bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study
Authors: Kabalo Bereket Yohannes , Lindtjørn Bernt 
Published: November 2022

Background and objectivesOver centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas.MethodsThis cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for 1 year (2017–2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (eg, household participation in a social safety net programme and water access) and some time-varying factors (eg, household food insecurity).ResultsChild wasting rates varied with seasonal household food insecurity (ᵪ2trend= 15.9, p=0.001), but stunting rates did not. Household participation in a social safety net programme was associated with decreased stunting (p=0.001) and wasting (p=0.002). In addition to its association with decreased wasting (p=0.001), protected drinking water access enhanced the association between household participation in a social safety net programme and decreased stunting (p=0.009). Absence of a household latrine (p=0.011), lower maternal education level (p=0.001), larger family size (p=0.004) and lack of non-farming income (p=0.002) were associated with increased child stunting.ConclusionsSeasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programmes, such as the Ethiopian social safety net programme, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition.Key terms:Z-scores; Social safety net program; Water access
Protocol for a prospective observational cohort study collecting data on demographics, symptoms and biomarkers in people with mesothelioma (ASSESS-meso)
Authors: Conway Ruairi J H , Symonds Jenny , Walton Deborah , Probets Janet , Comins Charles , Stadon Louise , Harvey John E , Blyth Kevin G , Maskell Nick A , Bibby Anna C 
Published: November 2022

IntroductionMesothelioma is a heterogeneous disease that can be challenging to monitor and prognosticate. ASSESS-meso is a multicentre, prospective, longitudinal observational cohort study of patients with mesothelioma. The primary aim is to describe different clinical phenotypes and investigate predictive and prognostic factors, including biomarkers from blood and pleural fluid. The secondary aim is to provide a resource for future trials and substudies.Methods and analysisWe aim to recruit 700 patients with a histological, cytological or clinicopathological diagnosis of mesothelioma, at any anatomical site (pleural, peritoneal, pericardial, etc). Longitudinal data will be collected, including clinical information, radiological investigations, blood tests and patient-reported outcome measures for breathlessness, chest pain and sweats. Preplanned analyses will use Cox proportional hazards method to evaluate factors associated with survival, linear and logistic regression models to investigate associations with symptoms, and analysis of variance modelling to explore changes in symptoms over time.Ethics and disseminationEthical approval has been granted by the Research Ethics Committee South West—Central Bristol (17-SW-0019) and Health Research Authority (IRAS ID 220360). A study steering committee has been established and results will be published OpenAccess in peer-reviewed journals.Trial registration numberISRCTN: 61861764.
Cross-sectional survey of child weight management service provision by acute NHS trusts across England in 2020/2021
Authors: Mears Ruth , Leadbetter Sofia , Candler Toby , Sutton Hannah , Sharp Deborah , Shield Julian P H 
Published: November 2022

ObjectiveWith one in five children in England living with obesity, we mapped the geographical distribution and format of child weight management services provided by acute National Health Service (NHS) trusts across England, to identify breadth of service provision.DesignA cross-sectional survey.SettingThe survey was sent to acute NHS trusts (n=148) in England in 2020, via a freedom of information request.ParticipantsResponses were received from 139 of 148 (94%) acute NHS trusts, between March 2020 to March 2021.Outcome measuresThe survey asked each acute NHS trust whether they provide a weight management service for children living with obesity. For those trusts providing a service, data were collected on eligibility criteria, funding source, personnel involved, number of new patients seen per year, intervention duration, follow-up length and outcome measures. Service characteristics were reported using descriptive statistics. Service provision was analysed in the context of ethnicity and Index of Multiple Deprivation score of the trust catchment area.ResultsFrom the 139 survey respondents, 23% stated that they provided a weight management service for children living with obesity. There were inequalities in the proportion of acute NHS trusts providing a service across the different regions of England, ranging from 4% (Midlands) to 36% (London). For trusts providing a service, there was variability in the number of new cases seen per year, eligibility criteria, funding source, intervention format and outcome measures collected. A multidisciplinary approach was not routinely provided, with only 41% of services reporting ≥3 different staff disciplines.ConclusionIn 2020/2021, there were geographical inequalities in weight management service provision by acute NHS trusts for children living with obesity. Services provided lacked standardisation, did not routinely offer children multidisciplinary care and were insufficient in size to meet need.
Incidence of stroke, systemic embolism and bleeding events in patients without anticoagulation based on real-world data in Japan: a retrospective cohort study
Authors: Tanizawa Kimihiko , Nishimura Yuki , Sera Shoji , Yaguchi Daichi , Okada Akira , Nishikawa Masakatsu , Tamaru Satoshi , Nagai Naomi 
Published: November 2022

ObjectivesTo examine the incidence of stroke or systemic embolic events (SSEs) and bleeding events in untreated patients with non-valvular atrial fibrillation (NVAF) after widespread use of direct oral anticoagulant agents (DOACs).DesignMulticentre, non-interventional, observational, retrospective cohort study using real-world data in Japan (2016-2018).SettingThe Mie, Musashino University study of NVAF, which used the Mie-Life Innovation Promotion Center Database. This is a regional clinical database involving one university hospital and eight general hospitals in Mie Prefecture in Japan.ParticipantsJapanese patients with NVAF (n=7001).Primary and secondary outcomeThe incidence of SSEs and bleeding events.ResultsA total of 7001 patients with NAVF were registered, and 53.0% were treated with DOACs, 10.6% were treated with warfarin and 36.4% had no treatment. Additionally, 29.5% of patients with a CHADS2 (congestive heart failure, hypertension, age≥75 years, diabetes, previous stroke or transient ischemic attack) score of 3–6 were untreated. In the no treatment group, the SSE rates by the CHADS2 score (0, 1, 2 and 3–6) were 1.4%, 1.4%, 3.2% and 8.0%, respectively. The rates of bleeding events by the CHADS2 score (0, 1, 2 and 3–6) in the no treatment group were 0.7%, 1.0%, 1.2% and 2.9%, respectively. A multivariate analysis of SSEs in components of the CHADS2 showed that the adjusted HRs were 2.32 for heart failure, 1.66 for an age ≥75 years, 1.81 for diabetes mellitus and 5.84 for prior stroke or transient ischaemic attack.ConclusionsApproximately one-third of the patients do not receive any anticoagulation in the modern DOAC era in Japan. The SSE rate increases by the CHADS2 score. The SSE rate is low in patients with a CHADS2 score <1, supporting no indication of anticoagulation in current guidelines. In patients with a CHADS2 score >1, the use of anticoagulant drug therapy is recommended because of a higher risk of stroke.
Relative vaccine effectiveness against Delta and Omicron COVID-19 after homologous inactivated vaccine boosting: a retrospective cohort study
Authors: Tang Lin , Zhang Yanyang , Wang Fuzhen , Wu Dan , Qian Zhao-Hui , Zhang Rui , Wang Ai-Bin , Huang Chang , Wang Haifeng , Ye Ying , Lu Mingxia , Wang Changshuang , Ma Ya-Ting , Pan Jingjing , Li Ya-fei , Lv Xiao-Ya , An Zhijie , Rodewald Lance , Wang Xuan-Yi , Shao Yi-Ming , Wu Zhi-Yin , Yin Zundong 
Published: November 2022

ObjectiveTwo COVID-19 outbreaks occurred in Henan province in early 2022—one was a Delta variant outbreak and the other was an Omicron variant outbreak. COVID-19 vaccines used at the time of the outbreak were inactivated, 91.8%; protein subunit, 7.5%; and adenovirus5-vectored, 0.7% vaccines. The outbreaks provided an opportunity to evaluate variant-specific breakthrough infection rates and relative protective effectiveness of homologous inactivated COVID-19 vaccine booster doses against symptomatic infection and pneumonia.DesignRetrospective cohort studyMethodsWe evaluated relative vaccine effectiveness (rVE) with a retrospective cohort study of close contacts of infected individuals using a time-dependent Cox regression model. Demographic and epidemiologic data were obtained from the local Centers for Disease Control and Prevention; clinical and laboratory data were obtained from COVID-19-designated hospitals. Vaccination histories were obtained from the national COVID-19 vaccination dataset. All data were linked by national identification number.ResultsAmong 784 SARS-CoV-2 infections, 379 (48.3%) were caused by Delta and 405 (51.7%) were caused by Omicron, with breakthrough rates of 9.9% and 17.8%, respectively. Breakthrough rates among boosted individuals were 8.1% and 4.9%. Compared with subjects who received primary vaccination series ≥180 days before infection, Cox regression modelling showed that homologous inactivated booster vaccination was statistically significantly associated with protection from symptomatic infection caused by Omicron (rVE 59%; 95% CI 13% to 80%) and pneumonia caused by Delta (rVE 62%; 95% CI 34% to 77%) and Omicron (rVE 87%; 95% CI 3% to 98%).ConclusionsCOVID-19 vaccination in China provided good protection against symptomatic COVID-19 and COVID-19 pneumonia caused by Delta and Omicron variants. Protection declined 6 months after primary series vaccination but was restored by homologous inactivated booster doses given 6 months after the primary series.
Prevalence of undernourishment and associated factors among adults with major depressive disorder at two public hospitals in Northwest Ethiopia: a cross-sectional study
Authors: Tesfa Hiwot , Jara Dube , Woyiraw Wubetu , Bogale Eyob Ketema , Asrat Biksegn 
Published: November 2022

ObjectiveUndernourishment is overlooked in people with major depressive disorder (MDD); however, it could have huge impacts on recovery, functioning and quality of life. This study aimed to assess the prevalence of undernourishment and associated factors among adults with MDD attending two public hospitals in Northwest Ethiopia.DesignInstitution-based cross-sectional study was used.SettingThis study was conducted in two public hospitals—a tertiary-level specialised care hospital (Felege-Hiwot Comprehensive Specialized Hospital) and a secondary-level referral hospital (Debre Markos Referral Hospital). Both hospitals are located around 200 km apart and are the busiest hospitals in Western Amhara region.ParticipantsA total of 396 participants were included in the study using a stratified sampling technique. The study participants were recruited from psychiatry units. Adults with MDD were recruited from both hospitals proportionally between September and November 2019.Outcome measuresUndernourishment was assessed using a body mass index measurement. Data were collected using a structured questionnaire and anthropometric measurements, and analysed using a binary logistic regression model.ResultsThe overall prevalence of undernourishment was 28.5% (95% CI: 23.7% to 33.4%) among adults with MDD attending psychiatric care in the two public hospitals in Northwest Ethiopia. Female gender (adjusted Odds Ratio (AOR)=2.18, 95% CI=1.20 to 3.96, p=0.01), rural residence (AOR=2.41, 95% CI=1.23 to 4.70, p=0.01), illiteracy (AOR=2.86, 95% CI=1.01 to 8.07, p=0.047), antidepressant side effects (AOR=2.04, 95% CI=1.08 to 3.88, p=0.028) and having HIV/AIDS (AOR=4.12, 95% CI=1.46 to 11.57, p=0.007) had a statistically significant association with undernourishment.ConclusionThe prevalence of undernourishment was high among adults with MDD in Northwest Ethiopia. This study suggests the need to include nutritional interventions for people with MDD in psychiatric care facilities.
Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study
Authors: Hirsch Jana A , Michael Yvonne L , Moore Kari A , Melly Steven , Hughes Timothy M , Hayden Kathleen , Luchsinger Jose A , Jimenez Marcia P , James Peter , Besser Lilah M , Sánchez Brisa , Diez Roux Ana V 
Published: November 2022

IntroductionThe burden of Alzheimer’s disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of—and disparities in—cognitive decline and dementia.Methods and analysesWe describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing.Ethics and disseminationThis project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.
INSTIs for the management of HIV-associated TB (INSIGHT study): a phase 2b study to evaluate the efficacy, safety and pharmacokinetics of a combination of bictegravir, emtricitabine and tenofovir alafenamide fumarate for the treatment of HIV-1 infection in patients with drug-susceptible tuberculosis on a rifampicin-based treatment regimen: a phase 2b open-label randomised controlled trial
Authors: Naidoo Anushka , Dooley Kelly E , Naidoo Kogieleum , Padayatchi Nesri , Yende-Zuma Nonhlanhla , Perumal Rubeshan , Dorse Gillian , Boodhram Resha , Osuala Emmanuella Chinonso 
Published: November 2022

IntroductionCotreatment of HIV and tuberculosis (TB) reduces morbidity and mortality in coinfected patients. Availability of antiretroviral treatment (ART) drug options, including within drug classes, is important, particularly in high HIV/TB burden low and middle-income countries.Methods and analysisThis is a phase 2b, open-label, non-comparative randomised controlled trial to assess the antiretroviral activity of a fixed-drug, single tablet, combination of bictegravir (BIC) 50 mg/emtricitabine (FTC) 200 mg/tenofovir alafenamide (TAF) 25 mg (Biktarvy). The primary objective is to determine the efficacy, safety and pharmacokinetics of two times per day, coformulated BIC 50 mg/FTC 200 mg/TAF 25 mg in HIV-positive ART-naïve patients with TB who are receiving a rifampicin-based treatment regimen and to characterise viral suppression rates at week 24 through to week 48 in the BIC/FTC/TAF arm. We will enrol 120 patients randomised in a 2:1 ratio to the intervention or control arm of the study. A non-comparative contemporaneous control arm in which participants receive a dolutegravir-based regimen (standard of care) will also be enrolled.Ethics and disseminationThe University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC) and the South African Health Products Regulatory Authority (SAHPRA) have granted regulatory approval (trial reference numbers: BREC/00001300/2020 and SAHPRA 20200810). Trial results will be disseminated through conference presentations, peer-reviewed publications and the clinical trial registry.Trial registration numberClinicaltrials.gov; Trial registration number:NCT04734652; South African National Clinical Trials Register (SANCTR DOH-27-012021-6789)
Cyclizine pharmacovigilance in hospice/palliative care: net effects for nausea or vomiting
Authors: McNeill Richard , Prael Grace , Hunt Jane , Chang Sungwon , Wilcock Andrew , Dunwoodie David , Lau Corey , Morgan Nicola , Iupati Salina , Currow David C 
Published: November 2022

ObjectivesTo describe the contemporary real-world use of cyclizine for nausea or vomiting, and the associated benefits and harms.MethodsThis was a prospective, consecutive case series of routine clinical use of cyclizine for nausea or vomiting in palliative care conducted across 19 sites in Australia, Aotearoa/New Zealand and the UK. Clinical outcomes were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events at baseline and 72 hours after initiation of cyclizine. Ad hoc safety reporting continued for 2 weeks.ResultsData were collected from 101 patients between May 2018 and December 2020. Cyclizine was mostly used in combination with another antiemetic. Overall, 79 patients benefited and 32 experienced harm (56 had benefit without harm; 9 had harm without benefit). The most common harms were constipation (13%), somnolence (9%) and confusion (7%), adding to the already high rates of these symptoms at baseline. For the four patients with serious harms (grade ≥3), these were exacerbations of existing symptoms. Nine patients stopped cyclizine at 72 hours and a further 20 patients within 2 weeks. The most common reasons for stopping were lack of benefit and symptom resolution; none stopped because of harms.ConclusionsWhen used as described in a palliative care setting, cyclizine benefits about three-quarters of patients, with about one-third experiencing tolerable harms.
Anticholinergic drugs for death rattle in dying patients with cancer: multicentre prospective cohort study
Authors: Yamaguchi Takashi , Yokomichi Naosuke , Yamaguchi Takuhiro , Maeda Isseki , Matsunuma Ryo , Tanaka-Yagi Yukako , Akatani Asami , Suzuki Kozue , Kohara Hiroyuki , Taniyama Tomohiko , Matsuda Yosuke , Nakajima Nobuhisa , Morita Tatsuya , Tsuneto Satoru , Mori Masanori 
Published: November 2022

BackgroundThis study aimed to investigate the effectiveness of anticholinergics (AC) for death rattle in dying patients with cancer.MethodsThis is a prospective cohort study enrolled Terminally ill adult (20 years or older) patients with cancer who developed substantial death rattle (Back score ≥2) from 23 palliative care units in Japan. AC treatment for death rattle was prescribed according to primary physician’s decision. The primary outcome was the proportion of patients whose death rattle improved, which was defined as a Back score of ≤1. We compared the proportion of improved cases in patients treated with (AC group) and without (non-AC group) AC, controlling potential confounders by employing propensity score weighting.ResultsOf the 1896 patients enrolled, we included 196 who developed a substantial death rattle. Of these, 81 received AC. 56.8% in the AC group and 35.4% in the non-AC group had an improved death rattle at 8 hours after baseline. In the weighted analysis, AC group showed significant improvements in death rattle, with an adjusted OR of 4.47 (95% CI 2.04 to 9.78; p=0.0024). All sensitivity analyses achieved essentially the same results. In the subgroup analysis, ACs were strongly associated with death rattle improvement in men, patients with lung cancer, and type 1 death rattle (adjusted OR 5.81, 8.38 and 9.32, respectively).ConclusionsIn this propensity score-weighted analysis, ACs were associated with death rattle improvement in terminally ill patients with cancer who developed substantial death rattle.Trial registration numberUMIN-CTR (UMIN00002545).
TeamSpiritous - A Retrospective Emotional Competence Development System for Video-Meetings
Authors: Benke Ivo , Schneider Maren , Liu Xuanhui , Maedche Alexander 
Published: November 2022

Video-meetings essentially determine remote work life. However, video-meetings experience challenges originating from human emotions. Therefore, emotional competence, the ability to perceive, understand, and regulate emotions, is of the highest relevance. With limited transfer capacity of emotional information and various communication challenges, developing emotional competence, however, is complex. To overcome this complexity, we present TeamSpiritous, an individual, retrospective emotional competence development system for video-meetings. TeamSpiritous allows to upload and analyze recorded video-meetings on emotional processes and provides support for individual development of emotional competence.
We evaluated TeamSpiritous quantitatively and qualitatively in a six-week, longitudinal field study with 47 participants from China and Germany. Results of our study show that intra- and interpersonal emotional competence significantly increased over time for the whole sample. In particular, intrapersonal emotion regulation and interpersonal emotion perception and understanding improved. Since remote work video-meetings are often multicultural, we also investigated cultural differences and observed in our results that the effects of TeamSpiritous exist beyond cultural backgrounds (China, Germany). With our work, we contribute with the design of TeamSpiritous and understanding of its effects on emotional competence development.