bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of tobacco smoking and alcohol drinking on dysmenorrhoea: a cross-sectional analysis of data from the Taiwan Biobank
Authors: Kuo Cheng-Shing , Wang Kuang-Te , Lai Jerry Cheng-Yen , Chen Shaw-Ji 
Published: February 2025

ObjectivesDysmenorrhoea, characterised by severe menstrual cramps, affects between 50% and 90% of women of reproductive age and considerably lowers their quality of life.DesignCross-sectional study.SettingThis study explored the influence of tobacco smoking and alcohol consumption on dysmenorrhoea, using data from the Taiwan Biobank.ParticipantsOur analysis involved 8567 individuals and examined the associations between dysmenorrhoea and variables such as alcohol consumption, tobacco smoking, demographic characteristics and lifestyle behaviours through multivariable logistic regression.ResultsThe findings reveal a significant association between concurrent alcohol and tobacco use and increased dysmenorrhoea risk, with adjusted ORs suggesting higher risk levels for dual users compared with those who only smoke or drink (adjusted OR (95% CI) both alcohol and tobacco: 3.19 (1.51 to 6.72); only tobacco: 1.21 (0.89 to 1.63); only alcohol: 1.06 (0.53 to 2.13)). Additionally, factors such as higher education level and early menarche were associated with increased dysmenorrhoea risk, whereas regular exercise and multiparity exerted a protective effect against the condition (adjusted OR (95% CI) higher education: 1.43 (1.19 to 1.71); early menarche: 1.37 (1.14 to 1.64); regular exercise: 0.77 (0.64 to 0.93); multiparity: 0.64 (0.52 to 0.77)).ConclusionsOur study also highlights the complex interactions between lifestyle factors and dysmenorrhoea, underscoring the need for targeted interventions and lifestyle modifications to mitigate the condition’s effects. Future research should employ longitudinal designs for causal inference and to explore the mechanisms underlying the associations observed in this study.
Efficacy and safety of 11 sodium-glucose cotransporter-2 inhibitors at different dosages in type 2 diabetes mellitus patients inadequately controlled with metformin: a Bayesian network meta-analysis
Authors: Xu Leqing , Wu Yike , Li Jiyifan , Ding Yanan , Chow Junwei , Li Longzhou , Liu Haiyang , Wang Zihan , Gong Tingting , Li Yue , Ma Guo 
Published: February 2025

Objectives
Assess the efficacy and safety profiles of different sodium-glucose cotransporter-2 inhibitors (SGLT2is) as an add-on to metformin in type 2 diabetes mellitus (T2DM) patients.

Design
Bayesian network meta-analysis.

Data sources
PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov were searched before 18 December 2024.

Eligibility criteria
Randomised controlled trials (RCTs) evaluating T2DM patients taking one of 12 SGLT2is as add-on therapy to metformin. Efficacy outcomes focused on glycated haemoglobin (HbA1c) reduction, fasting plasma glucose (FPG) reduction and weight loss (WL). Safety outcomes included adverse events (AEs), serious AEs (SAEs), hypoglycaemia, urinary tract infections (UTI) and genital infections (GI).

Data extraction and synthesis
Two investigators independently extracted data. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool (V.2.0) for RCTs.

Results
23 RCTs involving 9144 patients and 11 SGLT2is were included. Compared with placebo, most SGLT2is reduced HbA1c (mean difference (MD), −0.45~−0.80%), FPG (MD, −0.78~−2.02 mmol/L) and body weight (MD, −0.88~−2.67 kg). Only 10 mg of henagliflozin increased the incidence of AEs, and none of the included interventions increased the risks of SAEs or UTIs. 50 mg of empagliflozin exhibited higher risks of hypoglycaemia. Only 10 mg of empagliflozin increased the risk of GI. According to the surface under the cumulative ranking values, SGLT2is with optimal efficacy and safety were 15 mg of ertugliflozin in HbA1c reduction, 300 mg of canagliflozin in FPG reduction, WL and hypoglycaemia, 400 mg of sotagliflozin in total AEs, 10 mg of ertugliflozin and 150 mg of ipragliflozin in SAEs, 12.5 mg of ipragliflozin in UTI and 1 mg of ertugliflozin in GI.

Conclusions
As add-on therapy, SGLT2is demonstrated favourable antidiabetic efficacy and acceptable safety. 300 mg of canagliflozin was the best option among the included interventions considering favourable glucose control and WL. Some novel SGLT2is (eg, henagliflozin) exhibited promising efficacy and safety profiles, but more research is needed to validate the findings.
Lived experiences of gynaecological cancer survivors in Oman: a qualitative study
Authors: Al-Awaisi Huda , Moshtohry Aya , Al Balushi Muna , Bureny Ikram 
Published: February 2025

ObjectiveA significant number of patients with gynaecological cancers survive their disease and are considered cured. However, the diagnosis of cancer and its treatment can affect quality of life adversely. We sought to explore the lived experiences of women surviving gynaecological cancers in Oman.MethodsOmani patients with gynaecological cancers who had completed their treatment more than 1 year ago and were following up in the medical oncology clinic at a major cancer centre in Oman were interviewed. A qualitative study design was employed using face-to-face semistructured individual interviews. To prevent recall bias, women diagnosed with cancer within the past 5 years only were included. The sample size was determined using data saturation, where data collection revealed no new information. All interviews were tape recorded and transcribed verbatim. Transcripts were analysed using a standardised thematic analysis approach.ResultsFour main themes emerged: ‘Beliefs and attitudes’; ‘Living with Treatment Complications’; ‘Living with cancer’ and ‘Coping with the Cancer Journey’.ConclusionsThe diagnosis of cancer had a profound effect on the lives of women with gynaecological cancer. The diagnosis negatively affected their lives throughout their cancer journey due to social role changes, fertility and sexual problems. Religion and social support played major roles in coping with the disease. This is the first study describing the lived experiences of Muslim and Omani survivors of gynaecological cancers and may help to determine their survivorship needs.
Factors related to risky alcohol consumption and binge drinking in Spanish college students: a cross-sectional study
Authors: Ramón-Arbués Enrique , Antón-Solanas Isabel , Blázquez-Ornat Isabel Rosario , Gómez-Torres Piedad , García-Moyano Loreto , Benito-Ruiz Eva 
Published: February 2025

ObjectivesThe aim of this study was to determine the prevalence of risky alcohol consumption and regular binge drinking, and their associated factors, in Spanish college students.DesignA cross-sectional study was conducted.SettingThis study took place at a private university in a northern region of Spain.ParticipantsA total of 330 Spanish undergraduate university students enrolled in the 2022–2023 academic year voluntarily agreed to participate in this investigation.Primary and secondary outcome measuresData collection included sociodemographic information and health-related behaviours. The Alcohol Use Disorders Identification Test was used to assess alcohol consumption. Logistic regression models were used to identify independent predictors for risky alcohol consumption and regular binge drinking.Results40.0% of participants reported risky alcohol consumption, and 26.7% were classified as regular binge drinkers. Factors associated with risky alcohol consumption included smoking (OR=3.54, 95% CI 2.03 to 6.14) and problematic internet use (OR=2.10, 95% CI 1.24 to 3.53). Conversely, being older than 30 years was associated with a lower likelihood (OR=0.22, 95% CI 0.08 to 0.60). Regular binge drinking was associated with living outside the family home (OR=2.78, 95% CI 1.56 to 4.95), smoking (OR=3.53, 95% CI 1.94 to 6.40) and problematic internet use (OR=2.19, 95% CI 1.23 to 3.89). In contrast, being female (OR=0.50, 95% CI 0.27 to 0.94) and being over 30 years old (OR=0.28, 95% CI 0.10 to 0.86) were inversely associated.ConclusionsRisky alcohol consumption and binge drinking are relatively common among Spanish university students. Interventions to promote responsible alcohol consumption among this population should be implemented in collaboration with other stakeholders.
Effects of aspirin and omega-3 fatty acids on age-related macular degeneration in ASCEND-Eye: a randomised placebo-controlled trial in a population with diabetes
Authors: Sammons Emily , Bowman Louise , Stevens William , Buck Georgina , Hammami Imen , Parish Sarah , Armitage Jane 
Published: February 2025

PurposeAspirin and omega-3 fatty acids (FAs) are potential disease modifiers of age-related macular degeneration (AMD), but previous studies have produced inconsistent findings. Randomised evidence for the efficacy and safety of aspirin and omega-3 FAs on AMD is presented in this study.DesignASCEND-Eye is a substudy of eye effects in the 2×2 factorial design ASCEND (A Study of Cardiovascular Events iN Diabetes) double-blind, randomised, placebo-controlled trial for the primary prevention of cardiovascular events. Reports of AMD diagnoses were sourced from 6 monthly ASCEND follow-up questionnaires and a Visual Function Questionnaire.Participants15 480 UK adults at least 40 years of age with diabetes but no evident cardiovascular disease.Interventions100 mg aspirin daily versus placebo and, separately, 1 g omega-3 FAs daily versus placebo.Main outcome measureThe first post-randomisation reports of AMD.ResultsDuring 7.4 years of follow-up, 122 (1.6%) participants randomised to aspirin were reported as having AMD, compared with 138 (1.8%) randomised to placebo (rate ratio 0.88; 95% CI 0.69 to 1.12; p=0.31). AMD occurred in 130 (1.7%) participants randomised to omega-3 FAs, compared with 130 (1.7%) randomised to placebo (rate ratio 0.99; 95% CI 0.78 to 1.27; p=0.99).ConclusionNo clinically-meaningful effects of aspirin or omega-3 FAs on AMD were found. Although the study had very limited statistical power to detect clinically relevant effects, these data overcome some methodological limitations of previous observational studies, providing randomised evidence of both treatments on AMD, which could contribute to future meta-analyses.Trial registration numberISRCTN60635500andNCT00135226.
Healthcare professionals’ attitudes towards digital health interventions and perspectives on digital health inequalities in cardiometabolic care: a qualitative study
Authors: Ramasawmy Mel , Sunkersing David , Poole Lydia , Blandford Ann , Gill Paramjit , Khunti Kamlesh , Modha Shivali , Patel Kiran , Potts Henry , Sajid Madiha , Khan Nushrat , Banerjee Amitava 
Published: February 2025

BackgroundThe ue of digital health interventions (DHIs) for the management of cardiometabolic diseases has increased but may exacerbate existing health inequalities. Healthcare professionals (HCPs) play a vital role in recommending and supporting healthcare users to use these tools. There is a need to understand the role of HCPs in managing the implementation of digital health in communities at risk of health inequalities.ObjectiveTo explore the views of HCPs regarding digital health and its impact on health inequalities, focusing on cardiometabolic diseases and the South Asian population in the UK.DesignWe conducted online semi-structured interviews and focus groups with HCPs. These explored HCPs’ experiences and attitudes towards digital health, their perceptions of healthcare users’ barriers and facilitators to use such tools, as well as digital inequalities among specific healthcare user groups, and the impact of the COVID-19 pandemic on their practice in relation to digital health. After informed consent, transcription and coding, a reflexive thematic approach was taken for analysis.SettingPrimary, community and secondary care provided for cardiometabolic disease in the UK.ParticipantsHCPs in general practice (n=3), cardiometabolic specialities (n=3), pharmacy (n=4) and other practices (n=8).ResultsHCPs recognised the potential benefits of DHIs to improve access and delivery of care and healthcare user outcomes but described several barriers to successful implementation. HCPs demonstrated a good understanding of the challenges their healthcare users face in relation to wider inequalities, barriers to health behaviours and healthcare access, and digital health. Of particular concern was the impact of increasing reliance on digital interventions in healthcare on the exclusion of some population groups. Participants recommended improvement of the design and implementation of DHIs offered to healthcare users through working with at-risk populations throughout the process. Finally, participants emphasised the importance of ensuring non-digital services remained available to ensure equitable access to health and social care.ConclusionsHCPs described the complexities of delivering care to underserved communities. DHIs were identified as a potential way to improve health outcomes for some, while over-reliance risked exacerbating inequalities. HCPs made recommendations related to design, implementation and engaging target populations and provided practical examples to address digital health inequalities, such as working with other sectors to take a community approach.
Impact of patient sex on selection for abdominal aortic aneurysm repair: a discrete choice experiment
Authors: Pouncey Anna Louise , Loría-Rebolledo Luis Enrique , Sharples Linda , Bicknell Colin , Ryan Mandy , Powell Janet 
Published: February 2025

ObjectivesWomen with an abdominal aortic aneurysm (AAA) are less likely to receive elective repair than men. This study explored the effect of patient sex and other attributes on vascular surgeons’ decision-making for infrarenal AAA repair.DesignDiscrete choice experiment.SettingSimulated environment using case scenarios with varying patient attributes.ParticipantsVascular surgeons.InterventionsSurgical decision-making.Main outcome measuresAAA repair versus no repair and endovascular versus open repair.Results182 surgeons completed 2987 scenarios. When all other attributes were equal, a woman was more likely to be offered an AAA repair (marginal rate of substitution (MRS) 3.86 (95% CI 2.93, 4.79)), while very high anaesthetic risk (MRS −4.33 (95% CI –5.63, –3.03)) and hostile anatomy (MRS −3.28 (95% CI –4.55, –2.01)) were deterrents. Increasing age did not adversely affect the likelihood of offering repair to men but decreased the likelihood for women, which negated women’s selection advantage from the age of 83 years. Women were also more likely to be offered endovascular repair (MRS 2.57 (95% CI 1.30, 3.84)).ConclusionsPatient sex alone did not account for real-world disparity observed in selection for surgery. Rather, being a woman was associated with a higher likelihood of being offered AAA repair but also a higher likelihood of being offered less invasive endovascular repair. Increased age decreased the likelihood of surgical selection for women but not men. Preference for less invasive repair, combined with inferior rates of anatomical suitability, and the comparably older age of women at the time of AAA repair selection may account for lower rates of repair for women observed.
Developing patient-reported experience measures to evaluate an Emergency Department Outreach Programme for people experiencing homelessness in Toronto, Canada: a community-based participatory research study protocol
Authors: Xiao Sarah , Handford Curtis , Pinto Andrew , Snider Carolyn 
Published: February 2025

IntroductionPeople experiencing homelessness (PEH) have diverse and complex health and social needs and experience significant barriers to accessing support. As a result, PEH often use the emergency department (ED) for their unmet health and social needs. To address these challenges, the ED Outreach Programme at St. Michael’s Hospital was developed with community partners within the Downtown East Toronto Ontario Health Team in Toronto, Canada. PEH presenting in the ED are connected to an outreach worker to identify immediate needs for a safe discharge and to access health and social supports in the community. Following discharge, the outreach worker continues to maintain contact with clients to ensure continuity of care and assists with the coordination, navigation and follow-up of healthcare and community services.MethodsA three-phase community-based participatory research (CBPR) study will be conducted to evaluate patient experience in the ED Outreach Programme. Phase 1 involves conducting interviews with clients and staff/providers to understand their experiences with the programme and identify patient experience domains, constructs and measures. In Phase 2, programme clients, staff/providers and partners with lived experience co-design a set of patient-reported experience measures (PREMs) through focus groups. In Phase 3, the PREMs are pilot-tested to ensure their applicability and utility in the clinical setting. Central to CBPR principles, shared leadership and ownership of the project are facilitated by engaging and empowering community members. This study will contribute to new knowledge of building partnerships with PEH and marginalised communities in healthcare research, evaluation and quality improvement, particularly in developing PREMs.Ethics and disseminationThis study has been approved by the Unity Health Toronto Research Ethics Board (REB#21–315). Findings will be disseminated in peer-reviewed journals, conferences and forums, as well as through collaborating with partners with lived experience, community agencies and government bodies.
Ventilator settings for fibreoptic bronchoscopy during mechanical ventilation: a study protocol for a pragmatic randomised double-blind controlled trial VentSetFib
Authors: Lemyze Malcolm , Granier Maxime , Laouki Chems-Eddine , Belmeguenai Amir , Chared Habib , Audegond Clotilde , Mallat Jihad 
Published: February 2025

IntroductionFibreoptic bronchoscopy (FOB) is a challenging procedure during mechanical ventilation (MV) as it considerably reduces the endotracheal tube’s internal diameter, causing a drastic increase in respiratory resistance, which may compromise the delivery of ventilatory assistance. According to respiratory physiology principles applied to MV, the reduction of inspiratory flow and tidal volume is likely to reduce airway pressure during the inspiratory phase when respiratory resistances increase. Based on this assumption, we propose new ventilator settings aimed at reducing airway pressure during FOB. This study represents the first investigation to test special ventilator settings in order to facilitate FOB during MV.Methods and analysisThis is a single-centre randomised double-blind controlled trial, in which intubated patients undergoing an FOB will be assigned (1/1) either to receive the new ventilatory strategy or to stay on the ventilator settings previously selected by the attending physician. The intervention group will be applied the specific ventilator settings (inspiratory flow ≤25 L/min, tidal volume=5 mL/Kg, 1 s≤inspiratory time≤1.3 s, respiratory frequency=16 c/min, positive end-expiratory pressure=5 cm H2O). The primary endpoint will be the reduction of the occurrence of a serious adverse event (inability to deliver ventilatory support, significant arterial desaturation or haemodynamics instability) during FOB, prompting the interruption of the procedure. The primary endpoint will be validated a posteriori by an external adjudication committee. The sample size was estimated at a minimum of 42 patients to demonstrate a 50% reduction in the occurrence of such a serious adverse event with a power of 90% and an alpha risk of 0.05 (χ2test). Considering the possibility of technical problems in 10% of cases, 46 patients will be included.Ethics and disseminationThe study has been approved by the national ethics committee for the protection of the individuals (ID number: 2024-A00747-40). Written informed consent will be obtained from all patients. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT06562725.
Risk factors associated with urogenital schistosomiasis: a multilevel assessment approach using an Oversampling Schistosomiasis Survey (SOS) community-based, Plateaux region, Togo 2022
Authors: Alidou Smaila , Kamassa Hélène E , Lack Fiali , Ataba Essoham , Fleming Fiona M , Sossou Efoe , Hemou Manani , Yakpa Kossi , Tchalim Mawèké , Gnossike Piham , Vounatsou Penelope , Pullan Rachel , Gass Katherine , Dorkenoo Ameyo M 
Published: February 2025

BackgroundUrogenital schistosomiasis is endemic in Togo. Since 2010, Togo has used preventive chemotherapy to control the disease and periodically assess its impact. This study aimed to estimate the prevalence of urogenital schistosomiasis and identify associated risk factors among school-age children in three districts of the Plateaux Region of Togo.MethodsA cross-sectional study surveyed school-age children in three Togo districts, using an oversampling strategy of door-to-door visits to collect urine samples, metadata and lifestyle data. Statistical analyses, including descriptive and multilevel regression, were used to determine prevalence and investigate individual/community risk factors associated with urogenital schistosomiasis and infection intensity.ResultsThis study surveyed 6400 children, uncovering a 15.0% prevalence of urogenital schistosomiasis (95% CI: 14.1% to 15.8%). Notably, 48.3% (95% CI: 45.1% to 51.5%) showed heavy-intensity infections, averaging 38 eggs per 10 mL (range: 0–9688). Key risk factors included age (adjusted OR (aOR)=1.9), swimming in surface water (aOR=2.6) and residing in the Ogou district (aOR=11.2), while the Est-Mono district posed a lower risk (aOR=0.2). Factors such as gender, with boys at higher risk (aOR=1.7), age (aOR=2.9), school attendance (aOR=2.4) and swimming in surface water (aOR=4.7) were linked to infection intensity. Consumption of public tap water (aOR=2.4; 95% CI: 1.0 to 5.2) and residing in Ogou (aOR=28.6) increased intensity, whereas living in Est-Mono (aOR=0.0; 95% CI: 0.0 to 0.08) or using rainwater (aOR=0.0; 95% CI: 0.0 to 0.4) decreased it.ConclusionsThe prevalence and intensity of urogenital schistosomiasis were found to be correlated with household and behavioural risk factors. Integrating these factors into national control programmes and improving access to safe water and sanitation facilities will be crucial in eliminating this disease as a public health concern in Togo.