bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of modern contraceptive discontinuation and associated factors among married reproductive age group women in Debre Berhan town, Ethiopia: a community-based cross-sectional study
Authors: Ayele Siraye Genzeb , Mekonnen Baze , Deribe Leul , Tsige Abate Wondesen 
Published: April 2024

ObjectiveTo assess the prevalence of modern contraceptive discontinuation and associated factors among married reproductive age (15–49 years) group women.Study design, setting and participantsA community-based cross-sectional study was conducted in Debre Berhan town among 500 reproductive age group women. Study participants were selected using two-stage sampling procedures. Data were collected using a semistructured face-to-face interview questionnaire. The data were entered in EpiData V.4.2.0 and then exported to SPSS V.25 software for data analysis. Descriptive statistics such as mean, per cent and frequency were used to summarise women’s characteristics. Binary logistic regression analysis was used to identify predictors’ variables with modern contraceptive discontinuation and p<0.05 was used to declare association.ResultsThe prevalence of modern contraceptive discontinuation among married reproductive age group women was 35.2% with a mean duration of use of 2.6±2.1 months. This study also revealed that the discontinuation rate was 12.6% within the first year of use. In the current study, those living with their husband (adjusted OR (AOR)=3.81, p<0.001), experiencing side effects while using modern contraceptives (AOR=2.45, p=0.02), getting counselling service (AOR=5.51, p<0.001) and respondent husband acceptance of her modern contraceptive use (AOR=3.85, p=0.01) were significantly associated with modern contraceptive discontinuation.ConclusionThe findings of this study showed that the prevalence of modern contraceptive discontinuation rate of all methods among married reproductive age group women was 35.2%. To reduce modern contraceptive discontinuation, mutually, it is important to create community awareness about the importance of the continued use of modern contraceptives, improve the quality of family planning service in the health institution, strengthen family planning counselling service and give adequate counselling on details of effectiveness and side effects.
Trade-offs between overall survival and side effects in the treatment of metastatic breast cancer: eliciting preferences of patients with primary and metastatic breast cancer using a discrete choice experiment
Authors: Bullen Alistair , Ryan Mandy , Ennis Holly , Gray Ewan , Loría-Rebolledo Luis Enrique , McIntyre Morag , Hall Peter 
Published: April 2024

ObjectivesThere has been a recent proliferation in treatment options for patients with metastatic breast cancer. Such treatments often involve trade-offs between overall survival and side effects. Our study aims to estimate the trade-offs that could be used to inform decision-making at the individual and policy level.DesignWe designed a discrete choice experiment (DCE) to look at preferences for avoiding severity levels of side effects when choosing treatment for metastatic breast cancer. Treatment attributes were: fatigue, nausea, diarrhoea, other side effects (peripheral neuropathy, hand–foot syndrome and mucositis) and urgent hospital admission and overall survival. Responses were analysed using an error component logit model. We estimated the relative importance of attributes and minimum acceptable survival for improvements in side effects.SettingThe DCE was completed online by UK residents with self-reported diagnoses of breast cancer.Participants105 respondents participated, of which 72 patients had metastatic breast cancer and 33 patients had primary breast cancer.ResultsOverall survival had the largest relative importance, followed by other side effects, diarrhoea, nausea and fatigue. The risk of urgent hospital admission was not significant. While overall survival was the most important attribute, respondents were willing to forgo some absolute probability of overall survival for reductions in all Grade 2 side effects (12.02% for hand–foot syndrome, 11.01% for mucositis, 10.42% for peripheral neuropathy, 6.33% for diarrhoea and 3.62% for nausea). Grade 1 side effects were not significant, suggesting respondents have a general tolerance for them.ConclusionsPatients are willing to forgo overall survival to avoid particular severity levels of side effects. Our results have implications for data collected in research studies and can help inform person-centred care and shared decision-making.
Healthcare and economic cost burden of emergency medical services treated non-traumatic shock using a population-based cohort in Victoria, Australia
Authors: Bloom Jason E , Nehme Emily , Paratz Elizabeth Davida , Dawson Luke , Nelson Adam J , Ball Jocasta , Eliakundu Amminadab , Voskoboinik Aleksandr , Anderson David , Bernard Stephen , Burrell Aidan , Udy Andrew A , Pilcher David , Cox Shelley , Chan William , Mihalopoulos Cathrine , Kaye David , Nehme Ziad , Stub Dion 
Published: April 2024

ObjectivesWe aimed to assess the healthcare costs and impact on the economy at large arising from emergency medical services (EMS) treated non-traumatic shock.DesignWe conducted a population-based cohort study, where EMS-treated patients were individually linked to hospital-wide and state-wide administrative datasets. Direct healthcare costs (Australian dollars, AUD) were estimated for each element of care using a casemix funding method. The impact on productivity was assessed using a Markov state-transition model with a 3-year horizon.SettingPatients older than 18 years of age with shock not related to trauma who received care by EMS (1 January 2015–30 June 2019) in Victoria, Australia were included in the analysis.Primary and secondary outcome measuresThe primary outcome assessed was the total healthcare expenditure. Secondary outcomes included healthcare expenditure stratified by shock aetiology, years of life lived (YLL), productivity-adjusted life-years (PALYs) and productivity losses.ResultsA total of 21 334 patients (mean age 65.9 (±19.1) years, and 9641 (45.2%) females were treated by EMS with non-traumatic shock with an average healthcare-related cost of $A11 031 per episode of care and total cost of $A280 million. Annual costs remained stable throughout the study period, but average costs per episode of care increased (Ptrend=0.05). Among patients who survived to hospital, the average cost per episode of care was stratified by aetiology with cardiogenic shock costing $A24 382, $A21 254 for septic shock, $A19 915 for hypovolaemic shock and $A28 057 for obstructive shock. Modelling demonstrated that over a 3-year horizon the cohort lost 24 355 YLLs and 5059 PALYs. Lost human capital due to premature mortality led to productivity-related losses of $A374 million. When extrapolated to the entire Australian population, productivity losses approached $A1.5 billion ($A326 million annually).ConclusionThe direct healthcare costs and indirect loss of productivity among patients with non-traumatic shock are high. Targeted public health measures that seek to reduce the incidence of shock and improve systems of care are needed to reduce the financial burden of this syndrome.
Recovery duration and concussion severity in sport- and non-sport-related concussion among Pac-12 collegiate athletes: a retrospective cohort study
Authors: Konstantinides Niki , Geraghty Elisabeth , Harmon Kimberly , Whelan Bridget M , Poddar Sourav K , Bohr Adam 
Published: April 2024

ObjectivesTo examine non-sport- and sport-related concussion severity, clinical care frequency and delayed reporting in relation to recovery duration among collegiate athletes.DesignRetrospective cohort study.SettingPac-12 varsity collegiate athletes.Participants461 collegiate male and female athletesPrimary and secondary outcome measuresThe incidence of sport-related concussion (SRC) and non-sport-related concussion (NRC) were collected as well as times to recovery and return-to-play (RTP), symptom score and symptom severity and reported a loss of consciousness (LOC), retrograde amnesia (RGA) and post-traumatic amnesia (PTA) following concussion incidence.ResultsAmong 461 concussions, 388 (84%) occurred within sport and 73 (16%) occurred outside of sport. NRC, on average, required 3.5 more days to become asymptomatic (HR: 0.73, 95%confidence interval: 0.56 to 0.96, p=0.02) and 7 more days to RTP (HR: 0.64, 95% confidence interval: 0.49 to 0.85, p<0.01) compared with SRC. NRC were associated with an increase of 1.83 (p=0.07) symptoms reported at the time of diagnosis, an increase of 6.95 (p=0.06) in symptom severity and a higher prevalence of reported LOC (22% NRC vs. 3% SRC, p<0.001), PTA (15% NRC vs. 5% SRC, p<0.01) and RGA (10% NRC vs. 4% SRC, p=0.06), compared with SRC. There was no significant difference in clinical care (p=0.28) or immediate reporting (p=0.35) between NRC and SRC.ConclusionNRC were associated with greater severity and longer recovery duration when compared with SRC in a cohort of collegiate athletes.
Inequalities in birth before arrival at hospital in South West England: a multimethods study of neonatal hypothermia and emergency medical services call-handler advice
Authors: Goodwin Laura , Kirby Kim , McClelland Graham , Beach Emily , Bedson Adam , Benger Jonathan Richard , Deave Toity , Osborne Ria , McAdam Helen , McKeon-Carter Roisin , Miller Nick , Taylor Hazel , Voss Sarah 
Published: April 2024

ObjectivesTo examine inequalities in birth before arrival (BBA) at hospitals in South West England, understand which groups are most likely to experience BBA and how this relates to hypothermia and outcomes (phase A). To investigate opportunities to improve temperature management advice given by emergency medical services (EMS) call-handlers during emergency calls regarding BBA in the UK (phase B).DesignA two-phase multimethod study. Phase A analysed anonymised data from hospital neonatal records between January 2018 and January 2021. Phase B analysed anonymised EMS call transcripts, followed by focus groups with National Health Service (NHS) staff and patients.SettingSix Hospital Trusts in South West England and two EMS providers (ambulance services) in South West and North East England.Participants18 multidisciplinary NHS staff and 22 members of the public who had experienced BBA in the UK.Results35% (64/184) of babies conveyed to hospital were hypothermic on arrival. When compared with national data on all births in the South West, we found higher percentages of women with documented safeguarding concerns at booking, previous live births and ‘late bookers’ (booking their pregnancy >13 weeks gestation). These women may, therefore, be more likely to experience BBA. Preterm babies, babies to first-time mothers and babies born to mothers with disability or safeguarding concerns at booking were more likely to be hypothermic following BBA. Five main themes emerged from qualitative data on call-handler advice: (1) importance placed on neonatal temperature; (2) advice on where the baby should be placed following birth; (3) advice on how to keep the baby warm; (4) timing of temperature management advice and (5) clarity and priority of instructions.ConclusionsFindings identified factors associated with BBA and neonatal hypothermia following BBA. Improvements to EMS call-handler advice could reduce the number of babies arriving at hospital hypothermic.
Liver fat as a dietary target by Chinese Medical Nutrition Therapy (CMNT) diet for treating type 2 diabetes with non-alcoholic fatty liver disease: study protocol for a randomised controlled trial
Authors: Luo Wu , Xiao Zhiyong , Yang Xiao , Wu Ruiyu , Li Jian , Yu Zhen , Guo Shengxiang , Nie Beibei , Liu Dongbo 
Published: April 2024

IntroductionType 2 diabetes and non-alcoholic fatty liver disease (NAFLD) often coexist and increase risk for developing liver fibrosis and diabetes complications if no effective measures are taken. Dietary intervention is known to be able to achieve diabetes remission, while evidence regarding the long-term effect on liver fat is limited for comorbidity management of type 2 diabetes and NAFLD. This study aims to investigate the long-term effect of a Chinese Medical Nutrition Therapy (CMNT) diet accompanied by intermittent energy restriction on reducing liver fat and glycated haemoglobin (HbA1c) in patients with type 2 diabetes and NAFLD.Methods and analysisThis is a multicentre two-armed parallel randomised controlled trial study. 120 participants with type 2 diabetes and NAFLD will be recruited from the physical examination centres of multiple hospitals in China. Participants will be randomly allocated 1:1 to either the CMNT group or the usual care group. The CMNT group will be instructed to consume the provided specific meal replacement Chinese medicinal foods consisting of 6 cycles of 5 consecutive days followed by 10 days of regular food intake. The usual care group will be given standard dietary advice. Primary outcomes are changes in the controlled attenuation parameter value by transient elastography and HbA1c level. Secondary outcomes include differences in anthropometrics, clinical blood markers, questionnaires, gut microbiota and metabolomics. Further follow-up will be performed at 6 months, 1 year and 2 years.Ethics and disseminationThe study protocol was approved by the Biomedical Research Ethics Committee of Hunan Agricultural University (BRECHAU20200235).The results will be disseminated via relevant peer-reviewed publications and conference presentations.Trial registration numberNCT05439226.
Clinician and parent views on urine collection in precontinent children in the UK: a qualitative interview study
Authors: Armengol Monica , Hayward Gail , Abbott Molly Grace , Bird Chris , Bergmann Jeroen H M , Glogowska Margaret 
Published: April 2024

ObjectiveTo explore the experiences of healthcare professionals (HCPs) and parents of urine collection methods, to identify barriers to successful sampling and what could improve the process.DesignQualitative research, using individual semistructured interviews with HCPs and parents. The interviews were audiorecorded, transcribed and thematically analysed.SettingUK-based HCPs from primary and secondary care settings and parents with experience with urine collection in primary and/or secondary care settings.ParticipantsHCPs who were involved in aiding, supervising or ordering urine samples. Parents who had experience with urine collection in at least one precontinent child.Results13 HCPs and 16 parents were interviewed. 2 participating HCPs were general practitioners (GPs), 11 worked in paediatric secondary care settings (8 were nurses and 3 were doctors). Two parents had children with underlying conditions where frequent urine collection was required to rule out infections.HCPs and parents reported that there were no straightforward methods of urine collection for precontinent children. Each method—‘clean catch’, urine bag and urine pad—had limitations and problems with usage. ‘Clean catch’, regarded as the gold standard by HCPs with a lower risk of contamination, often proved difficult for parents to achieve. Other methods had elevated risk of contamination but were more acceptable to parents because they were less challenging. Many of the parents expressed the need for more information about urine collection.ConclusionsCurrent methods of urine collection are challenging to use and may be prone to contamination. A new device is required to assist with urine collection in precontinent children, to simplify and reduce the stress of the situation for those involved. Parents are key partners in the process of urine collection with young children. Meeting their expressed need for more information could be an important way to achieve better-quality samples while awaiting a new device.
Work engagement of psychiatric nurses: a scoping review
Authors: Mukaihata Tsuyoshi , Kato Yuichi , Swa Toshiyuki , Fujimoto Hirokazu 
Published: April 2024

ObjectivesWork engagement is an essential factor in improving employee performance. However, no reviews on the work engagement of psychiatric nurses have been conducted to date. This study aimed to examine the current status of research on the work engagement of psychiatric nurses and identify salient factors.DesignA scoping review.MethodsThis review adhered to the established scoping review methodological guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist. The inclusion criteria were based on nurses, work engagement and psychiatric settings without language or date restrictions. Regardless of the methodology or study design, research studies related to the work engagement of psychiatric nurses have been included. A systematic search was conducted in MEDLINE, CINAHL and PsycINFO from the inception of each database, with the search strategies being set by an information specialist. The deadline for the search was 15 February 2023.ResultsThe study included 12 studies. All studies have been published since 2013. The study designs included cross-sectional (n=10), longitudinal (n=1) and intervention (n=1) studies. The impacts of work engagement were classified into (1) attitudes towards patients, (2) attitudes towards work, (3) mental health and (4) quality of care. Factors influencing work engagement were classified into (1) demographics, (2) workplace factors, (3) individual factors and (4) patient factors.ConclusionWork engagement of psychiatric nurses has lately gained attention, although data are limited because most studies used a cross-sectional design. Psychiatric nurses with higher work engagement showed positive outcomes. Workplace and individual factors can potentially improve their work engagement. The findings can assist nursing managers in enhancing psychiatric nurses’ work engagement and, consequently, their performance.
SUPRAMAX-study: supramaximal resection versus maximal resection for glioblastoma patients: study protocol for an international multicentre prospective cohort study (ENCRAM 2201)
Authors: Gerritsen Jasper Kees Wim , Young Jacob S , Chang Susan M , Krieg Sandro M , Jungk Christine , van den Bent Martin J , Satoer Djaina D , Ille Sebastian , Schucht Philippe , Nahed Brian V , Broekman Marike Lianne Daphne , Berger Mitchel , De Vleeschouwer Steven , Vincent Arnaud J P E 
Published: April 2024

IntroductionA greater extent of resection of the contrast-enhancing (CE) tumour part has been associated with improved outcomes in glioblastoma. Recent results suggest that resection of the non-contrast-enhancing (NCE) part might yield even better survival outcomes (supramaximal resection, SMR). Therefore, this study evaluates the efficacy and safety of SMR with and without mapping techniques in high-grade glioma (HGG) patients in terms of survival, functional, neurological, cognitive and quality of life outcomes. Furthermore, it evaluates which patients benefit the most from SMR, and how they could be identified preoperatively.Methods and analysisThis study is an international, multicentre, prospective, two-arm cohort study of observational nature. Consecutive glioblastoma patients will be operated with SMR or maximal resection at a 1:1 ratio. Primary endpoints are (1) overall survival and (2) proportion of patients with National Institute of Health Stroke Scale deterioration at 6 weeks, 3 months and 6 months postoperatively. Secondary endpoints are (1) residual CE and NCE tumour volume on postoperative T1-contrast and FLAIR (Fluid-attenuated inversion recovery) MRI scans; (2) progression-free survival; (3) receipt of adjuvant therapy with chemotherapy and radiotherapy; and (4) quality of life at 6 weeks, 3 months and 6 months postoperatively. The total duration of the study is 5 years. Patient inclusion is 4 years, follow-up is 1 year.Ethics and disseminationThe study has been approved by the Medical Ethics Committee (METC Zuid-West Holland/Erasmus Medical Center; MEC-2020-0812). The results will be published in peer-reviewed academic journals and disseminated to patient organisations and media.
Impact of lens autofluorescence and opacification on retinal imaging
Authors: von der Emde Leon , Rennen Geena C , Vaisband Marc , Hasenauer Jan , Liegl Raffael , Fleckenstein Monika , Pfau Maximilian , Holz Frank G , Ach Thomas 
Published: April 2024

BackgroundRetinal imaging, including fundus autofluorescence (FAF), strongly depends on the clearness of the optical media. Lens status is crucial since the ageing lens has both light-blocking and autofluorescence (AF) properties that distort image analysis. Here, we report both lens opacification and AF metrics and the effect on automated image quality assessment.Methods227 subjects (range: 19–89 years old) received quantitative AF of the lens (LQAF), Scheimpflug, anterior chamber optical coherence tomography as well as blue/green FAF (BAF/GAF), and infrared (IR) imaging. LQAF values, the Pentacam Nucleus Staging score and the relative lens reflectivity were extracted to estimate lens opacification. Mean opinion scores of FAF and IR image quality were compiled by medical readers. A regression model for predicting image quality was developed using a convolutional neural network (CNN). Correlation analysis was conducted to assess the association of lens scores, with retinal image quality derived from human or CNN annotations.ResultsRetinal image quality was generally high across all imaging modalities (IR (8.25±1.99) >GAF >BAF (6.6±3.13)). CNN image quality prediction was excellent (average mean absolute error (MAE) 0.9). Predictions were comparable to human grading. Overall, LQAF showed the highest correlation with image quality grading criteria for all imaging modalities (eg, Pearson correlation±CI −0.35 (−0.50 to 0.18) for BAF/LQAF). BAF image quality was most vulnerable to an increase in lenticular metrics, while IR (−0.19 (−0.38 to 0.01)) demonstrated the highest resilience.ConclusionThe use of CNN-based retinal image quality assessment achieved excellent results. The study highlights the vulnerability of BAF to lenticular remodelling. These results can aid in the development of cut-off values for clinical studies, ensuring reliable data collection for the monitoring of retinal diseases.