bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-reported health complaints and healthcare-seeking behaviour among adult people in rural Bangladesh: results from a cross-sectional study
Authors: Kabir Ashraful , Karim Md Nazmul , Billah Baki 
Published: February 2025

ObjectivesThis study aims to assess self-reported health complaints and healthcare-seeking behaviours in a rural population of Bangladesh. These factors are crucial for understanding health challenges and designing effective healthcare services in rural areas.DesignA cross-sectional survey was conducted from May to October 2021.SettingFour randomly selected administrative districts/regions of Bangladesh.ParticipantsA total of 1645 rural participants aged 18 years and older.Outcome measuresThe study assessed the prevalence of self-reported health complaints and healthcare-seeking behaviours.ResultsAmong the participants, 66% (1084 out of 1645) reported experiencing health complaints, with 80% seeking care and 20% either not seeking care or opting for self-care. Multivariable analysis revealed that participants with formal occupations (adjusted OR (aOR) = 0.609; 95% CI 0.396 to 0.938; p=0.025), those from the second (aOR=1.742; 95% CI 1.014 to 2.991; p=0.044) and fifth quintiles (aOR=1.210; 95% CI 0.726 to 2.019; p=0.465), with non-communicable disease (NCD) related complaints (aOR=5.299; 95% CI 3.673 to 7.643; p <0.001), and those living more than 5 km from healthcare facilities (aOR=1.725; 95% CI 1.040 to 2.861; p=0.034), were more likely to seek healthcare. Additionally, participants in the wealthiest quintile (aOR=1.963; 95% CI 1.080 to 3.569; p=0.027), those with non-NCD complaints (aOR=5.299; 95% CI 3.673 to 7.643; p<0.001) and those living further than 5 km (aOR=4.615; 95% CI 3.121 to 6.824; p<0.001), were more likely to seek care from skilled providers or healthcare facilities.ConclusionA high prevalence of self-reported health complaints, particularly related to NCDs, was observed. Despite this, many participants did not seek healthcare, indicating the need to address barriers to healthcare access and improve health-seeking behaviours in rural Bangladesh.
Interventions for the management of post-COVID-19 condition (long COVID): protocol for a living systematic review and network meta-analysis
Authors: Zeraatkar Dena , Ling Michael , Kirsh Sarah , Jassal Tanvir , Pitre Tyler , Chakraborty Samantha , Turner Tari , Turkstra Lyn , McIntyre Roger S , Izcovich Ariel , Mbuagbaw Lawrence , Agoritsas Thomas , Flottorp Signe A , Garner Paul , Couban Rachel J , Busse Jason W 
Published: February 2025

BackgroundUp to 15% of survivors of COVID-19 infection experience long-term health effects, including fatigue, myalgia and impaired cognitive function, termed post-COVID-19 condition or long COVID. Several trials that study the benefits and harms of various interventions to manage long COVID have been published and hundreds more are planned or are ongoing. Trustworthy systematic reviews that clarify the benefits and harms of interventions are critical to promote evidence-based practice.ObjectiveTo create and maintain a living systematic review and network meta-analysis addressing the benefits and harms of pharmacologic and non-pharmacologic interventions for the treatment and management of long COVID.MethodsEligible trials will randomise adults with long COVID to pharmacologic or non-pharmacologic interventions, placebo, sham or usual care. We will identify eligible studies by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AMED and CENTRAL from inception, without language restrictions.Reviewers will work independently and in duplicate to screen search records, collect data from eligible trials, including trial and patient characteristics and outcomes of interest and assess risk of bias. Our outcomes of interest will include patient-reported fatigue, pain, postexertional malaise, changes in education or employment status, cognitive function, mental health, dyspnoea, quality of life, physical function, recovery and serious adverse events.For each outcome, when possible, we will perform a frequentist random-effects network meta-analysis. When there are compelling reasons to suspect that certain interventions are only applicable or effective for a subtype of long COVID, we will perform separate network meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach will guide our assessment of the certainty of evidence.We will update our living review biannually, on the publication of a seminal trial, or when new evidence emerges that may change clinical practice.ConclusionThis living systematic review and network meta-analysis will provide comprehensive, trustworthy and up-to-date summaries of the evidence addressing the benefits and harms of interventions for the treatment and management of long COVID. We will make our findings available publicly and work with guideline-producing organisations to inform their recommendations.Ethics and disseminationThe study describes the protocol for a systematic review that uses data from published trial reports. Therefore, the study is exempt from ethics review. We intend to deposit all data in a public repository and publish each iteration of the living review online.
Analysis of epidemiological trends and risk factors in high-risk areas for pulmonary tuberculosis: an observational longitudinal study in Xinjiang, China
Authors: Haritebieke Salawati , Lu Yaoqin , Wu Di , Liu Guangchao , Zheng Yanling , Zhang Liping 
Published: February 2025

ObjectiveTo explore the spatial and temporal variations in the long-term risk of developing tuberculosis (TB) and the factors influencing it in order to contribute to the goal of eradicating TB.DesignObservational longitudinal study.SettingXinjiang, China, 2005–2019.Primary and secondary outcome measuresComparison of TB incidence across age, period, cohort and space using socioeconomic (including gross domestic product per capita, population density, public budget revenue and total retail sales of consumer goods), public health (including the number of hospital beds, health technicians and basic medical insurance for urban residents) and environmental variables (PM2.5, mean air temperature, mean wind speed, mean relative humidity and precipitation). The relative importance of these variables to pulmonary TB (PTB) is revealed by the Q-value (0, 1), with larger values indicating that the spatial heterogeneity of the explanatory variables to PTB is more pronounced.ParticipantsAll clinically diagnosed and confirmed cases in Xinjiang, China, were collected. The descriptive analysis included confirmed cases from 2005 to 2019, while cases from various districts and counties between 2011 and 2019 were subjected to further analysis.ResultsFrom 2005 to 2019, a total of 642 332 cases of PTB were reported in Xinjiang, with an average annual incidence rate of 172/100 000. The age risk of PTB presented a bimodal distribution, namely 20–24 years and the elderly (>60 years). The high prevalence of PTB was distributed in the southern part of Xinjiang. Among the influencing factors that had a greater effect on the incidence of PTB, the lower GDP per capita (Q-value=0.65) had a largest effect on PTB in Xinjiang compared with others factors (higher PM2.5: Q-value=0.56, lower health personnel: Q-value=0.49, higher average temperature: Q-value=0.47 and higher urban residents’ health insurance: Q-value=0.46). The main influencing factors were heterogeneous in different regions. Furthermore, the interactions among these factors enhanced the explanatory power regarding the incidence of the disease.ConclusionsIdentifying the high-risk groups, regions, influencing factors and interactions of PTB in Xinjiang, China, will expand the epidemiological knowledge of PTB in high-risk areas and potentially aid in designing targeted interventions.
Cohort profile: Noncommunicable diseases and ideal cardiovascular health among people living with and without HIV in Zambia and Zimbabwe (NCDzz cohort)
Authors: Chihota Belinda Varaidzo , Mandiriri Ardele , Muula Guy , Banda Esau , Shamu Tinei , Bolton-Moore Carolyn , Chimbetete Cleophas , Bosomprah Samuel , Wandeler Gilles 
Published: February 2025

PurposeThe NCDzz study is a prospective cohort of people living with and without HIV attending primary care clinics in Zambia and Zimbabwe and was established in 2019 to understand the intersection between noncommunicable diseases (NCDs) and HIV in Southern Africa. Here, we describe the study design and population and evaluate their ideal cardiovascular health (ICVH) using the Life’s Simple 7 (LS7) score according to the American Heart Association.ParticipantsAntiretroviral therapy-naïve people living with HIV (PLWH) and people living without HIV (PLWOH) 30 years or older were recruited from three primary care clinics in Lusaka and Harare, and underwent comprehensive clinical, laboratory and behavioural assessments. All study measurements are repeated during yearly follow-up visits. PLWOH were recruited from the same neighbourhoods and had similar socioeconomic conditions as PLWH.Findings to dateBetween August 2019 and March 2023, we included 1100 adults, of whom 618 (56%) were females and 539 (49%) were PLWH. The median age at enrolment was 39 years (IQR 34–46 years). Among 1013 participants (92%) with complete data, the median LS7 score was 11/14 (IQR 10–12). Overall, 60% of participants met the criteria of ICVH metrics (5–7 ideal components) and among individual components of the LS7, more females had poor body mass index (BMI) than males, regardless of HIV status (27% vs 3%, p<0.001). Our data show no apparent difference in cardiovascular health determinants between men and women, but high BMI in women and overall high hypertension prevalence need detailed investigation. Untreated HIV (OR: 1.36 (IQR 1.05–1.78)) and being a Zambian participant (OR: 1.81 (IQR 1.31–2.51)) were associated with having ICVH metrics, whereas age older than 50 years (OR: 0.46 (IQR 0.32–0.65)) was associated with not having ICVH metrics.Future plansOur study will be regularly updated with upcoming analyses using prospective data including a focus on arterial hypertension and vascular function. We plan to enrich the work through conducting in-depth assessments on the determinants of cardiovascular, liver and kidney end-organ disease outcomes yearly. Additionally, we seek to pilot NCD interventions using novel methodologies like the trials within cohorts. Beyond the initial funding support, we aim to collect at minimum yearly data for an additional 5-year period.
Efforts to strengthen anatomic pathology diagnostic services for cancer in sub-Saharan Africa: a scoping review protocol
Authors: Ng Dianna L. , Edelweiss Marcia , Kimambo Asteria Herman , Vuhahula Edda , Mushi Beatrice Paul , Adegoke Omolade , Goldberg Johanna , Ibrahim Pendo M. , Illonga Zainab , Jackman Julia , Jamisse Luisa , Van Loon Katherine , Mmbaga Elia John 
Published: February 2025

IntroductionSub-Saharan Africa bears a disproportionate burden of cancer-related morbidity and mortality compared with high-resource settings. Although pathology services are essential to providing optimal oncological care, diagnostic capacity in sub-Saharan Africa is insufficient for the cancer burden. This scoping review will be conducted to summarise the current state of practices and evidence for interventions and implementation strategies to improve anatomic pathology services for cancer in the region. The objective of this scoping review is to describe efforts to strengthen capacity for anatomic pathology services in sub-Saharan Africa. The information gathered will be used to inform the design of future pathology capacity-building interventions. The primary aim of the scoping review is to comprehensively map the existing evidence on initiatives aimed at enhancing the capacity for pathology services.Methods and analysisThis study will follow Joanna Briggs Institute methodology for scoping reviews. MEDLINE, Embase, Cochrane Central and African Index Medicus will be searched for articles published in English and Portuguese with no limitations placed on date or publication type. A limited search for grey literature will be conducted using the WHO Institutional Repository for Information Sharing. Two independent reviewers will screen all articles, extract data and complete the descriptive analysis. All discrepancies will be resolved using a third reviewer. The results will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will consider scientific literature from published primary studies as well as scoping and systematic reviews related to capacity-building efforts to strengthen anatomic pathology services in any sub-Saharan African country. All study designs will be considered, including quantitative, qualitative and/or mixed-methods studies.Ethics and disseminationEthical approval is not required for this study. Dissemination of findings from this work will include the publication of the results in a peer-reviewed journal and presentations at conferences.Protocol registration numberOpen Science Framework,https://osf.io/6cmhg.
Protocol of an open-label safety and feasibility pilot study of ketamine-assisted psychotherapy for methamphetamine use disorder (the KAPPA trial)
Authors: Fletcher Kathryn , Ezard Nadine , Siefried Krista J , MacDonald Harriet , Acheson Liam , Bedi Gillinder , Guerin Alexandre , Knock Elizabeth , Millard Michael , May Robert , Brett Jonathan , Doumany Jess , Morgan Celia , Clifford Brendan 
Published: February 2025

IntroductionMethamphetamine use disorder is a significant public health concern. No pharmacological treatment options currently exist for methamphetamine use disorder, and psychotherapy is only moderately effective. Preliminary evidence suggests that ketamine-assisted psychotherapy produces sustained improvements in substance use and mental health symptomatology. In addition to direct antidepressant properties, ketamine is hypothesised to increase synaptogenesis and facilitate neuroplasticity, in turn prolonging and enhancing the effects of psychotherapy. Given the withdrawal-associated dysphoria and neurocognitive impairments characterising methamphetamine use disorder, ketamine-assisted psychotherapy may improve the efficacy of psychotherapy alone by addressing these features and facilitating therapeutic engagement. This pilot study aims to investigate the safety and feasibility (time taken to recruit sample, proportion of ineligible participants at pre-screening and screening, number of participants who complete four sessions of psychotherapy, retention rate over full duration of study, acceptability of the intervention) of subanaesthetic ketamine in combination with psychotherapy (cognitive behavioural therapy) for adults with methamphetamine use disorder. Changes in methamphetamine use, cravings and withdrawal, quality of life, and treatment satisfaction will also be explored.Methods and analysisThis is an open-label, single-arm clinical trial. 20 adults meeting DSM-5-TR criteria for methamphetamine use disorder who are seeking to reduce or cease methamphetamine use will be enrolled in the study through a single-site specialist outpatient stimulant treatment service in inner Sydney (St Vincent’s Hospital, Sydney). A 4-week course with three subcutaneous ketamine doses (0.75 mg/kg to 0.9 mg/kg, titrated according to tolerability) at weekly intervals and four sessions of cognitive behavioural therapy (one at treatment initiation and three within 24–48 hours following each ketamine administration session) will be delivered. Safety and feasibility will be assessed over an 8-week period. Secondary outcomes (changes in methamphetamine use, cravings, withdrawal, quality of life and treatment satisfaction) will be assessed over a 24-week period.Ethics and disseminationThis study has been approved by the St Vincent’s Hospital Human Research Ethics Committee, reference 2023/ETH00530. Study findings will be disseminated through articles in scientific, peer-reviewed journals, and at national and international conferences.Trial registration numberANZCTR: ACTRN12624000895583.Protocol versionThe trial protocol (Version 4.0) was approved on 24 June 2024.
Establishing primary care physician commitment in Canadian long-term care homes: a protocol for a modified e-Delphi study
Authors: Dash Darly , Potter Maya , Siu Henry Yu-Hin , Quail Patrick , Katz Paul , McCarthy Lisa M , Peck Samantha , Tripp Dee , Costa Andrew P , Rochon Paula , Savage Rachel D , Jones Aaron , Stall Nathan 
Published: February 2025

IntroductionThe delivery of medical services by primary care physicians (PCPs) in long-term care (LTC) homes lacks consistency. There is no Canadian standard for PCP commitment in the LTC home setting, which can influence the quality of care delivered and resident health outcomes. The PCP’s commitment to LTC practice is theorised as the proportion of a physician’s practice dedicated to LTC, the number of residents for whom they provide care and the time spent on individual resident encounters. We aim to establish consensus on expectations concerning PCP commitment in Canadian LTC homes.Methods and analysisWe describe a protocol for a two-round modified e-Delphi study assessing the consensus of an expert panel, guided by the RAND methodological guidance for conducting Delphi panels and the ACcurate COnsensus Reporting Document (ACCORD) guideline for healthcare-based consensus studies. We will recruit pan-Canadian experts who demonstrate extensive knowledge and experience in medical care delivery and medical practice models in the Canadian LTC sector. A literature review will generate a candidate list of statements constituting PCP commitment. The first round evaluates the relevance and feasibility of candidate statements through an online questionnaire. Panellists may also write open-ended, qualitative responses to add rationales, suggest alternatives and share new ideas. We will then host a virtual synchronous meeting to have an in-depth discussion about the results from round one. A second questionnaire will be distributed to evaluate the remaining statements that have not reached consensus, and any new statements added based on the same criteria.Ethics and disseminationThe Hamilton Integrated Research Ethics Board (Project ID #17321) approved our study. The findings will be disseminated through manuscripts, presentations, and the lead author’s thesis.Trial registration numberThe ISRCTN Registry: #35125526.
Keeping Active with Texting after Stroke (KATS): a single-arm feasibility and acceptability study of a behavioural intervention to promote community-based physical activity after stroke rehabilitation
Authors: Morris Jacqui H , Irvine Linda A , Breckenridge Jenna , Farre Albert , Ozakinci Gozde , Jenkinson Keith , Murphy Andrew , Dombrowski Stephan U 
Published: February 2025

ObjectivesTo test the feasibility and acceptability of a text-message-delivered behavioural intervention to promote and maintain physical activity and recovery after stroke rehabilitation.DesignA single-arm acceptability and feasibility study.SettingCommunity rehabilitation services in two Health Board areas in Scotland.ParticipantsPeople with stroke who could participate in physical activities and use a mobile phone were recruited during rehabilitation and community rehabilitation.InterventionKeeping Active with Texting after Stroke (KATS) is an automated text message-delivered intervention informed by behaviour change theory. It delivers a structured sequence of 103 messages over 14 weeks to support the uptake and maintenance of physical activities following stroke rehabilitation.OutcomesData on recruitment, retention and satisfaction were collected. Semistructured interviews explored intervention acceptability. Preintervention and postintervention measures provided preliminary information on step count, functional independence, mental well-being, self-efficacy and quality of life.Results18 men and 13 women were recruited; three withdrew before intervention commencement. All 28 participants who received at least one text message completed the study, indicating 100% retention. Median satisfaction score was 23/25 (range 12–25). All but one participant read and responded to texts, indicating good engagement. Effect sizes (Cohen’s d; per cent change) were demonstrated in step count (0.2; 13%), extended activities of daily living (0.24; 8.3%) and mental well-being (0.35; 7%). Participants perceived KATS as acceptable, valuing messages and motivational prompts, but personalised tailoring was desired by some.ConclusionsRecruitment, retention and outcome measure completion were feasible, and KATS was perceived as acceptable. Findings suggest some modifications of messages and goal-setting processes are required to accommodate participants with diverse physical activity capabilities before a definitive trial. Promising indicators of effects were detected, although interpretation must be cautious because the study was not powered to determine efficacy, and there was no control group. Based on these findings, KATS will be further optimised before evaluating effectiveness in a randomised controlled trial.Trial registration number and protocol availabilityISRCTN 13704805https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/keeping-active-with-texting-after-stroke-kats/Protocol availablehttps://www.isrctn.com/ISRCTN13704805?q=13704805&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10