bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEARER SCAN (LENO BESIK) evaluation of a task-sharing echocardiographic active case finding programme for rheumatic heart disease in Australia and Timor-Leste: protocol for a hybrid type II effectiveness-implementation study
Authors: Jones Benjamin , Marangou James , Yan Jennifer , Ralph Anna , Mitchell Alice , Kaethner Alex , Remenyi Bo , Wade Vicki , Katzenellenbogen Judith M , Monteiro Anferida Fernandes , Cannon Jeffrey W , Howard Natasha J , Gilles Marisa , Haynes Emma , Seixas Herculano , Maurays Joaquina , Neave Jade , Pears Chantelle , Engelman Daniel , Canuto Karla , Steer Andrew , Unger Holger , Bailey Meghan , Tanesi Maria , Amaral Salvador , Neto Helder , Stewart Maida , Burgess Paul , Brown Alex , Currie Bart J , Hillis Graham , Morris Peter , Simon David , Wheaton Gavin , Williamson Jacqui , de Dassel Jessica , Slota-Kan Simon , Carapetis Jonathan , English Mike , Nagraj Shobhana , Francis Joshua R 
Published: October 2024

IntroductionRheumatic heart disease (RHD) is underdiagnosed globally resulting in missed treatment opportunities and adverse clinical outcomes. We describe the protocol for a study which aims to co-design, implement and conduct an evaluation of a task-sharing approach to echocardiographic active case finding for early detection and management of RHD in high-risk settings in Australia and Timor-Leste.Methods and analysisEchocardiograms will be obtained by trained local staff using hand-held echocardiographic devices employing the ‘Single Parasternal Long Axis view with a Sweep of the Heart’ (SPLASH) technique and interpreted by experts remote from the site of acquisition. Approximately 1500 children and pregnant women will be screened across high-risk communities in Australia and Timor-Leste over an 18-month period. The study will use a type II effectiveness-implementation hybrid design. A tailored package of implementation strategies will be co-designed with communities and health services and mapped onto a Theory of Change framework. The clinical effectiveness will be assessed as the change in the proportion of the target population that are prescribed secondary prophylaxis for RHD by the end of the study compared with baseline. The implementation will be assessed as the adoption, penetration, sustainability, fidelity and cost of the programme with a mixed-methods theory-based and economic evaluation. Data will include numbers of normal, abnormal and uninterpretable SPLASH echocardiograms obtained, numbers of participants progressing through the cascade of care, interviews with staff and programme costs.Ethics and disseminationEthical approval has been obtained from the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, Darwin (HREC-2022-4479), the Western Australian Aboriginal Health Ethics Committee (HREC-1237) and the Instituto Nasional Saude Publika Timor-Leste Ethics and Technical Committee (03-UEPD/INSP-TL/V/2023). Informed consent is required to be enrolled. Study findings will be disseminated in the communities involved and submitted for publication.Trial registration numberNCT06002243.
Impact of dual sensory impairment on the risk of incident dementia: a protocol for a systematic review and meta-analysis
Authors: Giannoni-Luza Stefano , Urso Daniele , Alaoui Ahmed Amine , Ting Jeremy , Jabbour Samir , Fuente Adrian 
Published: October 2024

IntroductionStrong evidence supports the importance of potentially modifiable risk factors for dementia, with sensory loss, particularly visual and hearing impairment, being prominent among them. While single sensory impairment has been widely investigated, the influence of concomitant visual and hearing impairment is still not clear. Thus, in this systematic review, we aim to evaluate the risk of developing all-cause dementia due to dual sensory (visual and hearing) impairment and to comprehensively explore possible sources of heterogeneity.Methods and analysisThis protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement and has been registered on the PROSPERO international prospective register of systematic reviews. Our literature search will include two databases: MEDLINE-PubMed and Embase. The search strategy will consist of terms tailored for each database. We will include peer-reviewed longitudinal cohort studies reporting HRs. Screening and selection of articles will be performed independently by at least two reviewers using the Covidence systematic review manager. Discrepancies will be resolved by consensus. Data will be collected on study design, location, study setting, follow-up years, baseline demographics, sensory impairment and dementia diagnosis ascertainment, and number of adjusted covariates. The quality of the included studies will be evaluated using the Newcastle-Ottawa Scale for cohort studies. If meta-analysis is possible, we will perform DerSimonian-Laird random-effects models of HRs using the most adjusted model from each study. Subgroup analyses and meta-regressions are planned as a function of study setting, geographical location, sensory impairment and dementia diagnosis ascertainment, follow-up years and number of adjusted covariates.Ethics and disseminationEthical approval is not required because this study involves data already published by other authors. Our findings will be disseminated by a peer-reviewed publication and presentations at relevant scientific conferences. The results will support the understanding of dementia’s modifiable risk factors and may motivate the development of screening interventions to prevent dementia.PROSPERO registration numberCRD42023493401.
Social media influencers in the space of pregnancy and parenting: a scoping review protocol
Authors: Hives Lucy , Bray Emma P , Nowland Rebecca , Thomson Gill 
Published: October 2024

IntroductionSocial media influencers (SMIs) are popular sources of online information on various topics, including many aspects of health. Recently, there has been an upsurge in SMIs creating content about pregnancy and parenting, including from midwives, pregnant women and parents. Despite its popularity, SMI content on pregnancy and parenting is not currently regulated, which allows for misinformation and potential harm to women and their children. Research has also found that most women do not discuss the information they access online with their healthcare providers.This is the first scoping review to map the existing evidence on SMIs in the context of pregnancy and early parenting.Methods and analysisThe scoping review will be conducted from May to December 2024 and reported using guidance from Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. 10 academic databases will be searched for relevant studies, using keywords and subject headings for the concepts of “social media”, “influencers”, “pregnancy” and “parenting.” All primary and secondary research studies of pregnancy and early parenting SMIs will be included. Two authors will screen the identified studies for eligibility. The risk of bias of the included studies will not be assessed. Extracted data will be presented in tables and will be described narratively.Ethics and disseminationEthical approval was not needed for this scoping review. Results will be published in a peer-reviewed journal, presented at conferences, posted on social media and presented to relevant groups.Registration detailsThe review is registered with the Open Science Framework (https://osf.io/7v4qbhttps://osf.io/7v4qb)
Exploring the application status of qualitative studies in the research area of acupuncture: a scoping review protocol
Authors: Xie Yana , Ji Bo , Liu Cuiting , Fang Yang , Guo Tingting , Quan Ye , Xie Yixuan , Dai Jian 
Published: October 2024

IntroductionWith the wide development of acupuncture clinical practice, acupuncture research has been conducted worldwide, of which the most common method is quantitative study. However, research questions around acupuncture cannot always be addressed by quantitative studies due to their intrinsic characteristics. Qualitative studies can perfectly complement this knowledge gap in acupuncture research. To date, few qualitative studies on acupuncture research have been summarised. The objective of this scoping review is to review the application status of qualitative studies in the field of acupuncture research.MethodsIn accordance with the framework put forward by Arksey and O'Malley, this proposed scoping review (registration DOI:https://doi.org/10.17605/OSF.IO/VYBMT) will be applied as the following steps: (1) identifying the research questions, (2) identifying relevant studies, (3) study selection, (4) charting the data and (5) collating, summarising and reporting the results. Six databases with Google Scholar and Baidu Scholar will be searched with a comprehensive searching strategy, and two reviewers finishing uniform training and pilot test will independently screen the potential literature to include eligible ones. Endnote 20 will be used to manage the literature; a predesigned, standardised Excel sheet will be used to load all information extracted. Findings of this scoping review will be reported and described in a narrative manner. Tables, charts or figures will be used to present the results and qualitative content analysis and thematic analysis based on grounded theory will be adopted to analyse the data. We initiated our search on 13 March 2024.Ethics and disseminationAs scoping reviews are a form of secondary data analysis, ethical review is not required. Our research results will provide future research direction for qualitative studies of acupuncture and be disseminated through a peer-reviewed publication and related scientific conferences.
Embedding the ‘CoolCuddle’ intervention for infants undergoing therapeutic hypothermia for hypoxic-ischaemic encephalopathy in NICU: an evaluation using normalisation process theory
Authors: Beasant Lucy , Chakkarapani Ela , Horwood Jeremy , Odd David , Stocks Stephanie , Parker Denise , Ingram Jenny 
Published: October 2024

ObjectivesNewborn infants exposed to lack of oxygen and blood flow to the brain around birth may develop brain dysfunction (hypoxic-ischaemic encephalopathy—HIE). These infants undergo 72 hours of cooling therapy and most are not held by their parents in the UK. We examined the implementation of ‘CoolCuddle’, identifying factors that impact embedding of this complex intervention in neonatal intensive care units (NICUs) across England.DesignProcess evaluation and qualitative study using a standard questionnaire and interviews. Normalisation Process Theory (NPT) core constructs were used to assess relevant issues to staff embedding ‘CoolCuddle’, to discern change over time and different settings. Qualitative interviews provided valuable contextual exploration of implementation.Setting and participantsSix tertiary NICUs in England. Thirty-seven families with a newborn baby undergoing cooling therapy for HIE were recruited from September 2022 to August 2023; 17 NICU staff Normalisation MeAsure Development (NoMADs) at six NICUs over 6 months were included; 14 neonatal/research nurses from three participating NICUs were interviewed.InterventionThe family-centred intervention ‘CoolCuddle’ was developed to enable parents to hold their infant during cooling, without affecting the cooling therapy or intensive care.Outcome measuresNoMAD questionnaires at three timepoints over 6 months and NPT informed qualitative interviews.ResultsNoMAD questionnaires at baseline showed more variation between units, for intervention acceptability, than those at 3 and 6 months. Qualitative data highlighted that staff understood the benefits of CoolCuddle but were apprehensive due to perceived risks involved in moving cooling babies. A rigorous standard operating procedure was flexible enough to incorporate the use of local processes and equipment and provided the relevant procedural knowledge to deliver CoolCuddle safely.ConclusionsThe CoolCuddle intervention can be implemented safely under the supervision of standard neonatal teams as part of usual practice in diverse NICU settings in England. The importance of having a rigorous standard operating procedure, which can be adapted to support local settings, is highlighted.Trial registration numberISRCTN10018542; Results: registered on 30 August 2022.
Evaluation of an electronic clinical decision support algorithm to improve primary care management of acute febrile illness in rural Cambodia: protocol for a cluster-randomised trial
Authors: Chew Rusheng , Wynberg Elke , Liverani Marco , Rekol Huy , Nguon Chea , Dysoley Lek , Vanna Moul , Callery James John , Mishra Abhijit , Adhikari Bipin , Tripura Rupam , Chandna Arjun , Fegan Greg , Waithira Naomi , Maude Richard James , Day Nicholas P J , Peto Thomas Julian , Lubell Yoel 
Published: October 2024

IntroductionAcute febrile illness (AFI), traditionally attributed to malaria, is a common reason for seeking primary healthcare in rural South and Southeast Asia. However, malaria transmission has declined while health workers are often poorly equipped to manage non-malarial AFIs. This results in indiscriminate antibiotic prescribing and care escalation, which promotes antibiotic resistance and may increase healthcare costs. To address this problem, an electronic clinical decision support algorithm (eCDSA) called ‘Electronic clinical Decision support for Acute fever Management (EDAM)’ has been developed for primary health workers which integrates clinical, epidemiological and vital sign data with simple point-of-care tests to produce a diagnosis and management plan.Methods and analysisThis is a pragmatic cluster-randomised trial aiming to assess the effect of EDAM and related training on antibiotic prescribing rates in rural Cambodian primary health centres (PHCs) as the primary outcome, along with a range of secondary outcomes including safety. Patients with AFI are eligible for recruitment if they are aged ≥1 year. A cluster is defined as a PHC and PHCs will be randomised to control (standard of care) and intervention (EDAM and associated training) arms, with 15 PHCs per arm. Patients will be followed up after 7 days to ascertain the safety profile of EDAM. Each PHC will recruit 152 patients (total 4560), based on a baseline antibiotic prescription rate of 25% and expected reduction to 17.5% with EDAM.Ethics and disseminationResults will be published in international peer-reviewed journals to inform the design of future versions of EDAM and of future trials of similar eCDSAs and other digital health interventions targeted towards rural populations. This study was approved by the Oxford University Tropical Research Ethics Committee (550-23) and the Cambodian National Ethics Committee for Health Research (395-NECHR).Trial registration numberInternational Standard Randomized Controlled Trial Number Registry (ISRCTN15157105).
Real-world usage pattern, effectiveness and safety of oral tramadol/dexketoprofen trometamol fixed-dose combination in moderate-to-severe acute pain in Asia: a prospective, multicentre, observational study
Authors: Ho Kok Yuen , Gyanwali Bibek , Dimayuga Cesar , Eufemio Edgar Michael , Bernardo Edwin , Raju Gopinathan , Chong Keen Wai , Waithayayothin Kritsadakorn , Ona Leonardo , Castro Marc Anthony L , Sawaddiruk Passakorn , Salvador Roehl C , Roohi Sharifah Ahmad , Tangwiwat Suwimon , Wilairatana Vajara , Oon Zhi Hao , Gupta Ankur , Nagrale Dinesh 
Published: October 2024

ObjectivesThis study aims to determine the usage pattern, effectiveness and safety of oral tramadol 75 mg and dexketoprofen trometamol 25 mg fixed-dose combination (TRAM/DKP FDC) in the short-term treatment of moderate-to-severe acute pain in real-world clinical practice in Asia.DesignReal-world, prospective, multicentre, observational, phase IV study.Setting13 tertiary-care hospital sites across the Philippines, Thailand, Malaysia and Singapore.ParticipantsAdult patients aged 18–80 years prescribed TRAM/DKP FDC for the short-term (up to 5 days) treatment of moderate-to-severe acute pain.Main outcome measuresPrimary endpoints were the proportion of patients prescribed TRAM/DKP FDC with different types of postsurgical and non-surgical treatments, and the average dosing frequency and duration of TRAM/DKP FDC treatment. Secondary endpoints were the proportion of patients achieving ≥30% pain reduction at 8 hours post the first dose (pain severity was assessed using the 11-point Numeric Pain Rating Scale); patient satisfaction at the end of treatment (based on a 5-point Patient Global Evaluation Scale (PGE)) and safety including the incidence of adverse drug reactions (ADRs).ResultsAmong 599 patients (median age 44 years, 61.3% female) enrolled in this study, 68.61% (n=411) were postsurgical and 31.39% (n=188) were non-surgical patients. TRAM/DKP FDC was prescribed in a diverse group of postsurgical patients (eg, orthopaedic, general and cancer surgery) as well as in non-surgical conditions (eg, lower back pain and musculoskeletal pain). In the majority of patients, TRAM/DKP FDC was prescribed every 8 hours (65.94%) and for 5 days (78.80%). There was a significant reduction in pain intensity throughout the study and 65% of patients achieved ≥30% pain reduction from baseline at 8 hours post the first dose of TRAM/DKP FDC on day 1. 95.69% of patients were satisfied with the treatment (rated good, very good and excellent on the PGE scale). Overall, 13.9% of patients reported ADRs; most were mild to moderate in severity. The most common ADRs were nausea, vomiting and dizziness.ConclusionThis study showed that TRAM/DKP FDC was used in diverse types of postsurgical and non-surgical patients in the real-world setting in Asia. It effectively reduced pain and was well tolerated with a high level of patient satisfaction.
Exploring virtual delivery of academic detailing to general practitioners compared with in-person delivery: a qualitative study
Authors: Garcia Beate Hennie , Langaas Harald Christian , Jahnsen Jan Anker , Schjøtt Jan , Nilsen Terje , Lehnbom Elin Christina 
Published: October 2024

BackgroundInappropriate prescribing may have detrimental consequences for the patient and increase healthcare utilisation and costs. Academic detailing (AD) is an interactive outreach method to deliver non-commercial evidence-based medical information to healthcare professionals, aiming to improve patient care. Performing AD virtually has recently become more relevant, especially with the COVID-19 pandemic.ObjectivesThe aim of this study was to explore general practitioners’ (GP’s) experiences and perceptions of virtually delivered AD.MethodsWe invited practicing GPs that had received virtual AD in Norway during autumn 2020. Semistructured individual interviews were audio and video recorded during February–May 2021. Interviews were transcribed and analysed applying thematic analysis according to Braun and Clarke.ResultsFrom interviews with nine GPs, we identified five themes concerning (1) informants’ satisfaction with virtual AD and their opinions about the detailers and their characteristics, (2) factors that are important for participation in AD, with the campaign topic being the most important, (3) a paradox between the informants’ desire for more time for discussion and the time constraint they are facing, (4) the many benefits of virtual AD compared with in-person AD and (5) the informants’ perceived learning outcomes are unaffected by mode of AD delivery.ConclusionVirtual AD worked very well in terms of scheduling the visit, using technology to facilitate the visit and achieving the same learning outcomes. Virtual AD should be offered to GPs as an alternative to the traditional in-person AD, especially in remote geographical areas or in circumstances when physical outreach is challenging.
Retrospective analysis of volumes of manually expressed colostrum among healthy postnatal mothers at a tertiary care referral unit in South India. Not enough milk or not enough patience?
Authors: Nyamagoudar Anita H , Kannur Netra S , Chavan Vinod , Kulkarni Vijay 
Published: October 2024

IntroductionThe volumes of colostrum have been quantified as 5 mL and 25 mL per feed on days 1 and 3, respectively, as per the data described about 20 years ago. However, the use of commercial formula is on the rise and ‘not enough milk’ is a common complaint by postnatal mothers.ObjectivesTo determine the average volume of colostrum in one sitting per day on first three postnatal days among healthy late preterm and term gestational mothers and to compare the same among late preterm, term gestation and modes of delivery.DesignRetrospective study.SettingA tertiary care perinatal setting in South India.PatientsHealthy late preterm and term gestational mothers whose babies were roomed in.InterventionsA lactation consultant helped the mothers manually express breast milk.Main outcome measuresVolumes of manually expressed colostrum on first three postnatal days.ResultsOf the 391 mothers analysed in the study, on first three postnatal days, the average volume of colostrum in one sitting each was 4.68 mL, 8.87 mL and 22.53 mL, respectively. There was no statistically significant difference in volumes of colostrum secreted among term and late preterm mothers and also among mothers with different modes of delivery. As anticipated, multiparous mothers expressed significantly higher volumes as compared with primiparous mothers, on all three postnatal days.ConclusionsThe volumes of colostrum on first three postnatal days among healthy mothers were comparable with traditional volumes described about two decades ago. Gestational age and mode of delivery did not affect the volumes of colostrum in the present cohort.
Career duration and later-life health conditions among former professional American-style football players
Authors: Grashow Rachel , Tan Can Ozan , Thomas Julius Dewayne , DiGregorio Heather , Lee Hang , Rotem Ran S , Marengi Dean , Terry Douglas P , Eagle Shawn R , Iverson Grant L , Whittington Alicia J , Zafonte Ross D , Weisskopf Marc G , Baggish Aaron L 
Published: October 2024

ObjectivesCareer duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised.MethodsWe conducted a survey-based cross-sectional cohort study of former professional ASF players. Flexible regression methods measured associations between self-reported career duration and four self-reported health conditions: pain, arthritis, mood and cognitive symptoms. We also measured associations between career duration and four self-reported ASF exposures: prior concussion signs and symptoms (CSS), performance enhancing drugs, intracareer surgeries and average snaps per game. Models were adjusted for age and race.ResultsAmong 4189 former players (52±14 years of age, 39% black, 34% lineman position), the average career length was 6.7±3.9 professional seasons (range=1–20+). We observed inverted U-shaped relationships between career duration and outcomes (all p<0.001), indicating that adverse health effects were more common among men with intermediate career durations than those with shorter or longer careers. Similar findings were observed for play-related exposures (eg, CSS and snaps).ConclusionsRelationships between ASF career duration and subsequent health status are non-linear. Attenuation of the associations among longer career players may reflect selection effects and suggest career length may serve as a poor proxy for true causal factors. Findings highlight the need for cautious use of career duration as a proxy exposure metric in studies of former athletes.