bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leveraging data science and machine learning for urban climate adaptation in two major African cities: a HE2AT Center study protocol
Authors: Jack Christopher , Parker Craig , Kouakou Yao Etienne , Joubert Bonnie , McAllister Kimberly A , Ilias Maliha , Maimela Gloria , Chersich Matthew , Makhanya Sibusisiwe , Luchters Stanley , Makanga Prestige Tatenda , Vos Etienne , Ebi Kristie L , Koné Brama , Waljee Akbar K , Cissé Guéladio 
Published: June 2024

IntroductionAfrican cities, particularly Abidjan and Johannesburg, face challenges of rapid urban growth, informality and strained health services, compounded by increasing temperatures due to climate change. This study aims to understand the complexities of heat-related health impacts in these cities. The objectives are: (1) mapping intraurban heat risk and exposure using health, socioeconomic, climate and satellite imagery data; (2) creating a stratified heat–health forecast model to predict adverse health outcomes; and (3) establishing an early warning system for timely heatwave alerts. The ultimate goal is to foster climate-resilient African cities, protecting disproportionately affected populations from heat hazards.Methods and analysisThe research will acquire health-related datasets from eligible adult clinical trials or cohort studies conducted in Johannesburg and Abidjan between 2000 and 2022. Additional data will be collected, including socioeconomic, climate datasets and satellite imagery. These resources will aid in mapping heat hazards and quantifying heat–health exposure, the extent of elevated risk and morbidity. Outcomes will be determined using advanced data analysis methods, including statistical evaluation, machine learning and deep learning techniques.Ethics and disseminationThe study has been approved by the Wits Human Research Ethics Committee (reference no: 220606). Data management will follow approved procedures. The results will be disseminated through workshops, community forums, conferences and publications. Data deposition and curation plans will be established in line with ethical and safety considerations.
What is the association between the microbiome and cognition? An umbrella review protocol
Authors: Goldenberg Joshua Z , Wright Traver J , Batson Richard D , Wexler Ryan S , McGovern Kristen A , Venugopal Navneet K , Ward Weston W , Randolph Kathleen M , Urban Randall J , Pyles Richard B , Sheffield-Moore Melinda 
Published: June 2024

IntroductionCognitive impairment is reported in a variety of clinical conditions including Alzheimer’s disease, Parkinson’s and ‘long-COVID’. Interestingly, many of these clinical conditions are also associated with microbial dysbiosis. This comanifestation of cognitive and microbiome findings in seemingly unrelated maladies suggests that they could share a common mechanism and potentially presents a treatment target. Although a rapidly growing body of literature has documented this comorbid presentation within specific conditions, an overview highlighting potential parallels across healthy and clinical populations is lacking. The objective of this umbrella review, therefore, is to summarise and synthesise the findings of these systematic reviews.Methods and analysisOn 2 April 2023, we searched MEDLINE (Pubmed), Embase (Ovid), the Web of Science (Core Collection), the Cochrane Library of Systematic Reviews and Epistemonikos as well as grey literature sources, for systematic reviews on clinical conditions and interventions where cognitive and microbiome outcomes were coreported. An updated search will be conducted before completion of the project if the search-to-publication date is >1 year old. Screening, data abstraction and quality assessment (AMSTAR 2, A MeaSurement Tool to Assess systematic Reviews) will be conducted independently and in duplicate, with disagreements resolved by consensus. Evidence certainty statements for each review’s conclusions (eg, Grading of Recommendations Assessment, Development and Evaluation (GRADE)) will be extracted or constructed de novo. A narrative synthesis will be conducted and delineated by the review question. Primary study overlap will be visualised using a citation matrix as well as calculated using the corrected covered area method.Ethics and disseminationNo participant-identifying information will be used in this review. No ethics approval was required due to our study methodology. Our findings will be presented at national and international conferences and disseminated via social media and press releases. We will recruit at least one person living with cognitive impairment to collaborate on writing the plain language summary for the review.PROSPERO registration numberCRD42023412903
Cost-effectiveness of strength exercise or aerobic exercise compared with usual care for patients with knee osteoarthritis: secondary results from a multiarm randomised controlled trial in Norway
Authors: Killingmo Rikke Munk , Øiestad Britt Elin , Risberg May-Arna , Maas Esther , Grotle Margreth 
Published: June 2024

Objectives
To evaluate the 1-year cost-effectiveness of strength exercise or aerobic exercise compared with usual care for patients with symptomatic knee osteoarthritis (OA), from a societal and healthcare perspective.

Design
Cost-effectiveness analysis embedded in a three-arm randomised controlled trial.

Participants and setting
A total of 161 people with symptomatic knee OA seeking Norwegian primary or secondary care were included in the analyses.

Interventions
Participants were randomised to either 12 weeks of strength exercise (n=54), 12 weeks of aerobic exercise (n=53) or usual care (n=54).

Outcome measures
Quality-adjusted life-years (QALYs) estimated by the EuroQol-5 Dimensions-5 Levels, and costs related to healthcare utilisation and productivity loss estimated in euros (€), aggregated for 1 year of follow-up. Cost-effectiveness was expressed with mean incremental cost-effectiveness ratios (ICERs). Bootstrapping was used to estimate ICER uncertainty.

Results
From a 1-year societal perspective, the mean cost per patient was €7954, €8101 and €17 398 in the strength exercise, aerobic exercise and usual care group, respectively. From a 1-year healthcare perspective, the mean cost per patient was €848, €2003 and €1654 in the strength exercise, aerobic exercise and usual care group, respectively. Mean differences in costs significantly favoured strength exercise and aerobic exercise from a 1-year societal perspective and strength exercise from a 1-year healthcare perspective. There were no significant differences in mean QALYs between groups. From a 1-year societal perspective, at a willingness-to-pay threshold of €27 500, the probability of strength exercise or aerobic exercise being cost-effective was ≥98%. From a 1-year healthcare perspective, the probability of strength exercise or aerobic exercise being cost-effective was ≥97% and ≥76%, respectively.

Conclusion
From a 1-year societal and healthcare perspective, a 12-week strength exercise or aerobic exercise programme is cost-effective compared with usual care in patients with symptomatic knee OA.

Trial registration number

NCT01682980.
Facilitators and barriers to optimum uptake of multimonth dispensing of antiretroviral treatment in Morogoro, Tanzania: a qualitative study
Authors: Machumu Neema , Frumence Gasto , Anaeli Amani 
Published: June 2024

ObjectivesAimed at determining facilitators and barriers to optimum uptake of multimonth dispensing (MMD) of antiretroviral treatment (ART).DesignQualitative study conducted through in-depth interviews.SettingAn explorative qualitative approach conducted at three high-volume care and treatment clinics in Morogoro Municipality, Tanzania.ParticipantsData were collected from a purposefully selected sample of 22 participants. Of them, 9 were healthcare providers and 12 were clients on ART receiving MMD. Audio records from the interviews were transcribed, translated, and thematically analysed.ResultsEvidence showed that multimonth dispensing can be improved through strengthened health system barriers such as having proper guidelines and involving stakeholders. Other facilitators included service providers’ ability to identify eligible clients, fast-tracking of services, quality improvement implementation, peer-to-peer inspiration and clients’ satisfaction and awareness. Identified barriers to effective multimonth dispensing included inadequate drug supply, prolonged turn-around time of HIV viral load results, delayed integrated Tuberculosis (TB) preventive therapy initiation, stigma and retention challenges.ConclusionMultimonth dispensing has the potential to address the health system challenges in Tanzania if guidelines are well informed to stakeholders, and facets of quality of care are improved. Addressing the earmarked barriers such as ensuring medicine, supplies and diagnostics, while addressing retention challenges and stigma.
Whole-course quality of tuberculosis (TB) care in rural China: a retrospective study based on chart abstraction
Authors: Li Mingyue , Zhang Xiaotian , Cheng Haozhe , Zhang Baisong , Wei Tiantian , Cheng Xiaoran , Jiang Shiwen , Liu Xiaoyun 
Published: June 2024

Objectives
The aim of this study was to assess the quality of tuberculosis (TB) care for the whole course and assess factors that affect completing treatment.

Design
This is an observational retrospective study using chart abstraction for the whole course of TB care conducted at two underserved provinces in China.

Setting
The study was conducted from June 2021 to July 2021. All medical records (outpatient and inpatient) for the whole course (6–8 months) of patients with TB newly registered from July 2020 to December 2020 were reviewed and abstracted using predetermined checklists.

Participants
A total of 268 outpatient medical records and 126 inpatient records were included.

Primary and secondary outcome measures
The primary outcome included diagnostic quality, treatment quality and management quality. The secondary outcome was completing treatment.

Results
For diagnostic quality, 94.2% of the diagnosis were based on adequate evidence. For treatment quality, 240 (91.6%) outpatients and 100 (85.5%) inpatients took the standard chemotherapy regimens. 234 (87.3%) patients completed treatment. 85.1% of the inpatients prescribed with second-line drugs were inappropriate. For management quality, 128 (47.9%) patients received midterm assessments, but only 47 (19.7%) received sufficient services for the whole course. Patients with TB symptoms were 1.8 times more likely to complete treatment (p=0.011).

Conclusion
Patients with TB received high-quality diagnosis and treatment services, but low-quality whole-course management. Integration of medical and public health services should be strengthened to improve whole-course quality.
How accurate is clinical prognostication by oncologists during routine practice in a general hospital and can it be improved by a specific prognosis training programme: a prospective interventional study
Authors: Kupf Irma , Thanner Gabriele , Gerken Michael , Crispin Alexander , Braess Jan 
Published: June 2024

ObjectivesOncologists need competence in clinical prognostication to deliver appropriate care to patients with cancer. Most studies on prognostication have been restricted to patients in palliative care settings. This paper investigates (1) the prognostic accuracy of physicians regarding a broad cohort of patients with cancer with a median life expectancy of >2 years and (2) whether a prognosis training can improve prognostication.DesignProspective single-centre study comprising 3 phases, each lasting 1 month.SettingLarge teaching hospital, department of oncology and haematology, Germany.Participants18 physicians with a professional experience from entry level to 34 years. 736 patients with oncological and malignant haematological diseases.InterventionsBaseline prognostication abilities were recorded during an ‘untrained’ phase 1. As an intervention, a specific prognosis-training programme was implemented prior to phases 2 and 3. In phase 3, physicians had to provide additional estimates with the inclusion of electronic prognostic tools.Outcome measuresPrognostic estimates (PE) were collected using ‘standard’ surprise question (SQ), ‘probabilistic’ SQ (both for short-term prognostication up to 6 months) and clinician prediction of survival (CPS) (for long-term prognostication). Estimated prognoses were compared with observed survival. Phase 1 was compared with phases 2 and 3.ResultsWe included 2427 PE for SQ, 1506 for CPS and 800 for probabilistic SQ. Median OS was 2.5 years. SQ accuracy improved significantly (p<0.001) from 72.6% in phase 1 to 84.3% in phase 3. Probabilistic SQ in phase 3 showed 83.1% accuracy. CPS accuracy was 25.9% and could not be significantly improved. (Electronic) prognostic tools—used alone—performed significantly worse (p<0.0005) than physicians and—used by the clinicians—did not improve their performance.ConclusionA specific prognosis-training programme could improve short-term and intermediate-term prognostication. Improvement of long-term prognostication was not possible. Inexperienced residents as well as experienced oncologists benefited from training.
Structured medication reviews for adults with multimorbidity and polypharmacy in primary care: a systematic review protocol
Authors: Lammila-Escalera Elena , Greenfield Geva , Aldakhil Reham , Zaman Hadar , Neves Ana Luisa , Majeed Azeem , WJ Hayhoe Benedict 
Published: June 2024

Introduction
Polypharmacy is common among individuals with multimorbidity, often leading to inappropriate medication use and is associated with an increased risk of frailty, hospitalisation and mortality. Structured medication reviews (SMRs) have emerged as a promising method for optimising medication use. However, research examining their efficacy is limited. This review aims to evaluate the impact of SMRs on improving outcomes for adults with multimorbidity and polypharmacy in primary care settings. Additionally, this review seeks to identify prevailing patterns and trends in the mode of delivery of SMRs.

Methods and analysis
A systematic review will be conducted using Ovid MEDLINE, Ovid EMBASE, Web of Science and CINAHL (1997–present). Primary outcomes will include medication-related measures such as dose, frequency and dosage form. Secondary outcomes under investigation will include physical, mental, functional and health service outcomes, as reported. Two independent reviewers will conduct the screening and data extraction, resolving disagreements through discussion. Once eligible studies are identified, the extracted data will be summarised in tabular format. The risk of bias in the articles will be assessed using either the Cochrane Risk of Bias 2 tool or the Newcastle-Ottawa scale, depending on the design of the studies retrieved. Subgroup analysis will be performed using demographic variables and modes of delivery where the data supports. If appropriate, a meta-analysis of the data extracted will be conducted to determine the impact of the SMRs on reported outcomes. If a meta-analysis is not possible due to heterogeneity, a narrative synthesis approach will be adopted.

Ethics and dissemination
This proposed review is exempt from ethical approval as it aims to collate and summarise peer-reviewed, published evidence. This protocol and the subsequent review will be disseminated in peer-reviewed journals, conferences and patient-led lay summaries.

PROSPERO registration number
CRD42023454965.
Can digital innovation transform rural primary health care? A systematic review protocol
Authors: Nasir Bushra F , Leedie Floyd , Fox Jordan , Martin Priya , Alam Khorshed , Wallis Katharine , McGrail Matthew R , Kondalsamy-Chennakesavan Srinivas 
Published: June 2024

IntroductionDigital technology is increasingly being adopted within primary healthcare services to improve service delivery and health outcomes; however, the scope for digital innovation within primary care services in rural areas is currently unknown. This systematic review aims to synthesise existing research on the use and integration of digital health technology within primary care services for rural populations across the world.Methods and analysisA systematic approach to the search strategy will be conducted. Relevant medical and healthcare-focused electronic databases will be searched using key search terms between January 2013 and December 2023. Searches will be conducted using specific inclusion and exclusion criteria. A systematic study selection and data extraction process will be implemented, using standardised templates. Outcomes will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses- Protocol statement guidelines. Quality assessment and risk of bias appraisal will be conducted using the Mixed Methods Appraisal Tool.Ethics and disseminationEthical approval will not be required because there is no individual patient data collected or reviewed. The finding of this review will be disseminated through peer-reviewed publications and conference presentations. Outcomes will help to understand existing knowledge and identify gaps in delivering digital healthcare services, while also providing potential future practice and policy recommendations.PROSPERO registration numberCRD42023477233.
Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study
Authors: Li Shuaijun , Feng Qi , Huang Xiaofang , Tian Xiuying , Zhou Ying , Ji Yong , Zhai Shufen , Guo Wei , Zheng Rongxiu , Wang Haijun 
Published: June 2024

ObjectivesTo determine the dose-dependent associations between antenatal corticosteroids (ANS) exposure and the rates of major morbidities, and the early weight loss percentage (EWLP) in hospital among extremely preterm infants (EPI) or extremely low birthweight infants (ELBWI).MethodsA multicentre, retrospective cohort study of EPI or ELBWI born between 2017 and 2018 was conducted. Infants were classified into no ANS, partial ANS and complete ANS exposure group; three subgroups were generated by gestational age and birth weight. Multiple logistic regression and multiple linear regression were performed.ResultsThere were 725 infants included from 32 centres. Among no ANS, partial ANS and complete ANS exposure, there were significant differences in the proportions of bronchopulmonary dysplasia (BPD) (24.5%, 25.4% and 16.1%), necrotising enterocolitis (NEC) (6.7%, 2.0% and 2.0%) and death (29.6%, 18.5% and 13.5%), and insignificant differences in the proportions of intraventricular haemorrhage (IVH) (12.5%, 13.2% and 12.2%), and extrauterine growth restriction (EUGR) (50.0%, 56.6% and 59.5%). In the logistic regression, compared with no ANS exposure, complete ANS reduced the risk of BPD (OR 0.58, 95% CI 0.37 to 0.91), NEC (OR 0.21, 95% CI 0.08 to 0.57) and death (OR 0.36, 95% CI 0.23 to 0.56), and partial ANS reduced the risk of NEC (OR 0.23, 95% CI 0.07 to 0.72) and death (OR 0.54, 95% CI 0.34 to 0.87). Compared with partial ANS exposure, complete ANS decreased the risk of BPD (OR 0.58, 95% CI 0.37 to 0.91). There were insignificant associations between ANS exposure and IVH, EUGR. In the multiple linear regression, partial and complete ANS exposure increased EWLP only in the ≥28 weeks (w) and <1000 g subgroup (p<0.05).ConclusionsDifferent doses of ANS (dexamethasone) exposure were protectively associated with BPD, NEC, death in hospital, but not EUGR at discharge among EPI or ELBWI. Beneficial dose-dependent associations between ANS (dexamethasone) exposure and BPD existed. ANS exposure increased EWLP only in the ≥28 w and<1000 g subgroup. ANS administration, especially complete ANS, is encouraged before preterm birth.Trial registration numberNCT06082414.
What do clinical practice guidelines say about deprescribing? A scoping
review
Authors: Langford Aili Veronica , Warriach Imaan , McEvoy Aisling M , Karaim Elisa , Chand Shyleen , Turner Justin P , Thompson Wade , Farrell Barbara J , Pollock Danielle , Moriarty Frank , Gnjidic Danijela , Ailabouni Nagham J , Reeve Emily 
Published: June 2024

Introduction
Deprescribing (medication dose reduction or
cessation) is an integral component of appropriate
prescribing. The extent to which deprescribing recommendations are
included in clinical practice guidelines is unclear. This scoping review
aimed to identify guidelines that contain deprescribing recommendations,
qualitatively explore the content and format of deprescribing
recommendations and estimate the proportion of guidelines that contain
deprescribing recommendations.

Methods
Bibliographic databases and Google were searched for guidelines
published in English from January 2012 to November 2022. Guideline
registries were searched from January 2017 to February 2023. Two
reviewers independently screened records from databases and Google for
guidelines containing one or more deprescribing recommendations. A 10%
sample of the guideline registries was screened to identify eligible
guidelines and estimate the proportion of guidelines containing a
deprescribing recommendation. Guideline and recommendation
characteristics were extracted and language features of deprescribing
recommendations including content, form, complexity and readability were
examined using a conventional content analysis and the SHeLL Health
Literacy Editor tool.

Results
80 guidelines containing 316 deprescribing recommendations were
included. Deprescribing recommendations had substantial variability in
their format and terminology. Most guidelines contained recommendations
regarding forwho(75%, n=60),
what(99%, n=89) andwhen or
why(91%, n=73) to deprescribe, however, fewer
guidelines (58%, n=46) contained detailed guidance
onhowto deprescribe. Approximately 29% of
guidelines identified from the registries sample (n=14/49) contained one
or more deprescribing recommendations.

Conclusions
Deprescribing recommendations are increasingly being incorporated
into guidelines, however, many guidelines do not contain clear and
actionable recommendations onhowto
deprescribe which may limit effective implementation in clinical
practice. A co-designed template or best practice guide, containing
information on aspects of deprescribing recommendations that are
essential or preferred by end-users should be developed and
employed.

Trial registration number
osf.io/fbex4.