bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the current situation and demand for perinatal education in pregnant women in general grade A tertiary hospitals in China: a cross-sectional survey
Authors: Shen Jie , Zhang Yue , Xu Jinli , Wan Shenxian , Niu Meie , Chen Youguo , Huang Qin , Que Mochun , Jin Aiying 
Published: August 2024

ObjectivesThis study aimed to assess the factors influencing pregnant women’s participation in perinatal education and their demand for educational courses.DesignA cross-sectional study.SettingTertiary hospital in Suzhou, China, July–September 2022.ParticipantsPregnant women from a general grade A tertiary hospital in Suzhou were recruited via online survey invitations during the specified period.MeasuresA self-designed scale was used to evaluate pregnant women’s demand for perinatal education. Multiple response sets were employed for the assessment of multiple-choice items and analyses included frequency and cross-tabulation. Logistic regression analysis was conducted to assess the factors influencing pregnant women’s participation in perinatal education.OutcomeThe primary outcome measured was the demand for perinatal education among pregnant women.ResultsA majority (53.8%) of pregnant women expressed a preference for a mixed teaching mode combining online and offline formats. Logistic regression analysis showed that education level significantly influenced pregnant women’s participation in online learning. Specifically, women with higher education levels were more likely to participate actively in online courses. Additionally, compared with those with first-born children, pregnant women with second-born children participated less actively in online learning. Pregnant women in their second and third trimesters showed greater engagement in online learning compared with those in their first trimester.ConclusionsThese findings indicate that Chinese pregnant women’s preferences for perinatal education are influenced by their educational background, pregnancy history and the mode of teaching employed. The variability in educational needs underscores the importance of regularly updating course content based on participant feedback.
Perioperative non-pharmaceutical therapies for insomnia in cancer survivors: a systematic review and network meta-analysis protocol
Authors: Liu Lumin , Jin Qi , Chen Yuelai , Yin Ping 
Published: August 2024

IntroductionThe presence of perioperative insomnia is common but yet often overlooked among cancer survivors. Non-pharmaceutical therapies have shown promise in treating cancer-related insomnia during the perioperative period; however, the existing evidence from various studies remains inconsistent. Therefore, this study aims to systematically review and assess the effectiveness of a wide range of non-pharmaceutical interventions during perioperative period for cancer-related insomnia. Findings from this study will help to make evidence-based treatment decisions.Methods and analysisA comprehensive electronic search will be conducted to identify relevant articles from multiple databases, including PubMed, MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials and Chinese literature databases such as CNKI, VIP, Wanfang from inception to 1 December 2023. Language restrictions will not be imposed to ensure inclusivity. The change of the Pittsburgh Sleep Quality Index or the Insomnia Severity Index from baseline will be used as the primary outcome of the study. Studies using these as secondary outcomes are also acceptable. Pairwise meta-analysis and network meta-analysis will be conducted using Stata V.15.0 software. The Cochrane collaboration tool for assessing the Risk of Bias and Risk of Bias in Non-randomised Studies of Interventions will be used for risk and bias assessment. Additionally, the Grading of Recommendations, Assessment, Development and Evaluation scale will be employed to evaluate the quality of the evidence.Ethics and disseminationEthical approval is not required for this study since it involves the analysis of existing studies. The anticipated results will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42023437356.
Dating violence prevalence and factors associated among undergraduate public health students of Kathmandu metropolitan city, Nepal: a cross-sectional study
Authors: Gaire Manisha , Gautam Laxmi , Karki Prabin , Poudel Lisasha , Khanal Sudip 
Published: August 2024

ObjectiveThe objective of this research was to assess the prevalence of dating violence (DV) and factors associated among undergraduate public health students of Kathmandu metropolitan city (KMC), Nepal.DesignA descriptive cross-sectional study was conducted involving undergraduate public health students in Kathmandu. We recruited the students using probability proportionate sampling techniques. Data collection was carried out using a self-administered questionnaire. The duration of study was from May 2022 to March 2023.SettingWe conducted a quantitative study among undergraduate students of 11 colleges out of 14 public health colleges located within Kathmandu.Participants352 public health students including both men and women were involved in the study. College-going students who were willing to give consent were included in the study.Outcome measureA significant prevalence of DV was seen among undergraduate public health students of KMC. Both univariate and multivariate logistic regression techniques were applied to assess the relationship of factors associated with DV and reported adjusted ORs (aOR) with 95% CIs. All statistical analyses were executed using the SPSS V.24.ResultsAmong 352 respondents, 182 were having current or past dating relationships. The study shows that the majority (78.02%) of respondents had experienced DV during the time of study or any time in the past. DV was more likely among male participants (aOR 3.95, 95% CI 1.14 to 13.58) and whose partners consumed alcohol (aOR 4.58, 95% CI 1.70 to 12.34). Participants who had ever been exposed to violence done by family members were more likely to experience DV (aOR 5.97, 95% CI 1.39 to 25.49).ConclusionsThe study highlights a significant prevalence of DV among undergraduate public health students in Kathmandu, underscoring the urgency for implementing programmes aimed at addressing this issue.
Registry-based cohort study comparing percentages of patients reaching PASS for knee function outcomes after revision ACLR compared to primary ACLR
Authors: Herman Zachary J , Kaarre Janina , Grassi Alberto , Senorski Eric Hamrin , Musahl Volker , Samuelsson Kristian 
Published: August 2024

ObjectivesReaching the Patient-Acceptable Symptom State (PASS) threshold for the Knee injury and Osteoarthritis Outcome Score (KOOS) has previously been reported to successfully identify individuals experiencing clinical success after anterior cruciate ligament reconstruction (ACLR). Thus, the objectives of this study were to examine and compare the percentages of patients meeting PASS thresholds for the different KOOS subscales 1 year postoperatively after primary ACLR compared with revision ACLR (rACLR) and multiply revised ACLR (mrACLR), and second, to examine the predictors for reaching PASS for KOOS Quality of Life (QoL) and Function in Sport and Recreation (Sport/Rec) after mrACLR.DesignProspective observational registry study.SettingThe data used in this study was obtained from the Swedish National Ligament Registry and collected between 2005 and 2020.ParticipantsThe study sample was divided into three different groups: (1) primary ACLR, (2) rACLR and (3) mrACLR. Data on patient demographic, injury and surgical characteristics were obtained as well as mean 1-year postoperative scores for KOOS subscales and the per cent of patients meeting PASS for each subscale. Additionally, the predictors of reaching PASS for KOOS Sport/Rec, and QoL subscales were evaluated in patients undergoing mrACLR.ResultsOf the 22 928 patients included in the study, 1144 underwent rACLR and 36 underwent mrACLR. Across all KOOS subscales, the percentage of patients meeting PASS thresholds was statistically lower for rACLR compared with primary ACLR (KOOS Symptoms 22.5% vs 32.9%, KOOS Pain 84.9% vs 92.9%, KOOS Activities of Daily Living 23.5% vs 31.4%, KOOS Sport/Rec 26.3% vs 45.6%, KOOS QoL 26.9% vs 51.4%). Percentages of patients reaching PASS thresholds for all KOOS subscales were comparable between patients undergoing rACLR versus mrACLR. No predictive factors were found to be associated with reaching PASS for KOOS QoL and KOOS Sport/Rec 1 year postoperatively after mrACLR.ConclusionPatients undergoing ACLR in the revision setting had lower rates of reaching acceptable symptom states for functional knee outcomes than those undergoing primary ACLR.Level of evidenceProspective observational registry study, level of evidence II.
Palliative care needs and utilisation of specialist services for people diagnosed with motor neuron disease: a national population-based study
Authors: Bai Wenhui , Liu Huiqin , Ding Jinfeng , Zhang Hongmei , Johnson Claire E , Cook Angus 
Published: August 2024

IntroductionThere is a growing emphasis on the importance of the availability of specialist palliative care for people with motor neuron disease (MND). However, the palliative care needs of this population and the utilisation of different specialist services remain poorly defined.ObjectivesTo (1) describe clinical characteristics, symptom burden and functional levels of patients dying with MND on their admission to palliative care services; (2) determine factors associated with receiving inpatient or community palliative care services.DesignAn observational study based on point-of-care assessment data from the Australian Palliative Care Outcomes Collaboration.ParticipantsA total of 1308 patients who received palliative care principally because of MND between 1 January 2013 and 31 December 2020.MeasuresFive validated clinical instruments were used to assess each individual’s function, distress from symptoms, symptom severity and urgency and acuity of their condition.ResultsMost patients with MND had no or mild symptom distress, but experienced a high degree of functional impairment. Patients who required ‘two assistants for full care’ relative to those who were ‘independent’ (OR=11.53, 95% CI: 4.87 to 27.26) and those in ‘unstable’ relative to ‘stable’ palliative care phases (OR=16.74, 95% CI: 7.73 to 36.24) were more likely to use inpatient versus community-based palliative care. Associations between the use of different palliative care services and levels of symptom distress were not observed in this study.ConclusionsPatients with MND were more likely to need assistance for decreased function and activities of daily living, rather than symptom management. This population could have potentially been cared for in the palliative phase in a community setting if greater access to supportive services were available in this context.
Exploring adults’ recollections of growing up with childhood motor difficulties: a qualitative study using systematic text condensation
Authors: Zahlander Johanna , Fäldt Anna , Kirby Amanda , Johansen Kine 
Published: August 2024

ObjectiveTo explore the ramifications of childhood motor difficulties, providing insights into their impact and consequences over time.DesignA qualitative study using semistructured individual interviews. Data were analysed using systematic text condensation.SettingNeonatal intensive care recipients born at Uppsala University Children’s Hospital, Uppsala, Sweden, between 1986 and 1989, were enrolled in a longitudinal follow-up study and subsequently interviewed in 2019–2020.Participants13 individuals in their early 30s, who met the criteria for developmental coordination disorder or performed below the 5th percentile on motor tests at 6.5 years of age, were interviewed. Those with co-occurring deficits in attention or social behavioural at age 6.5 were excluded.ResultsTwo themes emerged: (1) lifelong challenges and (2) navigating the journey of motor difficulties: support, awareness and confidence. Five participants reported persistent motor difficulties. They adapted and integrated these challenges into their daily lives without feeling constrained. Parental support was crucial to their success, whereas support from schools was limited.ConclusionAdults who faced motor difficulties in childhood developed effective coping strategies, overcame challenges and now lead fulfilling lives. The findings stress the importance of parental support and understanding, addressing contextual factors and fostering positive attitudes and supportive environments to enhance well-being and participation.
Recruitment, retention and reporting of variables related to ethnic diversity in randomised controlled trials: an umbrella review
Authors: Owusu-Addo Ebenezer , Bennor Deborah M , Orkin Aaron Michael , Chan An-Wen , Welch Vivian A , Treweek Shaun , Green Heidi , Feldman Peter , Ghersi Davina , Brijnath Bianca 
Published: August 2024

ObjectiveThis umbrella review synthesises evidence on the methods used to recruit and retain ethnically diverse participants and report and analyse variables related to ethnic diversity in randomised controlled trials.DesignUmbrella review.Data sourcesOvid MEDLINE, Ovid Embase, CINAHL, PsycINFO and Cochrane and Campbell Libraries for review papers published between 1 January 2010 and 13 May 2024.Eligibility criteriaEnglish language systematic reviews focusing on inclusion and reporting of ethnicity variables. Methodological quality was assessed using the AMSTAR 2 tool.ResultsSixty-two systematic reviews were included. Findings point to limited representation and reporting of ethnic diversity in trials. Recruitment strategies commonly reported by the reviews were community engagement, advertisement, face-to-face recruitment, cultural targeting, clinical referral, community presentation, use of technology, incentives and research partnership with communities. Retention strategies highlighted by the reviews included frequent follow-ups on participants to check how they are doing in the study, provision of incentives, use of tailored approaches and culturally appropriate interventions. The findings point to a limited focus on the analysis of variables relevant to ethnic diversity in trials even when they are reported in trials.ConclusionSignificant improvements are required in enhancing the recruitment and retention of ethnically diverse participants in trials as well as analysis and reporting of variables relating to diversity in clinical trials.PROSPERO registration numberCRD42022325241.
Quantitative analysis of nortriptyline’s analgesic properties: a comparative systematic review and meta-analysis
Authors: Hashemzadeh Soroush , Mortazavi Mohammad , Abdi Dezfouli Ramin 
Published: August 2024

ObjectivesThis study aims to quantitatively analyse nortriptyline’s analgesic potency, safety and tolerability.DesignSystematic review and meta-analysis.Data sourcesThe systematic search was conducted in Scopus, Web of Science and PubMed in February 2023.Eligibility criteria for selecting studiesClinical trials evaluating the efficacy of nortriptyline in reducing pain scores (open-label studies and comparisons of nortriptyline with placebo or other analgesics) in different pain types were included.Data extraction and synthesisThe data extraction procedure and the screening phases were carried out based on predetermined eligibility criteria. To pool the data, the standardised mean difference (SMD) and standardised mean change (SMC) methods, along with random-effect and fixed-effect meta-analysis, were used. The risk of bias was assessed using the Cochrane Collaboration method, and the Grading of Recommendations Assessment, Development and Evaluation criteria were used to measure the certainty of the results.Results14 of the initial 648 studies were eventually imported. Nortriptyline was reported to significantly reduce pain severity in chronic low back pain, painful symptoms in major depressive disorder, neuropathy, chronic pelvic pain and neuropathic corneal pain. However, it was not superior to placebo in fibromyalgia and knee osteoarthritis. In comparison to placebo and various alternative analgesics, the pooled SMD for lowering pain scores was 0.43 (0.23–0.64) and −0.18 (−0.39 to 0.03), respectively. In the pretreatment and post-treatment analyses, the pooled SMC was −1.20 (−1.48 to –0.93). Although constipation and xerostomia were the most commonly reported side effects, all references indicated that the adverse events were well tolerated at the administered dosages.ConclusionWhile nortriptyline is effective in some chronic pains, such as neuropathies, it lacks efficacy in some other chronic pains, such as fibromyalgia and osteoarthritis. Nortriptyline is well tolerated when administered in doses intended for its analgesic effects. Moreover, several studies suggested that the analgesic effects of nortriptyline are comparable to those of amitriptyline and gabapentin.
Impact of the diagnostic label for a low-risk prostate lesion: protocol for two online factorial randomised experiments
Authors: Bullen James , Nickel Brooke , McCaffery Kirsten , Wilt Timothy J , Smith Jenna , Boroumand Farzaneh , Parker Lisa , Millar Jeremy , Brodersen John Brandt , Dahm Philipp , Delahunt Brett , Varma Murali , Glasziou Paul , Warden Andrew , Diller Lawrence , Billington Larry , van Rensburg Christo , Bell Katy 
Published: August 2024

Introduction
Many types of prostate cancer present minimal risk to a man’s lifespan or well-being, but existing terminology makes it difficult for men to distinguish these from high-risk prostate cancers. This study aims to explore whether using an alternative label for low-risk prostate cancer influences management choice and anxiety levels among Australian men and their partners.

Methods and analysis
We will run two separate studies for Australian men and Australian women with a male partner. Both studies are between-subjects factorial (3×2) randomised online hypothetical experiments. Following consent, eligible participants will be randomised 1:1:1 to three labels: ‘low-risk prostate cancer, Gleason Group 1’, ‘low-risk prostate neoplasm’ or ‘low-risk prostate lesion’. Participants will then undergo a second randomisation step with 1:1 allocation to the provision of detailed information on the benefits and harms of different management choices versus the provision of less detailed information about management choices. The required sample sizes are 1290 men and 1410 women. The primary outcome is the participant choice of their preferred management strategy: no immediate treatment (prostate-specific antigen (PSA)-based monitoring or active surveillance using PSA, MRI, biopsy with delayed treatment for disease progression) versus immediate treatment (prostatectomy or radiation therapy). Secondary outcomes include preferred management choice (from the four options listed above), diagnosis anxiety, management choice anxiety and management choice at a later time point (for participants who initially choose a monitoring strategy).

Ethics and dissemination

Ethics approval has been received from The University of Sydney Human Research Ethics Committee (2023/572). The results of the study will be published in a peer-reviewed medical journal and a plain language summary of the findings will be shared on the Wiser Healthcare publications page
http://www.wiserhealthcare.org.au/category/publications/

Trial registration numbers
Australian New Zealand Clinical Trials Registry (ID 386701 and 386889).
Rapid Assay Diagnostic for Acute Stroke Recognition (RADAR): study protocol for a diagnostic accuracy study
Authors: Shaw Lisa , Burgess David , Dixit Anand , Gaude Edoardo , Lendrem Clare , McClelland Graham , White Phil , Williams Cameron , Zhu Gewei , Price Christopher 
Published: August 2024

IntroductionLarge-vessel occlusion (LVO) stroke is effectively treated by time-critical thrombectomy, a highly specialised procedure only available in a limited number of centres. Many patients with suspected stroke are admitted to their nearest hospital and require transfer to access treatment, with resulting delays. This study is evaluating the accuracy of a new rapid portable test for LVO stroke which could be used in the future to select patients for direct admission to a thrombectomy centre.Methods and analysisRapid Assay Diagnostic for Acute Stroke Recognition (RADAR) is a prospective observational cohort study taking place in stroke units in England. Participants are adults with a new suspected stroke with at least one face, arm or speech (FAST) symptom(s) and known onset within 6 hours or last known to be well 6–24 hours ago. The index test (‘LVOne test’ (Upfront Diagnostics)), consists of two portable lateral flow assays which use fingerprick capillary blood to detect d-dimer and glial fibrillary acidic protein concentrations. Reference standards comprise independently adjudicated standard CT/MRI brain±CT/MR angiography with senior clinician opinion to establish: ischaemic stroke±LVO; intracerebral haemorrhage; transient ischaemic attack; stroke mimic. Analyses will report sensitivity, specificity and negative and positive predictive values for identification of LVO stroke. Powered using a primary analysis population (≥2 FAST symptoms and known onset within 6 hours), 276 participants will detect a test specificity of 92%. The broader total study population which allows evaluation of the test for milder symptoms and unknown onset times is estimated to be 552 participants.Ethics and disseminationEthical (North East—Newcastle & North Tyneside 2 Research Ethics Committee (reference: 23/NE/0043), Health Research Authority and participating National Health Service Trust approvals are granted. Consent is required for enrolment. Dissemination of results will include presentations at conferences, publication in journals and plain English summaries.Trial registration numberISRCTN12414986.
Preventing urinary tract infection in older people living in care homes: the ‘StOP UTI’ realist synthesis
Authors: Prieto Jacqui , Wilson Jennie , Tingle Alison , Cooper Emily , Handley Melanie , Rycroft Malone Jo , Bostock Jennifer , Loveday Heather 
Published: August 2024

BackgroundUrinary tract infection (UTI) is the most diagnosed infection in older people living in care homes.ObjectiveTo identify interventions for recognising and preventing UTI in older people living in care homes in the UK and explain the mechanisms by which they work, for whom and under what circumstances.MethodsA realist synthesis of evidence was undertaken to develop programme theory underlying strategies to recognise and prevent UTI. A generic topic-based search of bibliographic databases was completed with further purposive searches to test and refine the programme theory in consultation with stakeholders.Results56 articles were included in the review. Nine context–mechanism–outcome configurations were developed and arranged across three theory areas: (1) Strategies to support accurate recognition of UTI, (2) care strategies for residents to prevent UTI and (3) making best practice happen. Our programme theory explains how care staff can be enabled to recognise and prevent UTI when this is incorporated into care routines and activities that meet the fundamental care needs and preferences of residents. This is facilitated through active and visible leadership by care home managers and education that is contextualised to the work and role of care staff.ConclusionsCare home staff have a vital role in preventing and recognising UTI in care home residents.Incorporating this into the fundamental care they provide can help them to adopt a proactive approach to preventing infection and avoiding unnecessary antibiotic use. This requires a context of care with a culture of personalisation and safety, promoted by commissioners, regulators and providers, where leadership and resources are committed to support preventative action by knowledgeable care staff.