bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adapting and implementing breast cancer follow-up in primary care: protocol for a mixed methods hybrid type 1 effectiveness-implementation cluster randomized study
Authors: Fadem Sarah J. , Crabtree Benjamin F. , O’Malley Denalee M. , Mikesell Lisa , Ferrante Jeanne M. , Toppmeyer Deborah L. , Ohman-Strickland Pamela A. , Hemler Jennifer R. , Howard Jenna , Bator Alicja , April-Sanders Ayana , Kurtzman Rachel , Hudson Shawna V. 
Published: November 2023

Abstract
Background
Advances in detection and treatment for breast cancer have led to an increase in the number of individuals managing significant late and long-term treatment effects. Primary care has a role in caring for patients with a history of cancer, yet there is little guidance on how to effectively implement survivorship care evidence into primary care delivery.

Methods
This protocol describes a multi-phase, mixed methods, stakeholder-driven research process that prioritizes actionable, evidence-based primary care improvements to enhance breast cancer survivorship care by integrating implementation and primary care transformation frameworks: the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and the Practice Change Model (PCM). Informed by depth interviews and a four round Delphi panel with diverse stakeholders from primary care and oncology, we will implement and evaluate an iterative clinical intervention in a hybrid type 1 effectiveness-implementation cluster randomized design in twenty-six primary care practices. Multi-component implementation strategies will include facilitation, audit and feedback, and learning collaboratives. Ongoing data collection and analysis will be performed to optimize adoption of the intervention. The primary clinical outcome to test effectiveness is comprehensive breast cancer follow-up care. Implementation will be assessed using mixed methods to explore how organizational and contextual variables affect adoption, implementation, and early sustainability for provision of follow-up care, symptom, and risk management activities at six- and 12-months post implementation.

Discussion
Study findings are poised to inform development of scalable, high impact intervention processes to enhance long-term follow-up care for patients with a history of breast cancer in primary care. If successful, next steps would include working with a national primary care practice-based research network to implement a national dissemination study. Actionable activities and processes identified could also be applied to development of organizational and care delivery interventions for follow-up care for other cancer sites.

Trial registration
Registered with ClinicalTrials.gov on June 2, 2022: NCT05400941.
Social-ecological factors influencing loneliness and social isolation in older people: a scoping review
Authors: Meehan Drew Eleanor , Grunseit Anne , Condie Jenna , HaGani Neta , Merom Dafna 
Published: November 2023

AbstractThere are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only (n = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.
Predictors and outcomes of recurrent retroperitoneal liposarcoma: new insights into its recurrence patterns
Authors: Deng Huan , Gao Jingwang , Xu Xingming , Liu Guibin , Song Liqiang , Pan Yisheng , Wei Bo 
Published: November 2023

Abstract
Background
The clinical profiles of recurrent retroperitoneal liposarcoma (RLS) need to be explored. The recurrence patterns of RLS are controversial and ambiguous.

Methods
A total of 138 patients with recurrent RLS were finally recruited in the study. The analysis of overall survival (OS) and recurrence-free survival (RFS) was performed by Kaplan‒Meier analysis. To identify independent prognostic factors, all significant variables on univariate Cox regression analysis (P ≤ 0.05) were subjected to multivariate Cox regression analysis. The corresponding nomogram model was further built to predict the survival status of patients.

Results
Among patients, the 1-, 3-, and 5-year OS rates were 70.7%, 35.9% and 30.9%, respectively. The 1-, 3- and 5-year RFS rates of the 55 patients who underwent R0 resection were 76.1%, 50.8% and 34.4%, respectively. The multivariate analysis revealed that resection method, tumor size, status of pathological differentiation, pathological subtypes and recurrence pattern were independent risk factors for OS or RFS. Patients with distant recurrence (DR) pattern usually had multifocal tumors (90.5% vs. 74.7%, P < 0.05); they were prone to experience changes of pathological differentiation (69.9% vs. 33.3%, P < 0.05) and had a better prognosis than those with local recurrence (LR) pattern. R0 resection and combined organ resection favored the survival of patients with DR pattern in some cases.

Conclusions
Patients with DR pattern had better prognosis, and they may benefit more from aggressive combined resection than those with LR pattern. Classifying the recurrence patterns of RLS provides guidance for individualized clinical management of recurrent RLS.
What do we not know (yet) about recovery colleges? A study protocol on their (cost-)effectiveness, mechanisms of action, fidelity and positioning
Authors: van Wezel Marloes M. C. , Muusse Christien , van de Mheen Dike , Wijnen Ben , den Hollander Wouter , Kroon Hans 
Published: November 2023

AbstractBackgroundRecovery Colleges (RCs) have spread across the globe as a new way of supporting people with mental vulnerabilities in their recovery journey. RCs focus on ‘learning’ rather than ‘curing’ and in that line facilitate a transition from being a passive, dependent patient/client to an active, empowered student learning to live life, despite vulnerabilities. Peer support and co-creation are central in RCs, as peers learn from each other by sharing personal experiences with mental vulnerabilities in an accessible, inspiring and stimulating atmosphere. The implementation of RCs is highly encouraged internationally, and as a result RCs and related self-help initiatives increasingly emerge. However, high-quality research on RCs is scarce and there is a call for thorough investigation of (cost-)effectiveness, mechanisms of action, cross-border fidelity and positioning of RCs. In response, this research project aims to fill these gaps.MethodsThis research project entails (1) a prospective quasi-experimental effectiveness study and economic evaluation, (2) a multifaceted qualitative study to elaborate on the mechanisms of action of RCs for those involved (3) a study to develop a (Dutch) Fidelity Measure of Recovery Colleges, and (4) an organisational case study to describe the positioning of RCs in relation to other mental health care services and community-based initiatives. Following the ideals of co-creation and empowerment in RCs we conduct this research project in co-creation with RC students from Enik Recovery College in Utrecht, the Netherlands.DiscussionThis research project will lead to one of the first longitudinal controlled quantitative evaluations of both cost-effectiveness and effectiveness of RC attendance in a broad sense (beyond attending courses alone). Moreover, we will gather data on a micro level (i.e., impact on RC students), meso level (i.e., organisational fidelity) and macro level (i.e., positioning in the care and support domain), capturing all important perspectives when scrutinizing the impact of complex systems. Finally, we will demonstrate the validity and value of embracing experiential knowledge in science as a complementary source of information, leading to a more profound understanding of what is researched.Trial registrationThe prospective quasi-experimental study has been pre-registered at clinicaltrails.gov (#NCT05620212).
Push and pull factors influencing the choice of a health resort by Polish treatment-seekers
Authors: Godlewska Agnieszka , Mazurek-Kusiak Anna , Soroka Andrzej 
Published: November 2023

Abstract
Background
The objective of the study was to indicate social and psychological (inner) motives associated with the desire and needs of travelling to health resorts (push) as well as external motives resulting from destination’s attributes, and explaining the choice of the health tourism establishment (pull) by Polish treatment-seekers divided into two social groups: persons in employment and retired persons. The research hypothesis assumed the two groups of people differ very much in terms of preferences motivating them to participate in health resort tourism, destination choices and services offered by health resort establishments.

Methods
Of the 258 health resorts, 154 establishments were selected for research purposes taking into account a proportional distribution of health resorts throughout Poland. An authorial questionnaire was developed and it included three questions with multiple answers, each answer being assessed on a 5-point Likert scale. The research adds new insights by analysing motives associated with health resort tourism in terms of benefits sought by visitors. The main and strongest motive for choosing health resort tourism is concern for health. In addition to old age pensioners, it was legitimate to analyse the group of employed respondents as their stays at a health resort are undertaken to regain not only physical fitness but also work motivation.

Results
The present study has demonstrated that motives and age groups have a significant effect on destination choice. Based on the results, it can be concluded that these groups often have diverse needs, expectations and, as a result, motives for choosing this form of tourism and a given health resort. What follows is a possibility of dividing the visitors to health resorts in terms of push and pull motives.

Conclusions
The research hypothesis assuming the two groups varied considerably in terms of preferences motivating them to participate in health resort tourism, destination selection and choice of services offered by the health resort establishment has been confirmed. The ramifications of the study’s findings may also be relevant for health resort/spa tourism outside of Poland because healthy lifestyle promotion is a worldwide trend.
Socioeconomic characteristics and domestic work as correlates of family satisfaction in Hong Kong mothers of young children
Authors: Cerin Ester , Zhang Casper J.P. , Mellecker Robin R. , Ming Wai-kit , Barnett Anthony 
Published: November 2023

AbstractBackgroundFamily life satisfaction is an important contributor to the mental health of mothers with young children, who are particularly vulnerable to various sources of stressors. However, there is a dearth of studies on this topic in this demographic, the determinants of which likely differ across geographical and cultural contexts. We examined indicators of maternal socioeconomic status (SES) and domestic help as correlates of family satisfaction in Hong Kong mothers of young children.MethodsMothers (N = 322) of young children (3–5 years old) were recruited from neighbourhoods stratified by SES and population density. They self-completed a survey containing items on socio-demographics, SES characteristics (including household income and maternal education and employment status), maternal family satisfaction and division of domestic work in the household and family. Confounder-adjusted associations of maternal SES indicators and participation in housework and childcare activities by various agents (e.g., mother, spouse, other residents) were estimated. We also estimated the moderating effects of household income on the associations between maternal employment and family satisfaction, and those of maternal employment on the associations between domestic work division and family satisfaction.ResultsHousehold income and maternal education were positively related to maternal family satisfaction. Mothers in part-time employment had lower family satisfaction than non-working mothers and mothers working full-time. The latter reported higher family satisfaction than non-working mothers only if their household income was below HK$ 15,000. Domestic work performed by non-residents was predictive of higher family satisfaction, while mothers’ housework and child(ren) tutoring were predictive of lower family satisfaction. Only part-time employed mothers benefited from spouse’s assistance with domestic work. The interaction effects of maternal employment status on the associations between the division of child tutoring and family satisfaction were complex.ConclusionsIn Hong Kong, mothers of young children with lower education and household income, who hold a part-time job and participate in housework and child tutoring activities have the lowest levels of family satisfaction and, hence, are at higher risk of mental health problems. Spouses’ and non-resident family members’ participation in domestic work, as well as the establishment of more family-friendly employment practices, may help mitigate this risk.Trial registrationN/A.
A 5-year review of prevalence, temporal trends and characteristics of individuals experiencing moderate and severe food insecurity in 34 high income countries
Authors: Gatton Michelle L. , Gallegos Danielle 
Published: November 2023

Abstract
Background
Due to the relatively low numbers of households in high income countries experiencing food insecurity most studies conflate the levels of severity, which masks between- and within-country differences. This study aims to describe the characteristics of individuals living in high income countries who were moderately or severely food insecure and investigates temporal trends in prevalence. It assesses these characteristics in comparison to those who were food secure.

Methods
This is a secondary analysis of data collected by the FAO Voices of the Hungry between 2014–2018. The data were collected during the annual Gallup World Polls of nationally representative samples using the Food Insecurity Experience Scale. Data from 34 highly developed, wealthy countries were analysed. The age, gender, income, education, area of residence and household structure of individuals experiencing moderate/severe food insecurity (FI), and severe FI, were compared using ANOVA, Welch’s F, Pearson’s Chi-square, and Linear-by-Linear Association, dependent on the variable of interest. Hierarchical cluster analysis was used to group countries according to their prevalence of moderate/severe FI, and severe FI.

Results
Overall, 6.5% of the weighted sample were moderately/severely food insecure (M-SFI), while 1.6% were severely food insecure. M-SFI individuals were present in all 34 countries, in all years and across all education levels and income quintiles. The proportion of individuals experiencing moderate/severe FI varied between years and countries. Fifteen countries showed a significant downward temporal trend in prevalence of moderate/severe FI (p < 0.001), while three countries demonstrated an increasing temporal trend driven by increasing prevalence in those aged 65 years or less (p < 0.001). Comparing individuals experiencing moderate versus severe FI showed over-representation of males, single adult households and lower household income in the severe FI group.

Conclusions
Individuals across all income, education and age categories living in high income countries are experiencing moderate/severe food insecurity, but with higher prevalence in those experiencing more disadvantage. Over the study period some countries experienced escalating while others demonstrated decreasing moderate/severe FI trends. This comparison of countries with similar economic and human development indices highlights an opportunity to investigate subtle variations in social, economic and education policy that could have profound impacts on food insecurity.
Serum glucose/potassium ratio as a clinical risk factor for predicting the severity and prognosis of acute traumatic spinal cord injury
Authors: Zhou Wu , Liu Yihao , Wang Zhihua , Mao Zelu , Li Meihua 
Published: November 2023

Abstract
Objective
Acute traumatic Spinal cord injury (TSCI) is a devastating event that causes severe sensory and motor impairments as well as autonomic dysfunction in patients, yet relevant clinical biomarkers have not been established. This study aimed to determine the significance of the serum glucose/potassium ratio (GPR) in evaluating TSCI severity and predicting prognosis.

Methods
An analysis of 520 clinical records of acute TSCI patients from January 2012 to June 2022 was conducted. The relationships between serum GPR and The American Spinal Injury Association Impairment Scale (AIS) grade 6-month post-trauma prognosis and the admission AIS grade were analyzed. To evaluate the discriminatory ability, a receiver operating characteristic curve (ROC) analysis was used. All methods were performed in accordance with the relevant guidelines and regulations.

Results
Based on the initial assessment of AIS grade, 256 (49.2%) patients were categorized into the severe TSCI group (AIS A–B), and there was a significant correlation between the severe TSCI group and serum GPR (p < 0.001). Serum GPR was reduced in an AIS grade-dependent manner (R = − 0.540, p < 0.001). Of the 520 patients, 262 (50.4%) patients were classified as having a poor prognosis according to the AIS grade at discharge. Serum GPR was also reduced in an AIS grade at discharge-dependent manner (R = − 0.599, p < 0.001), and was significantly higher in the poor prognosis group compared to the good prognosis group (p < 0.001). Poor prognosis was significantly associated with sex (p = 0.009), severity of TSCI (p < 0.001), location of TSCI (p < 0.001), surgical decompression (p < 0.018), body temperature (p < 0.001), heart rate (p < 0.001), systolic arterial pressure (SAP) (p < 0.001), diastolic arterial pressure (DAP) (p < 0.001), serum GPR (p < 0.001), serum glucose (p < 0.001), serum potassium (p < 0.001), and white blood cell count (p = 0.003). Multivariate logistic regression analysis showed a significant correlation between poor prognosis and serum GPR (p = 0.023). The ROC analysis showed the area under the curve of serum GPR to be a poor predictor of prognosis in TSCI patients at 0.842 (95% confidence interval, 0.808–0.875).

Conclusion
There was a significant relationship between serum GPR and admission injury severity and the 6-month prognosis of acute TSCI patients. Serum GPR serves as a readily available clinical risk factor for predicting the severity and 6-month prognosis of acute traumatic spinal cord injury, which holds potential clinical significance for patients with TSCI.
Effects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review
Authors: Zhou Lingling , Qu Huanjia , Yang Lu , Shou Lan 
Published: November 2023

Abstract
Purpose
This study was aimed to assess the effectiveness of Glucagon-like peptide 1 receptor agonists on pregnancy rate, menses, anthropometric and hormonal parameters in PCOS patients.

Methods
We conducted searches of the published literature in PubMed, EMBASE, Cochrane Library, Web of Science up to September 2022. Data from randomized controlled trials were obtained to assess the effects of GLP1RAs in PCOS women. Weighted mean difference, standardized mean difference, and risks ratio were employed for effect size estimation using a random-effects model.

Results
A total of 840 patients with 469 individuals in GLP1RAs group and 371 individuals in control group from 11 RCTs were included. GLP1RAs usage was associated with an improvement in natural pregnancy rate (RR: 1.72, 95% CI 1.22 to 2.43, P = 0.002, I2 = 0%) and menstrual regularity (SMD: 1.72, 95% CI 0.60 to 2.85, P < 0.001, I2 = 95.6%). There were no statistically significant differences in total pregnancy rate, IVF pregnancy rate between two groups, but total PR elevated in a short time after GLP1RAs as shown in subgroup analysis. Randomization to GLP1RAs treatment was associated with great improvement in HOMA-IR, BMI, WC, SHBG and a slight reduction in TT compared to control group. A decrease in TBF was seen in European population. GLP1RAs monotherapy was not superior to metformin when it came to fT, DHEAS, FAI.

Conclusions
Prescription of GLP1RAs improves natural pregnancy rate, menstrual cyclicity and insulin sensitivity, anthropometrics, hormonal indexes in PCOS women.