bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘The false reporter will get a praise and the one who reported truth will be discouraged’: a qualitative study on intentional data falsification by frontline maternal and newborn healthcare workers in two regions in Ethiopia
Authors: Estifanos Abiy Seifu , Gezahegn Rediet , Keraga Dorka Woldesenbet , Kifle Abiyou , Procureur Fanny , Hill Zelee 
Published: October 2022

IntroductionHealth Management Information Systems (HMIS) are vital to ensure accountability and for making decisions including for tracking the Sustainable Development Goals. The Ethiopia Health Sector Transformation Plan II includes preventing data falsification as a major strategic initiative and our study aimed to explore the reasons why healthcare providers intentionally falsify maternal and newborn health (MNH) data in two regions of Ethiopia.MethodsWe conducted a qualitative study in two hospitals, four health centres and their associated health posts in Oromia and Amhara regions. We conducted 45 in-depth interviews with health facility managers, quality improvement (QI) focal persons, health information technicians, MNH care providers, Health Extension Workers and QI mentors. Data were collected in local languages and transcribed in English. During analysis we repeatedly read the transcripts, coded them inductively using NVivo V.12, and categorised the codes into themes.ResultsParticipants were hesitant to report personal data falsification but many reported that falsification is common and that they had experienced it in other facilities or had been told about it by other health workers. Falsification was mostly inflating the number of services provided (such as deliveries). Decreasing the number of deaths or reclassifying neonatal death into stillbirths was also reported. An overarching theme was that the health system focuses on, and rewards, the number of services provided over any other metric. This focus led to both system and individual level incentives for falsification and disincentives for accurate reporting.ConclusionOur finding suggests that to reduce facility level data falsification policy makers might consider disentangling reward and punishments from the performance reports based on the routine HMIS data. Further studies examining the high-level drivers of falsification at regional, national and global levels and effective interventions to address the drivers of data falsification are needed.
A randomised controlled trial of a probiotic and a prebiotic examining metabolic and mental health outcomes in adults with pre-diabetes
Authors: Barthow Christine , Hood Fiona , Crane Julian , Huthwaite Mark , Weatherall Mark , Parry-Strong Amber , Krebs Jeremy 
Published: October 2022

AimsTo evaluate the effect of the probioticLactobacillus rhamnosusHN001 and/or cereal enriched with oat-derived beta-glucan (OBG) on metabolic and mental health outcomes when administered to adults with pre-diabetes.Design2×2 factorial design randomised, parallel-groups placebo-controlled; double-blinded for probiotic, single-blinded for cereals.ParticipantsCommunity-dwelling adults aged 18–80 years with pre-diabetes: glycated haemoglobin (HbA1c) 41–49 mmol/mol.InterventionsCapsules containingLactobacillus rhamnosus(HN001) (6×109colony-forming units/day), or placebo capsules; and cereal containing 4 g/day OBG or calorie-matched control cereal, taken daily, for 6 months. Study groups were: (A) HN001 capsules+OBG cereal; (B) HN001 capsules+control cereal; (C) placebo capsules+OBG cereal and (D) placebo capsules+control cereal.Outcome measuresPrimary outcome: HbA1cat 6 months. Secondary outcomes: fasting plasma glucose, fasting insulin, homeostatic model assessment of insulin resistance, fasting lipids, blood pressure, body weight, waist circumference, body mass index and mental well-being.Results153 participants were randomised. There was complete HbA1coutcome data available for 129 participants. At 6 months the mean (SD) HbA1cwas 45.9 (4.4) mmol/mol, n=66 for HN001, and 46.7 (4.3) mmol/mol, n=63 for placebo capsules; 46.5 (4.0) mmol/mol, n=67 for OBG and 46.0 (4.6) mmol/mol n=62 for control cereal. The estimated difference between HN001-placebo capsules was −0.83, 95% CI −1.93 to 0.27 mmol/mol, p=0.63, and between OBG-control cereals −0.17, 95% CI −1.28 to 0.94 mmol/mol, p=0.76. There was no significant interaction between treatments p=0.79. There were no differences between groups or significant interactions between treatments for any of the secondary outcomes.ConclusionsThis study found no evidence of clinical benefit from the supplementation with either HN001 and/or cereal containing 4 g OBG on HbA1cand all secondary outcomes relevant to adults with pre-diabetes.Trial registration numberAustralian New Zealand Clincial Trials Registry number ACTRN12617000990325
Does hospital variation in intrapartum-related perinatal mortality among caesarean births reflect differences in quality of care? Cross-sectional study in 21 hospitals in Burkina Faso
Authors: Cavallaro Francesca L , Kabore Charles P , Pearson Rachel , Blackburn Ruth M , Sobhy Soha , Betran Ana Pilar , Ronsmans Carine , Dumont Alexandre 
Published: October 2022

ObjectivesTo examine hospital variation in crude and risk-adjusted rates of intrapartum-related perinatal mortality among caesarean births.DesignSecondary analysis of data from the DECIDE (DECIsion for caesarean DElivery) cluster randomised trial postintervention phase.Setting21 district and regional hospitals in Burkina Faso.ParticipantsAll 5134 women giving birth by caesarean section in a 6-month period in 2016.Primary outcome measureIntrapartum-related perinatal mortality (fresh stillbirth or neonatal death within 24 hours of birth).ResultsAlmost 1 in 10 of 5134 women giving birth by caesarean experienced an intrapartum-related perinatal death. Crude mortality rates varied substantially from 21 to 189 per 1000 between hospitals. Variation was markedly reduced after adjusting for case mix differences (the median OR decreased from 1.9 (95% CI 1.5 to 2.5) to 1.3 (95% CI 1.2 to 1.7)). However, higher and more variable adjusted mortality persisted among hospitals performing fewer caesareans per month. Additionally, adjusting for caesarean care components did not further reduce variation (median OR=1.4 (95% CI 1.2 to 1.8)).ConclusionsThere is a high burden of intrapartum-related perinatal deaths among caesarean births in Burkina Faso and sub-Saharan Africa more widely. Variation in adjusted mortality rates indicates likely differences in quality of caesarean care between hospitals, particularly lower volume hospitals. Improving access to and quality of emergency obstetric and newborn care is an important priority for improving survival of babies at birth.Trial registration numberISRCTN48510263.
Randomised parallel trial on the effectiveness and cost-effectiveness in screening gait disorder of silent cerebrovascular disease assisted by artificial intelligent system versus clinical doctors (ACCURATE-1): study protocol
Authors: Fei Beini , Zhao Jin , Li Xin , Tang Yanmin , Qin Guoyou , Zhang Wei , Ding Jing , Hu Min , Wang Xin 
Published: October 2022

IntroductionSilent cerebrovascular disease (SCD), which is a common disease in the elderly, leads to cognitive decline, gait disorders, depression and urination dysfunction, and increases the risk of cerebrovascular events. Our study aims to compare the accuracy of the diagnosis of SCD-related gait disorders between the intelligent system and the clinician. Our team have developed an intelligent evaluation system for gait. This study will evaluate whether the intelligent system can help doctors make clinical decisions and predictions, which aids the early prevention and treatment of SCD.Methods and analysisThis study is a multi-centred, prospective, randomised and controlled trial.SCD subjects aged 60–85 years in Shanghai and Guizhou will be recruited continuously. All subjects will randomly be divided into a doctor with intelligence assistance group or a doctor group, at a 1:1 ratio. The doctor and intelligent assistant group will accept the intelligent system evaluation. The intelligent system obtains gait parameters by an Red-Green-Blue-depth camera and computer vision algorithm. The doctor group will accept the clinicians’ routine treatment procedures. Meanwhile, all subjects will accept the panel’s gait assessment and recognition rating scale as the gold standard. The primary outcome is the sensitivity of the intelligent system and clinicians to screen for gait disorders. The secondary outcomes include the healthcare costs and the incremental cost effectiveness ratio of intelligent systems and clinicians to screen for gait disorders.Ethics and disseminationApproval was granted by the Ethics Committee of Zhongshan Hospital affiliated with Fudan University on 26 November 2019. The approval number is B2019-027(2) R. All subjects will sign an informed consent form before enrolment. Serious adverse events will be reported to the main researchers and ethics committees. The subjects’ data will be kept strictly confidential. The results will be disseminated in peer-reviewed journals.Trial registration numberNCT04457908
Effectiveness and safety of metoclopramide in treatment of intractable hiccup: a protocol of systematic review and meta-analysis
Authors: Wang Die , Zi Changyan , Zhang Baocheng , Wang Baojia , Chen Tao , Wang Long , Gao Yongxiang 
Published: October 2022

IntroductionHiccup is a common disease that not only occurred on adults but also on infants, which can severely do harm to patients’ physical and psychological health. Metoclopramide has been reported to have effects on intractable hiccup. However, there is a limited evidence that describes the efficacy and safety of metoclopramide in the treatment of intractable hiccup. The aim of this article is to obtain evidence on the effectiveness and safety of metoclopramide in treating patients with intractable hiccup.Methods and analysisWe will search the following databases, including PubMed, Cochrane Library, Embase, Web of Science, CBM, Wan-fang, VIP database, CNKI and MEDLINE from their inception to 11 November 2021. All the randomised controlled trials associated with metoclopramide in treating intractable hiccup will be included. Articles screened, selected and extracted will be performed by two researchers independently. The risk of bias will be assessed by using the Cochrane Collaboration. We will carry out the meta-analysis by using RevMan V.5.4 software.PROSPERO registration numberCRD42021293000.
Effects of milk protein concentrate supplementation on metabolic parameters, adipocytokines and body composition in obese women under weight-loss diet: study protocol for a randomised controlled trial
Authors: Haidari Fatemeh , Elahikhah Mahsa , Shariful Islam Sheikh Mohammed , Mohammadshahi Majid , Shahbazian Hajieh , Aghamohammadi Vahideh 
Published: October 2022

IntroductionObesity impairs metabolic function and increases the risk of cardiovascular disease and type 2 diabetes mellitus. Evidence suggests that high-protein diets help to increase weight loss and protect against weight gain. Milk protein concentrate (MPC) is a dairy product with a high protein content with a ratio of casein and whey protein similar to skim milk. This trial aims to evaluate the effect of MPC supplementation in obese women under a weight-loss diet.Methods and analysisWe will conduct a 2-month open-label, parallel-group, randomised controlled trial to determine the effect of MPC supplementation on levels of glycaemic and lipid profile, leptin, adiponectin, appetite, waist circumference, body mass index and body composition in 44 premenopausal obese women on a weight-loss diet.Ethics and disseminationThis protocol, approved by the Medical Ethics Committee of Ahvaz University of Medical Sciences, is in accordance with the Declaration of Helsinki (approval number: IR.AJUMS.REC.1399.795). The trial results will be published in peer-reviewed journals.Trial registration numberIranian Registry of Clinical Trials (IRCT20201223049804N1).
Validity and reliability of a new incremental step test for people with chronic obstructive pulmonary disease
Authors: Vilarinho Rui , Serra Lúcia , Águas Ana , Alves Carlos , Silva Pedro Matos , Caneiras Cátia , Montes António Mesquita 
Published: October 2022

BackgroundIncremental step tests (IST) can be used to assess exercise capacity in people with chronic obstructive pulmonary disease (COPD). The development of a new step test based on the characteristics of the incremental shuttle walk test (ISWT) is an important study to explore. We aimed to develop a new IST based on the ISWT in people with COPD, and assess its validity (construct validity) and reliability, according to Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) recommendations.MethodsA cross-sectional study was conducted in participants recruited from hospitals/clinics. During the recruitment, the participants who presented a 6-minute walk test (6MWT) report in the previous month were also identified and the respective data was collected. Subsequently, participants attended two sessions at their homes. IST was conducted on the first visit, along with the 1 min sit-to-stand (1MSTS) test. IST was repeated on a second visit, performed 5–7 days after the first one. Spearman’s correlations were used for construct validity, by comparing the IST with the 6MWT and the 1MSTS. Intraclass correlation coefficient (ICC2,1), SE of measurement (SEM) and minimal detectable change at 95% CI (MDC95) were used for reliability. The learning effect was explored with the Wilcoxon signed-rank test.Results50 participants (70.8±7.5 years) were enrolled. IST was significant and moderate correlated with the 6MWT (ρ=0.50, p=0.020), and with the 1MSTS (ρ=0.46, p=0.001). IST presented an ICC2,1=0.96, SEM=10.1 (16.6%) and MDC95=27.9 (45.8%) for the number of steps. There was a statistically significant difference between the two attempts of the IST (p=0.030).ConclusionDespite the significant and moderate correlations with the 6MWT and 1MSTS, the inability to full compliance with the COSMIN recommendations does not yet allow the IST to be considered valid in people with COPD. On the other hand, the IST is a reliable test based on its high ICC, but a learning effect and an ‘indeterminate’ measurement error were shown.Trial registration numberNCT04715659.
Estimating population-based incidence of community-acquired pneumonia and acute otitis media in children and adults in Ontario and British Columbia using health administrative data, 2005–2018: a Canadian Immunisation Research Network (CIRN) study
Authors: Nasreen Sharifa , Wang Jun , Sadarangani Manish , Kwong Jeffrey C , Quach Caroline , Crowcroft Natasha S , Wilson Sarah E , McGeer Allison , Morris Shaun K , Kellner James D , Sander Beate , Kus Julianne V , Hoang Linda , Marra Fawziah , Fadel Shaza A 
Published: October 2022

BackgroundThere is a paucity of data on the burden of the full spectrum of community-acquired pneumonia (CAP) and acute otitis media (AOM) from outpatient and inpatient settings across the age spectrum.MethodsWe conducted a population-based retrospective study in Ontario and British Columbia (BC), Canada, to estimate the incidence rate of CAP and AOM in children and adults over a 14-year period using health administrative databases. CAP and AOM cases were identified from outpatient physician consultation and hospitalisation data in both provinces, and from emergency department visit data in Ontario.ResultsDuring 2005–2018, Ontario had 3 607 124 CAP, 172 290 bacterial CAP, 7814 pneumococcal pneumonia, and 8 026 971 AOM cases. The incidence rate of CAP declined from 3077/100 000 in 2005 to 2604/100 000 in 2010 before increasing to 2843/100 000 in 2018; bacterial CAP incidence rate also declined from 178/100 000 in 2005 to 112/100 000 in 2010 before increasing to 149/100 000 in 2018. The incidence rate of AOM decreased from 4192/100 000 in 2005 to 3178/100 000 in 2018. BC had 970 455 CAP, 317 913 bacterial CAP, 35 287 pneumococcal pneumonia and 2 022 871 AOM cases. The incidence rate of CAP in BC decreased from 2214/100 000 in 2005 to 1964/100 000 in 2010 before increasing to 2176/100 000 in 2018; bacterial CAP incidence rate increased from 442/100 000 in 2005 to 981/100 000 in 2018. The incidence rate of AOM decreased from 3684/100 000 in 2005 to 2398/100 000 in 2018. The incidence rate of bacterial CAP increased with age in older adults (≥65 years) with the highest burden in the oldest cohort aged ≥85 years both before and after 13-valent pneumococcal conjugate vaccine (PCV13) programme in both provinces. Hospitalised pneumococcal pneumonia decreased slightly but non-hospitalised pneumococcal pneumonia increased in BC during PCV13 period. No consistent direct benefit of PCV13 on CAP was observed in the paediatric population.ConclusionsThere is a substantial burden of CAP and AOM in Ontario and BC. Indirect benefits from childhood PCV vaccination and polysaccharide vaccination of older adults have not substantially decreased the burden of pneumococcal pneumonia in older adults.
User-centered design and agile development of a novel mobile health application and clinician dashboard to support the collection and reporting of patient-reported outcomes for breast cancer care
Authors: Tsangaris Elena , Edelen Maria , Means Jessica , Gregorowitsch Madelijn , O’Gorman Joanna , Pattanaik Rakasa , Dominici Laura , Hassett Michael , Witkowski Mary Lynch , Schrieber Kristen , Frank Elizabeth , Carnie Martha , Pusic Andrea 
Published: October 2022

ObjectivesThere is a need for advancements in health information technology that will transform how patient-reported outcomes (PRO) data are collected, reported, and used in breast cancer care. The objective of this study was to develop an innovative and customizable platform, called imPROVE to support PRO uptake in breast cancer care.DesignUser-centered design and agile development were employed. Recurrent stakeholder meetings with experts in the field of breast cancer care, in-depth one-on-one qualitative interviews with a clinical sample of patients with breast cancer, and focus groups with Dana-Farber/Harvard Cancer Center (DF/HCC) Breast Cancer Advisory Group members, were used to elicit feedback for the design features and functions of a patient mobile application and clinician dashboard.SettingThis study was conducted at two academic hospitals in the USA.ParticipantsParticipants included experts in the field of breast cancer care, value-based healthcare, and health information technology, a clinical sample of patients with breast cancer, and members of the DF/HCC Breast Cancer Advisory Group.Main outcome measuresimPROVE incorporates the International Consortium for Health Outcomes Measurement (ICHOM) breast cancer standard outcome set as well as the complete BREAST-Q Breast Cancer Module.ResultsFeedback was elicited from eight stakeholder meetings (n=28 members), interviews with a clinical sample of patients (n=28), and two focus groups with members of the DF/HCC Breast Cancer Advisory Group (n=17 members in each focus group). Participant feedback led to the development of a patient mobile application consisting of five components (myCare, myStory, myResources, myCommunity, and myNotes) and a clinician dashboard that includes an overview table and individual patient profiles with data displays.ConclusionsimPROVE has the potential to transform the way we deliver care to patients. Developed from best practices in user-centered design, agile development, and qualitative methods; imPROVE addresses the needs of multiple stakeholders, including patients, clinicians, healthcare administrators, and researchers.
Tumor immune microenvironment of primary prostate cancer with and without germline mutations in homologous recombination repair genes
Authors: Trigos Anna Sofia , Pasam Anupama , Banks Patricia , Wallace Roslyn , Guo Christina , Keam Simon , Thorne Heather ,   kConFab, Mitchell Catherine , Lade Stephen , Clouston David , Hakansson Alexander , Liu Yang , Blyth Benjamin , Murphy Declan , Lawrentschuk Nathan , Bolton Damien , Moon Daniel , Darcy Phil , Haupt Ygal , Williams Scott G , Castro Elena , Olmos David , Goode David , Neeson Paul , Sandhu Shahneen 
Published: October 2022

BackgroundAberrations in homologous recombination repair (HRR) genes are emerging as important biomarkers for personalized treatment in prostate cancer (PCa). HRR deficiency (HRD) could affect the tumor immune microenvironment (TIME), potentially contributing to differential responses to poly ADP-ribose polymerase (PARP) inhibitors and immune checkpoint inhibitors. Spatial distribution of immune cells in a range of cancers identifies novel disease subtypes and is related to prognosis. In this study we aimed to determine the differences in the TIME of PCa with and without germline (g) HRR mutations.MethodsWe performed gene expression analysis, multiplex immunohistochemistry of T and B cells and quantitative spatial analysis of PCa samples from 36 patients withgHRD and 26 patients with sporadic PCa. Samples were archival tumor tissue from radical prostatectomies with the exception of one biopsy. Results were validated in several independent cohorts.ResultsAlthough the composition of the T cell and B cells was similar in the tumor areas ofgHRD-mutated and sporadic tumors, the spatial profiles differed between these cohorts. We describe two T-cell spatial profiles across primary PCa, a clustered immune spatial (CIS) profile characterized by dense clusters of CD4+T cells closely interacting with PD-L1+cells, and a free immune spatial (FIS) profile of CD8+cells in close proximity to tumor cells.gHRD tumors had a more T-cell inflamed microenvironment than sporadic tumors. The CIS profile was mainly observed in sporadic tumors, whereas a FIS profile was enriched ingHRD tumors. A FIS profile was associated with lower Gleason scores, smaller tumors and longer time to biochemical recurrence and metastasis.ConclusionsgHRD-mutated tumors have a distinct immune microenvironment compared with sporadic tumors. Spatial profiling of T-cells provides additional information beyond T-cell density and is associated with time to biochemical recurrence, time to metastasis, tumor size and Gleason scores.
Adherence to Healthy Eating Index-2015 and severity of disease in hospitalised military patients with COVID-19: a cross sectional study
Authors: Parastouei Karim , Shokooee Jud S , Sepandi M , Abbaszadeh S , Samadi M , Meftahi GH , Taghdir M 
Published: October 2022

IntroductionProper nutrition can play an important role in preventing and improving disease progression in patients with COVID-19. The Healthy Eating Index-2015 (HEI-2015) is one of the most common measures used to assess overall nutritional quality. This research aimed to identify the relationship between the HEI-2015 score and disease severity in hospitalised military patients with COVID-19.MethodsThis cross-sectional study was conducted in 295 hospitalised military patients (retired military and military reserve) with COVID-19. A validated food frequency questionnaire was used to assess food intake. To evaluate the quality of the diet, the HEI-2015 score was calculated. A multiple logistic regression analysis was performed to measure the association between HEI-2015 scores and disease severity (intensive care unit (ICU) admission and length of hospital stay greater than 4 days) in hospitalised military patients with COVID-19.ResultsThe mean HEI-2015 score was significantly higher in non-ICU patients than in ICU patients (58.39±15.02 vs 53.54±15.65, p=0.01). After adjusting for possible confounding factors including age, sex, comorbidities, calorie intake, body mass index and physical activity, adherence to HEI-2015 inversely related to ICU admission (OR 0.98; 95% CI 0.95 to 1.00) and length of hospital stay of more than 4 days (OR 0.99; 95% CI 0.97 to 1.00) in hospitalised military patients with COVID-19, although statistically not significant.ConclusionsAccording to the results of the study, adherence to HEI-2015 inversely related to both ICU admission and length of hospital stay in hospitalised military patients with COVID-19, although it was not statistically significant.