bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social support network of Brazilian Amazonian women to subsidise the decision-making power of planned home birth: a qualitative study
Authors: Reis Laena Costa dos , Beviláqua Jannaina Campos , Alves Valdecyr Herdy , Penna Lucia Helena Garcia , Dias Da Silva Sílvio Éder , Parente Andressa Tavares , Vieira Bianca Dargam Gomes , Pereira Audrey Vidal , Carneiro Marcia Simão , da Conceição Natalia Tifanny , Calandrini Tatiana do Socorro dos Santos , Pereira Rafaela Chagas , Almeida Malena da Silva , Rodrigues Diego Pereira 
Published: November 2024

ObjectiveTo understand the social support network of Amazonian women when making decisions about planned home births.MethodDescriptive, exploratory, qualitative research.SettingPlanned home birth care, accompanied by obstetric nurses, in the state of Pará, Brazil.Participants20 women who had a planned home birth in the metropolitan region of the state of Pará, Brazil. These women were surveyed by a team of obstetric nurses working in home birth care. In-depth semistructured interviews were conducted at the women’s homes between August 2021 and February 2022, with the audio captured on an mp3 device. The data were analysed at the same time as the data collection. Each interview was transcribed and content analysis was used to process the data.ResultsThe social support network shares experiences and knowledge between women in order to guarantee knowledge and not perpetuate traumatic episodes during childbirth. This network is a link to women’s power of choice in relation to their own birth, which culminates in successful experiences in the birth process.Final considerationsUnderstanding the social support network for women’s decision-making during planned home births is central to guaranteeing rights and expectations regarding the place of birth. Social support networks need to be expanded by non-governmental groups and by the Unified Health System itself, especially in primary healthcare.DescriptorsWomen; home childbirth; social support; access to information and nursing.
Equity of financial protection for health in high-income countries: scoping review protocol
Authors: Xie Edward C , Ali Shehzad , Law Michael , Allin Sara , Proaño Diego , Sander Beate 
Published: November 2024

IntroductionFinancial protection (FP) is a central function of health systems to enhance access to essential care and improve health equity. We aim to characterise evidence on the distribution of FP in high-income countries as well as how equity of FP is conceptualised and measured in these settings. Findings from this review can advance methodological and conceptual knowledge about equity in FP, guide the evaluation of health systems and inform policy on eliminating inequitable barriers to care to achieve universal health coverage.Methods and analysisWe will undertake a scoping review following guidance from Colquhounet aland the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. We will search four academic databases covering health sciences and economic literature as well as four grey literature sources for relevant publications. Screening for eligibility will be performed independently by two reviewers after calibration of screening criteria. Data will be charted using a standardised form and summarised by thematic analysis.Ethics and disseminationInstitutional research ethics review was not required; however, research ethics will be considered iteratively throughout the research process. Research findings will be disseminated to scientific and policy meetings, summarised for lay audiences and submitted for publication in a peer-reviewed journal.
Association between triglyceride-glucose index and risk of kidney stone: a Chinese population-based case–control study
Authors: Wang Dawei , Zhang Dingguo , Zhang Lin , Shi Feng , Zhu Yu 
Published: November 2024

ObjectiveTo investigate the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance and the risk of kidney stones (KSs) in a Chinese population.DesignCase–control study.SettingThree Physical Examination Centers in Shanghai, China, between January 2020 and December 2022.ParticipantsA total of 117 757 Chinese adults underwent health check-ups during the study period.Primary and secondary outcome measuresThe association between the TyG index and the risk of KS was assessed using multivariable logistic regression analysis. The dose–response relationship between the TyG index and KS risk was evaluated with a restricted cubic spline (RCS) analysis. Stratified analyses were conducted to explore whether factors such as age, sex, obesity, hypertension and diabetes modify the association between the TyG index and KS risk.ResultsOut Of the 117 757 participants, 11 645 (9.9%) were diagnosed with KS using ultrasound. Individuals with KS had significantly higher TyG values than controls (p<0.001). The multivariable-adjusted ORs for KS increased across TyG quartiles, with the highest quartile showing an OR of 1.28 (95% CI 1.20 to 1.36) compared with the lowest quartile. Each SD increase in the TyG index was associated with a 10% higher risk of KS (OR: 1.10, 95% CI 1.08 to 1.13). RCS analysis revealed a significant positive and linear association between TyG index and KS (p overall<0.001, p non-linear=0.136). The positive association persisted across the subgroup and sensitivity analyses.ConclusionsThe TyG index was positively associated with the risk of prevalent KS, suggesting that insulin resistance may be a risk factor for KS in the Chinese population.
Mediating role of gut microbiota on Baduanjin for cognitive function in community-dwelling older adults with mild cognitive impairment: a study protocol for a cluster randomised controlled trial
Authors: Sun Liwei , Geng Qian , Zheng Guohua 
Published: November 2024

IntroductionThe gut microbiome plays an important role in maintaining both cognitive and physical functions in older adults, and gut dysbiosis is an important pathophysiological mechanism of mild cognitive impairment (MCI) in older adults. As a typical traditional Chinese mind-body exercise, regular Baduanjin training has been shown to improve cognitive function and modulate the gut microbiome in community-dwelling older adults. However, the potential role of the gut microbiome in the benefits of Baduanjin on cognitive function remains unclear. The aim of this study is to investigate the mediating effect of gut microbiome between regular Baduanjin training and improvement in cognitive function in community-dwelling older adults with MCI.Methods and analysisThis is a two-arm, randomised, parallel-controlled, single-blinded trial. Four residential communities (clusters) with a total of 64 eligible participants (16 participants in each residential community) will be randomised 1:1 to either the 24-week Baduanjin exercise intervention group (60 min per session, four sessions per week) or the no specific exercise intervention control group. Global cognitive function and the subdimensions of cognition including executive function, visuospatial function, language function and memory function will be assessed using the Montreal Cognitive Assessment Scale, Trail Making Test, Auditory Verbal Learning Test, Boston Naming Test-30 and Clock-Drawing Test, while the gut microbiome and its metabolomics will be detected using 16S rRNA and ultra-high-performance liquid chromatography–tandem mass spectrometry at baseline and at the end of 24-week intervention. The intervention effect of Baduanjin exercise and mediating role of gut microbiota will be analysed using linear mixed models and the bootstrapping method in the Hayes process.Ethics and disseminationThis study conforms to Declaration of Helsinki principles and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of the Shanghai University of Medicine and Health Sciences (approval number: 2023-GZR-011). Written informed consent will be obtained from all participants. Results will be disseminated to relevant groups in peer-reviewed journal(s), and at relevant international or national scientific conferences. Key findings will also be shared with social media, healthcare providers, participants or community-dwelling older adults to support access for non-research audiences.Trial registration numberChiCTR2300078147.
Association between physician burnout and patient safety: study protocol for an overview of systematic reviews and meta-analyses
Authors: Vaquero-Cepeda Pablo , Pujol-de Castro Antonio , Catalá-López Ferrán 
Published: November 2024

IntroductionBurnout, a disorder caused by chronic stress at work, involves emotional exhaustion, depersonalisation and reduced professional efficacy. The prevalence of burnout appears to be high among physicians worldwide. Burnout may affect different dimensions of healthcare, such as patient safety. Several systematic reviews and meta-analyses have examined the relationship between physician burnout and quality of care, although with some controversial results. To our knowledge, no overview of systematic reviews and meta-analyses has been conducted, specifically evaluating physician burnout, patient safety and other relevant aspects of quality of care. The main objective of this study will be to evaluate the available evidence of the association between physician burnout and patient safety.Methods and analysisAn overview of systematic reviews and meta-analyses will be carried out. Systematic reviews with or without meta-analyses assessing the relationship between burnout in physicians and quality of care will be included. The primary outcome will be patient safety (ie, the occurrence of any adverse event related to healthcare which could have resulted, or did result, in unnecessary harm to patients). Secondary outcomes will be patient satisfaction and professionalism. Literature searches will be conducted (from their inception onwards) in PubMed/MEDLINE, EMBASE and Cochrane Database of Systematic Reviews. Two researchers will select studies that meet the predefined eligibility criteria and proceed to extract information from each included study. The methodological characteristics, measures of association and qualitative conclusions of the reviews will be assessed. The methodological quality of each review will also be analysed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) tool. A descriptive synthesis will be carried out using evidence tables and graphs.Ethics and disseminationThe proposed research mainly involves the analysis of existing studies, approval from a research ethics committee is not required. This overview of systematic reviews will help to gain a better understanding of the association between physician burnout and patient safety. Our findings could support future research, recommendations and policies in this area. We plan to publish the full study in a peer-reviewed journal.Registration of the protocolOpen Science Framework:https://osf.io/wr73u/
Pulmonary complications and mortality among COVID-19 patients undergoing a surgery: a multicentre cohort study
Authors: Amzallag Eva , Panchadsaram Thanushka , Girard Martin , Lecluyse Vincent , Couture Etienne , D'Aragon Frederick , Kandelman Stanislas , Turgeon Alexis F , Jodoin Caroline , Beaulieu Pierre , Richebé Philippe , Carrier Francois Martin 
Published: November 2024

ObjectivesOur primary objective was to assess the association between symptoms at the time of surgery and postoperative pulmonary complications and mortality in patients with COVID-19. Our secondary objective was to compare postoperative outcomes between patients who had recovered from COVID-19 and asymptomatic patients and explore the effect of the time elapsed between infection and surgery in the former. Our hypotheses were that symptomatic patients had a higher risk of pulmonary complications, whereas patients who had recovered from the infection would exhibit outcomes similar to those of asymptomatic patients.BackgroundManaging COVID-19-positive patients requiring surgery is complex due to perceived heightened perioperative risks. However, Canadian data in this context remains scarce.DesignTo address this gap, we conducted a multicentre observational cohort study.SettingAcross seven hospitals in the province of Québec, the Canadian province was most affected during the initial waves of the pandemic.ParticipantsWe included adult surgical patients with either active COVID-19 at the time of surgery or those who had recovered from the disease, from March 22, 2020 to April 30, 2021.OutcomesWe evaluated the association between symptoms or recovery time and postoperative pulmonary complications and hospital mortality using multivariable logistic regression and Cox models. The primary outcome was a composite of any postoperative pulmonary complication (atelectasis, pneumonia, acute respiratory distress syndrome and pneumothorax). Our secondary outcome was hospital mortality, assessed from the date of surgery up to hospital discharge.ResultsWe included 105 patients with an active infection (47 were symptomatic and 58 were asymptomatic) at the time of surgery and 206 who had recovered from COVID-19 prior to surgery in seven hospitals. Among patients with an active infection, those who were symptomatic had a higher risk of pulmonary complications (OR 3.19, 95% CI 1.12 to 9.68, p=0.03) and hospital mortality (HR 3.67, 95% CI 1.19 to 11.32, p=0.02). We did not observe any significant effect of the duration of recovery prior to surgery on patients who had recovered from their infection. Their postoperative outcomes were also similar to those observed in asymptomatic patients.InterpretationSymptomatic status should be considered in the decision to proceed with surgery in COVID-19-positive patients. Our results may help optimise surgical care in this patient population.Study registrationClinicalTrials.gov Identifier:NCT04458337registration date: 7 July 2020.
Association between gestational diabetes mellitus diagnostic criteria and adverse pregnancy outcomes—a systematic review and meta-analysis of adjusted effect sizes from studies using current diagnostic criteria
Authors: Mahmoud Elhassan , Elsayed Abdalla Moustafa , Elsayed Basant , Elsalakawi Yasmin , Gopinath Aswathy , Chivese Tawanda 
Published: November 2024

ObjectivesTo quantify the association between Gestational Diabetes Mellitus (GDM) and adverse pregnancy outcomes and primarily compare the associations between diagnostic criteria following the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations and non-IADPSG criteria, which use higher blood glucose cut-offs.DesignSystematic review and meta-analysis of observational studies using contemporary GDM diagnostic criteria.Data sourcesPubMed, Scopus, Google Scholar, Cochrane Database of Systematic Reviews and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for articles published between 2010 and 2023. The search was carried out on 15 May 2023.Eligibility criteriaStudies were included if they were observational studies that reported adjusted effect sizes for GDM-related adverse outcomes and compared outcomes between women with and without GDM, used contemporary diagnostic criteria and were conducted after 2010.Data extraction and synthesisTwo reviewers independently extracted data and assessed study quality using the MethodologicAl STandards for Epidemiological Research (MASTER) scale. Bias-adjusted inverse variance heterogeneity meta-analysis models were used to synthesise adjusted effect sizes. The same meta-analytic models were used to synthesise the overall OR and their 95% CIs for comparisons of the criteria which followed the IADPSG recommendations to other criteria, mostly with higher blood glucose cut-offs (non-IADPSG).ResultsWe included 30 studies involving 642 355 participants. GDM was associated with higher odds of maternal outcomes, namely; caesarean section (adjusted OR (aOR) 1.24, 95% CI 1.01 to 1.51) and pregnancy-induced hypertension (aOR 1.55, 95% CI 1.03 to 2.34). GDM was associated with higher odds of neonatal outcomes, specifically; macrosomia (aOR 1.38, 95% CI 1.13 to 1.69), large for gestational age (aOR 1.42, 95% CI 1.23 to 1.63), preterm birth (aOR 1.41, 95% CI 1.21 to 1.64), neonatal intensive care unit admission (aOR 1.42, 95% CI 1.12 to 1.78), neonatal hypoglycaemia (aOR 3.08, 95% CI 1.80 to 5.26) and jaundice (aOR 1.47, 95% CI 1.12 to 1.91). Further analyses showed no major differences in adverse pregnancy outcomes between IADPSG and non-IADPSG criteria.ConclusionsGDM is consistently associated with adverse pregnancy, maternal and foetal outcomes, regardless of the diagnostic criteria used. These findings suggest no significant difference in risk between lower and higher blood glucose cut-offs used in GDM diagnosis.
Results of a healthcare transition learning collaborative for emerging adults with sickle cell disease: the ST3P-UP study transition quality improvement collaborative
Authors: Osunkwo Ifeyinwa , Cornette Jennifer S , Noonan Laura , Courtlandt Cheryl , Mabus Sarah , White Patience H , McManus Margaret , Robinson Myra M , Wallander Michelle L , Eckman James R , Saah Elna , Alvarez Ofelia A , Goodwin Mark , Jerome Clay Leila , Desai Payal , Lawrence Raymona H 
Published: November 2024

BackgroundIndividuals with sickle cell disease (SCD) experience poor clinical outcomes while transitioning from paediatric to adult care. Standards for SCD transition are needed. We established a Quality Improvement (QI) Collaborative that aimed to improve the quality of care for all young adults with SCD by establishing a standardised SCD transition process. This study evaluates the implementation of the Six Core Elements (6CE) of Health Care Transition, which was a fundamental component of the cluster-randomised Sickle Cell Trevor Thompson Transition Project (ST3P-UP) study.MethodsA central QI team trained 14 ST3P-UP study sites on QI methodologies, 6CE and Got Transition’s process measurement tool (PMT). Site-level QI teams included a transition coordinator, clinic physicians/staff, patients/parents with SCD and community representatives. Sites completed the PMT every 6 months for 54 months and monthly audits of 10 randomly-selected charts to verify readiness/self-care assessments and emergency care plans.ResultsOf a possible 100, the aggregate mean (±SD) PMT score for paediatric clinics was 23.9 (±13.8) at baseline, 95.9 (±6.0) at 24 months and 98.9 (±2.1) at 54 months. The aggregate mean PMT score for adult clinics was 15.0 (±13.5) at baseline, 88.4 (±11.8) at 24 months and 95.8 (±6.8) at 54 months. The overall QI Collaborative PMT score improved by 402%. At baseline, readiness/self-care assessments were current for 38% of paediatric and 20% of adult patients; emergency care plans were current for 20% of paediatric and 3% of adult patients. Paediatric clinics had one median readiness assessment shift (76%) and four median emergency care plan shifts (65%, 77%, 79%, 84%). Adult clinics experienced three median self-care assessment shifts (58%, 63%, 70%) and two median emergency care plan shifts (57%, 70%).ConclusionsThe ST3P-UP QI Collaborative successfully embedded the 6CE of Health Care Transition into routine care and increased administration of assessments and emergency care plans for transition-aged patients with SCD.
Chronic pouchitis: what every gastroenterologist needs to know
Authors: Kamal Shahed , Mingos Nicholas , Andrew Bridgette , Segal Jonathan 
Published: November 2024

BackgroundChronic pouchitis is a complication after restorative proctocolectomy with ileal pouch-anal anastomosis in ulcerative colitis (UC) and patients with familial adenomatous polyposis. Despite medical advances, many patients develop chronic inflammation in the ileal pouch, affecting their quality of life.ObjectiveThis narrative review provides an overview of chronic pouchitis, focusing on pathogenesis, clinical presentation, diagnostics and management, highlighting the need for a multidisciplinary approach.MethodsA comprehensive literature review was conducted, analysing studies on chronic pouchitis incidence, pathogenesis, diagnosis and treatment, with an emphasis on emerging therapies and personalised medicine.ResultsThe pathogenesis of chronic pouchitis involves genetic, immunological, microbial and environmental factors. Symptoms include increased stool frequency, urgency and abdominal pain. Diagnosis relies on clinical evaluation, endoscopy and histology. Management includes antibiotics, probiotics, immunomodulators, biologics and dietary interventions. Emerging therapies like anti-TNFα monoclonal antibodies, vedolizumab, ustekinumab and small molecules show promise for refractory cases.ConclusionEffective chronic pouchitis management requires a personalised approach. Treatment aims to alleviate symptoms and prevent recurrence. Chronic pouchitis can severely impact on a patient’s quality of life, and therefore surgical options remain a valuable alternative for those not responding to medical therapy. Ongoing research and interdisciplinary collaboration are essential to improve patient outcomes.
Better end-of-life care in surgical patients: Veterans Affairs Bereaved Family Survey – a qualitative analysis
Authors: Shabet Christina , Vitous C Ann , Evans Emily , Edwards Sydney , Bradley Sarah E , Duby Ashley , Suwanabol Pasithorn A 
Published: November 2024

BackgroundEnd-of-life care among surgical patients is largely understudied and far fewer studies examine such care from the family perspective. To identify potential opportunities for improvement, we explored responses of family members of veterans who died following surgery using the Veterans Affairs (VAs) Bereaved Family Survey (BFS).MethodsWe examined data from the BFS open-text responses to explore insights into surgical patient’s end-of-life care. Data were analysed iteratively using qualitative content analysis and clustered into domains based on content.ResultsWe evaluated 936 open-text responses to the BFS for all decedents who underwent any high-risk surgical procedure across 124 VA medical centres from 2010 to 2019. This report focused on the following domains: patient needs, family/caregiver needs, clinical teams/personnel characteristics and facility/organisational characteristics. Key themes within patient needs included concerns about pain management, preservation of patient dignity and spiritual support. Within the family/caregiver domain, key themes included enhanced communication needs, assistance with logistics and displays of gratitude for the patient’s military service. The clinical team’s domain included the key themes of professionalism concerns and understaffing. Finally, key themes identified within the facility/organisation domain were the need for more robust support services and discomfort with the physical space.ConclusionsNarratives from the family perspective provide valuable insight into end-of-life care among surgical patients. Our data demonstrate the critical need for preserving patient dignity and improved communication, which emphasises family involvement and shared decision-making. In addition, hospital systems can optimise nurse-to-patient ratios and intentionally design physical spaces to help improve end-of-life care for surgical patients.