bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point-Of-Care low-field MRI in acute Stroke (POCS): protocol for a multicentric prospective open-label study evaluating diagnostic accuracy
Authors: Foschi Matteo , Galante Angelo , Ornello Raffaele , Necozione Stefano , Marini Carmine , Muselli Mario , Achard Paola Olimpia , Fratocchi Luciano , Vinci Sergio Lucio , Cavallaro Marco , Silvestrini Mauro , Polonara Gabriele , Marcheselli Simona , Straffi Laura , Colasurdo Marco , Sorrentino Luca , Franconi Enrico , Alecci Marcello , Caulo Massimo , Sacco Simona 
Published: January 2024

IntroductionFast and accurate diagnosis of acute stroke is crucial to timely initiate reperfusion therapies. Conventional high-field (HF) MRI yields the highest accuracy in discriminating early ischaemia from haemorrhages and mimics. Rapid access to HF-MRI is often limited by contraindications or unavailability. Low-field (LF) MRI (<0.5T) can detect several types of brain injury, including ischaemic and haemorrhagic stroke. Implementing LF-MRI in acute stroke care may offer several advantages, including extended applicability, increased safety, faster administration, reduced staffing and costs. This multicentric prospective open-label trial aims to evaluate the diagnostic accuracy of LF-MRI, as a tool to guide treatment decision in acute stroke.Methods and analysisConsecutive patients accessing the emergency department with suspected stroke dispatch will be recruited at three Italian study units: Azienda Sanitaria Locale (ASL) Abruzzo 1 and 2, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital. The estimated sample size is 300 patients. Anonymised clinical and LF-MRI data, along with conventional neuroimaging data, will be independently assessed by two external units: Marche Polytechnic University and ‘G. Martino’ Polyclinic University Hospital. Both units will independently adjudicate the best treatment option, while the latter will provide historical HF-MRI data to develop artificial intelligence algorithms for LF-MRI images interpretation (Free University of Bozen-Bolzano). Agreement with conventional neuroimaging will be evaluated at different time points: hyperacute, acute (24 hours), subacute (72 hours), at discharge and chronic (4 weeks). Further investigations will include feasibility study to develop a mobile stroke unit equipped with LF-MRI and cost-effectiveness analysis. This trial will provide necessary data to validate the use of LF-MRI in acute stroke care.Ethics and disseminationThe study was approved by the Research Ethics Committee of the Abruzzo Region (CEtRA) on 11 May 2023 (approval code: richyvgrg). Results will be disseminated in peer-reviewed journals and presented in academic conferences.Trial registration numberNCT05816213; Pre-Results.
Investigating the prevalence of cognitive impairment and dementia in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): the Harmonised Cognitive Assessment Protocol (HCAP) cross-sectional substudy
Authors: O'Hara Leeanne , Neville Charlotte , Marr Calum , McAlinden Michael , Kee Frank , Weir David , McGuinness Bernadette 
Published: January 2024

IntroductionThe Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) study is the largest study of ageing in Northern Ireland (NI). The Harmonised Cognitive Assessment Protocol (HCAP) is a substudy of NICOLA designed to assess cognitive impairment and dementia in individuals aged 65 and over. The NICOLA-HCAP substudy is funded by the National Institute on Aging as part of a network for enhancing cross-national research within a worldwide group of population-based, longitudinal studies of ageing, all of which are centred around the US-based Health and Retirement Study.Methods and analysisThe NICOLA-HCAP study will draw on the main NICOLA cohort (of 8283 participants) and randomly sample 1000 participants aged 65 and over to take part in the substudy. Participants will complete a series of cognitive tests (n=19) via a computer-assisted personal interview administered in their home (or alternatively within the research centre) and will be asked to nominate a family member or friend to complete an additional interview of validated instruments to provide information on respondent’s prior and current cognitive and physical functioning and whether the individual requires help with daily activities. The objectives of the study are: to investigate the prevalence of dementia and cognitive impairment in NICOLA; harmonise scoring of the NICOLA-HCAP data to the HCAP studies conducted in Ireland, the USA and England; to explore the validity of dementia estimates; and investigate the risk factors for dementia and cognitive impairment.Ethics and disseminationThe study received ethical approval from the Faculty of Medicine, Health and Life Sciences Research Ethics Committee, Queen’s University Belfast. We will provide data from the Northern Irish HCAP to the research community via data repositories such as the Dementias Platform UK and Gateway to Global Aging to complement existing public data resources and support epidemiological research by others. Findings will also be disseminated through peer-reviewed publications and at international conferences.
Cost-effectiveness of a primary healthcare intervention to treat male lower urinary tract symptoms: the TRIUMPH cluster randomised controlled trial
Authors: Cochrane Madeleine , Drake Marcus J , Worthington Jo , Frost Jessica , Cotterill Nikki , Fader Mandy , McGeagh Lucy , Hashim Hashim , Lane Athene , Macaulay Margaret , MacNeill Stephanie , Rees Jonathan , Ridd Matthew J , Robles Luke A , Sanderson Emily , Taylor Gordon , Taylor Jodi , Noble Sian 
Published: January 2024

ObjectivesTo estimate the cost-effectiveness of a primary care intervention for male lower urinary tract symptoms (LUTS) compared with usual care.DesignEconomic evaluation alongside a cluster randomised controlled trial from a UK National Health Service (NHS) perspective with a 12-month time horizon.SettingThirty NHS general practice sites in England.Participants1077 men aged 18 or older identified in primary care with bothersome LUTS.InterventionsA standardised and manualised intervention for the treatment of bothersome LUTS was compared with usual care. The intervention group (n=524) received a standardised information booklet with guidance on conservative treatment for LUTS, urinary symptom assessment and follow-up contacts for 12 weeks. The usual care group (n=553) followed local guidelines between general practice sites.MeasuresResource use was obtained from electronic health records, trial staff and participants, and valued using UK reference costs. Quality-adjusted life-years (QALYs) were calculated from the EQ-5D-5L questionnaire. Adjusted mean differences in costs and QALYs and incremental net monetary benefit were estimated.Results866 of 1077 (80.4%) participants had complete data and were included in the base-case analysis. Over the 12-month follow-up period, intervention and usual care arms had similar mean adjusted costs and QALYs. Mean differences were lower in the intervention arm for adjusted costs −£29.99 (95% CI −£109.84 to £22.63) while higher in the intervention arm for adjusted QALYs 0.001 (95% CI −0.011 to 0.014). The incremental net monetary benefit statistic was £48.01 (95% CI −£225.83 to £321.85) at the National Institute for Health and Care Excellence UK threshold of £20 000 per QALY. The cost-effectiveness acceptability curve showed a 63% probability of the intervention arm being cost-effective at this threshold.ConclusionsCosts and QALYs were similar between the two arms at 12 months follow-up. This indicates that the intervention can be implemented in general practice at neutral cost.Trial registration numberISRCTN11669964.
International consensus statement on the design, delivery and evaluation of sport-based interventions aimed at promoting social, psychological and physical well-being in prison
Authors: Murray Conor , Coyle Brendan , Morgan Haydyn , Marder Ian , Woods David , Haughey Tandy , Maycock Matthew , Genovesi Federico , Meek Rosie , Parker Andrew , Smith Andy , Kay Chris , Brink Gerko , Rovers Hubert , Haudenhuyse Rein , Roe Daniel , Contreras-Osorio Falonn , Donohue Brad , Bohall Greg , Martinez Nagore , Martos-Garcia Daniel , Whitley Meredith , Norman Mark , Demalija Rifat , Sherry Emma , Chitsawang Nathee , Adebayo Aderonmu Kehinde , Breslin Gavin 
Published: January 2024

ObjectiveTo develop an international consensus statement to advise on designing, delivering and evaluating sport-based interventions (SBIs) aimed at promoting social, psychological and physical well-being in prison.DesignModified Delphi using two rounds of survey questionnaires and two consensus workshops.ParticipantsA multidisciplinary panel of more than 40 experts from 15 international jurisdictions was formed, including representation from the following groups and stakeholders: professionals working in the justice system; officials from sport federations and organisations; academics with research experience of prisons, secure forensic mental health settings and SBIs; and policy-makers in criminal justice and sport.ResultsA core research team and advisory board developed the initial rationale, statement and survey. This survey produced qualitative data which was analysed thematically. The findings were presented at an in-person workshop. Panellists discussed the findings, and, using a modified nominal group technique, reached a consensus on objectives to be included in a revised statement. The core research team and advisory board revised the statement and recirculated it with a second survey. Findings from the second survey were discussed at a second, virtual, workshop. The core research team and advisory board further revised the consensus statement and recirculated it asking panellists for further comments. This iterative process resulted in seven final statement items; all participants have confirmed that they agreed with the content, objectives and recommendations of the final statement.ConclusionsThe statement can be used to assist those that design, deliver and evaluate SBIs by providing guidance on: (1) minimum levels of competence for those designing and delivering SBIs; (2) the design and delivery of inclusive programmes prioritising disadvantaged groups; and (3) evaluation measures which are carefully calibrated both to capture proposed programme outcomes and to advance an understanding of the systems, processes and experiences of sport engagement in prison.
Association between kimchi consumption and obesity based on BMI and abdominal obesity in Korean adults: a cross-sectional analysis of the Health Examinees study
Authors: Jung Hyein , Yun Ye-Rang , Hong Sung Wook , Shin Sangah 
Published: January 2024

ObjectivePrevious animal studies have shown the anti-obesity effect of kimchi-derived probiotic lactic acid bacteria. However, only a few epidemiological studies have investigated the association between kimchi consumption and obesity. Therefore, we aim to assess this relationship in Korean adults.DesignCross-sectional study.SettingThe Health Examinees study was conducted from 2004 to 2013.ParticipantsThis study analysed 115 726 participants aged 40–69 years enrolled in the Health Examinees study in Korea.Primary and secondary outcome measuresObesity was defined as body mass index ≥25 kg/m2, and abdominal obesity was defined as waist circumference ≥90 cm in men and ≥85 cm in women. Kimchi consumption was assessed by the validated food frequency questionnaire.ResultsIn men, total kimchi consumption of 1–3 servings/day was related to a lower prevalence of obesity (OR: 0.875 in 1–2 servings/day and OR: 0.893 in 2–3 servings/day) compared with total kimchi consumption of <1 serving/day. Also, men with the highest baechu kimchi (cabbage kimchi) consumption had 10% lower odds of obesity and abdominal obesity. Participants who consumed kkakdugi (radish kimchi) ≥median were inversely associated with 8% in men and 11% in women with lower odds of abdominal obesity compared with non-consumers, respectively.Conclusions and relevanceConsumption of 1–3 servings/day of total kimchi was associated with a lower risk of obesity in men. Baechu kimchi was associated with a lower prevalence of obesity in men, and kkakdugi was associated with a lower prevalence of abdominal obesity in both men and women. However, since all results showed a ‘J-shaped’ association, it is recommended to limit excessive kimchi intake.
Implementation of a nurse-led, multidisciplinary model of care for older adults with cancer: a process evaluation protocol
Authors: Dufton Polly Hypatia , Tarasenko Elena , Midgley Katrina , Lee Kathryn , Kelly Ray , Rodrigues Jeremy , Yates Paul , Arulananda Surein , Parakh Sagun 
Published: January 2024

IntroductionCancer is predominantly a disease of older adults, with an increasing number of cancer diagnoses in individuals aged 65 or older. Multiple geriatric factors have been shown to impact patient outcomes in cancer treatment. However, oncology specialists are not well adapted to incorporate geriatric assessment into practice due to a lack of resources and knowledge of the specialty.The primary aim of this study is to implement and evaluate a nurse-led, multidisciplinary model of care for older adults with cancer at two public tertiary hospitals in Melbourne, Australia.Methods and analysisThis study will aim to assess 200 patients across 2 sites. Both sites will assess individuals with lung cancer; the second site will also include individuals with genitourinary, upper gastrointestinal and colorectal cancers.This process evaluation will use quantitative and qualitative methods to explore the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of the nurse-led, multidisciplinary model of care.Ethics and disseminationEthical approval and local governance approvals have been obtained by Austin Health and Monash Health Human Research Ethics committees. Dissemination will occur via publications, conferences, social medical and local engagement with clinicians, consumers and managers.
Estimating the effectiveness of an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) service addressing the wider determinants of mental health: a real-world evaluation
Authors: Porter Alice , Franklin Matthew , De Vocht Frank , d'Apice Katrina , Curtin Esther , Albers Patricia , Kidger Judi 
Published: January 2024

BackgroundAddressing the wider determinants of mental health alongside psychological therapy could improve mental health service outcomes and population mental health.ObjectivesTo estimate the effectiveness of an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) mental health service compared with traditional IAPT in England. Alongside traditional therapy treatment, the enhanced service included well-being support and community service links.DesignA real-world evaluation using IAPT’s electronic health records.SettingThree National Health Service IAPT services in England.ParticipantsData from 17 642 service users classified as having a case of depression and/or anxiety at baseline.InterventionWe compared the enhanced IAPT service (intervention) to an IAPT service in a different region providing traditional treatment only (geographical control), and the IAPT service with traditional treatment before additional support was introduced (historical control).Primary outcome measuresPatient Health Questionnaire-9 (PHQ-9) Depression Scale (score range: 0–27) and Generalised Anxiety Disorder-7 (GAD-7) Anxiety Scale (score range: 0–21); for both, lower scores indicate better mental health. Propensity scores were used to estimate inverse probability of treatment weights, subsequently used in mixed effects regression models.ResultsSmall improvements (mean, 95% CI) were observed for PHQ-9 (depression) (−0.21 to –0.32 to −0.09) and GAD-7 (anxiety) (−0.23 to –0.34 to −0.13) scores in the intervention group compared with the historical control. There was little evidence of statistically significant differences between intervention control and geographical control.ConclusionsEmbedding additional health and well-being (H&W) support into standard IAPT services may lead to improved mental health outcomes. However, the lack of improved outcomes compared with the geographical control may instead reflect a more general improvement to the intervention IAPT service. It is not clear from our findings whether an IAPT service with additional H&W support is clinically superior to traditional IAPT models.
Neighbourhood environments for a healthy lifestyle among young single-person households experiencing housing poverty in Seoul, South Korea: a spatiotemporal qualitative study protocol
Authors: Kim Dong Ha , Lee Jihyun , Yoo Seunghyun 
Published: January 2024

IntroductionThe number of single-person households is increasing globally—including in South Korea, where they account for over 30% of all households. Young single-person households in South Korea face health problems and housing challenges. Both the perceived and objective aspects of the neighbourhood environment, as a community asset, play a significant role in sustaining a healthy lifestyle. This study aims to explore and describe the meaning, roles and spatiotemporal characteristics of neighbourhood environments for a healthy lifestyle in young single-person households experiencing housing poverty in Seoul, South Korea.Methods and analysisThis ongoing study uses an extended qualitative geographic information systems approach to explore a district in the city of Seoul that has the highest population density of young single-person households experiencing housing poverty. The study sample comprises young single-person households aged 19–39 years who are experiencing housing poverty in the study area, with an expected saturation point of approximately 55 participants. We employ online and offline recruitment strategies to ensure the inclusion of diverse perspectives and a multimethod approach that combines descriptive and spatiotemporal data collection techniques (eg, individual in-depth interviews, field observations and mobile global positioning system tracking). The data analysis encompasses thematic and content analyses to understand the neighbourhood environment’s perceived attributes and the spatiotemporal characteristics of healthy lifestyles. In the integrated analysis, we plan to combine the qualitative findings with living space and daily-life patterns using qualitative software and a hybrid relational database.Ethics and disseminationThe Institutional Review Board of Seoul National University approved the research protocol on 18 May 2021. The findings will be shared at international conferences and published in academic journals. Additionally, an online seminar will be conducted to share the results with policy-makers, researchers, community organisations and health workers working with young single-person households experiencing housing poverty.
Facilitators and barriers of digital health technologies implementation in hospital settings in lower-income and middle-income countries since the COVID-19 pandemic: a scoping review protocol
Authors: Yew Sheng Qian , Trivedi Daksha , Adanan Nurul Iman Hafizah , Chew Boon How 
Published: January 2024

IntroductionThe implementation of digital health technologies (DHTs) in hospitals worldwide has been uneven since the COVID-19 pandemic. Ambiguity in defining the landscape of DHTs adds to the complexity of this process. To address these challenges, this scoping review aims to identify the facilitators and barriers of implementing DHTs in hospitals in lower-income and middle-income countries (LMIC) since COVID-19, describe the DHTs that have been adopted in hospital settings in LMIC during this period, and develop a comprehensive classification framework to define the landscape of DHTs implemented in LMIC.Methods and analysisWe will conduct a systematic search in PubMed, Scopus, Web of Science and grey literature. Descriptive statistics will be used to report the characteristics of included studies. The facilitators and barriers to DHTs implementation, gathered from both quantitative and qualitative data, will be synthesised using a parallel-results convergent synthesis design. A thematic analysis, employing an inductive approach, will be conducted to categorise these facilitators and barriers into coherent themes. Additionally, we will identify and categorise all available DHTs based on their equipment types and methods of operation to develop an innovative classification framework.Ethics and disseminationFormal ethical approval is not required, as primary data collection is not involved in this study. The findings will be disseminated through peer-reviewed publications, conference presentations and meetings with key stakeholders and partners in the field of digital health.
Barriers to and facilitators of successful implementation of a palliative approach to care in primary care practices: a mixed methods study
Authors: Langley Jodi , Urquhart Robin , Tschupruk Cheryl , Christian Erin , Warner Grace 
Published: January 2024

ObjectiveIntegrating a palliative approach to care into primary care is an emerging evidence-based practice. Despite the evidence, this type of care has not been widely adopted into primary care settings. The objective of this study was to examine the barriers to and facilitators of successful implementation of a palliative approach to care in primary care practices by applying an implementation science framework.DesignThis convergent mixed methods study analysed semistructured interviews and expression of interest forms to evaluate the implementation of a protocol, linked to implementation strategies, for a palliative approach to care called Early Palliation through Integrated Care (EPIC) in three primary care practices. This study assessed barriers to and facilitators of implementation of EPIC and was guided by the Consolidated Framework for Implementation Research (CFIR). A framework analysis approach was used during the study to determine the applicability of CFIR constructs and domains.SettingPrimary care practices in Canada. Interviews were conducted between September 2020 and November 2021.Participants10 individuals were interviewed, who were involved in implementing EPIC. Three individuals from each practice were reinterviewed to clarify emerging themes.ResultsOverall, there were implementation barriers at multiple levels that caused some practices to struggle. However, barriers were mitigated when practices had the following facilitators: (1) a high level of intra-practice collaboration, (2) established practices with organisational structures that enhanced communications, (3) effective leveraging of EPIC project supports to transition care, (4) perceptions that EPIC was an opportunity to make a long-term change in their approach to care as opposed to a limited term project and (5) strong practice champions.ConclusionsFuture implementation work should consider assessing facilitators identified in our results to better gauge primary care pre-implementation readiness. In addition, providing primary care practices with support to help offset the additional work of implementing innovations and networking opportunities where they can share strategies may improve implementation success.