bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rural libraries implementing walking groups or walking groups plus civic engagement for walkability in rural communities: a comparative effectiveness trial study protocol
Authors: Perry Cynthia K , Seguin-Fowler Rebecca , Maddock Jay E. , Lenstra Noah , Dieckmann Nathan F. , Currier Jessica , Andreyeva Elena , Winkle Jim , Trost Stewart G. 
Published: October 2023

AbstractBackgroundRural residents generally lack adequate physical activity to benefit health and reduce disparities in chronic diseases, such as cardiovascular disease and certain cancers. The Socioecological Model describes physical activity as involving a dynamic and reciprocal interaction between individual, social, and community factors. Community group-based walking programs and civic engagement interventions aimed at enhancing physical activity have been successful in rural communities but have not targeted all three socioecological levels. Public libraries can act as innovative public health partners in rural communities. However, challenges remain because rural libraries often lack the capacity to implement evidence-based health promotion programming. The goals of this study are (1) build the capacity for rural libraries to implement evidence-based health promotion programs, (2) compare changes in physical activity between a group-based walking program and a combined group-based walking and civic engagement program with rural residents, and (3) conduct an implementation evaluation.MethodsWe will conduct a comparative effectiveness study of a group-based walking (standard approach) versus a group-based walking plus civic engagement program (combined approach) aimed at enhancing walkability to increase physical activity among rural adults. Key mediators between the program effects and change in outcomes will also be identified. Finally, we will evaluate program implementation, conduct a cost effectiveness evaluation, and use a positive deviance analysis to understand experiences of high and low changers on key outcomes. Twenty towns will be matched and randomized to one of the two conditions and our aim is to enroll a total of 350–400 rural residents (15–20 per town). Study outcomes will be assessed at baseline, and 6, 12, and 24 months.DiscussionThis study will build the capacity of rural libraries to implement evidence-based walking programs as well as other health promotion programs in their communities. The study results will answer questions regarding the relative effectiveness and cost effectiveness of two multilevel physical activity interventions targeting rural communities. We will learn what works and how these multilevel interventions can be implemented in rural populations.Trial RegistrationClinicalTrials.gov Identifier: NCT05677906.
Gender differences in estimated excess mortality during the COVID-19 pandemic in Thailand
Authors: Pothisiri Wiraporn , Prasitsiriphon Orawan , Apakupakul Jutarat , Ploddi Kritchavat 
Published: October 2023

Abstract
Background
There is a limited body of research specifically examining gender inequality in excess mortality and its variations across age groups and geographical locations during the COVID-19 pandemic. This study aims to fill this gap by analyzing the patterns of gender inequality in excess all-cause mortality in Thailand during the COVID-19 pandemic.

Methods
Data pertaining to all-cause deaths and population between January 1, 2010, and December 31, 2021, were obtained from Thailand’s Bureau of Registration Administration. A seasonal autoregressive integrated moving average (SARIMA) technique was used to estimate excess mortality during the pandemic between January 2020 to December 2021. Gender differential excess mortality was measured as the difference in age-standardized mortality rates between men and women.

Results
Our SARIMA-based estimate of all-cause mortality in Thailand during the COVID-19 pandemic amounted to 1,032,921 deaths, with COVID-19-related fatalities surpassing official figures by 1.64 times. The analysis revealed fluctuating patterns of excess and deficit in all-cause mortality rates across different phases of the pandemic, as well as among various age groups and regions. In 2020, the most pronounced gender disparity in excess all-cause mortality emerged in April, with 4.28 additional female deaths per 100,000, whereas in 2021, the peak gender gap transpired in August, with 7.52 more male deaths per 100,000. Individuals in the 80 + age group exhibited the largest gender gap for most of the observed period. Gender differences in excess mortality were uniform across regions and over the period observed. Bangkok showed the highest gender disparity during the peak of the fourth wave, with 24.18 more male deaths per 100,000.

Conclusion
The findings indicate an overall presence of gender inequality in excess mortality during the COVID-19 pandemic in Thailand, observed across age groups and regions. These findings highlight the need for further attention to be paid to gender disparities in mortality and call for targeted interventions to address these disparities.
What works in advocating for food advertising policy change across an english region – a realist evaluation
Authors: Sykes Susie , Watkins Megan , Bond Matthew , Jenkins Catherine , Wills Jane 
Published: October 2023

Abstract
Background
With increasing recognition of the role of commercial determinants of health, local areas in England have sought to restrict the advertising of products high in fat, salt and sugar (HFSS) on council-owned spaces, as part of wider strategies to reduce obesity. While there is some evidence of the impact of such policy change on behaviour, little is known about what works in the process of implementing this policy change.

Methods
Guided by a realist evaluation framework that explores the interaction between context, mechanism and outcomes, this study aims to investigate the factors that influence the restriction of outdoor advertising of HFSS products in one region in England. It refines a programme theory co-produced with stakeholders from 14 local authorities within a region and uses multiple data sources from each area with an in-depth examination of four case study sites. Data sources include longitudinal realist interviews, focus groups and surveys with policy advocates and policy stakeholders. Data were analysed retroductively to understand the causal link between context, mechanism and outcomes.

Results
Outcomes were driven by five dominant mechanisms: a strategic and staggered approach to stakeholder engagement, gathering intelligence, identifying policy champions, building relationships, reframing the issue; and two secondary mechanisms of amplifying the issue and increasing public will. These led to varied outcomes with no changes in formal policy position within the evaluation period but draft policy guidance in place and changes in political will demonstrated. Dominant context factors influencing change included having a named and resourced policy advocate in place supported by an external Community of Improvement and having existing aligned local objectives. Organisational complexity and change, financial concerns, lack of local examples, ideological positions and the pandemic were also influencing contextual factors.

Conclusion
Effecting policy change in this area requires the commitment of an extended period and the valuing of short-term policy outcomes, such as increasing political will. The importance of a resourced and well-supported policy advocate to lead this work is fundamental and the commercially sensitive nature of this policy change means that a complex interplay of mechanisms is required which may be dominated by a strategically staggered approach to stakeholder engagement.
How theories of complexity and resilience affect interprofessional simulation-based education: a qualitative analysis of facilitators’ perspectives
Authors: Amorøe Torben Nordahl , Rystedt Hans , Oxelmark Lena , Dieckmann Peter , Andréll Paulin 
Published: October 2023

Abstract
Background
Quality of care and patient safety rely on the ability of interprofessional teams to collaborate effectively. This can be trained through interprofessional simulation-based education (IPSE). Patient safety also relies on the ability to adapt to the complexity of such situations, an ability termed resilience. Since these needs are not explicitly addressed in IPSE, the aim of this study was to explore how central concepts from complexity-theory and resilience affect IPSE, from facilitators’ perspective, when applied in debriefings.

Methods
A set of central concepts in complexity-theory and resilience were introduced to facilitators on an IPSE course for nursing and medical students. In five iterations of focus groups interviews the facilitators discussed their application of these concepts by reviewing video recordings of their own debriefings. Video recordings of the interviews were subjected to coding and thematic analysis.

Results
Three themes were identified. The first, Concepts of complexity and resilience are relevant for IPSE, points to the applicability of these concepts and to the fact that students often need to deviate from prescribed guidelines/algorithms in order to solve cases. The second theme, Exploring complexity, shows how uncertainty could be used as a cue to explore complexity. Further, that individual performance needs to account for the context of actions and how this may lead to certain outcomes. Moreover, it was suggested that several ways to approach a challenge can contribute to important insight in the conditions for teamwork. The third theme, Unpacking how solutions are achieved, turns to needs for handling the aforementioned complexity. It illustrates the importance of addressing self-criticism by highlighting how students were often able to overcome challenges and find solutions. Finally, this theme highlights how pre-defined guidelines and algorithms still work as important resources to help students in transforming perceived messiness into clarity.

Conclusions
This study suggests that IPSE provides the possibility to explore complexity and highlight resilience so that such capability can be trained and improved. Further studies are needed to develop more concrete ways of using IPSE to account for complexity and developing resilience capacity and to evaluate to what extent IPSE can provide such an effect.
Use of routine health information systems data in developing and monitoring district and facility health plans: a scoping review
Authors: Byrne Elaine , Heywood Arthur 
Published: October 2023

Abstract
Background
Routine Health Information Systems data should be used in a systematic and institutionalised manner to support the making of plans, the monitoring of plans and in supportive supervision. To explore to what extent there is discussion about the linkage between planning, monitoring and supervision of sub-national programs using routine data we conducted a scoping review. The review question was: How are routine health information systems used in developing and monitoring health plans at district and facility level?

Methods
From a search of Ovid Medline (all), EMBASE and Web of Science along with a review of grey literature and involving a number of key stakeholders in identifying any missing resources a total of over 2200 documents were reviewed and data from 13 documents were extracted.

Results
Overall, there are many descriptions of how to implement and strengthen systems, ways to assess and improve data availability and quality, tools to improve the data use context, training in data use and mechanisms to involve stakeholders and strengthen infrastructure. However, there are gaps in examples of routine health data being used in the development, monitoring and supervision of plans at district and facility level.

Conclusions
There appears to be no institutionalised obligation of planners to monitor plans, very little guidance on how to practically monitor programs and minimal discussion about how to use the routinely available data to supportively supervise the implementation of the plans. To overcome these shortcomings, we recommend that practical procedures to ensure linkage of existing district plans to regular monitoring of priority programs are institutionalised, that mechanisms for making managers institutionally accountable for monitoring and supervising these plans are put in place, and that practical guidelines for linking plans with routine health information system data and regular monitoring and supportive supervision are developed.
Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study
Authors: Bek L. M. , Berentschot J. C. , Hellemons M. E. , Remerie S. C. , van Bommel J. , Aerts J. G. J. V. , Ribbers G. M. , van den Berg-Emons H. J. G. , Heijenbrok-Kal M. H. ,   on behalf of the CO-FLOW collaboration group, van Genderen Michel E. , Gommers Diederik A. M. P. J. , Ista Erwin , van der Stoep Robert , Osterthun Rutger , Wijffels Markus P. J. M. , Visser Marieke M. , Tazmi-Staal Janette J. , Willems Eva G. , Heller Roxane , Gajadin Shai A. , Blox Wouter J. B. , Oswald Laurien , Bindraban Sieshem , van de Sande Herbert J. , van Rossem Ronald N. , van Loon-Kooij Stephanie 
Published: October 2023

Abstract
Background
Currently, evidence about the long-term consequences of COVID-19 on return to work and health-related quality of life (HRQoL) is limited. We evaluated return to work and its associations with baseline characteristics and physical and mental recovery over time in patients up to 1 year after hospitalization for COVID-19. Secondly, we aimed to evaluate the association between return to work and health-related quality of life (HRQoL).

Methods
CO-FLOW, a multicenter prospective cohort study, enrolled adult participants hospitalized for COVID-19, aged ≥ 18 years within 6 months after hospital discharge. Return to work and HRQoL were collected at 3, 6, and 12 months after hospital discharge using the iMTA Productivity Cost Questionnaire and the 36-Item Short Form Health Survey, respectively. Data were collected between July 1, 2020, and September 1, 2022. Generalized estimating equations with repeated measurements were used to assess outcomes over time.

Results
In the CO-FLOW study, 371 participants were employed pre-hospitalization. At 3, 6, and 12 months post-discharge, 50% (170/342), 29% (92/317), and 15% (44/295) of participants had not returned to work, and 21% (71/342), 21% (65/317), and 16% (48/295) only partially, respectively. ICU admission (adjusted odds ratio (95% confidence interval): 0.17 (0.10 to 0.30), p < 0.001), persistent fatigue (0.93 (0.90 to 0.97), p < 0.001), female sex (0.57 (0.36 to 0.90), p = 0.017), and older age (0.96 (0.93 to 0.98), p < 0.001) were independently associated with no return to work. ICU patients required a longer time to return to work than non-ICU patients. Patients who did not return or partially returned to work reported lower scores on all domains of HRQoL than those who fully returned.

Conclusions
One year after hospitalization for COVID-19, only 69% of patients fully returned to work, whereas 15% did not return and 16% partially returned to work. No or partial return to work was associated with reduced HRQoL. This study suggests that long-term vocational support might be needed to facilitate return to work.

Trial registration
World Health Organization International Clinical Trials Registry Platform NL8710.
Radiographic determination of the tracheal indices at caudal cervical, thoracic-inlet, and intra-thoracic trachea in non-bulldog brachycephalic breeds without evidence of cardiorespiratory disease
Authors: Mostafa Ayman A. , Berry Clifford R. 
Published: October 2023

AbstractBackgroundCongenital tracheal hypoplasia is a component of airway syndrome affecting a wide variety of brachycephalic dog breeds. Several radiographic procedures were utilized to assess vertical tracheal diameter (VTD) in dogs. The objective of this study was to calculate the tracheal indices at the caudal cervical, thoracic-inlet, and intra-thoracic tracheal regions on the right lateral thoracic radiograph to further establish a screening protocol for diagnosis of tracheal hypoplasia in non-bulldog brachycephalic breeds. Dogs without clinical or radiographic evidence of tracheal, respiratory, or cardiovascular abnormalities were investigated. The absolute and average VTDs were normalized by manubrium length (ML), thoracic-inlet distance (Ti-D), and proximal 3rd rib width (PR3-W). Manubrium-tracheal index (M-TI), thoracic inlet-tracheal index (Ti-TI), and proximal R3-tracheal score (PR3-TS) were calculated. Correlations between averaged VTD and each of the normalizing parameters (ML, Ti-D, and PR3-W), and between M-TI and each of the previously established procedures (Ti-TI and PR3-TS) were determined.ResultsEighty healthy subjects met the inclusion criteria for the study. There were significant differences (P ≤ 0.0001) among the means of absolute and normalized VTDs at the 3 tracheal levels. The smallest VTD was identified at the thoracic inlet. The average tracheal diameter showed a better correlation with ML (rs=0.81,P < 0.0001) compared to Ti-D and PR3-W. There was a strong correlation (rs=0.83,P < 0.0001) between the averaged M-TI and Ti-TI.ConclusionRadiographic M-TI could be an alternative to traditional procedures to assess the tracheal lumen in non-bulldog brachycephalic dogs. M-TI < 0.39, < 0.30, or < 0.34 at caudal cervical, thoracic inlet, or intrathoracic trachea, respectively, may indicate tracheal hypoplasia in non-bulldog brachycephalic breeds. Screening of tracheal diameter using M-TI should be recommended. However, further investigation of non-bulldog brachycephalic breeds with cardiac and/or respiratory disease is indicated.
Insights into the genetics of menopausal vasomotor symptoms: genome-wide analyses of routinely-collected primary care health records
Authors: Ruth Katherine S. , Beaumont Robin N. , Locke Jonathan M. , Tyrrell Jessica , Crandall Carolyn J. , Hawkes Gareth , Frayling Timothy M. , Prague Julia K. , Patel Kashyap A. , Wood Andrew R. , Weedon Michael N. , Murray Anna 
Published: October 2023

Abstract
Background
Vasomotor symptoms (VMS) can often significantly impact women’s quality of life at menopause. In vivo studies have shown that increased neurokinin B (NKB) / neurokinin 3 receptor (NK3R) signalling contributes to VMS, with previous genetic studies implicating the TACR3 gene locus that encodes NK3R. Large-scale genomic analyses offer the possibility of biological insights but few such studies have collected data on VMS, while proxy phenotypes such as hormone replacement therapy (HRT) use are likely to be affected by changes in clinical practice. We investigated the genetic basis of VMS by analysing routinely-collected health records.

Methods
We performed a GWAS of VMS derived from linked primary-care records and cross-sectional self-reported HRT use in up to 153,152 women from UK Biobank, a population-based cohort. In a subset of this cohort (n = 39,356), we analysed exome-sequencing data to test the association with VMS of rare deleterious genetic variants. Finally, we used Mendelian randomisation analysis to investigate the reasons for HRT use over time.

Results
Our GWAS of health-records derived VMS identified a genetic signal near TACR3 associated with a lower risk of VMS (OR=0.76 (95% CI 0.72,0.80) per A allele, P=3.7x10-27), which was consistent with previous studies, validating this approach. Conditional analyses demonstrated independence of genetic signals for puberty timing and VMS at the TACR3 locus, including a rare variant predicted to reduce functional NK3R levels that was associated with later menarche (P = 5 × 10–9) but showed no association with VMS (P = 0.6). Younger menopause age was causally-associated with greater HRT use before 2002 but not after.

Conclusions
We provide support for TACR3 in the genetic basis of VMS but unexpectedly find that rare genomic variants predicted to lower NK3R levels did not modify VMS, despite the proven efficacy of NK3R antagonists. Using genomics we demonstrate changes in genetic associations with HRT use over time, arising from a change in clinical practice since the early 2000s, which is likely to reflect a switch from preventing post-menopausal complications in women with earlier menopause to primarily treating VMS. Our study demonstrates that integrating routinely-collected primary care health records and genomic data offers great potential for exploring the genetic basis of symptoms.
Clinical trials of new drugs for Alzheimer disease: a 2020–2023 update
Authors: Huang Li-Kai , Kuan Yi-Chun , Lin Ho-Wei , Hu Chaur-Jong 
Published: October 2023

AbstractAlzheimer's disease (AD) is the leading cause of dementia, presenting a significant unmet medical need worldwide. The pathogenesis of AD involves various pathophysiological events, including the accumulation of amyloid and tau, neuro-inflammation, and neuronal injury. Clinical trials focusing on new drugs for AD were documented in 2020, but subsequent developments have emerged since then. Notably, the US-FDA has approved Aducanumab and Lecanemab, both antibodies targeting amyloid, marking the end of a nearly two-decade period without new AD drugs. In this comprehensive report, we review all trials listed in clinicaltrials.gov, elucidating their underlying mechanisms and study designs. Ongoing clinical trials are investigating numerous promising new drugs for AD. The main trends in these trials involve pathophysiology-based, disease-modifying therapies and the recruitment of participants in earlier stages of the disease. These trends underscore the significance of conducting fundamental research on pathophysiology, prevention, and intervention prior to the occurrence of brain damage caused by AD.