bluuebunny/crossref_metadata_2025_split huggingface dataset:
Co-designing action-oriented mental health conversations between care providers and ageing Canadians in the community: a participatory mixed-methods study protocol
Authors: Giosa Justine L , Kalles Elizabeth , McAiney Carrie , Oelke Nelly D , Aubrecht Katie , McNeil Heather , Habib Perez Olinda , Holyoke Paul 
Published: January 2024

IntroductionThe mental health of ageing Canadians is a growing concern, particularly post-pandemic. Older adults face systemic ageism and mental health stigma as pervasive barriers to seeking needed mental health support, care and treatment within health and social care systems. These barriers are exacerbated when service providers focus on physical healthcare needs or lack the skills and confidence to talk about and/or address mental health during routine visits. This study aims to co-design and test an evidence-based approach to mental health conversations at the point-of-care in home and community settings with older adults, family and friend caregivers and health and social care providers that could facilitate help-seeking activities and care access.Methods and analysisA participatory mixed-methods study design will be applied, guided by a Working Group of experts-by-experience (n=30). Phase 1 engages ageing Canadians in four online workshops (n=60) and a national survey (n=1000) to adapt an evidence-based visual model of mental health for use with older adults in home and community care. Phase 2 includes six co-design workshops with community providers (n=90) in rural and urban sites across three Canadian provinces to co-design tools, resources and processes for enabling the use of the adapted model as a conversation guide. Phase 3 involves pilot and feasibility testing the co-designed conversations with older adult clients of providers from Phase 2 (n=180).Ethics and disseminationPhases 1 and 2 of this study have received ethics clearance at the University of Waterloo (ORE #44187), University of British Columbia (#H22-02306) and St. Francis Xavier University (#26075). While an overview of Phase 3 is included, details will rely on Phase 2 outcomes. Knowledge mobilisation activities will include peer-reviewed publications, conference presentations, webinars, newsletters, infographics and policy briefs. Interested audiences may include community organisations, policy and decision-makers and health and social care providers.
Effects of six teaching strategies on medical students: protocol for a systematic review and network meta-analysis
Authors: Zhang Shuailong , Zhu Dongmei , Wang Xiaqing , Liu Tianyao , Wang Lian , Fan Xiaotang , Gong Hong 
Published: January 2024

IntroductionMounting evidence has suggested that novel teaching strategies have a positive impact on the quality and efficiency of medical education. However, the comprehensive evidence about the superiority among various strategies is not clear. To address this issue, we aim to conduct a systematic review and network meta-analysis (NMA) to evaluate the effects of six main strategies on medical education, including case-based learning, problem-based learning, team-based learning, flipped classrooms, simulation-based education and bridge-in, objective, preassessment, participatory learning, postassessment and summary.Methods and analysisA systematic search will be conducted in PubMed, Embase, Web of Science and the Cochrane Library, covering studies published from database inception to November 2023. Randomised controlled trials which evaluated the different teaching methods and meet the eligibility criteria will be included. The effectiveness of medical students’ learning, which is evaluated by theoretical test score, experimental or practical test score, will be analysed as the primary outcomes. Besides, the secondary outcomes consist of learning satisfaction of students and formative evaluation score. The study selection and data extraction will be independently performed by two authors. The risk of bias in each study will be assessed using V.2 of the Cochrane risk-of-bias tool for randomised controlled trials. To compare the effects of six teaching strategies, pairwise meta-analysis and NMA will be performed using Rev Man, STATA and R software. Statistical analyses including homogeneity tests, sensitivity analysis, consistency tests, subgroup analysis, Egger’s test and publication bias will also be completed.Ethics and disseminationNo formal research ethics approval is required because this study is a meta-analysis based on published studies. The results will be disseminated to a peer-reviewed journal for publication.Protocol registration numberCRD42023456050.
Impact of left atrial appendage thrombus location on diagnostic accuracy of cardiac CT: a single-centre case-control study
Authors: Guo Chuxian , Jiang Zhi , He Jionghong , Ma Haiyan , Wang Yuquan , Tan Jing , Ou Qiaoqiao , Tian Ye , Tian Longhai , Liu Qifang , Huang Jing , Yang Long 
Published: January 2024

ObjectiveCardiac CT (CCT) is an emerging non-invasive modality for assessing left atrial appendage (LAA) thrombus, but the results were conflicting. Our study aims to evaluate the accuracy of CCT for detecting LAA thrombus in patients undergoing catheter ablation of atrial fibrillation, using trans-oesophageal echocardiography (TEE) as the reference standard.DesignCase-control study.SettingPatient data were collected from a tertiary hospital in China between 2017 and 2022.ParticipantsThe study enrolled 726 patients (male: 60.2%, age: 61±11 years) who had both TEE and CCT before catheter ablation of atrial fibrillation.MeasuresThe CCT protocol consisted of one angiographic phase and one delayed scan 30 s later. LAA thrombi were defined as solid masses on TEE or persistent defects on CCT. The thrombus dimension and location, the LAA filling and emptying flow velocity were assessed by TEE.ResultsOf the 57 (7.9%) patients with LAA thrombi identified by TEE, 29 (50.9%) were located at the LAA ostium, and 28 (49.1%) were in the LAA. The former showed higher motility following blood flow and heartbeats than the latter. The CCT detected 14 (48.3%) of the LAA-ostium thrombi but 25 (89.3%) of those in the LAA (p=0.001). The LAA-ostium thrombi with the LAA mean flow velocity >0.35 m/s and maximum diameters <10 mm were more prone to have CCT false-negative results.ConclusionFor patients undergoing catheter ablation for atrial fibrillation, CCT with a 30 s delay scan is less sensitive to LAA thrombi than TEE, especially for LAA-ostium thrombi with smaller sizes and higher LAA flow velocity.
Descriptive analysis to assess seasonal patterns of COVID-19 and influenza in low-income and middle-income countries in Asia, the Middle East and Latin America
Authors: Kyaw Moe H , Spinardi Julia Regazzini , Jagun Oladayo , Franco Villalobos Conrado , Kapetanakis Venediktos , Sharf-Williams Ruth , Yarnoff Benjamin 
Published: January 2024

ObjectivesUnderstanding disease seasonality can help predict the occurrence of outbreaks and inform public health planning. Respiratory diseases typically follow seasonal patterns; however, knowledge regarding the seasonality of COVID-19 and its impact on the seasonality of influenza remains limited. The objective of this study was to provide more evidence to understand the circulation of SARS-CoV-2, the virus responsible for COVID-19, in an endemic scenario to guide potential preventive strategies.DesignIn this study, a descriptive analysis was undertaken to describe seasonality trends and/or overlap between COVID-19 and influenza in 12 low-income and middle-income countries using Our World in Data and FluMart data sources. Plots of COVID-19 and influenza cases were analysed.SettingSingapore, Thailand, Malaysia, the Philippines, Argentina, Brazil, Mexico, South Africa, Morocco, Bahrain, Qatar and Saudi Arabia.Outcome measuresCOVID-19 cases and influenza cases.ResultsNo seasonal patterns of SARS-CoV-2 or SARS-CoV-2/influenza cocirculation were observed in most countries, even when considering the avian influenza pandemic period.ConclusionsThese results can inform public health strategies. The lack of observed seasonal behaviour highlights the importance of maintaining year-round vaccination rather than implementing seasonal campaigns. Further research investigating the influence of climate conditions, social behaviour and year-round preventive measures could be fundamental for shaping appropriate policies related to COVID-19 and respiratory viral disease control in low-income and middle-income countries as COVID-19 variant data and epidemiologic patterns accrue over time.
What is the coverage of retina screening services for people with diabetes? Protocol for a systematic review and meta-analysis
Authors: Chabba Nimisha , Silwal Pushkar Raj , Bascaran Covadonga , McCormick Ian , Goodman Lucy , Gordon Iris , Burton Matthew J , Keel Stuart , Evans Jennifer , Ramke Jacqueline 
Published: January 2024

IntroductionDiabetic retinopathy is a leading cause of vision impairment globally. Vision loss from diabetic retinopathy can generally be prevented by early detection and timely treatment. The WHO included a measure of service access for diabetic retinopathy as a core indicator in the Eye Care Indicator Menu launched in 2022:retina screening coverage for people with diabetes. The aim of this review is to provide a comprehensive global and regional summary of the available information on retina screening coverage for people with diabetes.Methods and analysisA search will be conducted in five databases without language restrictions for studies from any country reporting retina screening coverage for adults with any type of diabetes at the national or subnational level using data collected since 1 January 2000 until the search date. We will also seek reports and coverage statistics from government websites of all WHO member states. Two investigators will independently screen studies, extract relevant data and assess risk of bias of included studies. The results of the review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. We will summarise the range of coverage definitions reported across included studies and present the median retina screening coverage in WHO regions and by World Bank country income level. Depending on the availability of data, we will conduct meta-analysis to assess disparities in retina screening coverage for people with diabetes by factors in the PROGRESS framework (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status and Social capital).Ethics and disseminationThis review will only include published data thus no ethical approval will be sought. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences.Protocol registration numberOSF registration 17/10/2023:https://osf.io/k5p69.
Improving food insecurity screening across a health system throughout the COVID-19 pandemic
Authors: Kroese Lani , Lobo Kenia , Meyer Mary , Tate Jordan , Mays Mitra , Adye Rebecca , Qureshi Henna , Al-Shammaa Bann , Brito Albert , Seo-Mayer Patty , Moyer Katherine , Port Courtney 
Published: January 2024

BackgroundFood insecurity has direct and indirect negative outcomes on the physical and mental health of children, with impacts throughout adult life. Rates of food insecurity have increased dramatically since the start of the COVID-19 pandemic. The American Academy of Pediatrics recommends paediatricians screen and intervene to address food insecurity. We aimed to increase the percentage of patient encounters with food insecurity screening completion at the paediatric medical home from 0% to 85% by July 2020 with extension to the paediatric emergency department (ED) and paediatric specialty clinic in the following year.MethodsThis multicentre project occurred in three sites within our health system: a teaching safety-net, paediatric medical home; a paediatric ED; and five divisions within paediatric specialty medical clinics. A screening tool was created using the validated Hunger Vital Sign Questionnaire. A standard screening, documentation and referral process was developed. The Model for Improvement was used testing changes via Plan-Do-Study-Act cycles.ResultsThe percentage of households screened for food insecurity increased from a median of 0% to 30% for all sites combined. There was significant variability in screening with the ED screening a median of 24% and the medical home screening 80% by the end of the study period. A total of 9842 households (20.9%) screened were food insecure. During the study period, 895 families with 3925 household members received 69 791 pounds of food from our primary community resource using our clinic’s food prescription. Of these families, 44% (398) also qualified for the US Department of Agriculture programme ensuring ongoing food distribution up to twice a month.DiscussionUsing quality improvement methodology to address a critical community need, we implemented food insecurity screening across a hospital system including multiple sites and specialties and provided critical resources to households in need.
Time is a terrible thing to waste: optimising use of intraoperative monitoring practitioner time towards maximising in-house IOM service provision and reducing spend on external provision
Authors: Lodwick Stuart James , Antonacci Grazia , Proudlove Nathan 
Published: January 2024

Intraoperative monitoring (IOM) during orthopaedic and neurosurgical operations informs surgeons about the integrity of patients’ central and peripheral nervous systems. It is provided by IOM practitioners (IOMPs), who are usually neurophysiology healthcare scientists. Increasing awareness of the benefits for patient safety and surgical outcomes, along with post-COVID-19 service recovery, has resulted in a material increase in demand for IOM provision nationally, and particularly at Salford Royal Hospital (SRH), which is a regional specialist neurosciences centre.There is a shortage of IOMPs in the UK National Health Service (NHS). At SRH, this is exacerbated by staff capacity shortage, requiring £202 800 of supplementary private provision in 2022.At SRH, IOMPs work in pairs. Our productive time is wasted by delays to surgical starts beyond our control and by paired working for much of a surgery session. This quality improvement (QI) project set out to release productive time by: calling the second IOMP to theatre only shortly before start time, the other IOMP returning to the office during significant delays, releasing an IOMP from theatre when appropriate and providing a laptop in theatre for other work.We tested and refined these change ideas over two plan–do–study–act improvement cycles. Compared with complete paired working, we increased the time available for additional productive work and breaks from an average of 102 to 314 min per operating day, not quite achieving our project target of 360 min.The new ways of working we developed are a step towards ability (when staff capacity increases) to test supporting two (simultaneous) operations with three IOMPs (rather than two pairs of IOMPs). Having significantly improved the use of staff time, we then also used our QI project data to make a successful business case for investment in two further IOMP posts with a predicted net saving of £20 000 per year along with other associated benefits.
Developing a framework of concerns from people living with frailty, for the Measure Yourself Concerns and Wellbeing (MYCaW) person-centred outcome measure
Authors: Polley Marie J , Barker Ruth E , Collaco Niçole B , Cam Christine , Appleton Joanne , Seers Helen E 
Published: January 2024

IntroductionMeasure Yourself Concerns and Wellbeing is a validated person-centred outcome measure, piloted as a core monitoring tool to understand what matters to people living with frailty in Gloucestershire. This paper describes the acceptability of MYCaW used in this setting, and the development of a framework for analysing personalised concerns from people living with frailty.MethodsMYCaW was implemented in the Complex Care at Home service and South Cotswold Frailty Service from November 2020 onwards. MYCaW was completed at the person’s first meeting with a community matron and then 3 months later. Nineteen staff completed an anonymous survey to provide feedback on the acceptability of the tool. A framework of concerns bespoke to people living with frailty was created via iterative rounds of independent coding of 989 concerns from 526 people. The inter-rater reliability of the framework was determined by using the Cronbach alpha test.ResultsMYCaW was simple to use and helped health professionals’ discussions to be patient focused. A pictorial scale accompanying the Numerical Rating Scale was developed and tested to help people engage with scoring their concerns and well-being more easily. A framework of concerns from people living with frailty was produced with five main supercategories: Mental and Emotional Concerns; Physical Concerns; Healthcare and Service Provision Concerns, Concerns with General Health and Well-being and Practical Concerns. Inter-rater reliability was kappa=0.905.ConclusionsMYCaW was acceptable as a core monitoring tool for people living with frailty and enabled a systematic approach to opening ‘What Matters to Me’ conversations. The personalised data generated valuable insights into how the frailty services positively impacted the outcomes for people living with frailty. The coding framework demonstrated a wide range of concerns—many linked to inequalities and not identified on existing outcome measures recommended for people living with frailty.
Impact of a potential Chlamydia vaccine in the USA: mathematical modelling analyses
Authors: Makhoul Monia , Ayoub Houssein H , Awad Susanne F , Chemaitelly Hiam , Abu-Raddad Laith J 
Published: January 2024

IntroductionChlamydia trachomatis(CT) infection is a global health challenge. New approaches are needed to control CT disease burden.MethodsAn age-structured deterministic mathematical model calibrated to nationally representative population-based data was developed to investigate the impact of CT vaccination on the population of the USA if a vaccine becomes available. The model’s parameters were chosen based on current knowledge from the literature on CT’s natural history and epidemiology. The model’s calibration used age-specific CT prevalence data sourced from the biannual rounds of the National Health and Nutrition Examination Surveys. The reported data are based on the outcomes generated by the model’s simulations.ResultsOver a 10-year period, vaccinating 80% of individuals aged 15–49 with a vaccine that reduces by 50% susceptibility to infection (VES=50%), infectiousness (VEI=50%) or duration of infection (VEP=50%) resulted, respectively, in 36.3%, 26.5% and 42.1% reduction in CT prevalence, and 38.8%, 28.6% and 24.1% reduction in CT incidence rate. Number of averted infections was 11 346 000, 7 583 000 and 6 012 000, respectively. When efficacies acted together (VES=VEI=VEP=50%), CT prevalence and incidence rate were reduced by 66.3% and 61.0%, respectively. Number of vaccinations needed to avert one infection was 17.7 forVES=50%, 26.5 forVEI=50%, 33.4 forVEP=50%and 12.0 forVES=VEI=VEP=50%. Vaccinating individuals aged 15–19 and at highest risk of infection was most effective, requiring only 7.7 and 1.8 vaccinations to prevent one infection, respectively. Vaccination benefits were larger beyond 10 years.ConclusionA moderately efficacious CT vaccine can significantly reduce CT disease burden. Targeting specific populations can maximise cost-effectiveness. Additional potential ‘breakthrough’ effects of the vaccine on infectiousness and duration of infection could greatly increase its impact. CT vaccine development and implementation should be a public health priority.
Sulforaphane activates CD8+T cells antitumor response through IL-12RB2/MMP3/FasL-induced MDSCs apoptosis’
Authors: Liu Jinyan , Chen Huanan , Guo Caijuan , Li Jieyao , Li Miaomiao , Zhao Ming , Fu Ziyi , Zhang Zhen , Li Feng , Zhao Xuan , Yang Li , Wang Liping , Lv Quanjun , Zhang Yi 
Published: January 2024

BackgroundExtensive attention has been given to the role of myeloid-derived suppressor cells (MDSCs) in driving tumor progression and treatment failure. Preclinical studies have identified multiple agents that eliminate MDSCs. However, none have been authorized in the cliniccal ues due to the safety reasons. In the present study, we investigated the efficacy and mechanism of sulforaphane (SFN) to eliminate MDSCs in the tumor microenvironment (TME).MethodsWe monitored SFN effect on tumor growth and the percents or apoptosis of immune cell subsets in mice models bearing LLC or B16 cells. Flow cytometry, quantitative reverse transcription-PCR, immunohistochemistry, ELISA, immunofluorescence, imaging flow cytometry and western blot were performed to validate the role of SFN on MDSCs function in vivo and in vitro. RNA sequencing was then used to interrogate the mechanisms of how SFN regulated MDSCs function. Tumor xenograft models were established to evaluate the involvement of IL-12RB2/MMP3/FasL induced MDSCs apoptosis in vivo. We verified the effect of SFN on MDSCs and CD8+T cells in the blood samples from a phase I clinical trial (KY-2021–0350).ResultsIn this study, we elucidated that SFN liberated CD8+T-cell antitumor ability by reducing MDSCs abundance, leading to repressed tumor growth. SFN treatment suppressed MDSCs accumulation in the peripheral blood and tumor sites of mice, but had no effect on the bone marrow. Mechanistically, SFN activates IL-12RB2, which stimulates the MMP3/FasL signaling cascade to trigger caspase 3 cleavage and induce apoptosis in MDSCs. Clinically, SFN treatment eliminates peripheral MDSCs and increases the percentage and activation of CD8+T cells.ConclusionsCollectively, we uncovered the role of SFN in eliminating MDSCs to emancipate CD8+T cells through IL-12RB2/MMP3/FasL induced apoptosis, thus providing a strategy for targeting MDSCs to control tumors and improve clinical efficacy.