bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting population health with machine learning: a scoping review
Authors: Morgenstern Jason Denzil , Buajitti Emmalin , O’Neill Meghan , Piggott Thomas , Goel Vivek , Fridman Daniel , Kornas Kathy , Rosella Laura C 
Published: October 2020

ObjectiveTo determine how machine learning has been applied to prediction applications in population health contexts. Specifically, to describe which outcomes have been studied, the data sources most widely used and whether reporting of machine learning predictive models aligns with established reporting guidelines.DesignA scoping review.Data sourcesMEDLINE, EMBASE, CINAHL, ProQuest, Scopus, Web of Science, Cochrane Library, INSPEC and ACM Digital Library were searched on 18 July 2018.Eligibility criteriaWe included English articles published between 1980 and 2018 that used machine learning to predict population-health-related outcomes. We excluded studies that only used logistic regression or were restricted to a clinical context.Data extraction and synthesisWe summarised findings extracted from published reports, which included general study characteristics, aspects of model development, reporting of results and model discussion items.ResultsOf 22 618 articles found by our search, 231 were included in the review. The USA (n=71, 30.74%) and China (n=40, 17.32%) produced the most studies. Cardiovascular disease (n=22, 9.52%) was the most studied outcome. The median number of observations was 5414 (IQR=16 543.5) and the median number of features was 17 (IQR=31). Health records (n=126, 54.5%) and investigator-generated data (n=86, 37.2%) were the most common data sources. Many studies did not incorporate recommended guidelines on machine learning and predictive modelling. Predictive discrimination was commonly assessed using area under the receiver operator curve (n=98, 42.42%) and calibration was rarely assessed (n=22, 9.52%).ConclusionsMachine learning applications in population health have concentrated on regions and diseases well represented in traditional data sources, infrequently using big data. Important aspects of model development were under-reported. Greater use of big data and reporting guidelines for predictive modelling could improve machine learning applications in population health.Registration numberRegistered on the Open Science Framework on 17 July 2018 (available at https://osf.io/rnqe6/).
Uncovering motivation and self-regulated learning skills in integrated medical MOOC learning: a mixed methods research protocol
Authors: Hendriks Renée A , de Jong Peter G M , Admiraal Wilfried F , Reinders Marlies E J 
Published: October 2020

IntroductionMassive Open Online Courses (MOOCs) are informal learning environments. Since a few years, MOOCs are being reused and integrated in formal medical education. However, what constitutes optimal integration is still unclear. In this mixed methods study protocol we describe how we will investigate three MOOC integration designs using the same MOOC.This study holds multiple objectives(1) Describe motivation profiles in medical students that learn in integrated MOOCs, and discern if motivation profiles are associated with specific MOOC integration designs; (2) investigate how psychological needs of medical students are satisfied or frustrated in different MOOC integration designs; (3) investigate the relationship between autonomous motivation to learn in an integrated MOOC and use of self-regulated
learning skills in that MOOC; (4) uncover processes that are involved in goal acceptance or rejection of medical students in integrated medical MOOC designs with assigned learning goals; and (5) identify obstacles medical students encounter when learning with assigned learning goals in integrated medical MOOCs.Methods and analysisObjectives 1 and 2 will be pursued with a cross-sectional study design, objective 3 with an observational cohort study design and objectives 4 and 5 with a qualitative interview study design. All medical students in one of three MOOC integration designs at Leiden University Medical Center (LUMC) will be invited to participate. Primary endpoints for objectives 1 and 2 are motivation profiles, and variety in need satisfaction and frustration. For objective 3 the primary endpoints are autonomous motivation and self-regulated online learning. For objectives 4 and 5 primary endpoints are process themes regarding goal acceptance or rejection, and perceived obstacles when working with assigned online learning goals.Ethics and disseminationThis study has been approved by the Educational Research Review Board of the LUMC. Planned dissemination of findings include three presentations at (inter)national conferences and three research articles.
The Brabant study: design of a large prospective perinatal cohort study among pregnant women investigating obstetric outcome from a biopsychosocial perspective
Authors: Meems Margreet , Hulsbosch Lianne , Riem Madelon , Meyers Christina , Pronk Tila , Broeren Maarten , Nabbe Karin , Oei Guid , Bogaerts Stefan , Pop Victor 
Published: October 2020

BackgroundPregnancy is characterised by many biological and psychosocial changes. Adequate maternal thyroid function is important for the developing fetus throughout gestation. Latent class analyses recently showed three different patterns of change in thyroid function throughout pregnancy with different associations with obstetric outcome. Maternal distress during the pregnancy (anxiety and depression) negatively affects obstetric outcome. Pregnancy distress in turn may be affected by personality traits and attachment styles. Moreover, during the pregnancy, substantial social changes occur in the partner relationship and work experience. The aim of the Brabant study is to investigate the association between thyroid function trajectories and obstetric outcomes. Moreover, within the Brabant study, we will investigate how different trajectories of pregnancy distress are related to obstetric outcome, and the role of personality in this association. We will evaluate the possible role of maternal distress and attachment style on maternal–fetal bonding. Finally, we will study social changes in the perinatal period regarding partner relationship and well-being and performance at work.Methods and analysisThe Brabant study is a longitudinal, prospective cohort study of an anticipated 4000 pregnant women. Women will be recruited at 8–10 weeks gestation among community midwife practices in South-East Brabant in the Netherlands. Thyroid function parameters (TSH and fT4), thyroid peroxidase antibody and human chorionic gonadotrophin will be assessed at 12, 20 and 28 weeks gestation. Moreover, at these three time points women will fill out questionnaires assessing demographic and obstetric features, life style habits and psychological and social variables, such as depressive symptoms, personality, partner relationship quality and burnout. Data from the obstetric records will also be collected.Ethics and disseminationThe study has been approved by the Medical Ethical Committee of the Máxima Medical Center Veldhoven. Results will be submitted to peer-reviewed journals in the relevant fields and presented on national and international conferences.
Impact of involving people with dementia and their care partners in research: a qualitative study
Authors: Miah Jahanara , Parsons Suzanne , Lovell Karina , Starling Bella , Leroi Iracema , Dawes Piers 
Published: October 2020

ObjectivesWe aimed to evaluate the impact of patient and public involvement (PPI) at each stage of the research cycle in a dementia research programme.DesignWe used monitoring forms to record the impact of the research programme’s PPI at different stages of research and qualitative interviews with all participants to evaluate the impact of PPI.SettingWe evaluated Research User Groups (RUGs—older people with dementia and care partners) which were established to provide PPI support for the research programme in multiple European sites.ParticipantsWe purposively sampled RUG members (n=34) and researchers (n=13) who had participated in PPI activities. Inclusion criteria for the study were: (a) RUG members who had participated in the research awareness training and in PPI activities and had the capacity to consent; (b) researchers who involved RUGs in their work.ResultsImpact on the research: changes to the study conduct were made as a result of the feedback from RUGs. These included prioritisation of clinical recommendations, the wording of study information and recruitment materials, the content and layout of the user interface for a computerised memory test, interpretation of intervention results and advice on dissemination avenues. Impact on RUG members: they reported that involvement had given them a sense of purpose and satisfaction. Their perception of health research changed from being an exclusive activity to one, which lay people, could have meaningful involvement. Impact on researchers: PPI was a new way of working and interacting with PPI members had given them insight into the impact of their work on people living with dementia.ConclusionsPPI can have a substantial impact on dementia research and the people involved in the research. To justify the time and expense of PPI, the advantageous practical impacts of PPI should be systematically recorded and consistently reported.
How do patients and general practitioners in Denmark perceive the communicative advantages and disadvantages of access via email consultations? A media-theoretical qualitative study
Authors: Grønning Anette , Assing Hvidt Elisabeth , Nisbeth Brøgger Matilde , Fage-Butler Antoinette 
Published: October 2020

ObjectiveEmail consultations have become part of everyday doctor–patient communication in many countries. The objective of this study is to investigate how patients and general practitioners (GPs) perceive the communicative advantages and disadvantages of access via email consultation drawing on a media-theoretical perspective.DesignWe analysed qualitative interview data from general practices in Denmark to identify salient themes.ParticipantsOur data set consists of semi-structured interviews with 30 patients and 23 GPs. The data were collected from February 2016 to September 2019.ResultsThe following themes emerged: (1) lower contact threshold, (2) accessing a new interaction space and (3) access to access. From the patients’ perspective, email consultations provided more convenient contact with their GP. From the GPs’ perspective, email consultations facilitated contact with patients whom they otherwise rarely saw, but also resulted in overuse and inappropriate use. Patients and GPs considered email consultations as inviting new interactions, facilitating also communication about emotional and sensitive issues. Both patients and GPs experienced email consultations as a way in which patients could achieve easier access to face-to-face consultations (access to access).ConclusionDrawing on a media perspective, this study adds knowledge of how the potentials of the medium of email consultations are perceived by GPs and patients. Email consultations do not simply extend existing forms of contact and consultation (face-to-face and telephone); they produce a new communication space with its own possibilities which result in new practices. With increasing use of email consultations, there may be challenges involved in transferring GP–patient communication to the written medium.
Effect of female sex work-targeted community-based interventions along the HIV treatment cascade in sub-Saharan Africa: a systematic review protocol
Authors: Atuhaire Lydia , Adetokunboh Olatunji , Shumba Constance , Nyasulu Peter S 
Published: October 2020

IntroductionFemale sex workers (FSWs) are a known high-risk group that are at increased risk of HIV transmission due to exposure to multiple sexual partners and inability to negotiate safe sex attributed to challenging economic circumstances. Previous systematic reviews have examined the effectiveness of HIV interventions prioritising FSWs and have shown that targeted interventions improve access to HIV prevention and treatment services. Interventions that increase FSWs’ uptake of services are well documented; however, evidence on specific interventions aimed at improving FSWs’ continuity in HIV care along the treatment cascade is lacking. This systematic review aims to document the performance of community-based interventions along the HIV treatment cascade.Methods and analysisWe will use a sensitive search strategy for electronic bibliographic databases, bibliographies of included articles and grey literature sources. In addition, the Joint United Nations Programme on HIV/AIDS and the WHO websites, peer-reviewed conference papers and grey literature sources will be searched for additional reports of sex work programmes. We will include randomised controlled trials, cross-sectional surveys and cohort interventions where community-based HIV services were provided to FSWs and measure the performance of the HIV intervention on one or more cascade stages. We will conduct a systematic review of studies published from 2004 to present within the sub-Saharan Africa region. We will report quantitative study outcomes of HIV testing and diagnosis, linkage to care, initiation on antiretroviral therapy and viral suppression. We will analyse the data using the random-effects meta-analysis method, and funnel plots will be used to assess the publication bias.Ethics and disseminationThis systematic review will not require ethical approval; we will publish data from manuscripts. The results of this study will be disseminated in peer-reviewed journals and conference presentations.PROSPERO registration numberCRD42020157623.
Effectiveness of the e-Tabac Info Service application for smoking cessation: a pragmatic randomised controlled trial
Authors: Affret Aurélie , Luc Amandine , Baumann Cédric , Bergman Pierre , Le Faou Anne-Laurence , Pasquereau Anne , Arwidson Pierre , Alla François , Cambon Linda 
Published: October 2020

ObjectiveTo compare the effectiveness of the mobile e-Tabac Info Service (e-TIS) application (app) for helping adult smokers quit smoking with current practices.DesignPragmatic randomised controlled trial with a 1-year follow-up (2017–2018).SettingFrance, population-wide level.Participants2806 adult smokers who wished to quit smoking were recruited via the website of the French National Mandatory Health Insurance fund. Of them, 1400 were randomised to the e-TIS app arm and 1406 were randomised to the current practices arm (control).InterventionThe app involved personalised interactive contacts that included questionnaires, advice, activities and text messages. All contacts were individually tailored and based on each smoker’s progress.In the control group, recommended practices for quitting smoking were described on a non-interactive website.Primary and secondary outcomes measuresThe primary outcome was 7-day point prevalence abstinence (PPA) at 6 months. The secondary outcomes included continuous abstinence rates at 6 and 12 months, minimum 24-hour point abstinence at 3 months, minimum 30-day point abstinence at 12 months and number and duration of quit attempts.ResultsThere was no difference between the e-TIS and control arms for the primary outcome (12.6% vs 13.7% for 7-day PPA at 6 months, p=0.3949, intention-to-treat analysis). However, e-TIS participants with high levels of exposure to the app, which was defined by the completion of at least eight activities or questionnaires, showed higher rates of smoking cessation than the control participants (17.6% vs 12.9% for 7-day PPA at 6 months, p=0.0169, per-protocol analysis).ConclusionUse of the e-TIS app was not associated with a higher rate of smoking cessation. However, high level of exposure to the e-TIS app may have been more effective than current practices.Trial registration numberNCT02841683.
Determinants of treatment non-attendance among those referred to primary mental health care services in Western Sydney, Australia: a retrospective cohort study
Authors: Munasinghe Sithum , Page Andrew , Mannan Haider , Ferdousi Shahana , Peek Brendan 
Published: October 2020

ObjectivesRecommendations of the recent mental health reforms provided an opportunity to implement regional approaches to service provision through Primary Health Networks. This study is designed to identify the determinants of sociodemographic, diagnostic and referral-level factors and first treatment session non-attendance among those referred to primary mental health care (PMHC) services in Western Sydney, Australia.DesignThis study used routinely collected retrospective PMHC data between July 2016 and December 2018.SettingThe study was based on a geographical catchment that covers four local government areas of Blacktown, Parramatta, Cumberland and Hills Shire in Western Sydney, Australia.ParticipantsAll individuals 5 years of age or older referred to PMHC services.Primary outcome measureFirst treatment session non-attendance, following a referral to receive psychological treatments.ResultsThere were 9158 referrals received for 8031 clients, with 1769 (19.32%) referrals resulting in non-attendance to the first treatment session. Those with younger age (ORs ranging from 1.63 to 1.92), substance use (OR=1.55, 95% CI 1.17 to 2.06), poor English proficiency (OR=1.64, 95% CI 1.23 to 2.20), lower socioeconomic status (OR=1.57, 95% CI 1.34 to 1.83), psychotropic medication use (OR=1.20, 95% CI 1.06 to 1.36), and a referral by a social worker (OR=2.04, 95% CI 1.36 to 3.05), allied health (OR=1.49, 95% CI 1.03 to 2.16) or other professional (OR=1.72, 95% CI 1.30 to 2.29) were associated with a higher likelihood of first treatment session non-attendance. Those with a risk of suicide, who mainly speak a language other than English, and a previous use of PMHC services were more likely to attend their first treatment session.ConclusionYouth-specific treatment approaches, behavioural engagement strategies, facilitation of transport services for those live in deprived regions and improvements in capacity for mental health training among allied health professionals are areas of focus for primary care service and policy responses.
COVID-19 and ‘immune boosting’ on the internet: a content analysis of Google search results
Authors: Rachul Christen , Marcon Alessandro R , Collins Benjamin , Caulfield Timothy 
Published: October 2020

ObjectiveThe spread of misinformation has accompanied the coronavirus pandemic, including topics such as immune boosting to prevent COVID-19. This study explores how immune boosting is portrayed on the internet during the COVID-19 pandemic.DesignContent analysis.MethodsWe compiled a dataset of 227 webpages from Google searches in Canada and the USA using the phrase ‘boost immunity’ AND ‘coronavirus’ on 1 April 2020. We coded webpages for typology and portrayal of immune boosting and supplements. We recorded mentions of microbiome, whether the webpage was selling or advertising an immune boosting product or service, and suggested strategies for boosting immunity.ResultsNo significant differences were found between webpages that appeared in the searches in Canada and the USA. The most common types of webpages were from news (40.5%) and commercial (24.7%) websites. The concept of immune boosting was portrayed as beneficial for avoiding COVID-19 in 85.5% of webpages and supplements were portrayed as beneficial in 40% of the webpages, but commercial sites were more likely to have these portrayals. The top immune boosting strategies were vitamin C (34.8%), diet (34.4%), sleep (34.4%), exercise (30.8%) and zinc (26.9%). Less than 10% of the webpages provide any critique of the concept of immune boosting.ConclusionsPairing evidence-based advice for maintaining one’s health (eg, healthy diet, exercise, sleep) with the phrase immune boosting and strategies lacking in evidence may inadvertently help to legitimise the concept, making it a powerful marketing tool. Results demonstrate how the spread of misinformation is complex and often more subtle than blatant fraudulent claims.
What are the volume and budget needs to provide chemotherapy to all children with acute lymphoblastic leukaemia in Thailand? Development and application of an estimation tool
Authors: Sruamsiri Rosarin , Ferrario Alessandra , Ross-Degnan Dennis , Denburg Avram E , Frazier A Lindsay , Gupta Sumit , Ward Zachary J , Yeh Jennifer M , Wagner Anita Katharina 
Published: October 2020

ObjectiveInsufficient access to anticancer medicines may contribute to the wide survival differences of children with cancers across the globe. We developed a tool to estimate the volume of medicines and budget requirements to provide chemotherapy to children with acute lymphoblastic leukaemia (ALL).DesignDevelopment and application of an estimation tool.SettingPaediatric oncology hospital departments in Thailand.Participants318 children aged 0–14 years diagnosed with ALL and 215 children with undiagnosed ALL.InterventionsEstimates of volume and budget requirements for administering a full course of chemotherapy for ALL and a further course for children who relapse, according to National Treatment Guidelines.Primary and secondary outcome measuresPrimary outcome measures were the volume (mg) and cost (US$) of medicines needed to treat children with ALL. For medicines whose main indication is paediatric ALL (asparaginase and 6-mercaptopurine), we estimated the difference between volume needed and actual sales in 2017 (secondary outcome).ResultsTen anticancer medicines and four chemoprotective agents are needed for the treatment of paediatric ALL according to the Thai treatment guidelines. Of these 14 medicines, 13 are included in the WHO essential medicines list for children. All are available as generics. We estimated that essential chemotherapy and chemoprotective agents to treat all children diagnosed with ALL in Thailand in 2017 would cost US$ 814 952 (US$ 1 365 422 for diagnosed and undiagnosed children), which corresponds to 0.005% (0.008%) of the country’s total health expenditure. The volumes of asparaginase and 6-mercaptopurine available on the Thai market in 2017 were more than sufficient (2.3 and 1.5 times the amounts needed, respectively) to treat all children diagnosed with ALL.ConclusionsProcuring sufficient quantities of essential medicines to treat children with ALL requires relatively modest resources. Medicine cost should not be a major barrier to ALL treatment in similar settings.
Telephone clinic improves gluten-free dietary adherence in adults with coeliac disease: sustained at 6 months
Authors: Muhammad Humayun , Reeves Sue , Ishaq Sauid , Mayberry John Francis , Jeanes Yvonne Margaret 
Published: October 2020

BackgroundA gluten-free (GF) diet is the only treatment for coeliac disease (CD), non-adherence to the diet is associated with greater morbidity. The study aimed to examine the effect of a telephone clinic, designed to increase GF dietary knowledge and adherence, in adults with CD.MethodsA prospective study of 125 patients with histologically confirmed CD. Patients, not adhering to a GF diet (n=30), engaged in a personalised telephone clinic. Validated questionnaires were used to assess GF dietary adherence (Coeliac Disease Adherence Test; CDAT), knowledge of GF foods and CD-related quality of life (QoL). GF dietary adherence was assessed up to 12 months post telephone clinic. The control group completed the questionnaires only.ResultsGF dietary adherence (CDAT) median scores significantly improved at 3 and 6 months after the telephone clinic compared with baseline (16, 13 and 13, respectively, p<0.01). Reassuringly, the dietary burden QoL score remained similar to baseline values. No change in CDAT scores were observed in the control group. Change in GF dietary knowledge score was associated with improved GF dietary adherence CDAT score (r=−0.22; p=0.039). At 9 and 12 months, CDAT scores were similar to baseline values.ConclusionsTelephone clinics have a positive impact on dietary knowledge and GF dietary adherence in adults with CD, promoting health-benefitting behaviours in those previously not adhering to a GF diet. The study highlights the need for patients to have regular follow-up, with targeted reviews for those not adhering to a GF diet.