bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and impacts of nutritional programmes to address undernutrition of adults living with HIV in sub-Saharan Africa: a systematic review of evidence
Authors: Tesfay Fisaha Haile , Javanparast Sara , Gesesew Hailay , Mwanri Lillian , Ziersch Anna 
Published: January 2022

ObjectivesAlthough some studies have identified various challenges affecting nutritional programmes to effectively tackle undernutrition among people living with HIV, evidence about the characteristics and impacts of these programmes on weight-related nutritional outcomes varies based on country contexts, specific programme goals and the implementation processes. This systematic review sought to synthesise evidence on the characteristics and impact of nutritional programmes on weight-related nutritional outcomes of people living with HIV in sub-Saharan Africa.DesignSystematic review.Data sourcesWe searched for primary studies published in the following databases: Web of Science, Medline, Scopus, ScienceDirect, ProQuest and Google Scholar, supplemented by checking reference lists of included papers.Eligibility criteriaStudies published from 2005 to 10 July 2020 and reporting on the weight-related nutritional outcomes of undernourished people enrolled in nutritional programmes in HIV care in sub-Saharan Africa were included.Data extraction and synthesisData were extracted using a data extraction proforma. Weight-related nutritional outcomes of people living with HIV before and after enrolment in a nutritional programme were compared and narratively synthesised.ResultsSixteen studies assessing the impact of nutritional programmes in HIV care on weight-related nutritional outcomes were included. Of these, 13 examined nutritional programmes implemented in health facilities and the remaining three were delivered outside of health facilities. Nutritional recovery (defined differently in the studies) ranged from 13.1% to 67.9%. Overall programme failure rate, which included default after enrolment in a nutritional programme or non-response, ranged from 37.6% to 48.0%. More specifically, non-response to a nutritional programme ranged from 21.0% to 67.4% and default from the programme ranged from 19.0% to 70.6%. Key sociodemographic, clinical and nutritional characteristics that affect nutritional recovery, non-response and default were also identified.Conclusions and recommendationsNutritional programmes in HIV care have led to some improvements in weight-related nutritional outcomes among people living with HIV. However, the programmes were characterised by a high magnitude of default and non-response. To improve desired weight-related nutritional outcomes of people living with HIV, a holistic approach that addresses longer-term determinants of undernutrition is needed.PROSPERO registration numberCRD42020196827.
Marijuana smoking and asthma: a protocol for a meta-analysis
Authors: Lei Jincheng , Shao Mingjie 
Published: January 2022

IntroductionRecent studies have raised the concern on the risk of asthma in marijuana smokers; however, the results remain controversial and warrant further investigation. With a growing number of marijuana smokers, examining the association between marijuana smoking and asthma and quantifying such association through meta-analysis have important implications for public health and clinical decision-making. In view of this, the present protocol aims to detail a comprehensive plan of meta-analysis on the association aforementioned. The findings are expected to strengthen the current knowledge base pertaining to the potential adverse effects of marijuana smoking on pulmonary health and to facilitate the development of prevention strategies for asthma.Methods and analysisThe MEDLINE/PubMed, Web of Science and EMBASE databases will be searched systematically from inception to 1 September 2021 to retrieve the relevant observational studies focusing on the association between marijuana smoking and asthma. Both unadjusted and adjusted effect sizes, such as OR, relative risk, HR and the corresponding 95% CIs will be extracted for pooled analyses. Heterogeneity and publication bias across the included studies will be examined. The Newcastle-Ottawa Quality Scale will be used to assess the quality and risk of bias. Statistical software Review Manager V.5.3 and Stata V.11.0 will be used for statistical analyses.Ethics and disseminationSince no private and confidential patient data will be included in the reporting, approval from an ethics committee is not required. The results will be published in a peer-reviewed journal or disseminated in the relevant conferences. The study raises no ethical issue.OSF registration number10.17605/OSF.IO/UPTXC.
Characterising activity and diet compositions for dementia prevention: protocol for the ACTIVate prospective longitudinal cohort study
Authors: Smith Ashleigh E , Wade Alexandra T , Olds Timothy , Dumuid Dorothea , Breakspear Michael J , Laver Kate , Goldsworthy Mitchell R , Ridding Michael C , Fabiani Monica , Dorrian Jillian , Hunter Montana , Paton Bryan , Abdolhoseini Mahmoud , Aziz Fayeem , Mellow Maddison L , Collins Clare , Murphy Karen J , Gratton Gabriele , Keage Hannah , Smith Ross T , Karayanidis Frini 
Published: January 2022

IntroductionApproximately 40% of late-life dementia may be prevented by addressing modifiable risk factors, including physical activity and diet. Yet, it is currently unknown how multiple lifestyle factors interact to influence cognition. The ACTIVate Study aims to (1) explore associations between 24-hour time-use and diet compositions with changes in cognition and brain function; and (2) identify duration of time-use behaviours and the dietary compositions to optimise cognition and brain function.Methods and analysisThis 3-year prospective longitudinal cohort study will recruit 448 adults aged 60–70 years across Adelaide and Newcastle, Australia. Time-use data will be collected through wrist-worn activity monitors and the Multimedia Activity Recall for Children and Adults. Dietary intake will be assessed using the Australian Eating Survey food frequency questionnaire. The primary outcome will be cognitive function, assessed using the Addenbrooke’s Cognitive Examination-III. Secondary outcomes include structural and functional brain measures using MRI, cerebral arterial pulse measured with diffuse optical tomography, neuroplasticity using simultaneous transcranial magnetic stimulation and electroencephalography, and electrophysiological markers of cognitive control using event-related potential and time frequency analyses. Compositional data analysis, testing for interactions between time point and compositions, will assess longitudinal associations between dependent (cognition, brain function) and independent (time-use and diet compositions) variables.ConclusionsThe ACTIVate Study will be the first to examine associations between time-use and diet compositions, cognition and brain function. Our findings will inform new avenues for multidomain interventions that may more effectively account for the co-dependence between activity and diet behaviours for dementia prevention.Ethics and disseminationEthics approval has been obtained from the University of South Australia’s Human Research Ethics committee (202639). Findings will be disseminated through peer-reviewed manuscripts, conference presentations, targeted media releases and community engagement events.Trial registration numberAustralia New Zealand Clinical Trials Registry (ACTRN12619001659190).
Impacts of COVID-19 and SARS-CoV-2 on male reproductive function: a systematic review and meta-analysis protocol
Authors: Li Xinyun , Lu Hua , Li Fangyuan , Zhang Qi , Wang Tong , Qiang Lingxia , Yang Qian 
Published: January 2022

IntroductionCOVID-19 pandemic caused by SARS-CoV-2 has become a global health challenge. SARS-CoV-2 can infect host cells via the ACE2 receptor, which is widely expressed in the corpus cavernosum, testis and male reproductive tract, and participates in erection, spermatogenesis and androgen metabolism. Also, the immune response and persistent fever resulting from COVID-19 may lead to damage of the testicular activity, consequently compromising male fertility.Methods and analysisPubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal database, Chinese Biomedical Databases and Wanfang Data will be systematically searched for observational studies (case–control and cohort) published up to March 2021 in English or in Chinese literature on the impacts of COVID-19 and SARS-CoV-2 on male reproductive function. This protocol will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and Meta-analysis of Observational Studies in Epidemiology. The primary outcome will be semen parameters, and the additional outcomes will include: (a) detection of SARS-COV-2 in semen, (b) male sexual hormones, (c) sperm DNA fragmentation index, (d) erectile function, (e) evaluation of testis and also the male genital tract. Two reviewers will independently extract data from the included studies based on a predesigned data extraction form. The risk of bias of included studies will be evaluated through the Newcastle-Ottawa Scale for observational studies. Review Manager software V.5.3 will be used for statistical analysis. Q statistic and I² test will be performed to assess the heterogeneity among studies. Sensitivity analysis will be used to explore the robustness of pooled effects. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.Ethics and disseminationEthical approval is not required and results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42021245161.
Nationwide evaluation of the advanced clinical practitioner role in England: a cross-sectional survey
Authors: Fothergill Lauren Jade , Al-Oraibi Amani , Houdmont Jonathan , Conway Joy , Evans Catrin , Timmons Stephen , Pearce Ruth , Blake Holly 
Published: January 2022

Background and study objectiveIn response to growing pressures on healthcare systems, the advanced clinical practice (ACP) role has been implemented widely in the UK and internationally. In England, ACP is a level of practice applicable across various healthcare professions, who exercise a level of autonomy across four domains, referred to as the four pillars of practice (education, leadership, research and clinical practice). A national framework for ACP was established in 2017 to ensure consistency across the ACP role, however current ACP governance, education and support is yet to be evaluated. This study aimed to analyse data from a national survey of the ACP role to inform the development and improvement of policies relating to ACP in the National Health Service (NHS) in England.DesignA cross-sectional survey with free-text comments.SettingThe survey was distributed across primary and secondary levels of care to three distinct groups in England, including individual ACPs, NHS provider organisations and Trusts and primary care settings.ParticipantsA total of 4365 surveys were returned, from ACP staff (n=4013), NHS provider organisations and Trusts (n=166) and primary care organisations (n=186).ResultsConsiderable variation was found in role titles, scope of practice, job descriptions and educational backgrounds of ACPs. Differing approaches to governance were noted, which led to inconsistent ACP frameworks in some organisations. A further challenge highlighted included committing time to work across the four pillars of advanced practice, particularly the research pillar. ACPs called for improvements in supervision and continuing professional development alongside further support in navigating career pathways.ConclusionsA standardised approach may support ACP workforce development in England and enable ACPs to work across the four pillars of practice. Due to the wide uptake of ACP roles internationally, this study has relevance across professions for global healthcare workforce transformation
Enhancing the learning and transfer of preprocedural communication skills during clerkship using audio-visual material: a prospective case-controlled study over 2 years
Authors: Chiang Dung-Hung , Chen Chung-Ting , Wang Tse-Yao , Yang Ying-Ying , Huang Chia-Chang , Li Tzu-Hao , Huang Shiau-Shian , Kao Shou-Yen , Chen Chen-Huan , Hou Ming-Chih , Sheu Wayne Huey-Herng 
Published: January 2022

Objective/design/settingThis study aims to develop preprocedural communication-specific framework that emphasises the use of audiovisual materials and compares its acceptability by trainees with a regular module.TraineesBetween October 2018 and July 2021, 96 medical clerks were enrolled and randomly divided into regular and intervention groups. Another 48 trainees whose did not join the framework-based training but complete self-assessments were enrolled as the control group.InterventionsIn the intervention training module, the key steps of preprocedural communication-specific skills were structuralised into a framework using the acronym of OSCAR.Primary and secondary outcome measuresThis study compared the acceptability of trainees for two modules by measuring the degree of increase in the end-of-rotation and follow up (4 weeks later) competency from baseline by trainees’ self-assessments and physician assessments after serial trainings.ResultsIn comparison with regular group trainees, greater degree of improvements (framework-1 statement: 111%±13% vs 27%±5%, p<0.001; framework-2 statement: 77%±9% vs 48%±2%, p<0.05; skill-1 statement: 105%±9% vs 48%±3%, p<0.001); skill-2 statement: 71%±11% vs 50%±9%, p<0.05) were noted in the framework-related and skill-related statement 1–2 (the familiarity and confidence to use the framework and skills) than those of intervention group. At the end-of-rotation stage, the trainees ability to use the ‘A-step: using audiovisual materials’ of the OSCAR was significantly improved (229%±13%, p<0.001), compared with other steps. In the intervention group, the degree of improvement of the end-of-rotation data of trainees’ self-assessment from baseline was significantly correlated with the degree of the improvement in physicians’ assessment data in the aspects of skills, framework and steps in framework (R=0.872, p<0.01; R=0.813, p<0.001; R=0.914, p<0.001).ConclusionsThe OSCAR framework-based intervention module is well accepted by medical clerks and motivates them to integrate the acquired skills in clinical practice, which leads to trainees’ primary care patients being satisfied with their preprocedural communication.
Hypertensive response to exercise in adult patients with repaired aortic coarctation
Authors: Meijs Timion A , Muller Steven A , Minderhoud Savine C S , de Winter Robbert J , Mulder Barbara J M , van Melle Joost P , Hoendermis Elke S , van Dijk Arie P J , Zuithoff Nicolaas P A , Krings Gregor J , Doevendans Pieter A , Spiering Wilko , Witsenburg Maarten , Roos-Hesselink Jolien W , van den Bosch Annemien E , Bouma Berto J , Voskuil Michiel 
Published: January 2022

ObjectiveThe clinical and prognostic implications of a hypertensive response to exercise after repair of coarctation of the aorta (CoA) remain controversial. We aimed to determine the prevalence of a hypertensive response to exercise, identify factors associated with peak exercise systolic blood pressure (SBP) and explore the association of peak exercise SBP with resting blood pressure and cardiovascular events during follow-up.MethodsFrom the Dutch national CONgenital CORvitia (CONCOR) registry, adults with repaired CoA who underwent exercise stress testing were included. A hypertensive response to exercise was defined as a peak exercise SBP ≥210 mm Hg in men and ≥190 mm Hg in women. Cardiovascular events consisted of coronary artery disease, stroke, aortic complications and cardiovascular death.ResultsOf the original cohort of 920 adults with repaired CoA, 675 patients (median age 24 years (range 16–72 years)) underwent exercise stress testing. Of these, 299 patients (44%) had a hypertensive response to exercise. Mean follow-up duration was 10.1 years. Male sex, absence of a bicuspid aortic valve and elevated resting SBP were independently associated with increased peak exercise SBP. Peak exercise SBP was positively predictive of office SBP (β=0.11, p<0.001) and 24-hour SBP (β=0.05, p=0.03) at follow-up, despite correction for baseline SBP. During follow-up, 100 patients (15%) developed at least 1 cardiovascular event. Peak exercise SBP was not significantly associated with the occurrence of cardiovascular events (HR 0.994 (95% CI 0.987 to 1.001), p=0.11).ConclusionsA hypertensive response to exercise was present in nearly half of the patients in this large, prospective cohort of adults with repaired CoA. Risk factors for increased peak exercise SBP were male sex, absence of a bicuspid aortic valve and elevated resting SBP. Increased peak exercise SBP independently predicted hypertension at follow-up. These results support close follow-up of patients with a hypertensive response to exercise to ensure timely diagnosis and treatment of future hypertension.
Vessel wall imaging with advanced flow suppression in the characterization of intracranial aneurysms following flow diversion with Pipeline embolization device
Authors: Raz Eytan , Goldman-Yassen Adam , Derman Anna , Derakhshani Ahrya , Grinstead John , Dehkharghani Seena 
Published: January 2022

BackgroundHigh-resolution vessel wall MRI (VWI) is increasingly used to characterize intramural disorders of the intracranial vasculature unseen by conventional arteriography.ObjectiveTo evaluate the use of VWI for surveillance of flow diverter (FD) treated aneurysms.Materials and methodsRetrospective study of 28 aneurysms (in 21 patients) treated with a FD (mean 57 years; 14 female). All examinations included VWI and a contemporaneously obtained digital subtraction angiogram. Multiplanar pre- and post-gadolinium 3D, variable flip-angle T1 black-blood VWI was obtained using delay alternating nutation for tailored excitation (DANTE) at 3T. 3D time-of-flight MR angiography (MRA) was also carried out. Images were assessed for in-stent stenosis, aneurysm occlusion, presence and pattern/distribution of aneurysmal or parent vessel gadolinium enhancement.ResultsThe VWI-MRI was performed on average at 361±259 days after the intervention. Follow-up DSA was performed at 338±254 days postintervention. Good or excellent black-blood angiographic quality was recorded in 22/28 (79%) pre-contrast and 21/28 (75%) post-contrast VWI, with no cases excluded for image quality. Aneurysm enhancement was noted in 24/28 (85.7%) aneurysms, including in 79% of angiographically occluded aneurysms and 100% of angiographically non-occluded aneurysms. Enhancement of the stented parent-vessel wall occurred significantly more often when aneurysm enhancement was present (92% vs 33%, p=0.049).ConclusionAdvanced VWI produces excellent depiction of FD-treated aneurysms, with robust evaluation of the parent vessel and aneurysm wall to an extent not achievable with conventional MRI/MRA. Gadolinium enhancement may, however, continue even after enduring catheter angiographic occlusion, confounding interpretation, and requiring cognizance of this potentially prolonged effect in such patients.
Ophthalmic artery angioplasty for age-related macular degeneration
Authors: Lylyk Ivan , Bleise Carlos , Lylyk Pedro N , Perez Nicolas , Lundquist Javier , Scrivano Esteban , Francone Anibal A , Charles Martin , Zompa Tamara , Lylyk Pedro 
Published: January 2022

BackgroundThere is considerable overlap of contributors to cardiovascular disease and the development of age-related macular degeneration (AMD). Compromised ocular microcirculation due to aging and vascular disease contribute to retinal dysfunction and vision loss. Decreased choroidal perfusion is evident in eyes with dry AMD and is thought to play a role in retinal pigment epithelial dysfunction, the rate of development of geographic atrophy, and the development of neovascularization. The aim of the study was to demonstrate that AMD is correlated with a compromised blood flow in the ocular pathway and show OA angioplasty as a potential treatment of late-stage AMD.MethodsBased on the potential for the ophthalmic artery (OA) to be an anatomical target for the treatment of AMD as outlined above, five patients were found to be eligible for compassionate use treatment, presenting clinically significant late-stage AMD with profound vision loss in one or both eyes, and are included in this retrospective study.ResultsOA narrowing, or significant calcium burden at the ophthalmic segment of the internal carotid artery compromising the origin of the OA was confirmed in all cases. Subsequent OA cannulation was achieved in all patients with some difficulty. Subjective patient reports indicated that all patients perceived a benefit following the procedure; however, improved postoperative visual acuity did not confirm that perceived benefit for one of the patients.ConclusionsFeasibility and safety of the OA angioplasty were demonstrated, and a benefit perceived in five patients with profound vision loss and a desire to achieve improved quality of life. A clinical trial with controlled schedule, imaging, and methodologies is needed to confirm these results.
Nickels and tines: the myth of nickel allergy in intracranial stents
Authors: Vanent Kevin N , Federico Emma M , Bass David I , Barros Guilherme , Keen Jade , Levitt Michael R 
Published: January 2022

BackgroundMost intracranial stents contain nickel alloy, and nickel allergy or hypersensitivity is common. Neurological injury following endovascular treatment with a nickel containing intracranial stent has been reported in patients with purported nickel allergy, but it is unclear whether these reactions represent true nickel hypersensitivity. We quantified nickel release from commonly used intracranial stents to investigate whether such stents should be avoided in patients with nickel allergy.MethodsWe examined nickel release from seven commonly used intracranial stents: Enterprise, LVIS Jr, Neuroform, Wingspan, Zilver, Pipeline Flex Embolization Device, and Surpass Evolve. We incubated each stent in human plasma-like media for 30 days. Dimethylglyoxime (DMG) spot testing was performed on each stent to detect released nickel at 0 and 30 days. Inductively coupled plasma–optical emission spectroscopy (ICP-OES) was then used to quantify the nickel concentration of the media at 30 days. Nickel currency and nickel standard for atomic absorption spectrometry were used as positive controls.ResultsDMG spot tests indicated nickel release only from nickel currency at 0 and 30 days of incubation. No nickel release was detected from any stent at 30 days using ICP-OES.ConclusionsNickel release from commonly used intracranial stents is negligible. These results suggest that previously reported hypersensitivity to these stents may be misattributed to nickel allergy, and that patients with nickel allergy may be safely treated with select nickel-containing stents.