bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of blockchain for sustainable solar energy trading: a systematic review
Authors: Ranasinghe Diyana Sheharee , Rodrigo Navodana
Published: April 2024

Purpose

Blockchain for energy trading is a trending research area in the current context. However, a noticeable gap exists in the review articles focussing on solar energy trading with blockchain technology. Thus, this study aims to systematically examine and synthesise the existing research on implementing blockchain technology in sustainable solar energy trading.

Design/methodology/approach

The study pursued a systematic literature review to achieve its aim. The data extraction process focussed on the Scopus and Web of Science (WoS) databases, yielding an initial set of 129 articles. Subsequent screening and removal of duplicates led to 87 articles for bibliometric analysis, utilising VOSviewer software to discern evolutionary progress in the field. Following the establishment of inclusion and exclusion criteria, a manual content analysis was conducted on a subset of 19 articles.

Findings

The results indicated a rising interest in publications on solar energy trading with blockchain technology. Some studies are exploring the integration of new technologies like machine learning and artificial intelligence in this domain. However, challenges and limitations were identified, such as the absence of real-world solar energy trading projects.

Originality/value

This study offers a distinctive approach by integrating bibliometric and manual content analyses, a methodology seldom explored. It provides valuable recommendations for academia and industry, influencing future research and industry practices. Insights include integrating blockchain into solar energy trading and addressing knowledge gaps. These findings advance societal goals, such as transitioning to renewable energy sources (RES) and mitigating carbon emissions, fostering a sustainable future.
Optimising Precision Agriculture Choices for Arable Farmers in Germany and the UK: the LINKDAPA Approach
Authors: Latherow Tamisan , Arnoult Matthieu , Engel Thomas , Gralfs Renke , Hrynevych Oksana , Karampoiki Maria , Mahmood Salar , Murdoch Alistair , Paraforos Dimitrios , Ranieri Emanuelle , Todman Lindsay , Tranter Richard , Hammond John
Published: April 2024

Farmer adoption of so‐called Precision Agriculture (PA) or ‘smart’ technologies in the arable sector has grown in the last few decades with a focus on Global Navigation Satellite Systems (GNSS) and variable rate technologies (VRT). This has led to increased generation of large volumes of data about fields and their crop yields which could be used to increase the environmental and financial performance for farmers. However, survey results show that cost and adaptability have been issues for many farmers in the UK and Germany that have held back such adoption. The LINKDAPA (LINKing multi‐source Data for Adoption of Precision Agriculture) project's approach sought to minimise both concerns by creating a customisable web platform that incorporates both GNSS and VRT into one, easy to use, affordable option for farmers. The project developed an online cloud‐based decision support tool which takes into account different fertiliser strategies based on novel algorithms using soil, historic yield and satellite data. Co‐created by researchers, farmers and agricultural technology firms, the LINKDAPA approach offers both economical and easy to implement solutions for farm management to mitigate resource loss‐ratios such as in fertiliser use, provide financial performance analyses, and multi‐year graphical imagery for soil mapping.
Family Conflict and Adolescent Depression: Examining the Roles of Sense of Security and Stress Mindset
Authors: Jiang Shan , Du Ruoyu , Jiang Chaoxin , Tan Shilin , Dong Ziyi
Published: April 2024

An extensive body of research has demonstrated the multifaceted detrimental impact of family conflict on the psychological well‐being of adolescents. Nevertheless, there remains a significant scarcity of comprehensive studies investigating the full spectrum of family conflict—encompassing both interparental and parent–child relationships—and its effects on adolescent depression within the social context of China. The current study endeavours to bridge this gap by examining the relationship between family conflict and depression while concurrently assessing the mediating role of sense of security and the moderating role of stress mindset. A total of 814 adolescents (mean age = 16.79 years) completed the questionnaires regarding family conflict, sense of security, depression and stress mindset. The findings reveal a positive correlation between family conflict and adolescent depression. Additionally, the study uncovers the mediating role of sense of security and the moderating role of stress mindset. These insights offer valuable theoretical and practical contributions to understanding the impact of family conflict on adolescent psychological development.
Epidemiological profile of luxations injuries with or without dental fractures in permanent teeth: A 10‐years retrospective study
Authors: Amilcar Ana Laura Lopes , Vieira Walbert A. , Matta Aline Cristine Gomes , de Almeida Gomes Brenda Paula Figueiredo , da Silva Marina Angélica Marciano , de Almeida José Flávio Affonso , Ferraz Caio Cézar Randi , Santos Eduardo César Almada , Neto Julio Vargas , de Jesus Soares Adriana
Published: April 2024

Background/Aim

This study assessed the epidemiology of luxation injuries with or without dental fractures in patients attending the outpatient clinic of a Brazilian dental school over the past decade.

Material and Methods

We reviewed clinical records from a specialized center for dental trauma care in Brazil, focusing on patients who experienced at least one traumatic dental injury (TDI) in a permanent tooth between 2012 and 2022. The extracted data included sex, age, etiology, time between trauma occurrence and the search for initial care, TDI classification, and the need for endodontic treatment. The statistical analysis involved Pearson's chi‐squared and Fisher's exact tests at a 5% significance level.

Results

The 366 analyzed clinical records included 166 patients (350 teeth) with luxation injuries. Men (n = 102) showed a higher prevalence of luxation injuries than women (n = 64). Extrusive luxation prevailed (n = 99 patients and 208 teeth). Patients with luxation injuries sought care promptly after dental trauma incidents (p = .02) and demonstrated a higher incidence of endodontic treatment (p < .0001) than those without luxation injuries. Lateral luxation was notably associated with traffic accidents (p < .0001). The combination of luxation injuries and tooth fractures did not correlate with a higher need for endodontic treatment (p > .05).

Conclusions

Age and trauma etiology seemed to have influenced the epidemiological profile of luxation injuries. Additionally, these injuries affected the time to seek initial care and the need for endodontic treatment.
Evaluation of Pediatric Oral Health‐Related Quality of Life score in children with traumatic dental avulsion injury: A Questionnaire‐Based Cross‐Sectional survey
Authors: Celikel Peris , Ozturk Nilay , Bas Aybike , Sengul Fatih
Published: April 2024

Background/Aim

Dental avulsion injury, being one of the traumatic dental injuries, has negative impacts on children's life quality. This study aims to evaluate the Pediatric Oral Health‐Related Quality of Life (POQL) scores of children with dental avulsion history from their perspective.

Materials and Methods

The population of this cross‐sectional study comprises 40 patients, aged between 8 and 14, who have a history of dental avulsion, in comparison to 40 other healthy peers. A questionnaire including general questions (such as age, gender, loss of tooth due to dental avulsion, malocclusion) and POQL instrument, with subscales including physical function, social function, emotional function, and role function, were completed by these children. Mann–Whitney U‐test is used when comparing the POQL scores.

Results

The social scores (median: 47, interquartile range [IQR]: 17–95) and total score percentages (median: 30, IQR: 14–40) of children with a history of avulsion were higher than those of their healthy peers (p < 0.05). The higher total POQL scores among girls (median: 37, IQR: 31–47) with a history of dental avulsion compared to boys (median: 19, IQR: 8–34) (p = .002) can be attributed to girls achieving higher scores in both social (median: 81, IQR: 39–100) and emotional (median: 35, IQR: 17–47) scores following dental avulsion (psocial = .02, pemotional = .006). Whether the avulsed tooth is replanted or not, it has not made any visible impact on the POQL scores. However, the loss of replanted teeth over time has created a borderline significant difference in emotional scores (median: 21, IQR: 11–35, p = .055).

Conclusion

Within the limits of our study, avulsion injuries have negative effects on children's emotional, social, and total quality of life. Even though avulsion injuries may be inevitable, to prevent these negative effects, it is vital to provide appropriate psychological support in the treatment of these children.
Reduced hybrid survival in a migratory divide between songbirds
Authors: Blain Stephanie A. , Justen Hannah C. , Easton Wendy , Delmore Kira E.
Published: April 2024

Migratory divides, hybrid zones between populations that use different seasonal migration routes, are hypothesised to contribute to speciation. Specifically, relative to parental species, hybrids at divides are predicted to exhibit (1) intermediate migratory behaviour and (2) reduced fitness as a result. We provide the first direct test of the second prediction here with one of the largest existing avian tracking datasets, leveraging a divide between Swainson's thrushes where the first prediction is supported. Using detection rates as a proxy for survival, our results supported the migratory divide hypothesis with lower survival rates for hybrids than parental forms. This finding was juvenile‐specific (vs. adults), suggesting selection against hybrids is stronger earlier in life. Reduced hybrid survival was not explained by selection against intermediate phenotypes or negative interactions among phenotypes. Additional work connecting specific features of migration is needed, but these patterns provide strong support for migration as an ecological driver of speciation.
Does the NSW vegetation integrity assessment underestimate the conservation values of derived native grasslands?
Authors: Dorrough Josh , Oliver Ian
Published: April 2024

Vegetation condition metrics are often used as a surrogate of biodiversity to support management decisions, conservation regulations and biodiversity markets. Vegetation condition metrics, which aggregate multiple attributes, are often criticised for simplifying the complexity of biodiversity. A particular challenge is substitution when high‐scoring attributes compensate for those with low scores (e.g. high vegetation cover compensating for low growth from diversity). The geometric mean is often suggested for aggregation to reduce these effects. In New South Wales, Australia, the Vegetation Integrity metric, calculated as the geometric mean of Composition, Structure and Function sub‐indices, measures the losses and gains in biodiversity values within the NSW Biodiversity Offsets Scheme. However, concern has been raised that Vegetation Integrity underestimates conservation values of derived native grasslands when the Function sub‐index (primarily tree‐related attributes) approaches zero. We explore this issue using two datasets and compare the current Vegetation Integrity metric with aggregation using the arithmetic mean, adopting a minimum value of 10/100 for the Function sub‐index and use of a grassland benchmark for derived native grasslands. Our evaluation draws on a large‐scale expert elicitation of conservation values in Critically Endangered Box‐gum Grassy Woodlands and 4018 Vegetation Integrity estimates undertaken during development assessments. We find that Vegetation Integrity underestimates conservation values of derived native grasslands and that the problem is widespread. Although evidence most strongly supports aggregation using the arithmetic mean, this change could be disruptive to the Biodiversity Offsets Scheme. Alternatively, a sub‐index minimum of 10/100 eliminates underestimation of derived native grasslands without substantial impacts in other circumstances. We found little evidence to support the use of a grassland benchmark, which tended to overestimate conservation values. This study highlights the need for sufficient flexibility in biodiversity policies and regulations to accommodate ongoing metric evaluation and revision to support more robust biodiversity outcomes.
Expectant parents with intellectual disabilities in child protection: Risk factors for child safety
Authors: Zijlstra Annick , Sterenborg Tessel , van Nieuwenhuijzen Maroesjka , de Castro Bram O.
Published: April 2024

Background

Newborns of parents with intellectual disabilities face higher risks in their environment for child unsafety, despite parents' good intentions. To help parents prevent unsafe circumstances, a good understanding of the risk factors faced by these parents is needed.

Methods

This casefile study examined (1) which risk factors were present for expectant parents with intellectual disabilities in child protection, (2) which domains of risk factors, and (3) whether a cumulation of risk factors was related to child safety.

Results

Expectant parents with intellectual disabilities in child protection before the child was born often experienced a cumulation of risk factors. Child, family, and care factors best predicted child safety. A cumulation of risk factors over multiple life domains increased the risks for child unsafety.

Conclusions

To reduce the risks of unsafe parenting conditions for newborns, preventive interventions for expectant parents with intellectual disabilities should address their needs from an ecological perspective.
Tackling Unintended Consequences of EU Sanctions: NGOs' Advocacy for Humanitarian Exceptions
Authors: Manfredi Simone , Jugl Marlene
Published: April 2024

Sanctions are increasingly prominent foreign policy tools, but research on the policy process that leads to specific sanction design is limited. Sanctions can have unintended effects on the provision of humanitarian aid in sanctioned countries, which has led to calls for humanitarian exceptions in sanction design. This study focuses on non‐governmental organizations' (NGOs) advocacy for a humanitarian perspective on European Union (EU) sanctions in the period 2020–2021. Building on the Advocacy Coalition Framework and the triangulation of qualitative data sources including interviews and document analysis, this study describes an advocacy coalition of humanitarian NGOs in Brussels, their advocacy strategies and the effectiveness of these strategies. The analysis highlights the coalition's common policy beliefs and documents three advocacy strategies: coalition building, knowledge leadership and lobbying. The analysis then traces the link between these strategies and recent policy changes, namely, clearer European Commission guidelines on the implementation of humanitarian derogations. This policy change was further facilitated by policy brokers and an external shock, the Covid‐19 pandemic. The findings shed light on an understudied design feature of sanctions, i.e., humanitarian exceptions, and on the role of non‐governmental actors in shaping sanction designs.
Between the lines: Life cycle impact assessment models of collision and electrocution impacts of power lines on bird diversity in Norway
Authors: Gilad Dafna , May Roel , Stokke Bård G. , Verones Francesca
Published: April 2024

The expansion of the electric grid is inevitable. Renewable energy is on the rise, and new transmission lines must be built to link new electricity production facilities with the local network. In addition, higher electricity demand due to electrification will lead to the growth of the distribution grid. However, further construction of power lines will affect the local biodiversity. Birds are especially vulnerable: every year, power lines cause the deaths of hundreds of millions of birds by collision and electrocution. Yet the environmental impacts of the electric grid in life cycle assessment (LCA) are limited to a few impact categories, failing to cover the area of protection for damages to ecosystem quality. We developed the first methodology to quantify power lines' collision and electrocution impacts on bird richness within LCA. We calculated the potentially disappeared fraction of species (PDF) by developing species–area relationships using high‐resolution species distribution maps, species‐specific characteristics, and the location of power lines and pylons. We applied our models to Norway, a country that aims to become a low‐emission nation by 2050. The characterization factors ranged between 8.48 × 10−16 and 5.6 × 10−15 PDF*yr/kWh for collision and 3.27 × 10−18 and 1.66 × 10−16 PDF*yr/kWh for electrocution. Integrating power lines’ impacts on biodiversity in LCA is essential, as harmonized models can estimate the effects of electricity production alongside the impacts of electricity distribution. This brings us a step further in promoting a holistic assessment of energy systems.
Occult hepatitis B virus infection and current perspectives on global WHO 2030 eradication
Authors: Saravanan Shanmugam , Shankar Esaki M. , Vignesh Ramachandran , Ganesh Pitchaipillai Sankar , Sankar Sathish , Velu Vijayakumar , Smith Davey M. , Balakrishnan Pachamuthu , Viswanathan Dhivya , Govindasamy Rajakumar , Venkateswaran Arcot R.
Published: April 2024

The current World Health Organization (WHO) Hepatitis Elimination Strategy suffers from lack of a target for diagnosing or expunging occult HBV infection. A sizable segment of the global population has an undetected HBV infection, particularly the high‐risk populations and those residing in countries like India with intermediate endemicity. There is growing proof that people with hidden HBV infection can infect others, and that these infections are linked to serious chronic hepatic complications, especially hepatocellular carcinoma. Given the current diagnostic infrastructure in low‐resource settings, the WHO 2030 objective of obliterating hepatitis B appears to be undeniably challenging to accomplish. Given the molecular basis of occult HBV infection strongly linked to intrahepatic persistence, patients may inexplicably harbour HBV genomes for a prolonged duration without displaying any pronounced clinical or biochemical signs of liver disease, and present histological signs of moderate degree necro‐inflammation, diffuse fibrosis, and hence the international strategy to eradicate viral hepatitis warrants inclusion of occult HBV infection.
A place to speak and be heard? Parliamentary speech and media attention in Estonia, 2011–2019
Authors: Lupacheva Tatiana , Mölder Martin
Published: April 2024

While existing studies have addressed the importance of political profile for media visibility, far fewer works have examined how speaking in parliament is associated with media attention—an important mechanism in reaching out to voters. This paper tests how the amount and particularly the style of parliamentary speech are related to media attention. We employ a unique data set that covers all parliamentary transcripts for the 2011–2015 and 2015–2019 parliamentary terms in Estonia and online media content from that period (~ 2.7 million news articles). We assume that MPs can use parliamentary speech as a tool to foster personal attention. First, the results show that MPs who speak in parliament receive more media attention than those who do not, and speaking more means more media visibility. Second, the media pays more attention to rank‐and‐file MPs who use more negative, complex language and more singular and plural first‐person pronouns.
Melanoleuca lalsuhanraensis, a new species from Lal Suhanra National Park, Punjab, Pakistan
Authors: Elahi Humaira , Niazi Abdul Rehman
Published: April 2024

A new species of Melanoleuca subg. Urticocystis with urticiform cheilocystidia is proposed from Lal suhanra National Park, Bahawalpur district, Punjab, Pakistan. The identification is based on morphological characters and molecular phylogenetic analyses using ITS sequences. A comparison of morphological features and molecular phylogenetic data with the known taxa of the subgenus confirms the identity of the species as a new taxon. Detailed descriptions, line drawings and phylogenetic results are presented.
Applications of integrated response surface methodology statistic techniques and artificial neural network‐based machine learning to optimize residual chlorine production and energy consumption
Authors: Yimam Solomon Ali , Kang Joon Wun , Kassahun Shimelis Kebede
Published: April 2024

A multifactor interaction study was performed using the combined response surface methodology and an artificial neural network on the operational parameters and their influence on residual chlorine production. The operating variables, sodium chloride concentration, electrical potential, electrolysis time, and electrode gap, were evaluated over the response, residual chlorine and energy consumption. The results indicated that the optimum value for residual chlorine was 2450 mg/L achieved at an electrical potential of 8.8 V for 25 min in the presence of 25 g/L of sodium chloride and an electrode distance of 1 cm, and the optimum corresponding energy consumption was measured at 21.76 kWh/L. The study reveals that electric potential, sodium chloride concentration, and electrolysis time positively influence residual chlorine production. ANN models showed superior prediction ability compared with RSM models. This suggests electrolysis can be used for active chlorine production from saline solutions, potentially for industrial applications and water disinfection.
Mutations spike in a reservoir of compromised immunity
Authors: Seo Junghwa , Martinez David R.
Published: April 2024

The hierarchy of immunosuppression predicts SARS-CoV-2 time to clearance and intrahost viral evolution.
Diagnostic values of contrast-enhanced MRI and contrast-enhanced CT for evaluating the response of hepatocellular carcinoma after transarterial chemoembolisation: a meta-analysis
Authors: Zhang Chao , Chen Xin , Wang Jukun , Luo Tao
Published: April 2024

Objectives

To assess and compare the diagnostic value of contrast-enhanced MRI (CEMRI) and contrast-enhanced CT (CECT) for evaluating the response of hepatocellular carcinoma (HCC) after transarterial chemoembolisation (TACE).

Design

Systematic review and meta-analysis.

Data sources

PubMed, Embase, the Cochrane Library, CNKI and Wanfang databases were systematically searched from inception to 1 August 2023.

Eligibility criteria

Studies with any outcome that demonstrates the diagnostic performance of CEMRI and CECT for HCC after TACE were included.

Data extraction and synthesis

Two authors independently extracted the data and assessed the quality of included studies. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. The diagnostic performance of CEMRI and CECT for the response of HCC was investigated by collecting true and false positives, true and false negatives, or transformed-derived data from each study to calculate specificity and sensitivity. Other outcomes are the positive likelihood ratio/negative likelihood ratio (NLR), the area under the receiver operating characteristic curve (AUC) for diagnostic tests and the diagnostic OR (DOR). Findings were summarised and synthesised qualitatively according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

This study included 5843 HCC patients diagnosed with CEMRI or CECT and treated with TACE from 36 studies. The mean proportion of men in the total sample was 76.3%. The pool sensitivity, specificity and AUC of CEMRI in diagnosing HCC after TACE were 0.92 (95% CI: 0.86 to 0.96), 0.94 (95% CI: 0.86 to 0.98) and 0.98 (95% CI: 0.96 to 0.99). The pool sensitivity, specificity and AUC of CECT in diagnosing HCC after TACE were 0.74 (95% CI: 0.68 to 0.80), 0.98 (95% CI: 0.93 to 1.00) and 0.90 (95% CI: 0.88 to 0.93).

Conclusions

In conclusion, this study found that both CEMRI and CECT had relatively high predictive power for assessing the response of HCC after TACE. Furthermore, the diagnostic value of CEMRI may be superior to CECT in terms of sensitivity, AUC, DOR and NLR.
Hepatopancreaticobiliary Resection Arginine Immunomodulation (PRIMe) trial: protocol for a randomised phase II trial of the impact of perioperative immunomodulation on immune function following resection for hepatopancreaticobiliary malignancy
Authors: Behman Ramy , Auer Rebecca C , Bubis Lev , Xu Grace , Coburn Natalie G , Martel Guillaume , Hallet Julie , Balaa Fady , Law Calvin , Bertens Kimberly A , Abou Khalil Jad , Karanicolas Paul Jack
Published: April 2024

Introduction

Surgical stress results in immune dysfunction, predisposing patients to infections in the postoperative period and potentially increasing the risk of cancer recurrence. Perioperative immunonutrition with arginine-enhanced diets has been found to potentially improve short-term and cancer outcomes. This study seeks to measure the impact of perioperative immunomodulation on biomarkers of the immune response and perioperative outcomes following hepatopancreaticobiliary surgery.

Methods and analysis

This is a 1:1:1 randomised, controlled and blinded superiority trial of 45 patients. Baseline and perioperative variables were collected to evaluate immune function, clinical outcomes and feasibility outcomes. The primary outcome is a reduction in natural killer cell killing as measured on postoperative day 1 compared with baseline between the control and experimental cohorts.

Ethics and dissemination

This trial has been approved by the research ethics boards at participating sites and Health Canada (parent control number: 223646). Results will be distributed widely through local and international meetings, presentation, publication and ClinicalTrials.gov (identifier:NCT04549662). Any modifications to the protocol will be communicated via publications and ClinicalTrials.gov.

Trial registration number

ClinicalTrials.gov identifier:NCT04549662.
Cost-effectiveness of behavioural counselling intervention compared with non-intervention for adult patients with metabolic syndrome to prevent cardiovascular diseases and type 2 diabetes in Japan: a microsimulation modelling study
Authors: Akune Yoko , Anezaki Hisataka , Nakao Yoko M , Goto Rei
Published: April 2024

Objectives

Nationwide lifestyle intervention—specific health guidance (SHG) in Japan—employs counselling and education to change unhealthy behaviours that contribute to metabolic syndrome, especially obesity or abdominal obesity. We aimed to perform a model-based economic evaluation of SHG in a low participation rate setting.

Design

A hypothetical population, comprised 50 000 Japanese aged 40 years who met the criteria of the SHG, used a microsimulation using the Markov model to evaluate SHG’s cost-effectiveness compared with non-SHG. This hypothetical population was simulated over a 35-year time horizon.

Setting

SHG is conducted annually by all Japanese insurers.

Outcome measures

Model parameters, such as costs and health outcomes (including quality-adjusted life-years, QALYs), were based on existing literature. Incremental cost-effectiveness ratios were estimated from the healthcare payer’s perspective. Deterministic and probabilistic sensitivity analyses (PSA) were conducted to evaluate the uncertainty around the model input parameters.

Results

The simulation revealed that the total costs per person in the SHG group decreased by JPY53 014 (US$480) compared with that in the non-SHG group, and the QALYs increased by 0.044, wherein SHG was considered the dominant strategy despite the low participation rates. PSA indicated that the credibility intervals (2.5th–97.5th percentile) of the incremental costs and the incremental QALYs with the SHG group compared with the non-SHG group were −JPY687 376 to JPY85 197 (−US$6226 to US$772) and −0.009 to 0.350 QALYs, respectively. Each scenario analysis indicated that programmes for improving both blood pressure and blood glucose levels among other risk factors for metabolic syndrome are essential for improving cost-effectiveness.

Conclusions

This study suggests that even small effects of counselling and education on behavioural modification may lead to the prevention of acute life-threatening events and chronic diseases, in addition to the reduction of medication resulting from metabolic syndrome, which results in cost savings.
Quality of childbirth care and its determinants along the continuum of care among pregnant women who gave birth vaginally in Gondar town public health facility, Northwest Ethiopia, 2022: generalised structural equation modelling
Authors: Abebaw Wondwosen Abey , Wolde Haileab Fekadu , Tilahun Werkneh Melkie , Gebreegziabher Zenebe Abebe , Teshome Destaw Fetene
Published: April 2024

Objective

To assess the quality of childbirth care and its determinants along the continuum of care in Gondar town public health facility in Ethiopia.

Design

An institution-based, cross-sectional study was employed. Completed data were imported to Stata V.16 for cleaning and analysis. A generalised structural equation model was employed to examine the relationships along the continuum of childbirth care and to determine the factors affecting the quality of childbirth care.

Setting and participants

This study was conducted among a total of 865 women who delivered in the public health facility of Gondar, Ethiopia, from 19 May to 30 June 2022.

Results

The study revealed the proportion of good-quality childbirth care during admission, intrapartum and immediate postpartum period was 59% (95% CI 55.7, 62.4), 76.8% (95% CI 73.8, 79.5) and 45% (95% CI 41.7, 48.5), respectively. Postsecondary educational status of mothers (β=0.60, 95% CI 0.16, 1.04) and maternal age of 25–35 (β=0.68, 95% CI 0.33, 1.02) were predictors of quality of care at admission. Referral hospital (β=0.43, 95% CI 0.10, 0.76), presence of guidelines (β=1.36, 95% CI 0.72, 1.99) and provider age of 25–35 (β=0.61, 95% CI 0.12, 1.10) affected the quality of care during the intrapartum period. Urban residence (β=0.52, 95% CI 0.12, 0.93), skilled birth attendant experience (β=0.19, 95% CI 0.11, 0.28) and number of delivery couches (β=−0.29, 95% CI −0.44, –0.13) had significant associations with the quality of childbirth care during the immediate postpartum period.

Conclusions

Although our study found improvements in the quality of childbirth care along the continuum compared with previous studies, more workers are needed to alleviate the problem of poor-quality service. Different maternal, provider and facility factors were found to be predictors of the quality of childbirth care.
Effect of implementation strategies on the routine provision of antenatal care addressing smoking in pregnancy: study protocol for a non-randomised stepped-wedge cluster controlled trial
Authors: Daly Justine B , Doherty Emma , Tully Belinda , Wiggers John , Hollis Jenna , Licata Milly , Foster Michelle , Tzelepis Flora , Lecathelinais Christophe , Kingsland Melanie
Published: April 2024

Introduction

Globally, guideline-recommended antenatal care for smoking cessation is not routinely delivered by antenatal care providers. Implementation strategies have been shown to improve the delivery of clinical practices across a variety of clinical services but there is an absence of evidence in applying such strategies to support improvements to antenatal care for smoking cessation in pregnancy. This study aims to determine the effectiveness and cost effectiveness of implementation strategies in increasing the routine provision of recommended antenatal care for smoking cessation in public maternity services.

Methods and analysis

A non-randomised stepped-wedge cluster-controlled trial will be conducted in maternity services across three health sectors in New South Wales, Australia. Implementation strategies including guidelines and procedures, reminders and prompts, leadership support, champions, training and monitoring and feedback will be delivered sequentially to each sector over 4 months. Primary outcome measures will be the proportion of: (1) pregnant women who report receiving a carbon monoxide breath test; (2) smokers or recent quitters who report receiving quit/relapse advice; and (3) smokers who report offer of help to quit smoking (Quitline referral or nicotine replacement therapy). Outcomes will be measured via cross-sectional telephone surveys with a random sample of women who attend antenatal appointments each week. Economic analyses will be undertaken to assess the cost effectiveness of the implementation intervention. Process measures including acceptability, adoption, fidelity and reach will be reported.

Ethics and dissemination

Ethics approval was obtained through the Hunter New England Human Research Ethics Committee (16/11/16/4.07; 16/10/19/5.15) and the Aboriginal Health and Medical Research Council (1236/16). Trial findings will be disseminated to health policy-makers and health services to inform best practice processes for effective guideline implementation. Findings will also be disseminated at scientific conferences and in peer-reviewed journals.

Trial registration number

Australian New Zealand Clinical Trials Registry—ACTRN12622001010785.
Facilitators of and barriers to healthcare providers’ adoption of harm reduction in cannabis use: a scoping review protocol
Authors: Haddad Roula , Dagenais Christian , Huynh Christophe , Fallu Jean-Sébastien
Published: April 2024

Introduction

The high prevalence of cannabis use and the potential for negative effects indicate the need for effective prevention strategies and treatment of people who use cannabis. Studies show that harm reduction (HR) in cannabis use is effective in minimising the harmful consequences of the substance. However, health professionals often misunderstand it and resist its adoption due to various obstacles. To our knowledge, there has been no review of the scientific literature on the factors that facilitate or hinder practitioners’ adoption of HR in cannabis use. To fill this gap, we aim to identify, through a scoping review, facilitators and barriers to healthcare providers’ adoption of HR in cannabis use in Organisation for Economic Cooperation and Development (OECD) countries.

Methods and analysis

Our methodology will be guided by the six-step model initially proposed by Arksey and O’Malley (2005). The search strategy will be executed on different databases (Medline, PsycINFO, CINAHL, Web of Science, Embase, Sociological Abstracts, Érudit, BASE, Google Web and Google Scholar) and will cover articles published between 1990 and October 2022. Empirical studies published in French or English in an OECD country and identifying factors that facilitate or hinder healthcare providers’ adoption of HR in cannabis use, will be included. Reference lists of the selected articles as well as relevant systematic reviews will be scanned to identify any missed publications by the electronic searches.

Ethics and dissemination

Ethics approval is not required. The results will be disseminated through various activities (eg, publication in peer-reviewed journals, conferences, webinars and knowledge translation activities). The results will also allow us to conduct a future study aiming to develop and implement a knowledge translation process among healthcare practitioners working with youth in Quebec in order to enhance their adoption of HR in cannabis use.
Effect of nutritional supplementation on bone mineral density in children with sickle cell disease: protocol for an open-label, randomised controlled clinical trial
Authors: Condé Mohamed , Lespessailles Eric , Wanneveich Mathilde , Allemandou Delphine , Boulain Thierry , Dimitrov Georges
Published: April 2024

Introduction

Children with sickle cell disease show a significant decrease in bone mineral density, an increase in resting energy expenditure of more than 15%, a decrease in fat and lean mass as well as a significant increase in protein turnover, particularly in bone tissue. This study aims to evaluate the effectiveness of an increase in food intake on bone mineral density and the clinical and biological complications of paediatric sickle cell disease.

Methods and analysis

The study is designed as an open-label randomised controlled clinical trial conducted in the Paediatrics Unit of the Orléans University Hospital Centre. Participants aged 3–16 years will be randomly divided into two groups: the intervention group will receive oral nutritional supplements (pharmacological nutritional hypercaloric products) while the control group will receive age-appropriate and gender-appropriate nutritional intake during 12 months. Total body less head bone mineral density will be measured at the beginning and the end of the trial. A rigorous nutritional follow-up by weekly 24 hours recall dietary assessment and planned contacts every 6 weeks will be carried out throughout the study. A school absenteeism questionnaire, intended to reflect the patient’s school productivity, will be completed by participants and parents every 3 months. Blood samples of each patient of both groups will be stocked at the beginning and at the end of the trial, for future biological trial. Clinical and biological complications will be regularly monitored.

Ethics and dissemination

The protocol has been approved by the French ethics committee (Comité de Protection des Personnes Sud-Ouest et Outre-Mer 2, Toulouse; approval no: 2-20-092 id9534). Children and their parents will give informed consent to participate in the study before taking part. Results will be disseminated through peer-reviewed journals or international academic conferences.

Trial registration number

NCT04754711.
Caring burden and coping with haemodialysis: a qualitative study with family caregivers in Sri Lanka
Authors: Lasanthika Chalani , Janlöv Ann-Christin , Amarasekara Thamara , Larsson Helena
Published: April 2024

Objective

The number of patients with end-stage kidney disease (ESKD) requiring renal replacement therapy in Sri Lanka is significantly rising. Most of these patients depend on haemodialysis, carrying a significant burden on their family caregivers. To develop care and support for both the patient and their family caregiver, it is crucial to understand how caregivers experience their caregiving situation. Therefore, this study aimed to explore family caregivers’ experiences of burden and coping when caring for a family member receiving haemodialysis in the Sri Lankan context.

Design

Qualitative study with an exploratory design.

Setting

Family caregivers were recruited at a haemodialysis unit of a main government sector hospital in Sri Lanka between October and November 2021.

Participants

A purposive sampling of 11 family caregivers who cared for a family member receiving haemodialysis in a main government teaching hospital in Sri Lanka for at least 3 consecutive months. Data were collected through individual semistructured telephone interviews and analysed using qualitative content analysis.

Results

The results showed an overarching theme, ‘striving to hold on and not let go’, with four categories: (1) feeling exhausted by the care burden, (2) feeling burdened as failing the care responsibility, (3) striving to cope and find meaning in caregiving, and (4) coping with caregiving through others’ support.

Conclusion

The results show that the family caregivers have a multifaceted burden. They continued caring for their family member receiving haemodialysis while making adjustments to the burdensome caregiving situation despite many constraints and suffering. Psychosocial support and financial assistance, including family counselling, are needed by family caregivers, through a community support system, to ensure endurance during their family members’ illness trajectory. Advance care planning is vital to alleviate care uncertainty and to meet the care needs of patients with ESKD, particularly in resource-constrained settings.
Alpha 2 agonists for sedation to produce better outcomes from critical illness (A2B trial): protocol for a mixed-methods process evaluation of a randomised controlled trial
Authors: Aitken Leanne M , Emerson Lydia M , Kydonaki Kalliopi , Blackwood Bronagh , Creagh-Brown Benedict , Lone Nazir I , McKenzie Cathrine A , Reade Michael C , Weir Christopher J , Wise Matt P , Walsh Timothy S
Published: April 2024

Introduction

An association between deep sedation and adverse short-term outcomes has been demonstrated although this evidence has been inconsistent. The A2B (alpha-2 agonists for sedation in critical care) sedation trial is designed to determine whether the alpha-2 agonists clonidine and dexmedetomidine, compared with usual care, are clinically and cost-effective. The A2B intervention is a complex intervention conducted in 39 intensive care units (ICUs) in the UK. Multicentre organisational factors, variable cultures, perceptions and practices and the involvement of multiple members of the healthcare team add to the complexity of the A2B trial. From our pretrial contextual exploration it was apparent that routine practices such as type and frequency of pain, agitation and delirium assessment, as well as the common sedative agents used, varied widely across the UK. Anticipated challenges in implementing A2B focused on the impact of usual practice, perceptions of risk, ICU culture, structure and the presence of equipoise. Given this complexity, a process evaluation has been embedded in the A2B trial to uncover factors that could impact successful delivery and explore their impact on intervention delivery and interpretation of outcomes.

Methods and analysis

This is a mixed-methods process evaluation guided by the A2B intervention logic model. It includes two phases of data collection conducted during and at the end of trial. Data will be collected using a combination of questionnaires, stakeholder interviews and routinely collected trial data. A framework approach will be used to analyse qualitative data with synthesis of data within and across the phases. The nature of the relationship between delivery of the A2B intervention and the trial primary and secondary outcomes will be explored.

Ethics and dissemination

All elements of the A2B trial, including the process evaluation, are approved by Scotland A Research Ethics Committee (Ref. 18/SS/0085). Dissemination will be via publications, presentations and media engagement.

Trial registration number

NCT03653832.
Machine learning methods, applications and economic analysis to predict heart failure hospitalisation risk: a scoping review protocol
Authors: Seringa Joana , Abreu João , Magalhaes Teresa
Published: April 2024

Introduction

Machine learning (ML) has emerged as a powerful tool for uncovering patterns and generating new information. In cardiology, it has shown promising results in predictive outcomes risk assessment of heart failure (HF) patients, a chronic condition affecting over 64 million individuals globally.

This scoping review aims to synthesise the evidence on ML methods, applications and economic analysis to predict the HF hospitalisation risk.

Methods and analysis

This scoping review will use the approach described by Arksey and O’Malley. This protocol will use the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Protocol, and the PRISMA extension for scoping reviews will be used to present the results. PubMed, Scopus and Web of Science are the databases that will be searched. Two reviewers will independently screen the full-text studies for inclusion and extract the data. All the studies focusing on ML models to predict the risk of hospitalisation from HF adult patients will be included.

Ethics and dissemination

Ethical approval is not required for this review. The dissemination strategy includes peer-reviewed publications, conference presentations and dissemination to relevant stakeholders.
Physical Activity with Sports Scientist (PASS) programme to promote physical activity among patients with non-communicable diseases: a pragmatic randomised controlled trial protocol
Authors: Wattanapisit Apichai , Hemarachatanon Poramet , Somrak Kamlai , Manunyanon Saranrat , Wattanapisit Sanhapan , Amornsriwatanakul Areekul , Katewongsa Piyawat , Sangkaew Sorawat , Vichitkunakorn Polathep , Lee Ping Yein , Ramdzan Siti Nurkamilla , Salim Hani , Ng Chirk Jenn , Stoutenberg Mark
Published: April 2024

Physical activity (PA) effectively prevents and treats non-communicable diseases in clinical settings. PA promotion needs to be more consistent, especially in busy primary care. Sports scientists have the potential to support PA promotion in primary care. The Physical Activity with Sports Scientist (PASS) programme is created to personalise PA promotion led by a sports scientist in a primary care clinic. A pragmatic randomised controlled trial with two parallel groups will be conducted at a family medicine clinic. Physically inactive participants aged 35–70 years who have type 2 diabetes mellitus, hypertension or dyslipidaemia will be invited. The control group (n=60) will receive usual care. The intervention group (n=60) will receive the PASS programme and usual care. The PASS programme will consist of a tailored PA prescription after the physician’s consultation at the first visit and monthly phone follow-ups. The primary outcome is the proportion of participants who have achieved the PA goal defined as aerobic activity (≥150 min/week of moderate to vigorous-intensity PA), muscle-strengthening activity (≥2 days/week of moderate or greater intensity) and multicomponent PA (≥2 days/week of moderate or greater intensity). Secondary outcomes are body composition and physical fitness. The primary and secondary outcomes will be measured and compared between the control and intervention groups at visit 1 (month 0: baseline measurements), visit 2 (months 3–4: follow-up measurements), visit 3 (months 6–8: end-point measurements) and visit 4 (months 9–12: continuing measurements). The study protocol was registered with the Thai Clinical Trials Registry.

Trial registration number: TCTR20240314001.