bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of vitamin D in addition to letrozole on the ovulation rate of women with polycystic ovary syndrome: protocol of a multicentre randomised double-blind controlled trial
Authors: Ko Jennifer K Y , Yung Sofie S F , Lai Shui Fan , Wan Rebecca S F , Wong Catherine K Y , Wong Keedon , Cheung Ching-Lung , Ng Ernest H Y , Li Raymond H W 
Published: April 2024

IntroductionLow vitamin D status is prevalent among women with polycystic ovary syndrome (PCOS). The objective of the study is to assess the effect of vitamin D supplementation on (1) the ovulation rate to letrozole and (2) other reproductive, endocrine and metabolic outcomes after 1 year of supplementation in women with PCOS.Methods and analysisThis is a multicentre, randomised, double-blind, controlled clinical trial. A total of 220 anovulatory women with PCOS diagnosed by the Rotterdam criteria will be recruited. They will be randomly assigned to either the (1) vitamin D supplementation group or (2) placebo group. Those in the vitamin D group will take oral Vitamin D3 50 000 IU/week for 4 weeks, followed by 50 000 IU once every 2 weeks for 52 weeks. Those who remain anovulatory after 6 months will be treated with a 6-month course of letrozole (2.5 mg to 7.5 mg for 5 days per cycle titrated according to response) for ovulation induction. The primary outcome is the ovulation rate. All statistical analyses will be performed using intention-to-treat and per protocol analyses.Ethics and disseminationEthics approval was sought from the Institutional Review Board of the participating units. All participants will provide written informed consent before joining the study. The results of the study will be submitted to scientific conferences and peer-reviewed journals.Trial registration numberNCT04650880.
Efficacy and safety of seven Chinese patent medicines combined with conventional triple/quadruple therapy forHelicobacter pylori-positive peptic ulcers: a systematic review and network meta-analysis
Authors: Jiang Zhenyu , Deng Boning , Zhang Yaqi , Li Ye , Yu Zhijun , Deng Haiying , Chen Yajun 
Published: April 2024

ObjectivesTo compare the efficacy and safety of seven Chinese patent medicines (CPMs) combined with conventional triple/quadruple therapy (T/Q) forHelicobacter pylori-positive peptic ulcers.DesignA systematic review and network meta-analysis.Data sourcesChina National Knowledge Infrastructure, VIP database, Wanfang database, ScienceDirect, EBSCO, EMBASE, Web of Science, Cochrane Library and PubMed were searched through 1 June 2022.Eligibility criteriaRandomised controlled trials (RCTs) testing CPMs combined with T/Q forH. pylori-positive peptic ulcers were included. The CPMs included Anweiyang capsule, Jianweiyuyang tablets/capsule/granule, Jinghuaweikang capsule, Kangfuxin liquid, Puyuanhewei capsule, Weifuchun tablets/capsule and Weisu granule. At least one of the following outcome indicators was recorded: complete ulcer healing rate (CUHR), effective rate (ER),H. pylorieradication rate (HPER), rate of peptic ulcer recurrence (RPUR) and incidence of adverse reactions (IAR).Data extraction and synthesisTwo researchers independently conducted the study selection and extracted data for included studies. The risk of bias was assessed using the Cochrane risk of bias tool. A pairwise meta-analysis was performed using RevMan V.5.3. Network meta-analysis was performed using STATA/MP V.15.0. Confidence in the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation.ResultsA total of 36 RCTs involving 3620 patients were included. Compared with T/Q alone, Weisu+T/Q, Weifuchun+T/Q and Puyuanhewei+T/Q had the highest CUHR, ER andHPER, respectively. Weisu+T/Q and Jianweiyuyang+T/Q had the lowest RPUR and IAR, respectively. The cluster analysis results showed Jianweiyuyang+T/Q might be the best choice concerning efficacy and safety simultaneously, followed by Kangfuxin+T/Q.ConclusionAmong the combination therapies with the CPMs, Jianweiyuyang+T/Q might be the most favourable option forH. pylori-positive peptic ulcers, followed by Kangfuxin+T/Q. Considering the limited quantity and quality of the included RCTs, the results should be interpreted with caution.PROSPERO registration numberCRD42022327687.
Effect of a national infection control programme in Sweden on prosthetic joint infection incidence following primary total hip arthroplasty: a cohort study
Authors: Wildeman Peter , Rolfson Ola , Wretenberg Per , Nåtman Jonatan , Gordon Max , Söderquist Bo , Lindgren Viktor 
Published: April 2024

ObjectivesProsthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA) entailing increased mortality, decreased quality of life and high healthcare costs.The primary aim was to investigate whether the national project: Prosthesis Related Infections Shall be Stopped (PRISS) reduced PJI incidence after primary THA; the secondary aim was to evaluate other possible benefits of PRISS, such as shorter time to diagnosis.DesignCohort study.SettingIn 2009, a nationwide, multidisciplinary infection control programme was launched in Sweden, PRISS, which aimed to reduce the PJI burden by 50%.ParticipantsWe obtained data on patients undergoing primary THA from the Swedish Arthroplasty Registry 2012–2014, (n=45 723 patients, 49 946 THAs). Using personal identity numbers, this cohort was matched with the Swedish Prescribed Drug Registry. Medical records of patients with ≥4 weeks’ antibiotic consumption were reviewed to verify PJI diagnosis (n=2240, 2569 THAs).ResultsThe cumulative incidence of PJI following the PRISS Project was 1.2% (95% CI 1.1% to 1.3%) as compared with 0.9% (95% CI 0.8% to 1.0%) before. Cox regression models for the PJI incidence post-PRISS indicates there was no statistical significance difference versus pre-PRISS (HR 1.1 (95% CI 0.9 to 1.3)). There was similar time to PJI diagnosis after the PRISS Project 24 vs 23 days (p=0.5).ConclusionsDespite the comprehensive nationwide PRISS Project, Swedish PJI incidence was higher after the project and time to diagnosis remained unchanged. Factors contributing to PJI, such as increasing obesity, higher American Society of Anesthesiology class and more fractures as indications, explain the PJI increase among primary THA patients.
Association between accelerometer-derived physical activity and depression: a cross-sectional study using isotemporal substitution analysis
Authors: Park Jungmi , Nam Hee-Kyoung , Cho Sung-Il 
Published: April 2024

ObjectivesDepression is a significant public health concern, and physical activity has been identified as a non-pharmacological intervention. Understanding the dose–response relationship between physical activity and depression is crucial for designing effective exercise interventions and recommending physical activity to individuals with depression. The isotemporal substitution model is considered the gold standard for estimating the dose–response effects of physical activity. This study aims to investigate the dose–response association between depression and accelerometer-measured physical activity in the Korean population.DesignCross-sectional analysis.SettingA non-probability sample of the community population was drawn from the 2014 and 2016 Korean National Health and Nutrition Examination Survey.ParticipantsThe study included 1543 adults aged 19–64 years who completed the Patient Health Questionnaire-9 (PHQ-9) and volunteered to wear an accelerometer.Main outcome measuresPhysical activity was measured using a GT3X+ accelerometer for 7 consecutive days, and activity was categorised as sedentary behaviour (SB) or light, moderate or vigorous physical activity. Depression was assessed using the PHQ-9.ResultsPhysical activity and SB were associated with depression. In the single-parameter model, moderate–vigorous physical activity (MVPA) showed a significant association with reduced odds of depression (OR: 0.817, 95% CI: 0.678 to 0.985). Substituting 30 min of SB with 30 min of MVPA (OR: 0.815, 95% CI: 0.669 to 0.992) was linked to a decrease in the odds of depression. Conversely, replacing 30 min of MVPA with 30 min of SB (OR: 1.227, 95% CI: 1.008 to 1.495) was associated with an increase in the odds of depression.ConclusionsThis study provides evidence of an association between physical activity and depression in the Korean population, highlighting the importance of reducing SB and increasing MVPA to prevent and manage depression. Further research is needed to confirm causality and determine optimal levels of physical activity for preventing depression in different populations.
Maternal positional therapy for fetal growth and customised birth weight centile benefit in a Bayesian reanalysis of a double-blind, sham-controlled, randomised clinical trial
Authors: Coleman Jerry , Grewal Sahibjot , Warland Jane , Hobson Sebastian , Liu Kuan , Kember Allan 
Published: April 2024

ObjectivesTo update the Ghana PrenaBelt Trial’s (GPT) primary outcome data with the latest fetal growth standard and reanalyse it. To estimate the posterior probability, under various clinically relevant prior probabilities, of maternal nightly positional therapy (PT) throughout the third-trimester having a beneficial effect on customised birth weight centile (CBWC) using Bayesian analyses.DesignA reanalysis of a double-blind, sham-controlled, randomised clinical trial.SettingA single, tertiary-level centre in Accra, Ghana.ParticipantsTwo-hundred participants entered, 181 completed and 167 were included in the final analysis. Participants were Ghanaian, healthy, aged 18–35 years, with low-risk, singleton pregnancies in their third-trimester, with Body Mass Index<35 kg/m2at the first antenatal appointment for the index pregnancy and without known fetal abnormalities, pregnancy complications or medical conditions complicating sleep.InterventionsParticipants were randomised to receive treatment with either a PT or sham-PT device.Primary and secondary outcome measuresThe primary outcome was the CBWC using the latest Perinatal Institute, Gestation-Related Optimal Weight calculator. Using Bayesian methods, posterior probabilities of achieving a greater than 0%, 5% and 10% benefit in CBWC with PT were estimated. There was no secondary outcome.ResultsThe median (IQR) CBWC was 42% (15–71) and 28% (9–52) in the PT and sham-PT groups, respectively (difference 8.4%; 95% CI −0.30 to 18.2; p=0.06). For achieving a >0%, >5% and >10% gain in CBWC with PT, the posterior probabilities were highly probable, probable and unlikely, respectively, given a range of prior probabilities reflecting varying degrees of pre-existing enthusiasm and scepticism.ConclusionsMaternal nightly PT throughout the third-trimester did not have a statistically significant effect on CBWC on a frequentist analysis using the latest fetal growth standard. However, from a Bayesian analysis, clinicians can infer that PT is likely to benefit fetal growth but with a modest effect size.Trial registration numberNCT02379728.
Learning motivation and self-assessment in health economics: a survey on overconfidence in healthcare providers
Authors: Bushuven Stefan , Bentele Michael , Trifunovic-Koenig Milena , Gerber Bianka , Bentele Stefanie , Hagen Fritz , Schoeffski Oliver , Marung Hartwig , Strametz Reinhard 
Published: April 2024

IntroductionLifelong learning is the foundation for professionals to maintain competence and proficiency in several aspects of economy and medicine. Until now, there is no evidence of overconfidence (the belief to be better than others or tested) and clinical tribalism (the belief that one’s own group outperforms others) in the specialty of health economics. We investigated the hypothesis of overconfidence effects and their relation to learning motivation and motivational patterns in healthcare providers regarding healthcare economics.MethodsWe conducted a national convenience online survey of 116 healthcare workers recruited from social and personal networks to detect overconfidence effects and clinical tribalism and to assess learning motivation. Instruments included self-assessments for five learning dimensions (factual knowledge, skills, attitude, problem-solving and behaviour) and a four-item situational motivation scale. The analysis comprised paired t-tests, correlation analyses and two-step cluster analyses.ResultsWe detected overplacement, overestimation and signs of clinical tribalism. Responders in the physician subgroup rated themselves superior to colleagues and that their professional group was superior to other professions. Participants being educators in other competencies showed high overconfidence in health economics. We detected two groups of learners: overconfident but motivated persons and overconfident and unmotivated learners. Learning motivation did not correlate with overconfidence effects.DiscussionWe could show the presence of overconfidence in health economics, which is consistent with studies in healthcare and the economy. The subjective perception of some medical educators, being role models to students and having a superior ‘attitude’ (eg, morality) concerning the economy may foster prejudice against economists as students might believe them. It also may aggravate moral distress and disrupts interactions between healthcare providers managers and leaders. Considering the study’s limitations, lifelong interprofessional and reflective training and train-the-trainer programmes may be mandatory to address the effects.
Digital resources in the monitoring of patients with cleft lip and palate: protocol for a scoping review
Authors: Carvalho Livian Isabel Medeiros , de Araújo Eduarda Gomes Onofre , de Souza Breno Estevam Silva , Martins Hélder Domiciano Dantas , Lacerda Rosa Helena Wanderley , Bonan Paulo Rogerio Ferreti 
Published: April 2024

IntroductionCleft lip and/or palate (CL+/-P) is a congenital malformation affecting the lip and palate, requiring long-term treatment due to potential associated complications. For this reason, it is important for the patient to be continuously monitored and followed for health promotion and prevention, as well as improving the quality of life. The aim of this scoping review protocol is to identify and map the available evidence regarding the application of digital resources and technologies in the monitoring and follow-up of patients with CL+/-P.Methods and analysisThis scoping review protocol follows the guidelines recommended by the Joanna Briggs Institute Manual, employing the PCC acronym (Patient/Concept/Context). Searches will be conducted, in May 2024, of PubMed, Web of Science, Scopus, Latin American and Caribbean Health Sciences Literature, ScienceDirect, as well as grey literature indexed in ProQuest Open Access Dissertations & Theses and Google Scholar. The review will consider all types of published studies, including grey literature, in English, Portuguese and Spanish languages, and will consider studies regardless of publication date. Exclusions will apply to studies that do not address the use of digital resources and technologies in CL+/-P monitoring and follow-up.Ethics and disseminationAs this is a scoping review, no ethics committee approval is required. After completion, the plan is to publish results in scientific journals on craniofacial malformations.Study registrationOpen Science Framework, DOI:10.17605/OSF.IO/Y6AG8.
Maternity healthcare professionals’ experiences of supporting women in decision-making for labour and birth: a qualitative study
Authors: Hardman Kitty , Davies Anna , Demetri Andrew , Clayton Gemma , Bakhbakhi Danya , Birchenall Katherine , Barnfield Sonia , Fraser Abigail , Burden Christy , McGuinness Sheelagh , Miller Rachel , Merriel Abi 
Published: April 2024

ObjectivesTo explore and characterise maternity healthcare professionals’ (MHCPs) experience and practice of shared decision-making (SDM), to inform policy, research and practice development.DesignQualitative focus group study.SettingLarge Maternity Unit in the Southwest of England.ParticipantsMHCPs who give information relating to clinical procedures and pregnancy care relating to labour and birth and are directly involved in decision-making conversations were purposively sampled to ensure representation across MHCP groups.Data collectionA semistructured topic guide was used.Data analysisReflexive thematic analysis was undertaken.ResultsSeven focus groups were conducted, comprising a total of 24 participants (3–5 per group). Two themes were developed: contextualising decision-making and controversies in current decision-making. Contextual factors that influenced decision-making practices included lack of time and challenges faced in intrapartum care. MHCPs reported variation in how they approach decision-making conversations and asked for more training on how to consistently achieve SDM. There were communication challenges with women who did not speak English. Three controversies were explored: the role of prior clinical experience, the validity of informed consent when women were in pain and during life-threatening emergencies and instances where women declined medical advice.ConclusionsWe found that MHCPs are committed to SDM but need better support to deliver it. Structured processes including Core Information Sets, communication skills training and decision support aids may help to consistently deliver SDM in maternity care.
Development of a patient decision aid for children and adolescents following anterior cruciate ligament rupture: an international mixed-methods study
Authors: Gamble Andrew R , McKay Marnee J , Anderson David B , Pappas Evangelos , Alvarez Cooper Ignatius , Macpherson Sophie , Harris Ian A , Filbay Stephanie R , McCaffery Kirsten , Thompson Rachel , Hoffmann Tammy C , Maher Christopher G , Zadro Joshua R 
Published: April 2024

AimTo develop and user test an evidence-based patient decision aid for children and adolescents who are considering anterior cruciate ligament (ACL) reconstruction.DesignMixed-methods study describing the development of a patient decision aid.SettingA draft decision aid was developed by a multidisciplinary steering group (including various types of health professionals and researchers, and consumers) informed by the best available evidence and existing patient decision aids.ParticipantsPeople who ruptured their ACL when they were under 18 years old (ie, adolescents), their parents, and health professionals who manage these patients. Participants were recruited through social media and the network outreach of the steering group.Primary and secondary outcomesSemistructured interviews and questionnaires were used to gather feedback on the decision aid. The feedback was used to refine the decision aid and assess acceptability. An iterative cycle of interviews, refining the aid according to feedback and further interviews, was used. Interviews were analysed using reflexive thematic analysis.ResultsWe conducted 32 interviews; 16 health professionals (12 physiotherapists, 4 orthopaedic surgeons) and 16 people who ruptured their ACL when they were under 18 years old (7 were adolescents and 9 were adults at the time of the interview). Parents participated in 8 interviews. Most health professionals, patients and parents rated the aid’s acceptability as good-to-excellent. Health professionals and patients agreed on most aspects of the decision aid, but some health professionals had differing views on non-surgical management, risk of harms, treatment protocols and evidence on benefits and harms.ConclusionOur patient decision aid is an acceptable tool to help children and adolescents choose an appropriate management option following ACL rupture with their parents and health professionals. A clinical trial evaluating the potential benefit of this tool for children and adolescents considering ACL reconstruction is warranted.
Outcome measures for children with speech sound disorder: an umbrella review
Authors: Harding Sam , Burr Sam , Cleland Joanne , Stringer Helen , Wren Yvonne 
Published: April 2024

ObjectiveSpeech sound disorder (SSD) describes a ‘persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication’. There is a need to establish which care pathways are most effective and efficient for children with SSD. Comparison of care pathways requires clearly defined, evidence-based, interventions and agreement on how to measure the outcomes. At present, no definitive list of assessments, interventions or outcomes exists. The objective of this umbrella review paper is to provide a rigorous and detailed list of assessments, interventions and outcomes which target SSD in children.DesignIn December 2022, a systematic search of Ovid Medline, OVID Embase, CINAHL, PsycInfo and Cochrane and a number of grey literature platforms were undertaken. 18 reviews were included, and subsequently 415 primary research articles were assessed for data related to assessments, interventions or outcomes. The AMSTAR (Assessing the Methodological Quality of Systematic Reviews) framework was used to assess the quality of the retained reviews.SettingReviews were retained which took place in any setting.ParticipantsThe population is children of any age with a diagnosis of SSD of unknown origin.Primary and secondary outcome measuresReviews reporting outcomes, assessment and interventions for children with SSD.ResultsExtraction and analysis identified 37 assessments, 46 interventions and 30 outcome measures used in research reporting of SSD. Not all of the listed outcomes were linked to specific outcome measurement tools, but these were measurable through the use of one or more of the assessments extracted from the retained reviews.ConclusionsThe findings of this review will be used to develop a Core Outcome Set for children with SSD. The findings are part of a rigorous process essential for advancing healthcare research and practice in the specific area of speech and language therapy for children with SSD.PROSPERO registration numberCRD42022316284.