bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double burden of malnutrition and associated factors among women of reproductive age in sub-Saharan Africa: a multilevel multinomial logistic regression analysis
Authors: Seifu Beminate Lemma , Mare Kusse Urmale , Legesse Bruck Tesfaye , Tebeje Tsion Mulat 
Published: February 2024

BackgroundGlobally, malnutrition among women of reproductive age is on the rise and significantly contributing to non-communicable disease, deaths and disability. Even though the double burden of malnutrition (DBM) is a common problem among women in sub-Saharan Africa (SSA), there are limited studies examining the factors contributing to underweight, overweight, and obesity at the SSA level.ObjectiveTo determine the factors associated with the DBM, and their relative magnitude, among women of reproductive age in SSA.DesignCross-sectional study design.Setting33 SSA countries.Participants240 414 women of reproductive age.Primary and secondary outcome measuresA multilevel multinomial logistic regression model was applied to identify factors associated with malnutrition. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association.ResultsThe pooled prevalence of underweight, overweight and obesity among women in SSA were 8.87%, 16.47% and 6.10%, respectively. Women who are from rural residence and smoke cigarettes were more likely to be underweight. Conversely, women between the age of 24–34 and 35–49, who have higher education, belong to a middle and rich household, are ever married, have high parity, use contraceptives, have media exposure and smoke cigarettes were more likely to be overweight and/or obese.ConclusionThe findings of our study suggest that certain factors such as residence, education status, wealth, marital status, occupation, cigarette smoking, and contraceptive use have a significant assocation with malnutrition among women. Therefore, it is important for public health programs aimed at preventing the double burden of malnutrition to focus on these factors through comprehensive public awareness and cost-effective operational health interventions.
Role of HDL cholesterol in anthracycline-induced subclinical cardiotoxicity: a prospective observational study in patients with diffuse large B-cell lymphoma treated with R-CHOP
Authors: Ou Wenxin , Jiang Tiantian , Zhang Nan , Lu Kai , Weng Yue , Zhou Xi , Wang Dong , Dong Qian , Tang Xiaoqiong 
Published: February 2024

ObjectivesAnthracycline-induced cardiotoxicity is a debilitating cardiac dysfunction for which there are no effective treatments, making early prevention of anthracycline-induced subclinical cardiotoxicity (AISC) crucial. High-density lipoprotein cholesterol (HDL-C) plays a role in cardioprotection, but its impact on AISC remains unclear. Our study aims to elucidate the protective capacity of HDL-C in AISC in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (cyclophosphamide, vincristine, doxorubicin, prednisone and rituximab).DesignProspective observational study.SettingConducted in China from September 2020 to September 2022.Participants70 chemotherapy-naïve patients newly diagnosed with DLBCL who were scheduled to receive the standard dose of R-CHOP; 60 participants included in a case–control study (DOI: 10.1186/s12885-022-10085-6).Primary outcome measuresSerum biomarkers, 2D speckle tracking echocardiography and conventional echocardiography were measured at baseline, at the end of the third and sixth cycles of R-CHOP and 6 and 12 months after chemotherapy.Results24 patients experienced AISC, while 10 did not. 36 patients were lost to follow-up and death. Cox regression analysis showed that higher levels of HDL-C were associated with a significantly lower risk of AISC (unadjusted HR=0.24, 95% CI 0.09 to 0.67, p=0.006; adjusted HR=0.27, 95% CI 0.09 to 0.79, p=0.017). Patients without AISC had a more stable and higher HDL-C level during the follow-up period. HDL-C levels significantly decreased from the end of the third cycle of chemotherapy to the end of the sixth cycle of chemotherapy in all patients (p=0.034), and particularly in the AISC group (p=0.003). The highest level of HDL-C was significantly higher in patients without AISC than in those with AISC (1.52±0.49 vs 1.22±0.29, p=0.034).ConclusionsOur study suggests that higher HDL-C levels may associate with lower AISC risk in patients with DLBCL treated with R-CHOP. HDL-C could be a cardioprotective target, but further research is needed to confirm its benefits and limitations.Study registration numberStudy registration number: ChiCTR2100054721
Prolonged Remission Induced by FENofibrate in children with newly diagnosed type 1 diabetes (PRIFEN): protocol of a randomised controlled trial
Authors: Groele Lidia , Dżygało Katarzyna , Kowalska Agnieszka , Szypowska Agnieszka 
Published: February 2024

IntroductionSphingolipids regulate proinsulin folding, insulin secretion and control beta cells apoptosis. Recent evidence has demonstrated that, among other factors, reduced amounts of sulfatide may be relevant in the development of type 1 diabetes (T1D). Thus, fenofibrate, which activates sulfatide biosynthesis, may prolong remission in subjects with T1D. The aim of the study is to evaluate clinical efficacy of fenofibrate on the maintenance of residual beta-cell function in children with newly diagnosed T1D.Methods and analysisA total of 102 children aged 10–17 years with newly diagnosed T1D will be enrolled in a double-blind, two-centre randomised, non-commercial, placebo-controlled trial. Subjects who will meet all inclusion criteria will be randomly assigned to receive fenofibrate at a dose of 160 mg or an identically appearing placebo, orally, once daily, for 12 months. The primary endpoint will be the area under the curve of the C-peptide level during 2-hour responses to a mixed-meal tolerance test (MMTT). Secondary endpoints include fasting and maximum C-peptide concentration in the MMTT, parameters of diabetes control and glucose fluctuations, daily insulin requirement, inflammation markers, genetic analysis, safety and tolerance of the fenofibrateEthics and disseminationThe study protocol was approved by the Bioethics Committee. The results of this study will be submitted to a peer-reviewed diabetic journal. Abstracts will be submitted to international and national conferences.Trial registration numberEnduraCT 2020-003916-28.
Prevalence and correlates of depression and anxiety symptoms among older adults in Shenzhen, China: a cross-sectional population-based study
Authors: Peng Xiaodong , Zhang Shengming , You Liqin , Hu Wenxuan , Jin Shan , Wang Jianhong 
Published: February 2024

ObjectivesTo investigate the prevalence of depression and anxiety symptoms among older adults in an urban district in China, as well as their associated factors.DesignCross-sectional study.SettingGeneral communities in Shenzhen, Guangdong, China.ParticipantsA total of 5372 community-dwelling older adults aged 65 years or older were initially recruited. Ultimately, 5331 participants met the inclusion criteria and were included in this study.MethodsParticipants completed a sociodemographic questionnaire, along with assessments including the Patient Health Questionnaire-9, Generalised Anxiety Scale-7, UCLA Loneliness Simplification Scale, Insomnia Severity Index Scale (ISI), Community Dementia Brief Screening Scale and the 8-item Dementia Screening Questionnaire. Statistical analyses included the Shapiro-Wilk test, independent t-test, Wilcoxon rank test, χ2test and univariate and multivariate linear regression analysis.ResultsThe prevalence of depression and anxiety symptoms among older adults in Shenzhen communities was 10.4% and 11.3%, respectively. In multivariate analysis, age (B=−0.01, p<0.05), relatively poor health status in the past year (B=1.00, p<0.01), poor health status in the past year (B=2.40, p<0.01), ISI score (B=0.21, p<0.01), -item Ascertain Dementia Questionnaire (AD8) score (B=0.22, p<0.01), UCLA Loneliness Scale (ULS) score (B=0.24, p<0.01) were significantly associated with the severity of depression symptom, Compared with their respective reference categories, relatively poor health status in the past year (B=0.50, p<0.01), poor health status in the past year (B=1.32, p<0.01), ISI score (B=0.23, p<0.01), sleep duration (B=0.05, p<0.01), AD8 score (B=0.21, p<0.01), Community Screening Instrument for Dementia score (B=0.13, p<0.01), ULS score (B=0.22, p<0.01) were significantly associated with the severity of anxiety symptom.ConclusionsWe observed a high prevalence of depression and anxiety symptoms among older adults in this study. The existing welfare system and infrastructure should remain and targeted mental health programmes addressing the identified risk factors should be proposed.
Qualitative study investigating the professional and personal effects of patient suicide on general practitioners in Northern Ireland
Authors: McAnee Grainne , Norwood Kelly , Leavey Gerard 
Published: February 2024

ObjectiveThere is a dearth in suicide literature addressing the impact on general practitioners (GPs) of losing a patient. We aimed to examine the personal and professional impact as well as the availability of support and why GPs did or did not use it.DesignA qualitative study using one-to-one interviews with participants recruited using snowball sampling.SettingThe study was conducted in a primary care setting.ParticipantsInterviews were held with 19 GPs within primary care in Northern Ireland.ResultsGPs are impacted both personally and professionally when they lose a patient to suicide, but may not access formal help due to commonly held idealised notions of a ‘good’ GP who is regarded as having solid imperturbability. Fear of professional repercussions also plays a major role in deterring help-seeking.ConclusionsThere is a need for a systemic culture shift within general practice which allows doctors to seek support when their physical or mental health require it. This may help prevent stress, burnout and early retirement.
Examining behaviour change techniques (BCTs) in technology-based interventions for enhancing social participation in people with mild cognitive impairment (MCI) or dementia: a scoping review protocol
Authors: Zhu Di , Al Mahmud Abdullah , Liu Wei 
Published: February 2024

IntroductionTechnology-based interventions have improved the social participation of older adults with mild cognitive impairment (MCI) or dementia. Nevertheless, how these interventions modify social participation remains to be seen, and what efficient behaviour change techniques (BCTs) have been used. As such, this study aims to conduct a scoping review, identifying the features and BCTs behind technology-based interventions that improve social participation for individuals with MCI or dementia.Methods and analysisThe scoping review method will be used to search journal articles from electronic databases, such as PsycINFO, PubMed, MEDLINE, Web of Science, Scopus and reference lists. Following the population, concept and context structure, this study focuses on adults over 60 diagnosed with MCI or dementia. It delves into technology-based interventions, specifically focusing on BCTs, features and overall effectiveness for improving social participation. The research considers contextual factors, exploring the diverse settings where these interventions are used, including homes, healthcare facilities and community centres. This approach aims to provide nuanced insights into the impact of technology-based interventions on social participation in the targeted demographic. Two authors will independently screen titles, abstracts and full texts using Covidence software. Disagreements will be resolved through consensus or a third reviewer, and reasons for exclusion will be documented. We will conduct a detailed analysis of BCTs to pinpoint effective strategies applicable to future technology-based intervention designs. Through this scoping review, we aim to provide valuable insights that guide the direction of future research. Specifically, we seek to inform the development of effective technology-based interventions tailored to support social participation for people with MCI or dementia.Ethics and disseminationEthical approval is not necessary, as this review will use available articles from electronic databases. The outcome of the study will be published in a peer-reviewed journal.Protocol registration numberhttps://osf.io/tkzuf/
Manchester Intermittent Diet in Gestational Diabetes Acceptability Study (MIDDAS-GDM): a two-arm randomised feasibility protocol trial of an intermittent low-energy diet (ILED) in women with gestational diabetes and obesity in Greater Manchester
Authors: Dapre Elizabeth , Issa Basil G , Harvie Michelle , Su Ting-Li , McMillan Brian , Pilkington Andrea , Hanna Fahmy , Vyas Avni , Mackie Sarah , Yates James , Evans Benjamin , Mubita Womba , Lombardelli Cheryl 
Published: February 2024

IntroductionThe prevalence of gestational diabetes mellitus (GDM) is rising in the UK and is associated with maternal and neonatal complications. National Institute for Health and Care Excellence guidance advises first-line management with healthy eating and physical activity which is only moderately effective for achieving glycaemic targets. Approximately 30% of women require medication with metformin and/or insulin. There is currently no strong evidence base for any particular dietary regimen to improve outcomes in GDM. Intermittent low-energy diets (ILEDs) are associated with improved glycaemic control and reduced insulin resistance in type 2 diabetes and could be a viable option in the management of GDM. This study aims to test the safety, feasibility and acceptability of an ILED intervention among women with GDM compared with best National Health Service (NHS) care.Method and analysisWe aim to recruit 48 women with GDM diagnosed between 24 and 30 weeks gestation from antenatal clinics at Wythenshawe and St Mary’s hospitals, Manchester Foundation Trust, over 13 months starting in November 2022. Participants will be randomised (1:1) to ILED (2 low-energy diet days/week of 1000 kcal and 5 days/week of the best NHS care healthy diet and physical activity advice) or best NHS care 7 days/week until delivery of their baby. Primary outcomes include uptake and retention of participants to the trial and adherence to both dietary interventions. Safety outcomes will include birth weight, gestational age at delivery, neonatal hypoglycaemic episodes requiring intervention, neonatal hyperbilirubinaemia, admission to special care baby unit or neonatal intensive care unit, stillbirths, the percentage of women with hypoglycaemic episodes requiring third-party assistance, and significant maternal ketonaemia (defined as ≥1.0 mmol/L). Secondary outcomes will assess the fidelity of delivery of the interventions, and qualitative analysis of participant and healthcare professionals’ experiences of the diet. Exploratory outcomes include the number of women requiring metformin and/or insulin.Ethics and disseminationEthical approval has been granted by the Cambridge East Research Ethics Committee (22/EE/0119). Findings will be disseminated via publication in peer-reviewed journals, conference presentations and shared with diabetes charitable bodies and organisations in the UK, such as Diabetes UK and the Association of British Clinical Diabetologists.Trial registration numberNCT05344066.
A Digitally Enabled, Pharmacist service to detecT medicine harms in residential aged care (nursing home) (ADEPT): protocol for a feasibility study
Authors: Boord Monique S , Brown Peter , Soriano Julian , Meola Tahlia , Dumuid Dorothea , Milte Rachel , Roughead Elizabeth E , Lovell Nigel H , Stone Helen , Whitehouse Joseph , Janetzki Jack L , Gebreyohannes Eyob Alemayehu , Lim Renly 
Published: February 2024

IntroductionThis feasibility study aims to develop and test a new model of practice in Australia using digital technologies to enable pharmacists to monitor early signs and symptoms of medicine-induced harms in residential aged care.Methods and analysisThirty residents will be recruited from an aged care facility in South Australia. The study will be conducted in two phases. In phase I, the study team will work with aged care software providers and developers of digital technologies (a wearable activity tracker and a sleep tracking sensor) to gather physical activity and sleep data, as well as medication and clinical data from the electronic medication management system and aged care clinical software. Data will be centralised into a cloud-based monitoring platform (TeleClinical Care (TCC)). The TCC will be used to create dashboards that will include longitudinal visualisations of changes in residents’ health, function and medicine use over time. In phase II, the on-site pharmacist will use the centralised TCC platform to monitor each resident’s medicine, clinical, physical activity and sleep data to identify signs of medicine-induced harms over a 12-week period.A mixed methods process evaluation applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework will be used to assess the feasibility of the service. Outcome measures include service reach, changes in resident symptom scores (measured using the Edmonton Symptom Assessment System), number of medication adverse events detected, changes in physical activity and sleep, number of pharmacist recommendations provided, cost analysis and proportion of all pharmacists’ recommendations implemented at 4-week, 8-week and 12-week postbaseline period.Ethics and disseminationEthical approval has been obtained from the University of South Australia’s Human Research Ethics Committee (205098). Findings will be disseminated through published manuscripts, conference presentations and reporting to the study funder.Trial registration numberACTRN12623000506695.
Brain health measurement: a scoping review
Authors: Lee Angeline , Shah Suraj , Atha Karyna , Indoe Peter , Mahmoud Naira , Niblett Guy , Pradhan Vidushi , Roberts Nia , Malouf Reem Saleem , Topiwala Anya 
Published: February 2024

ObjectivesPreservation of brain health is an urgent priority for the world’s ageing population. The evidence base for brain health optimisation strategies is rapidly expanding, but clear recommendations have been limited by heterogeneity in measurement of brain health outcomes. We performed a scoping review to systematically evaluate brain health measurement in the scientific literature to date, informing development of a core outcome set.DesignScoping review.Data sourcesMedline, APA PsycArticles and Embase were searched through until 25 January 2023.Eligibility criteria for selecting studiesStudies were included if they described brain health evaluation methods in sufficient detail in human adults and were in English language.Data extraction and synthesisTwo reviewers independently screened titles, abstracts and full texts for inclusion and extracted data using Covidence software.ResultsFrom 6987 articles identified by the search, 727 studies met inclusion criteria. Study publication increased by 22 times in the last decade. Cohort study was the most common study design (n=609, 84%). 479 unique methods of measuring brain health were identified, comprising imaging, cognitive, mental health, biological and clinical categories. Seven of the top 10 most frequently used brain health measurement methods were imaging based, including structural imaging of grey matter and hippocampal volumes and white matter hyperintensities. Cognitive tests such as the trail making test accounted for 286 (59.7%) of all brain health measurement methods.ConclusionsThe scientific literature surrounding brain health has increased exponentially, yet measurement methods are highly heterogeneous across studies which may explain the lack of clinical translation. Future studies should aim to develop a selected group of measures that should be included in all brain health studies to aid interstudy comparison (core outcome set), and broaden from the current focus on neuroimaging outcomes to include a range of outcomes.
Impact of digital assistive technologies on the quality of life for people with dementia: a scoping review
Authors: Schneider Charlotte , Nißen Marcia , Kowatsch Tobias , Vinay Rasita 
Published: February 2024

BackgroundDigital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs or provide a generic view. Therefore, it is of essence to provide a review of different kinds of DATs and how they contribute to improving quality of life (QOL) for PWD.DesignScoping review using the framework proposed by Arksey and O’Malley and recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.Data sourcesCochrane, Embase, PubMed, Scopus and Web of Science (January 2013 to May 2023).Eligibility criteria for selecting studiesCompleted scientific literature with a primary focus on DATs for PWD, perspectives of caregivers, family members or healthcare workers in relation to a PWD, people living in diverse settings and all severities of dementia.Data extraction and synthesisScreening and data extraction were conducted, followed by quantitative and qualitative analyses using thematic analysis principles and Digital Therapeutics Alliance categories for DAT grouping.ResultsThe literature search identified 6083 records, with 1056 duplicates. After screening, 4560 full texts were excluded, yielding 122 studies of different designs. The DATs were categorised into digital therapeutics (n=109), patient monitoring (n=30), digital diagnostics (n=2), care support (n=2) and health system clinical software (n=1). These categories were identified to impact various aspects of QOL: preserving autonomy, engagement, and social interaction, health monitoring and promotion, improving activities of daily living, improving cognition, maintaining dignity, managing behavioural and psychological symptoms of dementia and safety/surveillance.ConclusionsVarious DATs offer extensive support, elevating the QOL of PWD. Digital therapeutics are predominantly used for ageing-in-place and independent living through assistance with daily tasks. Future research should focus on less-represented digital health technology categories, such as care support, health & wellness or software solutions. Observing ongoing DAT developments and their long-term effects on QOL remains essential.