bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring malaria prediction models in Togo: a time series forecasting by health district and target group
Authors: Thomas Anne , Bakai Tchaa Abalo , Atcha-Oubou Tinah , Tchadjobo Tchassama , Rabilloud Muriel , Voirin Nicolas 
Published: January 2024

ObjectivesIntegrating malaria prediction models into malaria control strategies can help to anticipate the response to seasonal epidemics. This study aimed to explore the possibility of using routine malaria data and satellite-derived climate data to forecast malaria cases in Togo.MethodsGeneralised additive (mixed) models were developed to forecast the monthly number of malaria cases in 40 health districts and three target groups. Routinely collected malaria data from 2013 to 2016 and meteorological and vegetation data with a time lag of 1 or 2 months were used for model training, while the year 2017 was used for model testing. Two methods for selecting lagged meteorological and environmental variables were compared: a first method based on statistical approach (‘SA’) and a second method based on biological reasoning (‘BR’). Both methods were applied to obtain a model per target group and health district and a mixed model per target group and health region with the health district as a random effect. The predictive skills of the four models were compared for each health district and target group.ResultsThe most selected predictors in the models per district for the ‘SA’ method were the normalised difference vegetation index, minimum temperature and mean temperature. The ‘SA’ method provided the most accurate models for the training period, except for some health districts in children ≥5 years old and adults and in pregnant women. The most accurate models for the testing period varied by health district and target group, provided either by the ‘SA’ method or the ‘BR’ method. Despite the development of models with four different approaches, the number of malaria cases was inaccurately forecasted.ConclusionsThese models cannot be used as such in malaria control activities in Togo. The use of finer spatial and temporal scales and non-environmental data could improve malaria prediction.
Patient safety culture and satisfaction in Ghana: a facility-based cross-sectional study
Authors: Botchwey Charles Owusu-Aduomi , Boateng Agartha Afful , Ahimah Patricia Ofori , Acquah Francis , Adoma Prince Owusu , Kumah Emmanuel , Boakye Dorothy Serwaa , Boahen Ebenezer Addae , Kruh Vivian , Koomson Joseph Bob Kow 
Published: January 2024

BackgroundGlobally, one of the measures of high performing healthcare facilities is the compliance of patient safety culture, which encompasses the ability of health institutions to avoid or drastically reduce patient harm or risks. These risks or harm is linked with numerous adverse patient outcomes such as medication error, infections, unsafe surgery and diagnosis error.ObjectivesThe general objective of this study was to investigate into the impact of patient safety culture practices experienced on patient satisfaction among patients who attend the Kwesimintsim Government Hospital in the Takoradi municipality.MethodsThis study was a descriptive cross-sectional study and a consecutive sampling technique was used to select 336 respondents for the study. Data was collected using a structured questionnaire and processed using Statistical Package for Social Sciences, V.21. Both descriptive and inferential statistics were carried out and result were presented using figures and tables.ResultsThe study found that the overall patient safety compliance level observed by the respondents was poor (29.2%). The prevalence of adverse events experienced among the respondents was high (58%). The leading adverse events mentioned were medication errors, followed by wrong prescriptions and infections. The consequences of these adverse events encountered by the respondents were mentioned as increased healthcare costs (52%), followed by hospitalisation (43%), worsening of health conditions (41%) and contraction of chronic health conditions (22%). Patient safety cultural practices such as teamwork (β=0.17, p=0.03), response to error (β=0.16, p=0.005), communication openness (β=0.17, p=0.003) and handoffs and information exchange (β=0.17, p=0.002) were found to positively influence patient satisfaction.ConclusionThe poor general compliance of the patient safety culture in the facility is unfortunate, and this can affect healthcare outcomes significantly. The study therefore entreats facility managers and various stakeholders to see patient safety care as an imperative approach to delivering quality essential healthcare and to act accordingly to create an environment that supports it.
Development, acceptability and usability of culturally appropriate survivor narrative videos for breast cancer treatment in Botswana: a pilot study
Authors: Martei Yehoda M , Mokokwe Lebogang , Ngwako Ngwao , Kebuang Keaobaka , Setlhako Dipho I , Gabaatlhole Goitsemang , Baaitse Bontswanetse , Segadimo Tumisang , Shulman Lawrence N , Barg Frances , Gaolebale Babe E 
Published: January 2024

ObjectivesNarrative communication has demonstrated effectiveness in promoting positive health behaviours, delivering support and coping with complex decision-making. Formal research evaluating this intervention for cancer treatment in Africa is lacking. We aimed to develop, and assess acceptability and usability of survivor video narrative interventions for breast cancer treatment in Botswana.DesignA pilot study design.SettingSingle-centre, tertiary hospital, sub-Saharan Africa.ParticipantsEight women, ≥18 years old, with stages I–III breast cancer were enrolled for the video intervention. 106 women, ≥18 years old, with stages I–IV breast cancer viewed the narrative videos and 98 completed the acceptability and usability surveys.InterventionSurvivor narrative videos were developed using the theory of planned behaviour and using a purposive sample of Batswana, Setswana-speaking, breast cancer survivors, who had completed systemic treatment and surgery with high rates of adherence to the prescribed treatment plan.Primary outcomesWe assessed acceptability and usability among prospectively enrolled patients presenting for routine breast cancer care at Princess Marina Hospital in Botswana, using a 13-item survey.ResultsParticipants expressed high acceptability and usability of the videos, including 99% (97/98) who strongly agreed/agreed that the video presentations were easy to understand, 92% (90/98) who would recommend to other survivors and 94% (92/98) who wished there were more videos. Additionally, 89% (87/98) agreed or strongly agreed that the one-on-one instruction on how to use the tablet was helpful and 87% (85/98) that the video player was easy to use.ConclusionCulturally appropriate survivor video narratives have high acceptability and usability among patients with breast cancer in Botswana. There is an opportunity to leverage this intervention in routine breast cancer care for treatment support. Future studies will test the implementation and effectiveness of narrative videos on a wider scale, including for patients being treated for other cancers.
Protocol for an evaluation of the initiation of an integrated longitudinal outpatient care model for severe chronic non-communicable diseases (PEN-Plus) at secondary care facilities (district hospitals) in 10 lower-income countries
Authors: Adler Alma J , Wroe Emily B , Atzori Andrea , Bay Neusa , Bekele Wondu , Bhambhani Victoria M , Nkwiro Remy Bitwayiki , Boudreaux Chantelle , Calixte Dawson , Chiwanda Banda Jonathan , Coates Matthew M , Dagnaw Wubaye Walelgne , Domingues Katia , Drown Laura , Dusabeyezu Symaque , Fenelon Darius , Gupta Neil , Ssinabulya Isaac , Jain Yogesh , Kalkonde Yogeshwar , Kamali Innocent , Karekezi Catherine , Karmacharya Biraj Man , Koirala Bhagawan , Makani Julie , Manenti Fabio , Mangwiro Alexio , Manuel Beatriz , Masiye Jones K , Goma Fastone Mathew , Mayige Mary Theodory , McLaughlin Amy , Mensah Emmanuel , Salipa Nicole Mocumbi , Mutagaywa Reuben , Mutengerere Alvern , Ngoga Gedeon , Patiño Marta , Putoto Giovanni , Ruderman Todd , Salvi Devashri , Sesay Santigie , Taero Fameti , Tostão Emílio , Toussaint Sterman , Bukhman Gene , Mocumbi Ana Olga 
Published: January 2024

IntroductionThe Package of Essential Noncommunicable Disease Interventions—Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs. Over 3 years, the countries and state are expected to: (1) establish PEN-Plus clinics in one or two district hospitals, (2) support these clinics to mature into training sites in preparation for national or state-level scale-up, and (3) work with the national or state-level stakeholders to describe, measure and advocate for PEN-Plus to support development of a national operational plan for scale-up.Methods and analysisGuided by Proctor outcomes for implementation research, we are conducting a mixed-method evaluation consisting of 10 components to understand outcomes in clinical implementation, training and policy development. Data will be collected through a mix of quantitative surveys, routine reporting, routine clinical data and qualitative interviews.Ethics and disseminationThis protocol has been considered exempt or covered by central and local institutional review boards. Findings will be disseminated throughout the project’s course, including through quarterly M&E discussions, semiannual formative assessments, dashboard mapping of progress, quarterly newsletters, regular feedback loops with national stakeholders and publication in peer-reviewed journals.
Clinical decision support system for clinical nurses’ decision-making on nurse-to-patient assignment: a scoping review protocol
Authors: Kwon Hyunjeong , Lee Dayeon 
Published: January 2024

IntroductionOptimal nurse-to-patient assignment plays a crucial role in healthcare delivery, with direct implications for patient outcomes and the workloads of nursing staff. However, this process is highly intricate, involving a multitude of factors that must be carefully considered. The application of a clinical decision support system (CDSS) to support nursing decision-making can have a positive impact not only on patient outcomes but also on nursing efficiency. This scoping review aims to explore the implementation of CDSS in the decision process of optimal nurse-patient assignment (NPA).Methods and analysisThis scoping review will follow a stage of the Arksey and O’Malley framework. It will also be based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews’ (PRISMA-ScR) guidelines. The research primarily aims to identify studies’ findings on applying CDSSs in the NPA process. Hence, academic and grey literature articles from six international bibliographic databases (ie, MEDLINE via PubMed, EMBASE via Ovid, CINAHL via EBSCOhost, IEEE Xplore, Scopus, ProQuest Dissertations and Theses Global) will be considered, where search strategies will be tailored to each database. The literature search will be conducted in February 2024, and the identified studies will be independently screened by two primary reviewers. After extracting data, the qualitative data will be analysed thematically, and the quantitative data will be subjected to descriptive statistics. The research is scheduled to conclude in December 2024.Ethics and disseminationEthical approval is not required as primary data will not be collected in this study. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.
Real-world implementation of the National Early Warning Score-2 in an acute respiratory unit
Authors: Gonem Sherif , Lemberger Joseph , Baguneid Abdulla , Briggs Steve , McKeever Tricia M , Shaw Dominick 
Published: January 2024

IntroductionThe National Early Warning Score-2 (NEWS-2) is used to detect deteriorating patients in hospital settings. We aimed to understand how NEWS-2 functions in the real-life setting of an acute respiratory unit.MethodsClinical observations data were extracted for adult patients (age ≥18 years), admitted under the care of respiratory medicine services from July to December 2019, who had at least one recorded task relating to clinical deterioration. The timing and nature of urgent out-of-hours medical reviews (escalations) were extracted through manual review of the case notes.ResultsThe data set comprised 765 admission episodes (48.9% women) with a mean (SD) age of 69.3 (14.8). 8971 out of 35 991 out-of-hours observation sets (24.9%) had a NEWS-2 ≥5, and 586 of these (6.5%) led to an escalation. Out of 687 escalations, 101 (14.7%) were associated with observation sets with NEWS-2<5. Rising oxygen requirement and extreme values of individual observations were associated with an increased risk of escalation. 57.6% of escalations resulted in a change in treatment. Inpatient mortality was higher in patients who were escalated at least once, compared with those who were not escalated.ConclusionsMost observation sets with NEWS-2 scores ≥5 did not lead to a medical escalation in an acute respiratory setting out-of-hours, but more than half of escalations resulted in a change in treatment. Rising oxygen requirement is a key indicator of respiratory patient acuity which appears to influence the decision to request urgent out-of-hours medical reviews.
Peritumoral administration of immunomodulatory antibodies as a triple combination suppresses skin tumor growth without systemic toxicity
Authors: Wright Quentin G , Sinha Debottam , Wells James W , Frazer Ian H , Gonzalez Cruz Jazmina L , Leggatt Graham Robert 
Published: January 2024

BackgroundSkin cancers, particularly keratinocyte cancers, are the most commonly diagnosed tumors. Although surgery is often effective in early-stage disease, skin tumors are not always easily accessible, can reoccur and have the ability to metastasize. More recently, immunotherapies, including intravenously administered checkpoint inhibitors, have been shown to control some skin cancers, but with off-target toxicities when used in combination. Our study investigated whether peritumoral administration of an antibody combination targeting PD-1, 4-1BB (CD137) and VISTA might control skin tumors and lead to circulating antitumor immunity without off-target toxicity.MethodsThe efficacy of combination immunotherapy administered peritumorally or intravenously was tested using transplantable tumor models injected into mouse ears (primary tumors) or subcutaneously in flank skin (secondary tumors). Changes to the tumor microenvironment were tracked using flow cytometry while tumor-specific, CD8 T cells were identified through enzyme-linked immunospot (ELISPOT) assays. Off-target toxicity of the combination immunotherapy was assessed via serum alanine aminotransferase ELISA and histological analysis of liver sections.ResultsThe data showed that local administration of antibody therapy eliminated syngeneic murine tumors transplanted in the ear skin at a lower dose than required intravenously, and without measured hepatic toxicity. Tumor elimination was dependent on CD8 T cells and was associated with an increased percentage of CD8 T cells expressing granzyme B, KLRG1 and Eomes, and a decreased population of CD4 T cells including CD4+FoxP3+cells in the treated tumor microenvironment. Importantly, untreated, distal tumors regressed following antibody treatment of a primary tumor, and immune memory prevented growth of subcutaneous flank tumors administered 50 days after regression of a primary tumor.ConclusionsTogether, these data suggest that peritumoral immunotherapy for skin tumors offers advantages over conventional intravenous delivery, allowing antibody dose sparing, improved safety and inducing long-term systemic memory. Future clinical trials of immunotherapy for primary skin cancer should focus on peritumoral delivery of combinations of immune checkpoint antibodies.
Effects of antineoplastic and immunomodulating agents on postvaccination SARS-CoV-2 breakthrough infections, antibody response, and serological cytokine profile
Authors: New Jacob , Cham Jason , Smith Lana , Puglisi Leah , Huynh Tridu , Kurian Sunil , Bagsic Samantha , Fielding Russel , Hong Lee , Reddy Priya , Eum Ki Suk , Martin Allison , Barrick Bethany , Marsh Christopher , Quigley Michael , Nicholson Laura J , Pandey Amitabh C 
Published: January 2024

BackgroundDespite immunization, patients on antineoplastic and immunomodulating agents have a heightened risk of COVID-19 infection. However, accurately attributing this risk to specific medications remains challenging.MethodsAn observational cohort study from December 11, 2020 to September 22, 2022, within a large healthcare system in San Diego, California, USA was designed to identify medications associated with greatest risk of postimmunization SARS-CoV-2 infection. Adults prescribed WHO Anatomical Therapeutic Chemical (ATC) classified antineoplastic and immunomodulating medications were matched (by age, sex, race, and number of immunizations) with control patients not prescribed these medications yielding a population of 26 724 patients for analysis. From this population, 218 blood samples were collected from an enrolled subset to assess serological response and cytokine profile in relation to immunization.ResultsPrescription of WHO ATC classified antineoplastic and immunomodulatory agents was associated with elevated postimmunization SARS-CoV-2 infection risk (HR 1.50, 95% CI 1.38 to 1.63). While multiple immunization doses demonstrated a decreased association with postimmunization SARS-CoV-2 infection risk, antineoplastic and immunomodulatory treated patients with four doses remained at heightened risk (HR 1.23, 95% CI 1.06 to 1.43). Risk variation was identified among medication subclasses, with PD-1/PD-L1 inhibiting monoclonal antibodies, calcineurin inhibitors, and CD20 monoclonal antibody inhibitors identified to associate with increased risk of postimmunization SARS-CoV-2 infection. Antineoplastic and immunomodulatory treated patients also displayed a reduced IgG antibody response to SARS-CoV-2 epitopes alongside a unique serum cytokine profile.ConclusionsAntineoplastic and immunomodulating medications associate with an elevated risk of postimmunization SARS-CoV-2 infection in a drug-specific manner. This comprehensive, unbiased analysis of all WHO ATC classified antineoplastic and immunomodulating medications identifies medications associated with greatest risk. These findings are crucial in guiding and refining vaccination strategies for patients prescribed these treatments, ensuring optimized protection for this susceptible population in future COVID-19 variant surges and potentially for other RNA immunization targets.
Endovascular thrombectomy for large ischemic strokes: meta-analysis of six multicenter randomized controlled trials
Authors: Chen Huanwen , Colasurdo Marco 
Published: January 2024

BackgroundSix randomized controlled trials have concluded their investigations on the efficacy and safety of endovascular thrombectomy (EVT) for patients with large infarcts.To synthesize the results from six trials which met the inclusion criteria (RESCUE-Japan LIMIT, ANGEL-ASPECT, SELECT2, TESLA, TENSION, and LASTE) to provide high-level evidence and guide providers on optimizing EVT treatment decisions for patients presenting with large ischemic strokes seen on initial imaging.MethodsStudy and patient characteristics of the six included trials were collected, and 90-day modified Rankin Scale (mRS) outcomes were tabulated. Generalized odds ratios (OR) of mRS score shift and utility-weighted mRS values were calculated for each study. Random-effects models were used to pool study outcomes.Results922 patients received EVT, and 924 received medical management. Most patients had Alberta Stroke Program Early CT (ASPECT) scores of 3 to 5 and intracranial occlusion in the internal carotid artery (ICA) or the first segment of the middle cerebral artery (M1). EVT was significantly superior to medical management in terms of likelihood of better mRS score, functional independence (mRS score 0–2), and independent walking (mRS score 0–3) at 90 days, representing numbers needed to treat of 4.7 (95% CI 3.7 to 6.6), 7.1 (95% CI 5.6 to 9.6), and 10.6 (95% CI 8.2 to 14.8), respectively. EVT was not significantly associated with higher risk of symptomatic intracranial hemorrhage (1.7% (95% CI −0.32% to 3.72%), P=0.10). There was significant inter-study heterogeneity in mortality risk, which might have been due to differences in treatment time windows.ConclusionsThis study provides strong evidence that EVT is effective for patients presenting within 6 hours of stroke onset, ASPECT scores of 3 to 5, and intracranial ICA or proximal M1 occlusion. Use of EVT beyond 6 hours or for more distal occlusions requires further investigation.
Prevalence and clinical characteristics of patients with rheumatoid arthritis with interstitial lung disease using unstructured healthcare data and machine learning
Authors: Román Ivorra Jose A , Trallero-Araguas Ernesto , Lopez Lasanta Maria , Cebrián Laura , Lojo Leticia , López-Muñíz Belén , Fernández-Melon Julia , Núñez Belén , Silva-Fernández Lucia , Veiga Cabello Raúl , Ahijado Pilar , De la Morena Barrio Isabel , Costas Torrijo Nerea , Safont Belén , Ornilla Enrique , Restrepo Juliana , Campo Arantxa , Andreu Jose L , Díez Elvira , López Robles Alejandra , Bollo Elena , Benavent Diego , Vilanova David , Luján Valdés Sara , Castellanos-Moreira Raul 
Published: January 2024

ObjectivesReal-world data regarding rheumatoid arthritis (RA) and its association with interstitial lung disease (ILD) is still scarce. This study aimed to estimate the prevalence of RA and ILD in patients with RA (RAILD) in Spain, and to compare clinical characteristics of patients with RA with and without ILD using natural language processing (NLP) on electronic health records (EHR).MethodsObservational case–control, retrospective and multicentre study based on the secondary use of unstructured clinical data from patients with adult RA and RAILD from nine hospitals between 2014 and 2019. NLP was used to extract unstructured clinical information from EHR and standardise it into a SNOMED-CT terminology. Prevalence of RA and RAILD were calculated, and a descriptive analysis was performed. Characteristics between patients with RAILD and RA patients without ILD (RAnonILD) were compared.ResultsFrom a source population of 3 176 165 patients and 64 241 683 EHRs, 13 958 patients with RA were identified. Of those, 5.1% patients additionally had ILD (RAILD). The overall age-adjusted prevalence of RA and RAILD were 0.53% and 0.02%, respectively. The most common ILD subtype was usual interstitial pneumonia (29.3%). When comparing RAILD versus RAnonILD patients, RAILD patients were older and had more comorbidities, notably concerning infections (33.6% vs 16.5%, p<0.001), malignancies (15.9% vs 8.5%, p<0.001) and cardiovascular disease (25.8% vs 13.9%, p<0.001) than RAnonILD. RAILD patients also had higher inflammatory burden reflected in more pharmacological prescriptions and higher inflammatory parameters and presented a higher in-hospital mortality with a higher risk of death (HR 2.32; 95% CI 1.59 to 2.81, p<0.001).ConclusionsWe found an estimated age-adjusted prevalence of RA and RAILD by analysing real-world data through NLP. RAILD patients were more vulnerable at the time of inclusion with higher comorbidity and inflammatory burden than RAnonILD, which correlated with higher mortality.