bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteinuria's Influence on Clinical Outcomes and Prognostic Accuracy in Acute Ischaemic Stroke Patients Undergoing Reperfusion Therapy: A Comprehensive Meta‐Analysis
Authors: Rajesh Kruthajn , Bhaskar Sonu M. M.
Published: January 2025

Aim

Proteinuria commonly accompanies acute ischaemic stroke (AIS) patients undergoing reperfusion therapies such as intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). Understanding its influence on outcomes is crucial for prognosis and optimising management strategies. This study aims to elucidate proteinuria's role in mediating outcomes among reperfusion‐treated patients.

Methods

Through a random‐effects meta‐analysis, we analysed data to assess the association of proteinuria with functional outcomes, symptomatic intracerebral haemorrhage (sICH) and mortality. A total of 33 140 patients were included in the meta‐analysis.

Results

Proteinuria demonstrated a pooled prognostic sensitivity of 58% (95% CI: [48%; 67%]; p < 0.001) for poor functional outcomes at 90 days. It was linked with increased odds of unfavourable functional outcome at 90 days in both IVT (OR 2.27; 95% CI: [1.95; 2.66]; p < 0.001) and EVT (OR 2.57; 95% CI: [2.16; 3.05]; p < 0.001) groups. Furthermore, it was associated with increased odds of 90‐day mortality in IVT‐treated patients (OR 2.31; 95% CI: [1.76; 3.02]; p < 0.001), while EVT‐treated patients exhibited increased odds of in‐hospital mortality (OR 2.71; 95% CI: [1.22; 6.04]; p < 0.05).

Conclusions

The clinical significance of proteinuria is underscored by its impact on outcomes for AIS patients receiving reperfusion treatments. This awareness may guide individualised treatment by considering the intricate interplay between kidney function and its correlation with stroke. Consequently, this has the potential to improve prognosis and overall outcomes in AIS therapy.
Latitudinal differences in thermal response curves across populations demonstrate context‐dependent warming effects within species
Authors: Neale Zoey R. , Rudolf Volker H. W.
Published: January 2025

Rising global temperatures are expected to reshape predator–prey interactions, which are central to the structure, dynamics and functioning of natural ecosystems. While predator feeding rates are known to depend on temperature and vary across species, how this relationship varies within species across the different climatic regions conditions they inhabit is still poorly understood. Yet identifying this relationship is essential to predict how natural populations and communities will be affected by climate change across different geographic and climatic regions. Here we address this knowledge gap by experimentally measuring the thermal responses of predators collected from nine populations representing three latitudes spanning most of the continental US (a gradient of 11°). Specifically, we set up 145 independent replicated predator–prey systems across an experimental temperature gradient ranging from 5–35°C to quantify the thermal response curves for each of the nine predator populations. We found stark differences in thermal responses across latitudes ranging from clear humped‐shaped curves to a mostly linear increase. Most notably, these intraspecific differences in the overall shapes of thermal responses reveal opposing latitudinal patterns depending on the range of temperature considered. These results reveal that local climate can shape how interactions respond to warming and highlight the need to consider past local climatic conditions when predicting responses of natural systems to climate change at the local, regional, and global scale.
Maternal Prepregnancy Obesity and Offspring Intelligence Quotient at 5 Years: A Multicohort Analysis
Authors: Dow Courtney , Lorthe Elsa , Bernard Jonathan Y. , Galera Cédric , Marchand‐Martin Laetitia , Tafflet Muriel , Ancel Pierre‐Yves , Charles Marie‐Aline , Heude Barbara
Published: January 2025

Background

The relationship between maternal obesity and childhood cognitive development remains unclear. Prior studies did not adjust for important confounders, and preterm infants are a developmentally distinct group that remains scarcely examined.

Objectives

To determine whether maternal prepregnancy body mass index (BMI) is associated with offspring intelligence quotient (IQ) up to 5 years and whether this relationship varies with gestational age.

Methods

Data from two French birth cohorts, EDEN (all gestational ages) and EPIPAGE‐2 (preterm children born between 24 and 34 weeks of gestation), were used for this study. Maternal prepregnancy weight and height were used to calculate prepregnancy BMI. The Wechsler Preschool and Primary Scale of Intelligence was used to assess child IQ around 5 years. Multivariable models were adjusted for confounders, including socioeconomic status and paternal BMI.

Results

Analytical cohorts included 1100 children from EDEN and 2629 from EPIPAGE‐2. Lower intellectual functioning (full‐scale IQ < 85) was observed in 8.1% of children in EDEN and 19.6% in EPIPAGE‐2. The prevalence of maternal obesity was 13.6% (EDEN) and 21.3% (EPIPAGE‐2) among children with lower intellectual functioning compared to 8.9% (EDEN) and 12.9% (EPIPAGE‐2) among children with normal intellectual functioning. Maternal prepregnancy obesity was associated with an approximately 3‐point decrease in full‐scale IQ scores in fully adjusted models (adjusted β −2.8, 95% confidence interval [CI] −5.6, −0.1 and −2.6, 95% CI −4.7, −0.6 in EDEN and EPIPAGE‐2, respectively). In EDEN, maternal obesity was associated with lower scores in the verbal IQ domain. Among infants born preterm (EPIPAGE‐2), maternal obesity was associated with lower scores in the processing, reasoning, and verbal IQ domains. Adjustment for paternal BMI did not change the magnitude of the relationship with maternal obesity.

Conclusions

High maternal prepregnancy BMI is associated with child cognitive development around 5 years of age.
Natural farming needs manure augmentation to optimize soil quality and crop productivity
Authors: Thakur Praveen , Paliyal Sukhdev Singh , Kumar Pardeep , Raj Yog , Thakur Pratibha , Dev Purushottam , Thakur Anjali , Butail Nagender Pal , Gill Ankit
Published: January 2025

While assuming natural farming (NF) superior over conventional farming in improving physical, chemical and biological attributes, we hypothesized that the inclusion of farmyard manure (FYM) in addition to NF components would further enhance the soil quality and productivity. The objectives of the study were to assess the efficacy of NF in maize–blackgram intercropping, evaluating effect on soil quality of FYM‐integrated NF, and to identify key soil quality indicators under rainfed agroecosystem. Over a 2 years span, the factorial experiment employed Jeevamrit concentrations (J1: 5% and J2: 10%), application intervals (I1: 15 days and I2: 30 days) and FYM levels (F1: 0 t FYM ha−1, F2: 5 t FYM ha−1 and F3: 10 t FYM ha−1) as factors, resulting in 12 combinations arranged in a randomized block design under maize intercropped blackgram. An additional recommended dose of fertilizers (RDF) enabled an orthogonal contrast to compare effects of conventional farming and bio‐farming. The results revealed that yield and soil attributes of maize, intercropped with blackgram, were significantly improved with FYM‐augmented NF system. The combined application of 10 t FYM ha−1 and 10% Jeevamrit with 15 days application interval significantly improved the bulk density (1.43 Mg m−3), mean weight diameter of soil aggregates (1.12 mm), saturated hydraulic conductivity (8.13 cm h−1) and plant available water (14.2 cm m−1) over rest of the treatments. The study yielded no evidence supporting the efficacy of NF on its own, as it failed to demonstrate any considerable impact on soil physical, chemical and nutrient attributes from their initial status. However, NF treatments substantially enhanced the biological activity (microbial biomass carbon by 3.88% and dehydrogenase by 21.95%) over treatment receiving RDF. The conventional farming reduced the soil organic carbon content (5.58 g kg−1), along with lower levels of available nitrogen (286 kg ha−1), phosphorus (19.2 kg ha−1) and sulphur (18.4 mg kg−1) when compared to bio‐farming. Application of 10% Jeevamrit at 15‐day span +10 t FYM ha−1 increased the maize grain equivalent yield by 8.65% over conventional farming. Soil quality index measured 0.68 under conventional farming system, 0.73 under NF that further improved to 0.90 with 10 t FYM ha−1 addition. The study demonstrates the potential synergy between FYM and the NF approach, leading to improved soil quality and agricultural productivity.
Development of a simplified platelet cryopreservation method: An in vitro investigation of reducing the DMSO concentration to allow administration without its pre‐transfusion removal
Authors: Johnson Lacey , Lei Pearl , Roan Christopher , Marks Denese C.
Published: January 2025

Background and Objectives

The most widely used method of platelet cryopreservation requires the addition of 5%–6% dimethylsulphoxide (DMSO), followed by its pre‐freeze removal via centrifugation, to minimize toxicity. However, this adds complexity to the pre‐freeze and post‐thaw processing. Accordingly, the aim of this study was to simplify platelet cryopreservation by reducing the DMSO concentration and omitting the requirement for pre‐transfusion removal.

Materials and Methods

Apheresis platelets were cryopreserved at −80°C according to standard blood‐banking methods using 5.5% DMSO, with centrifugation, pre‐freeze removal of DMSO and reconstitution in plasma following thawing (standard). In parallel, doses of DMSO (0%, 1.5%, 3%, 5.5%) were tested without centrifugation and reconstitution (no‐wash). In vitro platelet quality was assessed by flow cytometry, aggregation, viscoelastic testing (thromboelastography [TEG]) and clot retraction.

Results

Many in vitro platelet quality parameters showed DMSO dose dependency using the no‐wash protocol (recovery, annexin‐V, TEG maximum amplitude [MA]). Platelets frozen using the no‐wash method with 3% DMSO showed a higher abundance of GPIbα (3% DMSO no‐wash median fluorescence intensity [MFI]: 228 ± 16; standard MFI: 184 ± 16; p = 0.0016) and less degranulation (reduced P‐selectin‐positive platelets and concentration of supernatant P‐selectin) than platelets frozen using the standard method. All functional properties measured were comparable to those of platelets frozen using the standard method.

Conclusion

This study shows that improvements in cryopreserved platelet quality parameters can be obtained by removing the centrifugation processes (standard vs. 5.5% DMSO no‐wash). A reduction in DMSO to 3% supports quality parameters, and if shown to be clinically acceptable, this cryopreservation method could improve platelet accessibility, as it is simpler and cheaper than the standard method.
Perinatal care experiences of women living with disability in Africa: a qualitative systematic review protocol
Authors: Mekonen Dawit Gebeyehu , Snelgrove-Clarke Erna , Macdonald Danielle , Donnelly Catherine , Engeda Eshetu
Published: January 2025

Objective:

This review will explore the perinatal care experiences of women living with disability in African countries.

Introduction:

In many African countries, most women with disability face stigma and discrimination. They are also at risk of unwanted pregnancy and sexually transmitted diseases due to gender-based violence and sexual abuse. Qualitative studies on perinatal care experiences of women with disability in Africa indicate challenges such as social stereotypes, lack of access to health facilities, and insensitivity from health professionals. Synthesizing the qualitative findings about the perinatal care experiences of women with disability in Africa will provide insights into the needs of this population and identify gaps in health care practice.

Inclusion criteria:

We will include all settings in which women with disability in Africa receive maternal health care services, such as hospitals, clinics, primary care, community health centers, and homes. We will consider studies published from 2008 onward that present qualitative data, including designs such as phenomenology, grounded theory, ethnography, action research, and feminist research.

Methods:

The review will be conducted in line with the JBI methodology for systematic reviews of qualitative evidence. The following databases will be searched: Global Health, CINHAL (EBSCOhost), MEDLINE (Ovid), Web of Science, Embase (Ovid), Sabinet African Journals, and PsycINFO (EBSCOhost). Theses and dissertations will be searched through ProQuest and Google Scholar. Two independent reviewers will conduct study selection, critical appraisal, data extraction, and meta-aggregation. Confidence in the findings will be assessed in accordance with the ConQual approach.

Systematic review registration number:

PROSPERO CRD42023431799.
Paramedic assessment of suspected or confirmed COVID-19 patients in the out-of-hospital environment: a scoping review protocol
Authors: Gleeson-Hammerton Thomas , Pearce James , Eckert Marion , Esterman Adrian , Peters Micah DJ
Published: January 2025

Objective:

The objective of this review is to develop a comprehensive collection of information about the current processes for paramedics assessing and referring suspected or confirmed COVID-19 patients in the out-of-hospital environment.

Introduction:

Patients with COVID-19 are frequently encountered by paramedics and ambulance service clinicians. Increased demand on ambulance services has resulted in many of these services developing alternative referral pathways to avoid unnecessary conveyance to emergency departments. There is not a strong body of literature or rigorous clinical practice guideline on this topic to support the assessment and referral decision-making for COVID-19 patients in the out-of-hospital setting.

Inclusion criteria:

Any suspected or confirmed COVID-19 patients in the out-of-hospital environment who are seeking care for COVID-19-related symptoms and being assessed by paramedics will be considered for inclusion. Sources from scholarly literature and gray literature, such as ambulance service clinical practice guidelines, will be included. Sources from Australia, Aotearoa New Zealand, USA, Canada, and the UK will be included.

Methods:

The review will be guided by the JBI methodology for scoping reviews and will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A database search for scholarly literature will be performed, followed by a gray literature search. Databases will include MEDLINE, CINAHL, Scopus, Emcare, Embase, amber, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, and Epistemonikos. Gray literature will include clinical practice guidelines, protocols, and procedures obtained from ambulance service websites and apps. Results will be presented through figurative, tabular, and narrative synthesis methods.

Review registration:

Open Science Framework osf.io/yc7vq
Effect of cochlear implants on cognitive function in children and adolescents with hearing loss: a systematic review protocol
Authors: Jammula Varna , Kramer Nicholas , Manthei Scott , DeArmond Megan , Koshy-Chenthittayil Sherli
Published: January 2025

Objective:

The objective of this review is to evaluate the effect of cochlear implants on cognitive function in pediatric patients with hearing loss.

Introduction:

Cognitive impairments have been reported in children with hearing loss. This is supported by the auditory scaffolding hypothesis, which describes sound as the basis for processing sequential information. Cochlear implants are proven to be successful in assisting these patients with language and speech recognition. Therefore, understanding whether such implants may additionally improve cognitive function is important for health care professionals in determining whether a child would benefit from a cochlear implant.

Inclusion criteria:

This review will include quantitative studies evaluating cognitive function in pediatric patients (0–18 years) with hearing loss who received unilateral or bilateral cochlear implants. Studies that do not use objective neuropsychological assessments to assess cognitive outcomes will be excluded.

Methods:

PubMed, Embase, CINAHL, Scopus, and PsycINFO will be searched for published studies. Google Scholar, LILACS, Livivo, and ProQuest Dissertation and Theses Global will be searched for unpublished and gray literature. ClinicalTrials.gov, the EU Clinical Trials Register, and WHO’s ICTRP will also be searched for trials. There will be no date or language limitations. Study selection, critical appraisal, and data extraction will be performed by 2 independent reviewers. If meta-analysis is possible, evidence will be summarized using R, with subgroup analyses providing insight into the effect of age, gender, and underlying conditions on the cognitive impairment. Certainty of the evidence will be assessed using the GRADE approach, and a Summary of Findings table will be generated using GRADEpro GDT 2021.

Systematic review registration number:

CRD42024500320
Equitable health care delivery for adult Nova Scotians: a scoping review protocol
Authors: Lane Jennifer , Barber Brittany , McCulloch Holly , Wong Helen , Forbes Neil , Alizadeh Takhtehchoobi Neda , Kuri Marwa , Lackie Kelly , Cassidy Christine , Wozney Lori , Curran Janet , Lane Kris , MacEachern Kendra , Thompson Hallie , O’Brien Cyril , Obeng Nkrumah Elizabeth , Pennell Courtney , Sheppard Darius , Burchell Drew , Macdonald Marilyn
Published: January 2025

Objective:

The objective of this review is to identify international and Nova Scotian standards of care, CPGs, and policies informing equitable health care.

Introduction:

The lack of attention given to intersectional health care needs of diverse populations perpetuates health inequities among under-served groups, creating an urgent need for health care reform globally.

Inclusion criteria:

This scoping review will include standards of care, CPGs, and policies focusing on equity-related health indicators. Academic and gray literature sources, published from 2014 to present, will be considered if they relate to one or more defined equity-related health indicators. Sources will be excluded if they do not explicitly relate to standards of care, CPGs, or policies for equitable health care delivery.

Methods:

This scoping review will be guided by Intersectionality Theory and conducted in accordance with the JBI methodology for scoping reviews. Academic databases MEDLINE ALL (Ovid) and Embase (Elsevier) will be searched using identified search terms. An advanced Google search will be undertaken to identify gray literature sources. A 2-phased approach will be conducted to identify sources that will be synthesized and presented in tabular format using equity-related health indicators, providing an inventory of health equity standards of care, CPGs, or policies to be disseminated to health care providers in Nova Scotia.

Review registration:

Open Science Framework https://osf.io/6rnx2
Barriers to and facilitators of human trafficking screening in the health care setting: a scoping review protocol
Authors: Hosey Lisa , Palokas Michelle
Published: January 2025

Objective:

The objective of this scoping review will be to identify barriers to and facilitators of screening children, adolescents, and adults for human trafficking in the health care setting.

Introduction:

Human trafficking is a global issue that violates human rights and undermines the fabric of society. The effects of human trafficking span domestic and international borders, cultures, and socio-economic backgrounds. The magnitude of human trafficking has become increasingly evident, with estimates indicating millions of victims annually.

Inclusion criteria:

This review will consider studies that include children, adolescents, and adults who are either victims or potential victims of human trafficking, and the health care providers caring for them in the health care setting. Studies that report on barriers to and facilitators of screening for human trafficking will be included. Studies may be conducted in any health care setting, in any geographical location or culture.

Methods:

This review will follow the JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The key databases to be searched will include PubMed, CINAHL (EBSCOhost), PsycINFO (EBSCOhost), and Web of Science Core Collection. Sources of unpublished studies and gray literature will include MedNar and LILACS. Two independent reviewers will retrieve and review full-text studies and extract data. The results will be presented in diagrammatic or tabular format with a narrative summary.

Review registration number:

Open Science Framework https://doi.org/10.17605/OSF.IO/ETX7W
“Good Advice for a Bloodsport”: Injury, Coercion, Harm, and Physical Extraction in U.S. College Football
Authors: Silva Derek , Kalman-Lamb Nathan
Published: January 2025

Most mainstream debates about exploitation in college athletics are unquestionably right to highlight the foundational injustice that players are not compensated directly for their value-producing athletic work. Yet, what this discourse does not often account for is the fact that exploitation is not just about how benefits are distributed in an exchange but also how harm is distributed. College football is a site of some of the most brutal working conditions in U.S. society, yet it is unregulated by occupational health and safety standards and unprotected by labor organizing. Drawing on semistructured interviews with 25 former college football players, we argue that players are often subjected to brutal physical (and emotional) harm and discipline in the course of their work, compelled to play through injury, and forced to endure abusive coaching, often without long-term health insurance. We thus take account of the physical and emotional harm that saturates college football.
Marker Nomenclature and Control of Type I and Type II Errors in Cattle Parentage Verification Using Microsatellite Markers
Authors: Modorov M. V. , Tkachenko I. V. , Kleshcheva A. A. , Sevost’yanov M. Yu.
Published: January 2025

Abstract—

Wrong pedigree records reduce the quality of cattle breeding. For these reasons, DNA-based parentage verification has become an integral part of breeding work. Traditionally, in the Russian Federation, parentage verification was performed using immunogenetic markers. However, the improvement of technologies and strengthening of regulatory requirements have led to the fact that in recent years, microsatellite markers have replaced immunogenetics. Currently, there is no Russian protocol that clearly regulates the procedure of cattle parentage verification using microsatellite loci, which complicates the work of testing laboratories. In particular, the requirements for the number and nomenclature of genetic markers to be used in testing exist only for cattle, embryos, and sperm products transported between the member states of the Eurasian Economic Union. There are no requirements for the control of type I (false positive results) and type II (false negative results) errors, to be considered in certification. In this paper the approaches to solving these issues suggested by the International Society for Animal Genetics (ISAG), the International Committee for Animal Recording (ICAR), the Collegium of the Eurasian Economic Commission, as well as Russian regulatory documents governing forensic medical examination procedure related to the parentage assignment, will be considered. Based on the results of this review, a nomenclature of microsatellite markers and the examination protocol, which includes control of type I and type II errors, will be provided. Particular attention will be paid to the description of sources of type II errors and the need to control them in issuing a certificate.
Encountering Arc of Bühler during pancreaticoduodenectomy surgery
Authors: Yu Joyce , Mohtashami Ali , Samra Jaswinder
Published: January 2025

The Arc of Bühler (AoB) is a rare anatomical variant in gastrointestinal vasculature where there is an aberrant anastomotic vessel between coeliac and superior mesenteric arteries. We present a rare case where AoB was noted intraoperatively to have haemodynamically significant flow in the context of coeliac artery stenosis, supplementing arterial supply to the hepatic artery proper via the gastroduodenal artery (GDA). An interpositional jump graft between the aorta and the GDA stump was created using the long saphenous vein, and flow was restored. The patient recovered well postoperatively. This case highlights the importance of understanding variations in gastrointestinal vasculature and the role of preoperative planning.
Novel inclusion in the silvery hair syndromes: unravelling the mystery behind the silvery hair of homocystinuria
Authors: Velusamy Breethiga , Pandian Ashwini , Vakkalagadda Shanker K , Somagani Rohan Kumar
Published: January 2025

Homocystinuria is a disorder of methionine metabolism leading to abnormal accumulation of homocysteine and its metabolites in blood and urine. This condition presents with a wide range of cutaneous and systemic features. This case report focuses on the particular cutaneous finding of silvery hair in this patient and its examination under a microscope that reveals an unusual and not yet reported finding of melanin clumps. Melanin clumps in association with silvery hair have until now been found in very few rare syndromes, and their finding in homocystinuria makes it a novel phenotypic feature for its utilisation in the upcoming times for better patient diagnosis and management.
Detection of anomalous left coronary artery origin from pulmonary artery in an adult patient presenting with monomorphic ventricular tachycardia
Authors: Anand Abhinav Bhairawnath Pandey , Rathod Keyur , Sabnis Girish Ramkrishna , Mahajan Ajay
Published: January 2025

A man in his early 50s presented to the emergency department (ED) with sudden onset of palpitation and presyncope. The 12-lead electrocardiogram (ECG) recorded in ED showed monomorphic ventricular tachycardia requiring cardioversion in view of haemodynamic instability. The patient was subsequently detected to have an anomalous left coronary artery origin from the pulmonary artery. We present the features of this case that lead to clinical suspicion of this disease and discuss the presentation of anomalous left coronary artery origin from the pulmonary artery (ALCAPA) in adults.
Impact of resistance training on cardiometabolic health-related indices in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis of randomised controlled trials
Authors: Al-Mhanna Sameer Badri , Franklin Barry A , Jakicic John M , Stamatakis Emmanuel , Pescatello Linda S , Riebe Deborah , Thompson Walter R , Skinner James , Colberg Sheri R , Alkhamees Nouf H , Bin Sheeha Bodor , Gülü Mehmet , Alghannam Abdullah F , Batrakoulis Alexios
Published: January 2025

Objective

To evaluate the effects of resistance training on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus (T2DM) and overweight/obesity.

Design

Systematic review and meta-analysis of randomised controlled trials (RCTs).

Data sources

PubMed, Web of Science, Scopus, Science Direct, Cochrane Library and Google Scholar databases were searched from inception up to May 2024. The search strategy included the following keywords: diabetes, resistance exercise and strength training.

Eligibility criteria for selecting studies

RCTs published in English comparing resistance training alone with non-exercising standard treatment. Participants were adults diagnosed with T2DM and concurrent overweight/obesity (body mass index (BMI) ≥25 kg/m2).

Results

A total of 18 RCTs qualified involving 1180 patients (48.6/51.4 female/male ratio; 63.3±7.0 years; 29.3±4.3 kg/m2). Waist circumference (standardised mean differences (SMD) −0.85 cm, 95% CI −1.66 to −0.04), waist-to-hip ratio (SMD −0.72, 95% CI −1.30 to −0.15), high-density lipoprotein cholesterol (SMD +0.40 mg/dL, 95% CI 0.07 to −0.72), triglycerides (SMD −0.54 mg/dL, 95% CI −1.06 to −0.02), fasting blood glucose (SMD −0.65 mmol/L, 95% CI −1.19 to −0.12), fasting insulin (SMD −0.74 uIU/mL, 95% CI −1.12 to −0.36) and glycated haemoglobin (SMD −0.32%, 95% CI −0.63 to −0.01) improved compared with standard treatment. The risk of bias was low to unclear, and the quality of evidence was very low to moderate.

Conclusions

Resistance training as a standalone exercise intervention in the management and treatment of T2DM with concurrent overweight/obesity is associated with many cardiometabolic benefits when compared with standard treatment without exercise.

PROSPERO registration number

CRD42022355612.
Developing a Shariah-compliant medical services framework in Malaysia: an expert system approach using fuzzy Delphi method and interpretive structural modelling
Authors: Che Jamaludin Farrah Ilyani , Abdullah Muhammad Ridhuan Tony Lim , Endut Mohd Nuri Al Amin , Saifuddeen Shaikh Mohd , Hamimi Kamarul Afendey , Harun Shariff
Published: January 2025

Introduction

In an increasingly diverse healthcare landscape, addressing the specific needs of Muslim patients has become paramount. The absence of comprehensive frameworks for Shariah-compliant healthcare services often poses challenges for healthcare professionals striving to provide care that aligns with Islamic values.

Objective

The objective of this study was to develop a comprehensive framework for Shariah-compliant healthcare services, ensuring alignment with Islamic practices in healthcare.

Methods, setting, participants

This consensus study employed a key input approach using the fuzzy Delphi method (FDM) and interpretive structural modelling. Conducted in Malaysia, the study involved 10 experts from various regions across the country. These experts were selected based on clear criteria that included professionals with experience in Islamic and/or healthcare, while those lacking relevant expertise were excluded.

Results

The primary outcome was the identification of pertinent elements for the framework, with final elements measured based on expert consensus achieved through FDM. The panel of experts reached consensus on 10 essential elements that form the backbone of the framework for Shariah-compliant healthcare services. These elements include governance, medical ethics, patient care, human resources and professional development, facilities for Islamic worship (ibadah), spiritual care support, end-of-life care, Islamic environment, medicine and drugs, and affordability and accessibility.

Conclusion

Ultimately, the development of this comprehensive framework is a crucial step in addressing the specific needs and concerns of Muslim patients worldwide. By incorporating the input and consensus of experts from various relevant fields, the resulting framework provides healthcare professionals with a solid foundation to deliver healthcare services that align with Islamic values, ultimately promoting the well-being of Muslim patients in Malaysia and tourists globally.
Equity in Basic Medical Education accreditation standards: a scoping review protocol
Authors: Shaheen Neelofar , Mahboob Usman , Sethi Ahsan , Irfan Muhammad
Published: January 2025

Introduction

Accreditation in Health Professions Education is a pivotal process to ensure the quality of medical institutions and health professionals. ‘Equity’is an umbrella term reflecting the principles of justice and support to disadvantaged entities according to their needs. While commonly applied to various domains in medical education, there is potential to determine how ‘equity’is considered or discussed while practically implementing accreditation standards for Basic Medical Education (BME) globally.

Methods and analysis

The scoping review protocol has been drafted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocol (PRISMA-P) checklist. We will conduct a planned scoping review according to the Joanna Briggs Institute (JBI) guidelines for scoping review and adhere to the PRISMA-Scoping Review extension (PRISMA-ScR) checklist. A systematic literature search, from inception to May 2024, will be conducted across search engines and databases including Google Scholar, PubMed, Web of Science, Wiley Online Library and ProQuest, in collaboration with a qualified librarian. Peer-reviewed research articles, commentaries, opinion papers and reviews that explicitly or implicitly discuss equity in reference to accreditation standards will be eligible for inclusion. A qualitative inductive thematic analysis will be employed to systematically identify categories and themes from the extracted data and draw conclusions.

The review team anticipates the development of a conceptual map that will evolve during the synthesis of the literature, as a description of the term ‘equity’in the implementation of BME accreditation standards. We also anticipate finding any methodological or theoretical framework that is used in the literature to discuss the concept of ‘equity’in the implementation of BME accreditation standards.

Ethics and dissemination

This scoping review aims to systematically map the literature on the burgeoning domain of accreditation in BME. The scoping review entails the collection and synthesis of literature and does not require ethical approval as per local regulations, as it does not involve primary data collection or interaction with human participants. The research findings will be disseminated through peer-reviewed publications, social media platforms, and academic presentations at workshops and conferences.
‘Do they care?’: a qualitative examination of patient perspectives on primary care clinician communication related to opioids in the USA
Authors: Olson Anthony W , Bucaloiu Andrei , Allen Clayton I , Tusing Lorraine D , Henzler-Buckingham Hillary A , Gregor Christina M , Freitag Laura A , Hooker Stephanie A , Rossom Rebecca C , Solberg Leif I , Wright Eric A , Haller Irina V , Romagnoli Katrina M
Published: January 2025

Objectives

This substudy’s objectives were to (1) examine the transferability of a four archetype framework (simplified pattern of prototypical features) for patients at high risk for opioid use disorder (OUD) developed from a previous study with a similar population; (2) explore how patient preferences for terminology can inform clinician communication strategies for patients with OUD across archetypes and (3) explore how patient perceptions of opioid risks can inform clinician communication strategies across patient archetypes.

Design

This qualitative study collected data via semistructured phone interviews with patients about views on opioid-related discussions with primary care clinicians. Qualitative data were coded using the Rigorous and Accelerated Data Reduction technique and analysed via iterative inductive/deductive thematic analysis.

Setting

40 primary care clinics affiliated with two health systems (site1=Pennsylvania; site2=Minnesota, Wisconsin and North Dakota).

Participants

40 adults meeting one of the following: OUD diagnosis; taking medication for OUD (MOUD) and ≥3 opioid prescriptions in the previous year.

Results

The aforementioned four archetype framework transferred well to the study sample and hinted at archetype differences in participant OUD-terminology preferences and opioid risk perceptions. Two additional archetypes of ‘in treatment/recovery for OUD and not taking MOUD’ and ‘in treatment/recovery for OUD and taking MOUD’ were identified. Participants best fitting archetypes 1–4 preferred clinicians to refrain from using addiction terminology to describe their relationship with opioids, finding the term ‘dependence’ as more appropriate and a signal that clinicians cared for patients. Participants who best first archetypes 5–6 felt ‘addiction’ was an appropriate, direct term that accurately described their condition, often using it themselves. Patients in all archetypes recognised risks of harm from using opioids, especially participants fitting archetypes 2, 5 and 6 who conveyed the greatest concern.

Conclusion

The modified six archetype framework may help clinicians tailor their communication and care for patients diagnosed with or at high risk for OUD.

Trial registration number

NCT04198428.
Impact of adverse childhood experiences on sensory thresholds in adults living with multimorbidity and chronic pain (the ACE-MAP study): protocol for an observational feasibility study
Authors: Senaratne Dhaneesha N S , Smith Blair H , Hales Timothy G , Marryat Louise , Colvin Lesley A
Published: January 2025

Introduction

Exposure to adverse childhood experiences (ACEs) is associated with a range of poor long-term health outcomes, including multimorbidity and chronic pain. Epidemiological evidence underpins much of this relationship; however, psychophysical testing methods, such as quantitative sensory testing (QST), may provide valuable insights into potential mechanisms. Previous studies have shown inconsistent links between ACEs and QST, but the QST profiles of people with multimorbidity have not been reported. We hypothesise that exposure to ACEs is associated with lowered QST thresholds (ie, experience of pain with milder stimuli) and that this association is stronger in adults with multimorbidity and/or chronic pain. The ACE-MAP study is a cross-sectional feasibility study with the primary aim of assessing the feasibility and acceptability of the proposed study procedures. The secondary aim is to generate preliminary data to understand the impact of ACEs on QST thresholds.

Methods and analysis

We plan to recruit 40 participants, with 10 in each of the following groups: (1) chronic pain with multimorbidity; (2) chronic pain without multimorbidity; (3) multimorbidity without chronic pain; and (4) controls. Participants will complete a series of questionnaires (including on ACEs, chronic pain and long-term conditions) and will then take part in QST assessments. The primary study outcomes will include measures of feasibility and acceptability of the proposed study design. The secondary study outcomes will include exploratory analysis on the relationship between ACEs and QST thresholds.

Ethics and dissemination

The study was approved by the Scotland B Research Ethics Committee (reference: 24/SS/0031). Results from the study will be presented at scientific conferences, published in a peer-reviewed journal and shared with patients and members of the public through other media streams.

Trial registration number

ISRCTN10049430.
Relationship between staff experience and patient outcomes in hospital settings: an overview of reviews
Authors: Bragge Peter , Delafosse Veronica , Kellner Paul , Cong-Lem Ngo , Tsering Diki , Giummarra Melita J , Lannin Natasha A , Andrew Nadine , Reeder Sandra
Published: January 2025

Objectives

This review aimed to investigate the relationship between staff experience and patient health and experience outcomes in hospital inpatient settings.

Design

Systematic review of reviews.

Methods

Searches were performed in Medline (OVID), CINAHL and Google Scholar using key terms from relevant review articles. The search was conducted on 28 August 2023. Inclusion criteria were systematic or narrative reviews in English from 2020 onwards, focusing on inpatients in hospital and related tertiary care facilities, examining the relationship between staff experience and patient outcomes. A review of reviews approach was used, with broad definitions for staff experience (eg, hospital culture, stress and burnout) and patient outcomes (eg, adverse events and patient experience). Independent screening and quality appraisal were conducted by two researchers. An evidence map of links between staff experience and patient outcomes was created. The methodological quality of systematic reviews was assessed using the AMSTAR 2 tool and narrative reviews with the SANRA tool.

Results

From 2365 citations, 21 reviews (18 systematic, 3 narrative) were included. Review quality ranged from moderate to high. Mapping revealed 66 associations between staff experience and patient outcomes. Common associations included burnout, stress and fatigue with adverse events (six reviews); communication with patient satisfaction (four reviews) and teamwork with patient satisfaction (four reviews).

Conclusions

Staff burnout, teamwork and communication practices directly impact adverse events and patient satisfaction. These findings guide hospital managers and clinicians in improving health service policies and practices. Further research is needed to strengthen the evidence base.
Relationship between vaginal and gut microbiome and pregnancy outcomes in eastern Ethiopia: a protocol for a longitudinal maternal-infant cohort study (the EthiOMICS study)
Authors: Weldegebreal Fitsum , Ayana Desalegn Admassu , Wilfong Tara , Dheresa Merga , Yadeta Tesfaye Assebe , Negesa Akewok Sime , Demmu Yohannes Mulugeta , Tesfa Tewodros , Alemu Tegbaru Nibrat , Eticha Tadesse Gure , Geremew Abraham , Roba Kedir Teji , Abdissa Alemseged , Assefa Nega , Negash Abel Abera , Cools Piet , Tura Abera Kenay
Published: January 2025

Introduction

Although evidence exists on the impact of microbiota on pregnancy outcomes in many high-resource settings, there is a lack of research in many low-resource settings like Ethiopia. This study aims to fill this gap by studying the gut and vaginal microbiota changes throughout pregnancy and assess how these changes relate to pregnancy outcomes among a cohort of pregnant women in eastern Ethiopia.

Methods and analysis

Vaginal and stool samples will be collected using DNA/RNA Shield Collection kits three times starting at 12–22 weeks, 28–36 weeks and at birth (within 7 days). Postnatally, newborns’ skin swabs (at birth) and rectal swabs will be obtained until 2 years of age. Moreover, breast milk samples at birth and 6 months and environmental samples (water, indoor air and soil) will be collected at enrolment, birth, 6, 12 and 24 months post partum. DNA will be extracted using Roche kits. Metagenomic sequencing will be performed to identify metataxonomic profiling and assess variations in microbial profiles, and α and β diversity of the microbiota. Information on socioeconomic, behavioural, household and biological factors will be collected at enrolment. The collected data will be coded, entered into EpiData 3.1 and analysed using Stata 17.

Ethics and dissemination

The Institutional Health Research Ethics Review Committee (Ref No. IHRERC/033/2022) of Haramaya University, Ethiopia has approved this study ethically. Written informed consent regarding the study and sample storage for biobanking will be obtained from all participants. Results will be published in international peer-reviewed journals, and summaries will be provided to the study funders. Clinical study data will be submitted to Data Compass (https://datacompass.lshtm.ac.uk/), and molecular profiles of the microbiome and whole-genome sequences will be submitted to the European Nucleotide Archive (https://www. ebi.ac.uk/ena). Requests for data should be directed to daberaf@gmail.com. The decision to share data will be made by the study steering committee under the College of Health and Medical Sciences, Haramaya University, Ethiopia.
Sensory alterations and immunological changes during the chronification of postsurgical pain: a study protocol for a prospective observational cohort study
Authors: van Driel Marjelle E C , van Veenendaal Nadine , Vernooij Lisette Margaretha , Eijkelkamp Niels , Koenderman Leo , Timmerman L , Custers Roel J H , Delawi Diyar , Huygen Frank J P M , Rijsdijk M
Published: January 2025

Introduction

Chronic postsurgical pain (CPSP) represents a widely underdiagnosed and often poorly treated medical problem, affecting 10–50% of all surgical patients, exhibiting neuropathic features in 35–60%. It is hypothesised that surgery-induced tissue damage and the subsequent immune response cause sensory alterations in the early postoperative period, ultimately leading to a chronic neuropathic or nociplastic pain state. The ‘Sensory Changes and Immunological parameters in Postsurgical pain’ study (SCIP-Pain study) was designed to test this hypothesis and identify sensory alterations and changes in the immunological response that are related to the development of CPSP with neuropathic features.

Methods and analysis

This protocol describes the SCIP-Pain study—an ongoing prospective observational cohort study involving 150 adult patients undergoing elective lower extremity orthopaedic surgery. Study participants complete questionnaires, undergo quantitative sensory testing (QST) and provide blood samples to assess the immunological response at various time points: before surgery, 2 weeks and 3 months after surgery. To reduce dimensionality, cluster analyses will be conducted on QST and immunological parameters. Cluster allocation, along with other preselected candidate predictors, will subsequently be used in a generalised mixed-effects model to predict CPSP with neuropathic features within 3 months after surgery as the primary outcome.

Ethics and dissemination

This study received approval from the Medical Ethics Committee NedMec (protocol NL77085.041.21), as well as from all participating centres. The study results are expected to be published in peer-reviewed journals and disseminated at international conferences.
Clinical and ultrasound assessment of body composition in preterm infants at discharge: an observational study
Authors: Izquierdo Renau Montserrat , García González Elsa , Balcells-Esponera Carla , del Rey Hurtado de Mendoza Beatriz , Inarejos Clemente Emilio J , Iglesias-Platas Isabel
Published: January 2025

Objectives

While the target of growth of very preterm infants (VPIs) during Neonatal Intensive care unit (NICU) admission is still controversial, the most accepted objective is that they should follow their intrauterine trajectory in terms of growth and body composition (BC). BC is difficult to measure in clinical daily routine but proxies like body ratios and skinfolds have been used. Prenatal and postnatal factors can influence the growth and BC of VPIs in the NICU.

Design, setting and patients

We conducted a case-control study, including preterm infants born before 32 weeks gestational age at term-corrected age (TCA) and healthy late preterm or term infants as controls and also a retrospective cohort analysis of factors influencing VPI’s BC at discharge. Patients had an anthropometric evaluation at discharge including weight, length, head circumference, body circumferences (waist, arm), skinfolds and abdominal ultrasound (US).

Results

191 VPIs were eligible for discharge visits, but only 83 had a complete evaluation and we collected 26 controls. VPIs at TCA were smaller in weight, length and head circumference but had greater ratios (arm fat-to-circumference and waist-to-length). Abdominal fat assessed by US was smaller in VPIs compared with term infants. Intrauterine growth restriction-VPI remained smaller at TCA but experienced less weight z-score loss. Sex did not seem to influence growth and BC proxies at TCA. Higher nutritional support during the first 2 weeks of life was related to a lower loss of length z-scores, and exclusive human milk feeding correlates with arm fat-to-circumference ratio.

Conclusions

Growth and BC of VPIs can be approached using simpler measures in clinical practice. Arm skinfolds and arm circumferences point to a greater adiposity of VPIs at TCA compared with term infants, while US does not show a greater visceral adiposity. Nutritional factors played a small effect in BC at the time of discharge.