bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-absorbable surgical sutures versus autologous tendons in the reconstruction of medial patellofemoral ligaments: a randomised controlled trial protocol
Authors: Pan Linyuan , Liu Gaoming , Lu Wenhao , Liu Xu , Jin Hongfu , Xiao Wenfeng , Li Yusheng 
Published: December 2024

IntroductionArthroscopic-assisted medial patellofemoral ligament reconstruction (MPFLR) is a common surgical procedure for patellar dislocation. We present the protocol of a randomised controlled clinical trial to compare postoperative pain, knee function and quality of life outcomes of MPFL reconstruction using the non-absorbable surgical sutures (FiberWire) and semitendinosus tendon.Methods and analysisThis single-blind, randomised controlled trial enrolled patients with patellar dislocation who were undergoing inpatient surgery at the Department of Orthopedics, Xiangya Hospital, Central South University. Participants were randomly allocated to either the experimental or the control group using a random number table method, with an equal number of 15 subjects in each group. The experimental group was treated with a FiberWire for the MPFLR, whereas the control group received reconstruction using the semitendinosus tendon. A standardised postoperative rehabilitation protocol was implemented for both groups. All subjects will be evaluated for imaging, pain, knee function and quality of life at five time points: preoperatively and at 1 month, 3 months, 6 months and 12 months postoperatively. MRI scans will be performed preoperatively and at 12 months postoperatively to assess changes in patellar tilt angles and congruence angles. Pain assessment is performed using the Visual Analogue Scale (VAS). Knee function will be assessed using the Kujala score, Lysholm score and International Knee Documentation Committee (IKDC) knee function score. Quality of life was assessed using the 12-Item Short Form Survey scale.Ethics and disseminationThe trial was approved by the Medical Ethics Committee of Xiangya Hospital of Central South University on 26 October 2021 (ethics number: 202110478) and registered in the China Clinical Trials Registry on 15 March 2022. Data will be published in peer-reviewed journals and presented at national and international conferences.Trial registration numberChiCTR2200057574.
Considerations of equity in the development of tools that identify and respond to end-of-life carer support needs: a scoping review protocol
Authors: Brooks Joanna , Hall Alex , Higgerson James , Long Hannah , Urwin Sean , Rowland Christine 
Published: December 2024

IntroductionInformal caregivers are essential in supporting end-of-life patients at home but are often ill-prepared for the carer role. There is growing interest in the development of tools to assess caregiver support needs and a recognised need for a greater focus on addressing inequities in end-of-life care. We plan to undertake a scoping review of available literature to (1) identify and describe tools developed to assess the support needs of informal caregivers in end-of-life care; (2) report on any inequities and under-represented groups in tool development and use.Methods and analysisThe review will conform to best practice methodological guidance (Joanna Briggs Institute) for scoping reviews. The search strategy will target published and unpublished studies using any methodology, which reports on developing or using tools or measures to assess informal carer support needs in end-of-life/palliative care settings. The following databases will be searched: MEDLINE, CINAHL, PsycINFO, Web of Science, ASSIA and Proquest. Both title/abstract screening and full-text assessment will be undertaken to ensure eligibility. Searches will be conducted between May and December 2024. We will extract data relating to (1) tools/measures identified, and outcome measures used to assess these; (2) participant characteristics. Extracted data will be tabulated with accompanying narrative description to address the review objectives. Data will be extracted and write-up will be completed between January and May 2025.Ethics and disseminationThis scoping review will provide an overview of the tools developed to identify and assess informal caregiver support needs in palliative and end-of-life care. The identification of any inequities will increase awareness of potentially underserved groups and contexts within the current literature, highlighting how future research and resource can be more equitably focused and implemented in a way that does not further embed disparity. Findings will be made publicly available through the Open Science Framework and disseminated through a peer-reviewed publication. As a scoping review of available literature, this work does not require ethical approval.
Exploring the effects of time-restricted eating on body weight and associated cardiometabolic outcomes in South African women living with HIV (TESSA): protocol for a randomised controlled trial
Authors: Mendham Amy E , Goedecke Julia H , Heckens Lorena , Hoosen Fatima , Pico Majken Lillholm , Kengne Andre P , Christensen Dirk L , Olesen Ole F , Quist Jonas Salling , Dave Joel , Færch Kristine , Groth Grunnet Louise 
Published: December 2024

IntroductionWe codesigned an intervention with a low-resourced community with the aim to investigate the effects of time-restricted eating (TRE) on changes in body weight and associated cardiometabolic outcomes in South African women living with overweight/obesity and HIV who have initiated dolutegravir (DTG)-based antiretroviral therapy (ART).Methods and analysisWomen with overweight or obesity (body mass index ≥25 kg/m², no upper limit), aged 20–45 years, living with HIV and in a low-resourced community, and receiving DTG-based ART for less than 2 years will be recruited from a community healthcare centre in Khayelitsha, Cape Town (n=152). Participants will be randomised 1:1 to the TRE group (n=76) or standard of care control group (n=76) for 12 months. The TRE group will be required to restrict their eating window to ~8–10 hours/day and will receive nutritional information sessions at baseline and at 3, 6, 9 and 12 months. The primary outcome of body weight will be assessed at baseline and monthly. Cardiometabolic measures will be reported as secondary outcomes. At baseline, 6- and 12 months, an oral glucose tolerance test (to estimate insulin sensitivity and beta-cell function), questionnaires (sociodemographic, food insecurity, quality of life, social support and sleep quality) and a quantified food frequency questionnaire (total energy and macronutrient composition) will be completed. Every 3 months, appetite ratings, bioelectrical impedance (fat mass and fat-free mass), fasting venous bloods (glucose, insulin, gut hormones and systemic inflammation) and process evaluation (qualitative interviews) will be completed. Monthly monitoring will also include anthropometry and blood pressure.Ethics and disseminationThe study is conducted in accordance with the Declaration of Helsinki and has been approved by the Human Research Ethics Committee of the University of Cape Town (628/2021). Verbal and written consent is required from study participants. Results of this study will be published in peer-reviewed journals and presented at conferences.Trial registration numberPACTR202302484999720.
Multisectoral One Health collaborations across human, animal and environmental health: a protocol paper for an umbrella systematic review of conceptual and analytical approaches to sustainability
Authors: Dar Osman Ahmed , Akhbari Melika , Nacer Hadjer 
Published: December 2024

IntroductionRecent decades have seen a growth in multisectoral and transdisciplinary approaches to improving global health, particularly across human, animal and environmental health-related sciences that advocate for participatory, systems-based perspectives to understanding and promoting health and well-being in the context of social and ecological interactions. For several issues, including human health, animal health and food security, researchers have highlighted the need for transdisciplinary One Health approaches to assess the sustainability of interventions. To understand the current thinking and conceptualisation of sustainability across One Health disciplines, we present a protocol paper for an umbrella systematic review study planned in 2024.Methods and analysisA search strategy based on Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines was developed. The Medline, Embase, Global Health and Web of Science Core Collection were the four databases interrogated through the search strategy and included all articles found in the English language up to 14 April 2024. Meta-analyses, systematic, structured literature reviews and narrative reviews on sustainability will be included and a full-text review of all articles will be undertaken. The articles will be quality appraised using the AMSTAR 2 tool. Data that cover proposed factors influencing and characterising sustainability will be extracted across One Health disciplines including similarities and differences, and a summative content analysis will be completed to identify any emerging themes and develop an analytical framework. The conceptualisation of sustainability in the context of One Health multisectoral approaches will be summarised, a definition of sustainability proposed and include an identification of tools for measuring and assessing sustainability.Ethics and disseminationNo primary data will be collected; therefore, ethical approval will not be required. The results will be disseminated in peer-reviewed literature and conference presentations. The findings will also be directly disseminated to the Quadripartite agencies.Prospero registration numberCRD42018094031
Outcomes for women with diabetes admitted for labour care to midwifery units in the UK: a national prospective cohort study and survey of practice using the UK Midwifery Study System (UKMidSS)
Authors: Morelli Alessandra , Smith Lisa , Karia Amar , Marshall Amber , Plachcinski Rachel , Tyler Wendy , Rowe Rachel 
Published: December 2024

ObjectivesTo describe outcomes in women admitted for labour care to midwifery units with gestational or pre-existing diabetes, compare outcomes with other women admitted to the same units and describe admission and care guidance in midwifery units typically admitting women with diabetes.DesignA national cohort study and a survey of practice.SettingWe used the UK Midwifery Study System to collect data from midwifery units in the UK between October 2021 and February 2023.ParticipantsWomen with a diagnosis of diabetes admitted for labour care to a midwifery unit were compared with a cohort of women without diabetes admitted for labour care to the same units.Primary and secondary outcome measuresThe primary outcome was a composite measure of maternal outcome reflecting the need for obstetric care (one or more of augmentation, instrumental birth, caesarean birth, maternal blood transfusion, third or fourth-degree perineal tear, maternal admission to higher level care). We also investigated a number of secondary maternal and neonatal outcomes.ResultsOverall, 420 (0.7% (95% CI 0.67% to 0.82%) of the 56 648 women admitted to midwifery units in the study period were recorded as having diabetes, most (84%) with diet-controlled gestational diabetes. Women with diabetes were no more likely than comparison women to experience the composite primary outcome (18.7% vs 20.7%, adjusted relative risk=1.31, 95% CI 0.96 to 1.80). We found no statistically significant differences between the two groups for the secondary maternal and neonatal outcomes investigated: augmentation, postpartum haemorrhage >1.5 L, shoulder dystocia, maternal blood transfusion and maternal admission for higher level care, Apgar <7 at 5 min, initiation of breast feeding and neonatal unit admission.ConclusionsThe findings of this study provide evidence that selected women with well-controlled gestational diabetes may safely plan birth in midwifery units on the same site as obstetric and neonatal services. With clear admission criteria and careful care planning, access to a midwifery unit provides an opportunity to increase choice, reduce intervention and improve outcomes for these women.
Temporal trends and spatial heterogeneity of sanitation facilities in Ethiopia: evidence from the 2005–2019 Demographic and Health Surveys
Authors: Azanaw Jember , Tsegaye Mesenbet , Mesele Wodage 
Published: December 2024

BackgroundThe main aim of sanitation is to prevent human contact with faecal pathogens to decrease occurrences of diseases. However, no region in the world is on the right track to accomplish Sustainable Development Goal (SDG) 6.2 for universal access to sanitation. Sub-Saharan Africa, including Ethiopia, is significantly behind in meeting the 2030 SDG 6.2 targets. Hence, this study focused on the spatial and temporal analysis of sanitation in Ethiopia based on four demographic health surveys.DesignThis research was undertaken among households in Ethiopia based on a weighted sample size. Variables with a p<0.2 in bivariable analysis were incorporated into the multivariable analysis. Subsequently, a 95% CI and a p<0.05 were used to assess the statistical significance of the final model. Global and local indicators of spatial correlation were done. Statistical analyses were performed by using STATA V.17 and ArcGIS V.10.7 software.ResultsThis study includes data from 13 721 households in the 2005 Ethiopian Demographic and Health Survey (EDHS), 16 702 households in the 2011 EDHS, 16 650 households in the 2016 EDHS and 8663 households in the 2019 EDHS. The prevalence of improved sanitation facilities in Ethiopia was 20.46%, 25.61%, 25.86% and 27.45% based on EDHS 2005, 2011, 2016 and 2019, respectively. Global Moran’s I spatial autocorrelations, hotspots and spatial interpolation analysis indicated the inequality of improved sanitation facilities. Educational status of primary (adjusted OR, AOR 2.43, 95% CI 2.00, 2.95), secondary (AOR 2.02, 95% CI 1.61, 2.54) and higher (AOR 4.12, 95% CI 3.35, 7.54), watching television (AOR 5.49, 95% CI 4.37, 6.89), urban areas (AOR 9.08, 95% CI 6.69, 12.33) and region were factors statistically associated with sanitation facilities.ConclusionThe overall finding of this study concludes a very slow increment in sanitation facilities over time and the presence of geographical heterogeneity in Ethiopia. Educational status, watching television, wealth index, community-level education, type of residence and region were factors statistically associated with sanitation facilities.
Analysing the effects of National Centralised Drug Procurement and Price Negotiation Policies on novel hypoglycaemic drug usage and costs in Shanghai, China: an interrupted time series analysis
Authors: Song Jie , Guo Wei , Jin Chunlin , Xu Yuan , Hu Xiaojing , Zhang Zheng , Lin Hai 
Published: December 2024

ObjectivesTo analyse the impacts of multiple rounds of National Centralised Drug Procurement Policy (NCDP) and National Drug Price Negotiation Policy (NDPN) on the utilisation, expenditure and daily cost of novel hypoglycaemic drugs.DesignThe drug procurement data were obtained from the Shanghai Medical Procurement Agency between January 2016 and December 2022. We examined changes in volume, expenditure of overall hypoglycaemic drugs by descriptive analysis. For novel hypoglycaemic drugs, we employed interrupted time series analysis with segmented regression to investigate the change in usage, expenditure and daily cost of specific drug affected by related policies.SettingAll the public and private hospitals in Shanghai, China.Primary outcome measuresVolume, expenditure and daily cost of novel hypoglycaemic drugs.ResultsFrom 2016 to 2022, the overall usage and expenditure of hypoglycaemic drugs in Shanghai have been gradually increasing. Consumption of novel hypoglycaemic drugs had shown a rapid increase, which was significantly increased by 212.28 defined daily doses (95% CI 188.25, 236.31, p<0.001) after policy implementation. For each specific drug, daily cost was significantly decreased immediately after policy implementation (p<0.001). Dulaglutide, loxenatide, liraglutide, semaglutide and dapagliflozin had all seen significant increases in consumption and expenditure after NDPN implementation (p<0.001). Vildagliptin and saxagliptin, which were affected by the NCDP, experienced a significant decrease in usage. Empagliflozin and canagliflozin, which were regulated by both NCDP and NDPN, experienced an initial increase, followed by a significant decline. Consumption of beinaglutide and exenatide was not upregulated by NDPN.ConclusionImplementation of NDPN and NCDP had successfully cut-off the price of novel hypoglycaemic drugs and significantly increased their utilisation. In the future, the government needs to control pharmaceutical expenses more strictly while ensuring the rational use of the drugs.
Assessing the relationship between teaching quality and satisfaction with clinical teachers among medical students: a correlational cross-sectional study
Authors: Amini Keyvan , Salehzadeh Meisam , Noktehsanj Reza 
Published: December 2024

ObjectivesThis study aimed to determine the relationship between teaching quality and satisfaction with clinical teachers among medical students at Ardabil University of Medical Sciences.DesignA correlational cross-sectional study was conducted in 2023 on 255 medical students in Ardabil (northwest Iran).SettingThe study was conducted in Ardabil, a city in northwest Iran, within a medical school that trains future healthcare professionals. This environment allows for assessing the educational quality and clinical training provided to a diverse group of medical students.ParticipantsParticipants were selected through simple random sampling. Data were collected using a demographic information form, the Persian version of the System for Evaluation of Teaching Qualities questionnaire, and the Medical Students’ Satisfaction with Clinical Education questionnaire.ResultsThe overall mean scores for teaching quality and satisfaction with clinical teachers among medical students were 3.37±0.56 and 3.22±0.72, respectively. The highest mean score for teaching quality was related to professional attitude towards students (3.46±0.83), while the lowest was for the teaching and learning environment (3.28±0.68). Multiple linear regression analysis revealed that subscales of teaching quality (student assessment and feedback) and residence status were predictors of satisfaction with clinical teachers, accounting for 31.4% of the total variance (F=9.908, p<0.001).ConclusionThe study highlights that regular and constructive feedback is pivotal for promoting student development in clinical education. We propose that clinical educators implement structured feedback mechanisms to improve educational conditions that encourage ongoing student communication. Additionally, assessing learners’ performance systematically can help educators identify specific areas where students require further assistance. We can enhance learning outcomes by fostering an environment that prioritises feedback and evaluation and better equips students with the necessary skills to address real-world challenges. Ultimately, these improvements will benefit students and educators, leading to a more effective clinical education experience.
Comparative efficacy of non-pharmacological management for chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis protocol
Authors: Qin Zongshi , Zhang Chao , Wei Xinyao , Cui Jiaming , Yu Yanlan , Pang Ran , Li Xiao , Kwong Joey S W , Doiron R. Christopher , Nickel J. Curtis , Wu Jiani 
Published: December 2024

BackgroundChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has posed a significant burden on affected individuals and healthcare systems. While pharmacological treatments are commonly used, non-pharmacological management strategies have gained attention for their potential benefits in improving CP/CPPS symptoms. However, the comparative efficacy of these non-pharmacological interventions remains unclear. The aim of this study is to assess the comparative effectiveness of non-pharmacological interventions for CP/CPPS regarding prostatic symptoms.MethodThis systematic review and network meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search will be conducted in electronic databases, including PubMed, Embase, Cochrane Library and Web of Science, to identify relevant studies. Eligible studies will include randomised controlled trials investigating non-pharmacological management strategies for CP/CPPS. Two independent reviewers will screen the retrieved citations, extract data and assess the risk of bias. Data synthesis will involve performing a network meta-analysis to compare the efficacy of different non-pharmacological interventions while considering both direct and indirect evidence.Ethics and disseminationThe review does not require ethical approval. The findings of the review will be disseminated through publication in an academic journal, presentations at conferences and various media outlets.PROSPERO registration numberCRD42024506143.
Qualitative analysis of concordance in advance care planning discussions between patients with advanced cancer and their surrogate decision makers
Authors: Chen Qian , Liang Siqi , Liang Jingzhang , Xu Jiefang , Liang Mengna , Lu Qiaocong 
Published: December 2024

ObjectivesThis study aimed to explore the concordance in advance care planning (ACP) discussions between patients with advanced cancer and surrogate decision makers within an oncology ward.DesignPurposive and snowball sampling methods were used in this qualitative study, which involved conducting semistructured interviews to gather patients with advanced cancer and their surrogate decision makers. Interpretative phenomenological analysis was performed on the interview data to identify commonalities and differences in ACP discussions and to explore the factors influencing these differences.SettingThe research was conducted in the oncology ward of a tertiary hospital located in Foshan, China.ParticipantsParticipants included a total of 15 pairs of patients with advanced cancer and their surrogate decision makers in oncology wards.ResultsInterpretative phenomenological analysis yielded three main themes and fourteen subthemes. The identified themes were: (1) personal factor; (2) family intrinsic factors and (3) external factor.ConclusionThis study revealed the consistency of ACP between patients with advanced cancer and their surrogate decision makers in China and its influencing factors. Future research should further explore family-centred ACP practices, delve into how family factors influence the implementation of ACP for patients and develop conceptual frameworks and implementation strategies for ACP that align with Chinese cultural values and healthcare systems. These efforts will contribute to enhancing understanding in clinical practice, advancing scientific research and guiding policy formulation. ACP holds promise as a crucial intervention to improve the quality of end-of-life care for patients with advanced cancer in China, playing a central role in the field of palliative care in the country.