showed significant instability of CD11b and OCR after phorbol 12-myristate 13-acetate stimulation at 3 hours post-enrichment. During HL-60 neutrophil-like cell differentiation, there was a significant increase in surface CD15 and CD11b expression together with the loss of mitochondrial mass. Differentiated neutrophil-like cells also exhibited higher CD11b expression and were significantly more phagocytic. In higher glucose media, we measured a decrease in citrate synthase and CPT1 activities during neutrophil-like differentiation.ConclusionsHL-60 neutrophil-like differentiation recapitulated known molecular and metabolic features of human neutrophil differentiation. Increased glucose concentrations correlated with features described in hyperglycemic donor neutrophils including increased CD11b and phagocytosis. We used this model to describe metabolic features of neutrophil-like cell differentiation in hyperglycemia and show for the first time the downregulation of CPT1 and citrate synthase activity, independently of mitochondrial mass.
Vitamin B6 status and chronic chemotherapy-induced peripheral neuropathy: a prospective cohort study among patients with non-metastatic colorectal cancer receiving oxaliplatin-based chemotherapy
Authors: Renting Lisanne , Zwart Nienke R K , Ueland Per Magne , McCann Adrian , Ulvik Arve , van Halteren Henk K , Lubberman Floor J E , Winkels Renate M , Kampman Ellen , Kok Dieuwertje E 
Published: August 2024

ObjectiveChronic chemotherapy-induced peripheral neuropathy (CIPN) is a long-lasting side-effect of oxaliplatin. Vitamin B6 might play a role in the pathogenesis of CIPN. Therefore, we investigated associations between plasma vitamin B6 markers and the occurrence and severity of chronic CIPN in patients with non-metastatic colorectal cancer (CRC).Methods and analysis242 patients with CRC receiving oxaliplatin-based chemotherapy were included. Blood samples were collected at diagnosis (ie, before chemotherapy), and 6 and 12 months after diagnosis (ie, during and after chemotherapy, respectively). Pyridoxal 5′-phosphate (PLP), pyridoxal (PL) and xanthurenic acid:3-hydroxykynurenine (XA:HK) ratio were measured as vitamin B6 markers using liquid chromatography tandem mass spectrometry. Chronic CIPN was assessed 12 months after diagnosis using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN twenty-item scale questionnaire. Prevalence ratios (PRs) and restricted cubic splines (RCSs) were used to assess associations with chronic CIPN occurrence, and linear regressions were used to assess associations with chronic CIPN severity. Analyses were adjusted for age, sex, smoking, alcohol consumption, diabetes and timing of chemotherapy (neoadjuvant/adjuvant/both).ResultsChronic CIPN was found in 80% (n=194) of patients. Higher PLP levels and XA:HK ratios during chemotherapy were associated with lower occurrence of chronic CIPN (PRperdoubling0.75, 95% CI 0.62 to 0.91 and PRCS<0.05, respectively) and lower chronic CIPN severity (βperdoubling−4.54, 95% CI −7.12 to −1.96 and βperdoubling−6.30, 95% CI −9.53 to −3.07, respectively). No associations between PL levels and chronic CIPN were observed.ConclusionWithin this population, merely having PLP levels within the normal range, higher vitamin B6 status during chemotherapy was associated with lower occurrence and severity of chronic CIPN. Future research is warranted to investigate causality and the optimal vitamin B6 status during chemotherapy.
Somebody who understands the culture and their needs that can cater for them in their retirement time: a peer research study exploring the challenges faced by British Muslims with palliative care needs during the COVID-19 pandemic
Authors: Hudson Briony F , Clarke Gemma , Kupeli Nuriye , Rizk Noura , Safdar Mansur , Sherif Jamil , Shafi Shuja 
Published: August 2024

BackgroundInequities in palliative and end-of-life care access exist, with evidence of lower uptake of these services among people from the British Muslim community. Little research exists exploring the experiences of British Muslims with palliative care needs and their families during the pandemic or before.AimTo coproduce peer research exploring the experiences of British Muslims with palliative care needs and their families during the COVID-19 pandemic.DesignA collaborative peer research interview study. Peer researchers were recruited and trained to undertake qualitative interviewing. Data were analysed using reflective thematic analysis.Setting/participants3 peer researchers conducted 11 telephone interviews (10 in English and 1 in Urdu) between August and September 2021 with 12 participants (5 people with palliative care needs and 7 family carers).ResultsFour themes were identified: (1) issues in accessing healthcare exacerbated by the COVID-19 pandemic, (2) the impact on family carers, (3) variation in support from community groups and (4) social and information exclusion. The COVID-19 pandemic exacerbated existing challenges to accessing healthcare services for British Muslims with palliative care needs. Family members experienced the cumulative impact of supporting people with palliative needs while also advocating for and supporting them to access the care they required. Language barriers, digital exclusion and uncertainly about how to access information, in addition to the apparent lack of consideration of important festivals in the Muslim calendar in the implementation of policies around lockdowns, culminated in a sense of exclusion from COVID-19-related policies and messaging for this population.ConclusionsThese findings support the need to involve people from diverse backgrounds in the design and delivery of healthcare services and policies. Learning from this unique time in our histories should be used to shape future delivery of culturally aware and inclusive care.
Protocol for a randomised trial of a self-directed digital pain management intervention (Empowered Relief) tailored to adults with chronic pain and prescription opioid misuse/disorder: the MOBILE Relief study
Authors: Edwards Karlyn A , Palenski Paige , Perez Luzmercy , You Dokyoung Sophia , Ziadni Maisa S , Jung Corinne , Adair Emma , Tian Lu , Mackey Sean C , Darnall Beth D 
Published: August 2024

IntroductionChronic pain increases the risk of prescription opioid misuse or opioid use disorder (OUD). Non-pharmacological treatments are needed to dually address pain and opioid risks. The purpose of the Mobile and Online-Based Interventions to Lessen Pain (MOBILE Relief) study is to compare a one-session, video-based, on-demand digital pain relief skills intervention for chronic pain (‘Empowered Relief’ (ER); tailored to people at risk for opioid misuse or with opioid misuse/OUD) to a one-session digital health education intervention (‘Living Better’; no pain management skills).Methods and analysisMOBILE Relief is an international online randomised controlled clinical trial. Study participants are adults with chronic, non-cancer pain (≥6 months) with daily pain intensity ≥3/10, taking ≥10 morphine equivalent daily dose and score ≥6 on the Current Opioid Misuse Measure. Participants are recruited through clinician referrals and clinic advertisements. Study procedures include electronic eligibility screening, informed consent, automated 1:1 randomisation to the treatment group, baseline measures, receipt of assigned digital treatment and six post-treatment surveys spanning 3 months. Study staff will call participants at baseline and 1-month and 3 months post-treatment to verify the opioid prescription. The main statistical analyses will include analysis of covariance and mixed effects model for repeated measurements regression.Main outcomesPrimary outcomes are self-reported pain catastrophising, pain intensity, pain interference, opioid craving and opioid misuse at 1-month and 3 months post-treatment. We will determine the feasibility of ER (≥50% participant engagement, ≥70% treatment appraisal ratings). We hypothesise the ER group will be superior to the Living Better group in the reduction of multiprimary pain outcomes at 1-month post-treatment and opioid outcomes at 1-month and 3 months post-treatment.Ethics and disseminationThe study protocol was approved by the Stanford University School of Medicine Institutional Review Board (IRB 61643). We will publish results in peer-reviewed journals; National Institute of Drug Abuse (funder) and MOBILE Relief participants will receive result summaries.Trial registration numberNCT05152134.
Quality improvement initiative to reduce URI-associated antibiotic prescriptions among adult primary care providers
Authors: Sathe Niharika , Klein Marlena , Rose Lucia , Byrne Dana 
Published: August 2024

ImportanceDespite evidence that most upper respiratory infections (URIs) are due to viruses, antibiotics are frequently prescribed for this indication in the outpatient setting. Antibiotic stewardship strategies are needed to reduce adverse patient outcomes and staggering healthcare costs due to resistant infections that ensue from inappropriate prescriptions.ObjectiveTo determine if individual provider scorecards detailing antibiotic prescribing rates paired with educational resources reduce inappropriate antibiotic use for URIs in the outpatient primary care setting.Design, setting and participantsThis quality improvement project investigated the number of URI-coded office visits in the primary care setting over three consecutive influenza seasons, which resulted in an antibiotic prescription in Cooper University Healthcare’s 14 primary care offices. We compared provider’s individual prescribing patterns to their peers’ average and created a scorecard that was shared with each provider over a series of intervention phases. Data were collected from a preintervention period (November 2017–February 2018), and two postintervention phases, phase I (November 2018–February 2019) and phase II (November 2019–February 2020).InterventionA personalised, digital scorecard containing antibiotic-prescribing data for URI-coded visits from the prior influenza season was emailed to each primary care provider. Prior to the subsequent influenza season, prescribers received their updated prescribing rates as well as peer-to-peer comparisons. In both phases, the scorecard was attached to an email with antimicrobial stewardship educational materials.Main outcomes and measuresThe primary outcome was a reduction in the number of inappropriate antibiotic prescriptions for URI-related diagnoses. The diagnoses were organised into five broad coding categories, including bronchitis, sinusitis, sore throat excluding strep, influenza and tonsillitis excluding strep.
Integrating SARS-CoV-2 rapid antigen testing in maternal, neonatal and child health, HIV, and TB clinics in Kenya and Cameroon: outcomes from the Catalysing COVID-19 Action Project
Authors: Tchounga Boris K , Hoffman Nelia , Masaba Rose , Djikeussi Tatiana , Ndimbii James , Moma Elvis , Pearson Sharee , Sikuku Evallyne , Gitau Virginia , Argaw Shabir , Tchendjou Patrice , Siamba Stephen , Kimani Njoki , Zoung-Kanyi Bissek Anne-Cecile , Fokam Joseph , Tiam Appolinaire , Yemaneberhan Aida , Guay Laura , Bhatt Nilesh Balbhadra , Machekano Rhoderick 
Published: August 2024

IntroductionEarly diagnosis of SARS-CoV-2 infection is key to preventing severe disease and poor outcomes in vulnerable populations, such as pregnant women and people living with HIV or diagnosed with tuberculosis (TB). We assessed outcomes achieved with the integration of SARS-CoV-2 antigen-detecting rapid diagnostic testing (Ag-RDT) into maternal, neonatal and child health (MNCH); HIV and TB clinics in the Catalysing COVID-19 Action project.MethodsScreening and testing for SARS-CoV-2 per national guidelines were integrated into MNCH, HIV and TB clinics in 50 health facilities in Cameroon and Kenya. In Cameroon, screening and testing were done by existing facility staff, while in Kenya, additional community workers and laboratory staff were involved. Clients aged >2 years attending MNCH, HIV and TB clinics between May and October 2022 were included in the study. We estimated the proportion of participants screened, tested and tested positive; calculated the SARS-CoV-2 case detection rate per 1000 attendees and determined factors associated with screening, testing and positivity.ResultsOverall, 528 567 attendee visits were reported in Cameroon (282 404) and Kenya (246 163), with screening for SARS-CoV-2 performed in 256 049 (48.4%), showing substantive variations between countries (62.6% in Cameroon and 32.2% in Kenya). Among the 256 049 screened, 19 013 (7.4%) were eligible for testing (9.0% in Cameroon and 3.9% in Kenya), of whom 12 934 (68.0%) were tested for SARS-CoV-2 including 9866/15 934 (61.9%) in Cameroon and 3068/3079 (96.6%) in Kenya. A total of 390 (3.0%) positive tests were identified (329/9866, 3.3%, in Cameroon and 61/3068, 2.0%, in Kenya). Country integration strategy, facility level, setting and clinic were independently associated with screening and testing.ConclusionsIntegration of SARS-CoV-2 Ag-RDT in MNCH, HIV and TB clinics in both countries allowed detection of SARS-CoV-2 cases among vulnerable populations. Integration strategies should consider facility settings and additional human resources in high-volume facilities to improve screening and testing proportions.Trial registration numberNCT05498727.
Clinical symptoms, comorbidities, treatment patterns and time to diagnosis in patients with eosinophilic oesophagitis in England: a retrospective cohort study
Authors: Xu Xiao , Chen Stephanie Y , Maslova Ekaterina , Kielar Danuta , Kwiatek Justin , Stirnadel-Farrant Heide , Katial Rohit , Langham Julia , Langham Sue , Woodland Philip 
Published: August 2024

ObjectiveDescribe clinical characteristics, treatment patterns, time to diagnosis and development of strictures in patients diagnosed with eosinophilic oesophagitis (EoE) between January 2014 and October 2020 in England.Design/MethodRoutinely collected data were sourced from three linked databases in England: Clinical Practice Research Datalink (CPRD) Aurum; Hospital Episode Statistics (HES); and Office for National Statistics mortality files. Eligible patients in the CPRD, who could be linked to HES data, had ≥1 diagnosis of EoE, recorded using a diagnostic code during the study period, and ≥12 months (baseline period) continuous registration with the practice before diagnosis, during which EoE-related symptoms and comorbidities were evaluated.ResultsPatients with EoE (n=2381) more frequently reported dysphagia (40.0% vs 0.2%), acid reflux/heartburn (21.6% vs 0.9%; including gastro-oesophageal reflux disease), abdominal pain (10.8% vs 2.9%) and food impaction (8.2% vs 0.0%) during baseline than age-matched and sex-matched controls (n=9365). The most common first-line and second-line therapies were proton pump inhibitor (PPI) monotherapy and PPI plus swallowed topical corticosteroids, respectively. Median (IQR) time from first recorded symptom to diagnosis was 4.5 (1.3 to 16.4) months. Patients with prolonged time to diagnosis (≥24 months) more frequently reported EoE-related comorbidities and were younger (<18 years) than those with shorter time to diagnosis (<24 months). Patients who developed strictures ≤3 years after diagnosis were more frequently men and more frequently reported food impaction or dysphagia at baseline.ConclusionThis study helps characterise patients with EoE who require closer monitoring, highlighting the need for earlier diagnosis and treatment.
Triple digital divide and depressive symptoms among middle-aged and older Chinese adults: a disparity analysis
Authors: Liu Danxia , Zhang Bo , Guo Jing 
Published: August 2024

BackgroundThe triple digital divide refers to the lack of internet access, use and knowledge among specific populations. In China, middle-aged and older adults and those living in rural areas or various regions of the country are more likely to have limited internet access and skills and, thus, have less accessibility to internet services. Few longitudinal studies have explored the association between the digital divide and the progression of depressive symptoms among middle-aged and older Chinese adults. Significantly, none of the existing studies have estimated this long-term relationship from a disparity perspective.AimsThis study investigates the association between the triple digital divide and depressive symptom trajectories among middle-aged and older adults in China during a 10-year follow-up period from 2011 to 2020.MethodsThe sample for this secondary analysis comprises 3019 urban and 10 427 rural respondents selected from the China Health and Retirement Longitudinal Study baseline survey in 2011. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Employing longitudinal mixed-effects models, this study explored the association between the triple digital divide and depressive symptom trajectories among middle-aged and older Chinese adults by examining gender, rural–urban and regional disparities in this relationship.ResultsOur findings revealed a significant association between the triple digital divide and increasing trajectories of depressive symptoms, showing significant disparities based on gender, rural–urban dwelling and regional location. Notably, for both male and female participants who resided in urban areas or the central region of the country, their ability to use the internet, coupled with enhanced internet skills and greater access to internet services, was found to have a mitigating effect on the increasing trajectories of depressive symptoms.ConclusionsTo alleviate some of the confounding influences on the trajectory of depression in middle-aged and older adults, policymakers in China should continue to prioritise the development of internet technology, foster easy access to the internet to ensure it is ‘elder-friendly’, provide internet skill training platforms for this population and broaden access to various internet services appropriate for them. Additionally, the implementation of tailored interventions to address depression, especially targeting the more vulnerable cohorts, such as middle-aged and older women, those residing in rural areas and the western regions, is crucial. Such tailored approaches are essential for addressing the disparities and challenges associated with the triple digital divide.
Venous sinus stenting under conscious sedation
Authors: Kalsoum Erwah , Scarcia Luca , Abdalkader Mohamad , Dmytriw Adam A , Farhat Firas , Tuilier Titien , Geismar Maxime , Quesnel Christophe , Tourbah Ayman , Abdellaoui Mohamed , Nguyen Thanh N , Kikano Raghid , El Ojaimi Rami 
Published: August 2024

BackgroundVenous sinus stenting (VSS) is an increasingly performed procedure for the treatment of idiopathic intracranial hypertension (IIH) refractory to medical treatment. VSS is typically performed under general anesthesia.ObjectiveTo present our experience of VSS in patients with IIH performed under conscious sedation.MethodsRetrospective review of a prospectively maintained database of all patients with IIH who underwent VSS in a single center between September 2019 and January 2024. The sedation protocol consisted of a remifentanil-based target-controlled infusion. Patients’ clinical and radiological data, dosage of anesthesia, procedural characteristics, and outcomes were collected.ResultsTwenty-six patients with IIH underwent venous manometry (VM) and VSS under awake sedation and were included in our study. Patients were predominantly women (24/26) with a median age (IQR) of 33 (13) years. The median (IQR) body mass index was 34 (10) kg/m2. There was no need for general anesthesia conversion. Technical success was achieved in all patients. Median (IQR) follow-up after stenting was 7 (2) months. All patients reported resolution of the pulsatile tinnitus; headaches regressed in 20/24 (83.3%) patients and papilledema improved in 16/20 (80%). Only one non-neurological complication (retroperitoneal hematoma) occurred, without any permanent morbidity or mortality.ConclusionOur study confirms that performing VM and VSS under conscious sedation is safe and feasible. Conscious sedation is a viable alternative to general anesthesia for managing IIH in these patients.