bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and correlates of stunting and thinness among adolescent students in Lideta subcity, Addis Ababa, Ethiopia: a cross-sectional study
Authors: Getahun Genanew Kassie , Assfaw Alebachew , Muhammad Esmael Ali , Shitemaw Tewoderos 
Published: May 2023

ObjectivesTo determine the prevalence of stunting and thinness and associated factors among adolescents attending public schools in Lideta subcity, Addis Ababa, Ethiopia, in 2021.DesignCross-sectional.SettingPublic schools in Lideta subcity, Addis Ababa, Ethiopia.EligibilityAdolescents from grades 5–12 in public schools and students whose parents gave consent for participation.Data analysisBivariate and multivariable logistic regression analyses were used to examine the association between the independent variables and stunting and thinness. Using a 95% CI and adjusted OR (AOR), factors with a p value of less than 0.05 were determined to have a significant association.Outcome measuresThe prevalence of stunting and thinness, as well as the factors associated with stunting and thinness, were secondary outcomes.ResultsThe overall prevalence of stunting and thinness was 7.2% (95% CI: 5.3% to 9.3%) and 9% (95% CI: 6.8% to 11.4%), respectively. Stunting was associated with a larger family size (AOR=3.76; 95% CI: 1.58 to 8.94), low dietary diversity (AOR=2.87; 95% CI: 1.44 to 5.74), food insecurity (AOR=2.81; 95% CI: 1.38 to 5.71) and a lower wealth index (AOR=3.34; 95% CI: 1.51 to 7.41). On the other hand, thinness was associated with maternal education in those who were unable to read and write (AOR=2.5; 95% CI: 1.97 to 8.11), inadequate dietary diversity (AOR=4.81; 95% CI: 2.55 to 9.07) and larger family size (AOR=2.46; 95% CI: 1.14 to 5.29).ConclusionAdolescent stunting and thinness were common in Addis Ababa’s public schools. Family size, dietary diversity and food security were the main factors associated with both thinness and stunting. Therefore, to solve the problem of adolescent stunting and thinness, the administration of Addis Ababa city should prioritise minimising food insecurity while boosting productivity to enhance adolescent nutritional diversity. Moreover, nutritional education should be strengthened by healthcare providers working at public schools as well as health extension workers.
Social bias in artificial intelligence algorithms designed to improve cardiovascular risk assessment relative to the Framingham Risk Score: a protocol for a systematic review
Authors: Garcha Ivneet , Phillips Susan Paula 
Published: May 2023

IntroductionCardiovascular disease (CVD) prevention relies on timely identification of and intervention for individuals at risk. Risk assessment models such as the Framingham Risk Score (FRS) have been shown to over-estimate or under-estimate risk in certain groups, such as socioeconomically disadvantaged populations. Artificial intelligence (AI) and machine learning (ML) could be used to address such equity gaps to improve risk assessment; however, critical appraisal is warranted before ML-informed clinical decision-making is implemented.Methods and analysisThis study will employ an equity-lens to identify sources of bias (ie, race/ethnicity, gender and social stratum) in ML algorithms designed to improve CVD risk assessment relative to the FRS. A comprehensive literature search will be completed using MEDLINE, Embase and IEEE to answer the research question: do AI algorithms that are designed for the estimation of CVD risk and that compare performance with the FRS address the sources of bias inherent in the FRS? No study date filters will be imposed on the search, but English language filters will be applied. Studies describing a specific algorithm or ML approach that provided a risk assessment output for coronary artery disease, heart failure, cardiac arrhythmias (ie, atrial fibrillation), stroke or a global CVD risk score, and that compared performance with the FRS are eligible for inclusion. Papers describing algorithms for the diagnosis rather than the prevention of CVD will be excluded. A structured narrative review analysis of included studies will be completed.Ethics and disseminationEthics approval was not required. Ethics exemption was formally received from the General Research Ethics Board at Queen’s University. The completed systematic review will be submitted to a peer-reviewed journal and parts of the work will be presented at relevant conferences.
Motivation to stop smoking in the German population between 2016 - 2021 and associated factors: results from a repeated cross-sectional representative population survey (German Study on Tobacco Use, DEBRA study)
Authors: Borchardt Benjamin , Kastaun Sabrina , Pashutina Yekaterina , Viechtbauer Wolfgang , Kotz Daniel 
Published: May 2023

ObjectivesWe aimed to describe population trends in motivation to stop smoking between 2016 and 2021 in Germany. Furthermore, the aim was to estimate to what extent higher ratings on the validated German version of the Motivation To Stop Scale (MTSS) are associated with sociodemographics, nicotine dependence, past quit attempts, and use of e-cigarettes and tobacco product alternatives.MethodsWe used data from the German Study on Tobacco Use: an ongoing repeated cross-sectional face-to-face household survey collecting representative data of the German population every other month since 2016. We analysed data from 18 969 adult current smokers with multivariable ordinal regression and described MTSS scores between 2016 and 2021 (scores 1–7=lowest to highest level of motivation).ResultsThe mean MTSS score was 2.04 (SD=1.37) and showed a slight downward trend over time. Younger age, higher level of education, fewer cigarettes per day, more time spent with urges to smoke, a recent quit attempt, no previous waterpipe use and current or past e-cigarette use were associated with higher MTSS scores. The largest effect estimates were observed for at least one quit attempt 0–6 months ago versus no attempt in the past year (OR=7.54; 95% CI 6.78 to 8.40), at least one quit attempt 7–12 months ago versus no attempt in the past year (OR=4.00; 95% CI 3.59 to 4.45) and for current versus never use of e-cigarettes (OR=1.71; 95% CI 1.48 to 1.99).ConclusionsRecent quit attempts and current use of e-cigarettes were associated with higher motivation to stop smoking in the German population. Actions to boost the general motivation to stop smoking are required.
Remdesivir-associated bradycardia in COVID-19: a rapid review protocol
Authors: Tian Elli , Cosme Celica , Bauzon Justin , Batra Kavita , Azar Fadi , Schreiber Ariyon 
Published: May 2023

IntroductionRemdesivir is an antiviral medication that is used in the treatment of severe COVID-19. Research has highlighted the potential cardiac side effects of remdesivir, including the occurrence of remdesivir-associated bradycardia (RAB), but these findings have not been consistent. In addition, very little is known about the clinical implications and outcomes of RAB. The aim of this rapid systematic review is to determine the event rate of developing bradycardia while receiving remdesivir treatment compared with not receiving remdesivir in patients diagnosed with COVID-19.Methods and analysisThis study follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines and will include original papers related to COVID-19, remdesivir and bradycardia. Only English language papers published from 1 December 2019 to 31 December 2022 will be included. The following databases will be searched using keywords and controlled vocabulary: Ovid MEDLINE, Ovid EMBASE, Scopus, Cochrane, PubMed and Web of Science. Two reviewers will independently perform screening and data abstraction. Data will be synthesised qualitatively as well as quantitatively. A random-effects model will be used to calculate the pooled estimates.Ethics and disseminationThis review will systematically analyse the clinical studies available to help better characterise RAB. The results will support a retrospective study investigating RAB that is currently being conducted at the University Medical Center of Southern Nevada in Las Vegas, Nevada.PROSPERO registration numberThis protocol has been submitted to and approved by PROSPERO (Protocol ID: CRD42022331614).
Preoperative steroid for enhancing patients’ recovery after head and neck cancer surgery with free tissue transfer reconstruction: protocol for a phase III, placebo-controlled, randomised, double-blind study (J-SUPPORT 2022, PreSte-HN Study)
Authors: Shinozaki Takeshi , Imai Takayuki , Kobayashi Kenya , Yoshimoto Seiichi , Zenda Sadamoto , Yamaguchi Takuhiro , Eguchi Kohtaro , Okano Tomoka , Mashiko Tomoe , Kurosaki Miyuki , Miyaji Tempei , Matsuura Kazuto 
Published: May 2023

IntroductionThere is no established methodology for the perioperative management of head and neck cancer surgery and free tissue transfer reconstruction (HNS-FTR). A single dose of corticosteroid administered immediately before surgery has been shown to reduce postoperative pain and nausea/vomiting after some types of surgery. However, the efficacy of this strategy has not been demonstrated in HNS-FTR, and the increased risk of infectious complications associated with its use cannot be ruled out. This phase III, placebo-controlled, randomised, double-blind, comparative, multicentre study seeks to determine if preoperative administration of corticosteroid hormone has an adjunctive effect in terms of reducing pain and nausea/vomiting after surgery and improving the quality of postoperative recovery.Methods and analysisUsing the minimisation method, patients undergoing HNS-FTR are currently being recruited and randomly assigned to a study arm at a 1:1 allocation rate. The study treatment arm consists of 8.0 mg of dexamethasone phosphate dissolved in 100 mL of saline administered as a single dose by intravenous infusion. These treatments will be administered in a double-blind fashion. All patients will receive perioperative care according to the common multicentre enhanced recovery after surgery programme. The primary endpoint is the quality of postoperative recovery, as determined by the area under the curve (AUC) for total score on the Japanese version of the Quality of Recovery Score (QOR-40J) on postoperative days 2 and 4. The point estimate and CI for the difference in the AUC between the groups on postoperative days 2 and 4 will be calculated.Ethics and disseminationThe study will be performed in accordance with the Declaration of Helsinki and Japan’s Clinical Trials Act. The study protocol was approved by the Certified Review Board of National Cancer Center Hospital East (Reference K2021004).Trial registration numberThe study was registered in the Japan Registry of Clinical Trials (jRCTs031210593; V.3.0, November 2021, available athttps://jrct.niph.go.jp/en-latest-detail/jRCTs031210593).
Prevalence and associated factors of low back pain among taxi drivers in Gondar City, Northwest Ethiopia: a community-based cross-sectional study
Authors: Abere Giziew , Yenealem Dawit Getachew , Worede Eshetu Abera 
Published: May 2023

ObjectiveThis study aimed to assess the prevalence of low back pain and associated factors among professional taxi drivers.DesignCommunity-based cross-sectional study.Setting and participantsA Modified Nordic Musculoskeletal Questionnaire was used to collect data. Through a simple random sampling technique, 371 taxi drivers were selected in Gondar City, Ethiopia.Data analysisSPSS V.22 was used for data analysis. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with low back pain. A p value less than 0.05 and an adjusted odds ratio (AOR) with 95% CI were used to declare statistical significance.ResultA total of 371 respondents, with a response rate of 95.4%, have participated. The past 1 year and week’s prevalence of low back pain among taxi drivers was 85.7% (95% CI 82.5 to 89.2) and 53.4% (95% Cl 48.0 to 58.5), respectively. Overweight/obese (AOR=0.33, 95% CI (0.14 to 0.80)), alcohol drinking (AOR=4.77, 95% CI (1.16 to 19.5)), job dissatisfaction (AOR=4.58, 95% CI (1.39 to 15.2)), prolonged working hours per day (AOR=2.64; 95% CI (1.02 to 6.08)), not using the adjustable seat with back support (AOR=6.38, 95% CI (2.39 to 17.01)) were associated with low back pain among taxi drivers.ConclusionThe prevalence of low back pain among taxi drivers was high. Being overweight/obese, alcohol drinking, job dissatisfaction, prolonged working hours per day, and not using adjustable seats with back support, were factors associated with low back pain among taxi drivers. Therefore, ergonomic and behavioural-related awareness training is recommended to minimise the burden of low back pain among taxi drivers.
Ciprofol versus propofol for sedation in gastrointestinal endoscopy: protocol for a systematic review and meta-analysis
Authors: Qin Xiaoyu , Lu Xiaoting , Tang Lu , Wang Chunai , Xue Jianjun 
Published: May 2023

IntroductionPainless gastrointestinal endoscopy is being increasingly practised in the clinical field. The management and choice of sedation are important during the endoscopy procedure to reduce patient discomfort and facilitate high disease detection rates. Ciprofol is principally an agonist of the γ-aminobutyric acid type A receptor; it comprises the active ingredient HSK3486, which is similar to the currently used intravenous anaesthetic propofol in clinical practice. A systematic review and meta-analysis comparing ciprofol and propofol will be conducted to assess their efficacy and safety during endoscopy. Before starting the study, we describe the specific protocol of this systematic review.Methods and analysisThis protocol was prepared in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols 2015. The following databases will be searched: Embase, Cochrane Library, PubMed, Web of Science, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and a clinical trial registry. The database search strategy will adopt a combination of subject words and free words. Randomised controlled trials related to ciprofol use for sedation during gastrointestinal endoscopy will also be included. Based on the inclusion and exclusion criteria, two researchers will independently screen the articles and extracted data. Following the qualitative evaluation of each study, analysis will be conducted using Review Manager software.Ethics and disseminationThe protocol for this systematic review and meta-analysis involves no individual patient data; thus, ethical approval is not required. This will be the first meta-analysis to assess the sedation efficacy of ciprofol and provide evidence to clinicians for decision-making. The results will be disseminated through conference presentations and publications in peer-review journals related to this field.PROSPERO registration numberCRD42022370047.
Risk reduction intervention for raised blood pressure (REVERSE): protocol for a mixed-methods feasibility study
Authors: Hives Lucy , Georgiou Rachel F , Spencer Joseph , Benedetto Valerio , Clegg Andrew , Rutter Paul , Watkins Caroline , Williams Nefyn , Bray Emma P 
Published: May 2023

IntroductionAround 40% of adults have pre-hypertension (blood pressure between 120–139/80–89), meaning they are at increased risk of developing hypertension and other cardiovascular disease-related conditions. There are limited studies on the management of pre-hypertension; however, guidance recommends that it should be focused on lifestyle modification rather than on medication. Self-monitoring of blood pressure could allow people to monitor and manage their risk status and may allow individuals to modify lifestyle factors. The purpose of this study is to determine the feasibility and acceptability, to both healthcare professionals and people with pre-hypertension, of blood pressure self-monitoring.Methods and analysisA prospective, non-randomised feasibility study, with a mixed-methods approach will be employed. Eligible participants (n=114) will be recruited from general practices, pharmacies and community providers across Lancashire and South Cumbria. Participants will self-monitor their blood pressure at home for 6 months and will complete questionnaires at three timepoints (baseline, 6 and 12 months). Healthcare professionals and participants involved in the study will be invited to take part in follow-up interviews and a focus group. The primary outcomes include the willingness to engage with the concept of pre-hypertension, the acceptability of self-monitoring, and the study processes. Secondary outcomes will inform the design of a potential future trial. A cost-analysis and cost-benefit analysis will be conducted.Ethics and disseminationEthics approval has been obtained from London–Fulham NHS Research Ethics Committee, the University of Central Lancashire Health Ethics Review Panel and the HRA. The results of the study will be disseminated via peer-reviewed publications, feedback to service users and healthcare professionals, and to professional bodies in primary care and pharmacy.Trial registration numberISRCTN13649483.
Mandibular advancement device versus CPAP in lowering 24-hour blood pressure in patients with obstructive sleep apnoea and hypertension: the CRESCENT trial protocol
Authors: Ou Yi-Hui , Colpani Juliana Tereza , Chan Siew-Pang , Loke Weiqiang , Cheong Crystal S , Kong William , Chin Calvin W , Kojodjojo Pipin , Wong Philip , Cistulli Peter , Lee Chi-Hang 
Published: May 2023

IntroductionAlthough treatment of obstructive sleep apnoea (OSA) using continuous positive airway pressure (CPAP) reduces blood pressure (BP), adherence to CPAP is often suboptimal. A mandibular advancement device (MAD) is a guideline-endorsed alternative therapy for OSA. Still, there is limited evidence on the relative efficacy between MAD and CPAP on BP reduction. We evaluate whether treatment of moderate-to-severe OSA using MAD can improve BP and other health-related outcomes compared with CPAP.Methods and analysisThis is a randomised, controlled, non-inferiority trial conducted. We will recruit 220 Asians with a history of hypertension and high cardiovascular risk for an overnight polysomnography screening. Those with moderate-to-severe OSA (apnoea–hypopnoea index ≥15 events/hour) will be randomised to treatment with either MAD or CPAP in a 1:1 ratio. Stratified by age (60 vs <60 years old), body mass index (25 vs <25 kg/m2) and apnoea–hypopnoea index (30 vs <30 events/hour), an adaptive randomisation scheme with permuted blocks constructed in real-time is implemented to restrict imbalance. The overall study duration is 12 months. The primary endpoint is the 24-hour mean arterial BP difference between baseline and 6-month follow-up. The secondary endpoints include other measures of ambulatory BP monitoring, arrhythmia based on a 4-day electrocardiographic monitoring, biomarker and proteomic analysis, cardiovascular magnetic resonance-derived myocardial fibrosis and remodelling and quality-of-life questionnaires. Recruitment began in October 2019 and ended in December 2022. Comparison between MAD and CPAP will be performed using covariance (ANCOVA) analysis of the changes in 24-hour mean arterial BP while adjusting for the baseline 24-hour mean arterial BP. We will compare the 95% CIs around the treatment difference point estimate with the prespecified non-inferiority margin (1.5 mm Hg). If the upper limit of the 95% CI is <1.5 mm Hg and crosses 0, non-inferiority of the MAD relative to CPAP will be established.Ethics and disseminationThe Domain Specific Review Board-C, National Healthcare Group under approved the study protocol (NHG DSRB Ref: 2019/00359, approved on 28 August 2019). Study findings will be disseminated to various local, national, and international audiences through abstract presentations and publication in peer-reviewed journals.Trial registration numberNCT04119999.
Factors that influence the administration of tranexamic acid (TXA) to trauma patients in prehospital settings: a systematic review
Authors: Nicholson Helen , Scotney Natalie , Briscoe Simon , Kirby Kim , Bedson Adam , Goodwin Laura , Robinson Maria , Taylor Hazel , Thompson Coon Jo , Voss Sarah , Benger Jonathan Richard 
Published: May 2023

ObjectiveIn the UK there are around 5400 deaths annually from injury. Tranexamic acid (TXA) prevents bleeding and has been shown to reduce trauma mortality. However, only 5% of UK major trauma patients who are at risk of haemorrhage receive prehospital TXA. This review aims to examine the evidence regarding factors influencing the prehospital administration of TXA to trauma patients.DesignSystematic literature review.Data sourcesAMED, CENTRAL, CINAHL, Cochrane Database of Systematic Reviews, Conference Proceedings Citation Index—Science, Embase and MEDLINE were searched from January 2010 to 2020; searches were updated in June 2022. Clinicaltrials.gov and OpenGrey were also searched and forward and backwards citation chasing performed.Eligibility criteriaAll primary research reporting factors influencing TXA administration to trauma patients in the prehospital setting was included.Data extraction and synthesisTwo independent reviewers performed the selection process, quality assessment and data extraction. Data were tabulated, grouped by setting and influencing factor and synthesised narratively.ResultsTwenty papers (278 249 participants in total) were included in the final synthesis; 13 papers from civilian and 7 from military settings. Thirteen studies were rated as ‘moderate’ using the Effective Public Health Practice Project Quality Assessment Tool. Several common factors were identified: knowledge and skills; consequences and social influences; injury type (severity, injury site and mechanism); protocols; resources; priorities; patient age; patient sex.ConclusionsThis review highlights an absence of high-quality research. Preliminary evidence suggests a host of system and individual-level factors that may be important in determining whether TXA is administered to trauma patients in the prehospital setting.Funding and registrationThis review was supported by Research Capability Funding from the South Western Ambulance Service NHS Foundation Trust and the National Institute for Health Research Applied Research Collaboration South West Peninsula.PROSPERO registration numberCRD42020162943.