bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the association between genetically proxied circulating levels of immune checkpoint proteins and cancer survival: protocol for a Mendelian randomisation analysis
Authors: Bate Tessa , Martin Richard M , Yarmolinsky James , Haycock Philip C 
Published: February 2024

IntroductionCompared with the traditional drug development pathway, investigating alternative uses for existing drugs (ie, drug repurposing) requires substantially less time, cost and resources. Immune checkpoint inhibitors are licensed for the treatment of certain breast, colorectal, head and neck, lung and melanoma cancers. These drugs target immune checkpoint proteins to reduce the suppression of T cell activation by cancer cells. As T cell suppression is a hallmark of cancer common across anatomical sites, we hypothesise that immune checkpoint inhibitors could be repurposed for the treatment of additional cancers beyond the ones already indicated.Methods and analysisWe will use two-sample Mendelian randomisation to investigate the effect of genetically proxied levels of protein targets of two immune checkpoint inhibitors—programmed cell death protein 1 and programmed death ligand 1—on survival of seven cancer types (breast, colorectal, head and neck, lung, melanoma, ovarian and prostate). Summary genetic association data will be obtained from prior genome-wide association studies of circulating protein levels and cancer survival in populations of European ancestry. Various sensitivity analyses will be performed to examine the robustness of findings to potential violations of Mendelian randomisation assumptions, collider bias and the impact of alternative genetic instrument construction strategies. The impact of treatment history and tumour stage on the findings will also be investigated using summary-level and individual-level genetic data where available.Ethics and disseminationNo separate ethics approval will be required for these analyses as we will be using data from previously published genome-wide association studies which individually gained ethical approval and participant consent. Results from analyses will be submitted as an open-access peer-reviewed publication and statistical code will be made freely available on the completion of the analysis.
Healthcare-seeking behaviours of patients with acute respiratory infection: a cross-sectional survey in a rural area of southwest China
Authors: Dai Peixi , Qi Li , Jia Mengmeng , Li Tingting , Ran Hua , Jiang Mingyue , Tang Wenge , Yan Chaoyang , Yang Weizhong , Ren Yuhua , Feng Luzhao 
Published: February 2024

ObjectivesThis study aimed to assess the healthcare-seeking behaviour and related factors of people with acute respiratory symptoms in the rural areas of central and western China to estimate the disease burden of influenza more accurately.DesignCross-sectional survey.SettingsFifty-two communities/villages in the Wanzhou District, Chongqing, China, a rural area in southwest China, from May 2022 to July 2022.ParticipantsThe participants were those who had been living in Wanzhou District continuously for more than 6 months and consented to participate.Outcome measuresA semistructured questionnaire was used to determine the healthcare-seeking behaviour of participants, and the dichotomous response of ‘yes’ or ‘no’ was used to assess whether participants had acute respiratory symptoms and their healthcare-seeking behaviour.ResultsOnly 50.92% (360 of 707) of the patients with acute respiratory infection visited medical and health institutions for treatment, whereas 49.08% (347 of 707) avoided treatment or opted for self-medication. The primary reason for not seeing a doctor was that patients felt their condition was not serious and visiting a medical facility for treatment was unnecessary. Short distance (87.54%) and reasonable charges (49.48%) were ranked as the most important reasons for choosing treatment at primary medical and health facilities (80.27%). The primary reasons for which patients visited secondary and tertiary hospitals (7.78% and 8.61%, respectively) were that doctors in such facilities were better at diagnosis (57.14%) and at treatment (87.10%).ConclusionThe findings provided in this study indicated that regular healthcare-seeking behaviour investigations should be conducted. The disease burden of influenza can be calculated more accurately when healthcare-seeking behaviour investigations are combined with surveillance in the hospitals.
Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review protocol
Authors: Söderberg Anja , Lindgren Britt-Marie , Looi Git-Marie Ejneborn , Bäckström Josefin , Gabrielsson Sebastian 
Published: February 2024

IntroductionPsychiatric inpatient care (PIC) is often characterised by high pressure and thresholds for admission, brief periods of care and limited time for caring activities. Dissociative identity disorder (DID) is a contested diagnosis, and persons with DID are at risk of not receiving adequate support when cared for in PIC. Because the limited literature addressing the topic includes no overview on how persons with DID are cared for in psychiatric inpatient settings, the aim of this scoping review is to map the area of knowledge on PIC for persons experiencing DID. This scoping review will provide an overview with the possibility to elucidate gaps in the evidence base and needs for future research on PIC for persons experiencing DID.Methods and analysisThis scoping review will follow Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews and steps 1–5 described in the established method for scoping reviews: identifying research question, identifying relevant studies, study selection, charting the data and collating, summarising and reporting results.Ethics approvalNot applicable.DisseminationThis scoping review will be submitted for publication in an international, peer-reviewed journal.
Identifying neonates at risk for post-discharge mortality in Dar es Salaam, Tanzania, and Monrovia, Liberia: Derivation and internal validation of a novel risk assessment tool
Authors: Rees Chris A , Ideh Readon C , Kisenge Rodrick , Kamara Julia , Coleman-Nekar Ye-Jeung G , Samma Abraham , Godfrey Evance , Manji Hussein K , Sudfeld Christopher R , Westbrook Adrianna L , Niescierenko Michelle , Morris Claudia R , Whitney Cynthia G , Breiman Robert F , Duggan Christopher P , Manji Karim P 
Published: February 2024

IntroductionThe immediate period after hospital discharge carries a large burden of childhood mortality in sub-Saharan Africa. Our objective was to derive and internally validate a risk assessment tool to identify neonates discharged from the neonatal ward at risk for 60-day post-discharge mortality.MethodsWe conducted a prospective observational cohort study of neonates discharged from Muhimbili National Hospital in Dar es Salaam, Tanzania, and John F Kennedy Medical Centre in Monrovia, Liberia. Research staff called caregivers to ascertain vital status up to 60 days after discharge. We conducted multivariable logistic regression analyses with best subset selection to identify socioeconomic, demographic, clinical, and anthropometric factors associated with post-discharge mortality. We used adjusted log coefficients to assign points to each variable and internally validated our tool with bootstrap validation with 500 repetitions.ResultsThere were 2344 neonates discharged and 2310 (98.5%) had post-discharge outcomes available. The median (IQR) age at discharge was 8 (4, 15) days; 1238 (53.6%) were male. In total, 71 (3.1%) died during follow-up (26.8% within 7 days of discharge). Leaving against medical advice (adjusted OR [aOR] 5.62, 95% CI 2.40 to 12.10) and diagnosis of meconium aspiration (aOR 6.98, 95% CI 1.69 to 21.70) conferred the greatest risk for post-discharge mortality. The risk assessment tool included nine variables (total possible score=63) and had an optimism corrected area under the receiver operating characteristic curve of 0.77 (95% CI 0.75 to 0.80). A score of ≥6 was most optimal (sensitivity 68.3% [95% CI 64.8% to 71.5%], specificity 72.1% [95% CI 71.5% to 72.7%]).ConclusionsA small number of factors predicted all-cause, 60-day mortality after discharge from neonatal wards in Tanzania and Liberia. After external validation, this risk assessment tool may facilitate clinical decision making for eligibility for discharge and the direction of resources to follow-up high risk neonates.
Developing a quality framework for community pharmacy: a systematic review of international literature
Authors: Hindi Ali M K , Campbell Stephen M , Jacobs Sally , Schafheutle Ellen Ingrid 
Published: February 2024

ObjectiveTo identify the defining features of the quality of community pharmacy (CP) services and synthesise these into an evidence-based quality framework.DesignSystematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesInternational research evidence (2005 onwards) identified from six electronic databases (Embase, PubMed, Scopus, CINAHL, Web of Science and PsycINFO) was reviewed systematically from October 2022 to January 2023. Search terms related to ‘community pharmacy’ and ‘quality’.Eligibility criteria for selecting studiesTitles and abstracts were screened against inclusion or exclusion criteria, followed by full-text screening by at least two authors. Qualitative, quantitative and mixed-method studies relevant to quality in CP were included.Data extraction and synthesisA narrative synthesis was undertaken. Following narrative synthesis, a patient and public involvement event was held to further refine the quality framework.ResultsFollowing the title and abstract screening of 11 493 papers, a total of 81 studies (qualitative and quantitative) were included. Of the 81 included studies, 43 investigated quality dimensions and/or factors influencing CP service quality; 21 studies assessed patient satisfaction with and/or preferences for CP, and 17 studies reported the development and assessment of quality indicators, standards and guidelines for CPs, which can help define quality.The quality framework emerging from the global literature consisted of six dimensions: person-centred care, access, environment, safety, competence and integration within local healthcare systems. Quality was defined as having timely and physical access to personalised care in a suitable environment that is safe and effective, with staff competent in the dispensing process and pharmacy professionals possessing clinical knowledge and diagnostic skills to assess and advise patients relative to pharmacists’ increasingly clinical roles.ConclusionThe emerging framework could be used to measure and improve the quality of CP services. Further research and feasibility testing are needed to validate the framework according to the local healthcare context.
Effects of ambient air pollution on obesity and ectopic fat deposition: a protocol for a systematic review and meta-analysis
Authors: Munir Mehnaz , Azab Sandi M , I Bangdiwala Shrikant , Kurmi Om , Doiron Dany , Brook Jeffrey , Banfield Laura , de Souza Russell J 
Published: February 2024

IntroductionGlobally, the prevalence of obesity tripled from 1975 to 2016. There is evidence that air pollution may contribute to the obesity epidemic through an increase in oxidative stress and inflammation of adipose tissue. However, the impact of air pollution on body weight at a population level remains inconclusive. This systematic review and meta-analysis will estimate the association of ambient air pollution with obesity, distribution of ectopic adipose tissue, and the incidence and prevalence of non-alcoholic fatty liver disease among adults.Methods and analysisThe study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for conduct and reporting. The search will include the following databases: Ovid Medline, Embase, PubMed, Web of Science and Latin America and the Caribbean Literature on Health Sciences, and will be supplemented by a grey literature search. Each article will be independently screened by two reviewers, and relevant data will be extracted independently and in duplicate. Study-specific estimates of associations and their 95% Confidence Intervals will be pooled using a DerSimonian and Laird random-effects model, implemented using the RevMan software. The I2statistic will be used to assess interstudy heterogeneity. The confidence in the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Ethics and disseminationAs per institutional policy, ethical approval is not required for secondary data analysis. In addition to being published in a peer-reviewed journal and presented at conferences, the results of the meta-analysis will be shared with key stakeholders, health policymakers and healthcare professionals.PROSPERO registration numberCRD42023423955.
Clinical decision support system based on deep learning for evaluating implantable collamer lens size and vault after implantable collamer lens surgery: a retrospective study
Authors: Yang Yixuan , Long Zhengqin , Lei Bo , Liu Wei , Ye Jian 
Published: February 2024

ObjectivesTo aid doctors in selecting the optimal preoperative implantable collamer lens (ICL) size and to enhance the safety and surgical outcomes of ICL procedures, a clinical decision support system (CDSS) is proposed in our study.DesignA retrospective study of patients after ICL surgery.SettingChina Tertiary Myopia Prevention and Control Center.Participants2772 eyes belonging to 1512 patients after ICL surgery. Data were collected between 2018 and 2022.Outcome measuresA CDSS is constructed and used to predict vault at 1 month postoperatively and preoperative ICL dimensions using various artificial intelligence methods. Accuracy metrics as well as area under curve (AUC) parameters are used to determine the CDSS prediction methods.ResultsAmong the ICL size prediction models, conventional neural networks (CNNs) achieve the best prediction accuracy at 91.37% and exhibit the highest AUC of 0.842. Regarding the prediction model for vault values 1 month after surgery, CNN surpasses the other methods with an accuracy of 85.27%, which has the uppermost AUC of 0.815. Thus, we select CNN as the prediction algorithm for the CDSS.ConclusionsThis study introduces a CDSS to assist doctors in selecting the optimal ICL size for patients while improving the safety and postoperative outcomes of ICL surgery.
Community engagement approaches for malaria prevention, control and elimination: a scoping review
Authors: Awasthi Kiran Raj , Jancey Jonine , Clements Archie C A , Rai Rajni , Leavy Justine Elizabeth 
Published: February 2024

IntroductionGlobally malaria programmes have adopted approaches to community engagement (ACE) to design and deliver malaria interventions. This scoping review aimed to understand, map, and synthesise intervention activities guided by ACE and implemented by countries worldwide for the prevention, control and elimination of malaria.MethodsThree databases (Web of Science, Proquest, and Medline) were searched for peer-reviewed, primary studies, published in English between 1 January 2000 and 31 December 2022. Advanced Google was used to search for grey literature. The five levels of the International Association for Public Participation were used to categorise ACE - (1) Inform, (2) Consult, (3) involve, (4) Collaborate, and (5) Co-lead. Intervention activities were categorised as health education (HE), and/or health services (HS), and/or environmental management (EM). Outcomes were collected as knowledge, attitude, behaviour, help-seeking, health and HS and environment. Enablers and barriers were identified. Malaria intervention phases were categorised as (1) prevention (P), or (2) control (C), or (3) prevention and control (PC) or prevention, control and elimination (PCE).ResultsSeventy-five studies were included in the review. Based on ACE levels, most studies were at the inform (n=37) and involve (n=26) level. HE (n=66) and HS (n=43) were the common intervention activities. HE informed communities about malaria, its prevention and vector control. EM activities were effective when complemented by HE. Community-based HS using locally recruited health workers was well-accepted by the community. Involvement of local leaders and collaboration with local stakeholders can be enablers for malaria intervention activities.ConclusionInvolving local leaders and community groups in all stages of malaria prevention programmes is vital for successful interventions. Key elements of successful ACE, that is, consult, collaborate, and co-lead were under-represented in the literature and require attention. National programes must consult and collaborate with community stakeholders to develop ownership of the interventions and eventually co-lead them.
Informing understanding of coordination of care for patients with heart failure with preserved ejection fraction: a secondary qualitative analysis
Authors: Brooman-White Rosalie , Blakeman Thomas , McNab Duncan , Deaton Christi 
Published: February 2024

BackgroundPatients with heart failure with preserved ejection fraction (HFpEF) are a complex and underserved group. They are commonly older patients with multiple comorbidities, who rely on multiple healthcare services. Regional variation in services and resourcing has been highlighted as a problem in heart failure care, with few teams bridging the interface between the community and secondary care. These reports conflict with policy goals to improve coordination of care and dissolve boundaries between specialist services and the community.AimTo explore how care is coordinated for patients with HFpEF, with a focus on the interface between primary care and specialist services in England.MethodsWe applied systems thinking methodology to examine the relationship between work-as-imagined and work-as-done for coordination of care for patients with HFpEF. We analysed clinical guidelines in conjunction with a secondary applied thematic analysis of semistructured interviews with healthcare professionals caring for patients with HFpEF including general practitioners, specialist nurses and cardiologists and patients with HFpEF themselves (n=41). Systems Thinking for Everyday Work principles provided a sensitising theoretical framework to facilitate a deeper understanding of how these data illustrate a complex health system and where opportunities for improvement interventions may lie.ResultsThree themes (working with complexity, information transfer and working relationships) were identified to explain variability betweenwork-as-imaginedandwork-as-done. Participants raised educational needs, challenging work conditions, issues with information transfer systems and organisational structures poorly aligned with patient needs.ConclusionsThere are multiple challenges that affect coordination of care for patients with HFpEF. Findings from this study illuminate the complexity in coordination of care practices and have implications for future interventional work.
Role of knowledge and reasoning processes as predictors of resident physicians’ susceptibility to anchoring bias in diagnostic reasoning: a randomised controlled experiment
Authors: Mamede Sílvia , Zandbergen Adrienne , de Carvalho-Filho Marco Antonio , Choi Goda , Goeijenbier Marco , van Ginkel Joost , Zwaan Laura , Paas Fred , Schmidt Henk G 
Published: February 2024

Background
Diagnostic errors have been attributed to reasoning flaws caused by cognitive biases. While experiments have shown bias to cause errors, physicians of similar expertise differed in susceptibility to bias. Resisting bias is often said to depend on engaging analytical reasoning, disregarding the influence of knowledge. We examined the role of knowledge and reasoning mode, indicated by diagnosis time and confidence, as predictors of susceptibility to anchoring bias. Anchoring bias occurs when physicians stick to an incorrect diagnosis triggered by early salient distracting features (SDF) despite subsequent conflicting information.

Methods
Sixty-eight internal medicine residents from two Dutch university hospitals participated in a two-phase experiment. Phase 1: assessment of knowledge of discriminating features (ie, clinical findings that discriminate between lookalike diseases) for six diseases. Phase 2 (1 week later): diagnosis of six cases of these diseases. Each case had two versions differing exclusively in the presence/absence of SDF. Each participant diagnosed three cases with SDF (SDF+) and three without (SDF−). Participants were randomly allocated to case versions. Based on phase 1 assessment, participants were split into higher knowledge or lower knowledge groups. Main outcome measurements: frequency of diagnoses associated with SDF; time to diagnose; and confidence in diagnosis.

Results
While both knowledge groups performed similarly on SDF- cases, higher knowledge physicians succumbed to anchoring bias less frequently than their lower knowledge counterparts on SDF+ cases (p=0.02). Overall, physicians spent more time (p<0.001) and had lower confidence (p=0.02) on SDF+ than SDF− cases (p<0.001). However, when diagnosing SDF+ cases, the groups did not differ in time (p=0.88) nor in confidence (p=0.96).

Conclusions
Physicians apparently adopted a more analytical reasoning approach when presented with distracting features, indicated by increased time and lower confidence, trying to combat bias. Yet, extended deliberation alone did not explain the observed performance differences between knowledge groups. Success in mitigating anchoring bias was primarily predicted by knowledge of discriminating features of diagnoses.
A comparative study of fodder Galega (Galega orientalis LAM.) and common forage legumes in monoculture and grass–legume binary mixture in Canadian Prairies
Authors: Biligetu Bill , Bainard Jillian , Khanal Nityananda , Wang Hu 
Published: February 2024

Fodder Galega ( Galega orientalis Lam.) is a perennial legume adapted to the temperate regions of the world. The objective of this research was to compare the performance of fodder Galega to alfalfa ( Medicago sativa L.), sainfoin ( Onobrychis viciifolia Scop.), and cicer milkvetch ( Astragalus cicer L.) in monocultures and grass–legume mixtures. From 2018 to 2020, a multiple-location trial was conducted at Swift Current, Saskatoon, Melfort, SK and Beaverlodge, AB, Canada. The average forage mass of fodder Galega in monoculture was 3226, 1176, and 1678 kg·ha–1 at Melfort, Saskatoon, and Swift Current, respectively, and was lower than alfalfa. However, fodder Galega and alfalfa had similar forage mass at Beaverlodge (7900 and 7670 kg·ha−1, respectively). The proportion of fodder Galega in the grass–legume mixtures was 36%–42% in 2019, decreasing to 3%–27% at Saskatoon. At Swift Current, fodder Galega in the mixtures was 11%–13% in 2019, which almost disappeared from the stand in 2020. At Beaverlodge, fodder Galega maintained 38%–47% in 2019 and increased to 47%–69% in 2020. Fodder Galega had similar acid detergent fiber to cicer milkvetch at two of four sites, which was lower than those of alfalfa and sainfoin. The crude protein of fodder Galega and its mixtures with grasses was lower than other mixtures at the three Saskatchewan sites, but was higher at Beaverlodge. Our results indicate that fodder Galega has potential to be utilized as a forage legume in cooler northern regions, but its productivity was low in the Dark Brown and Brown soil.