bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with recruitment to randomised controlled trials in general practice: a systematic mixed studies review
Authors: Moffat Keith R. , Shi Wen , Cannon Paul , Sullivan Frank 
Published: February 2023

Abstract
Background
A common challenge for randomised controlled trials (RCTs) is recruiting enough participants to be adequately powered to answer the research question. Recruitment has been set as a priority research area in trials to improve recruitment and thereby reduce wasted resources in conducted trials that fail to recruit sufficiently.

Methods
We conducted a systematic mixed studies review to identify the factors associated with recruitment to RCTs in general practice. On September 8, 2020, English language studies were identified from MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and CENTRAL databases for published studies. NTIS and OpenGrey were searched for grey literature, and BMC Trials was hand searched. A narrative synthesis was conducted for qualitative studies and a thematic synthesis for qualitative studies.

Results
Thirty-seven studies met the inclusion criteria. These were of different study types (10 cross-sectional, 5 non-randomised studies of interventions, 2 RCTs, 10 qualitative and 10 mixed methods). The highest proportion was conducted in the UK (48%). The study quality was generally poor with 24 (65%) studies having major concerns. A complex combination of patient, practitioner or practice factors, and patient, practitioner or practice recruitment were assessed to determine the possible associations. There were more studies of patients than of practices or practitioners.

Conclusions
For practitioners and patients alike, a trial that is clinically relevant is critical in influencing participation. Competing demands are given as an important reason for declining participation. There are concerns about randomisation relating to its impact on shared decision-making and not knowing which treatment will be assigned. Patients make decisions about whether they are a candidate for the trial even when they objectively fulfil the eligibility criteria. General practice processes, such as difficulties arranging appointments, can hinder recruitment, and a strong pre-existing doctor-patient relationship can improve recruitment. For clinicians, the wish to contribute to the research enterprise itself is seldom an important reason for participating, though clinicians reported being motivated to participate when the research could improve their clinical practice. One of the few experimental findings was that opportunistic recruitment resulted in significantly faster recruitment compared to systematic recruitment. These factors have clear implications for trial design. Methodologically, recruitment research of practices and practitioners should have increased priority. Higher quality studies of recruitment are required to find out what actually works rather than what might work.

Trial registration
PROSPERO CRD42018100695. Registered on 03 July 2018.
The impact of parent treatment preference and other factors on recruitment: lessons learned from a paediatric epilepsy randomised controlled trial
Authors: Carter Bernie , Bray Lucy , al-Najjar Nadia , Piella Agnès Tort , Tudur-Smith Catrin , Spowart Catherine , Collingwood Amber , Crudgington Holly , Currier Janet , Hughes Dyfrig A. , Wood Eifiona , Martin Rachael , Morris Christopher , Roberts Deborah , Rouncefield-Swales Alison , Sutherland Heather , Watson Victoria , Cook Georgia , Wiggs Luci , Gringras Paul , Pal Deb 
Published: February 2023

AbstractBackgroundIn paediatric epilepsy, the evidence of effectiveness of antiseizure treatment is inconclusive for some types of epilepsy. As with other paediatric clinical trials, researchers undertaking paediatric epilepsy clinical trials face a range of challenges that may compromise external validityMain bodyIn this paper, we critically reflect upon the factors which impacted recruitment to the pilot phase of a phase IV unblinded, randomised controlled 3×2 factorial trial examining the effectiveness of two antiseizure medications (ASMs) and a sleep behaviour intervention in children with Rolandic epilepsy. We consider the processes established to support recruitment, public and patient involvement and engagement (PPIE), site induction, our oversight of recruitment targets and figures, and the actions we took to help us understand why we failed to recruit sufficient children to continue to the substantive trial phase.The key lessons learned were about parent preference, children’s involvement and collaboration in decision-making, potential and alternative trial designs, and elicitation of stated preferences pre-trial design.Despite pre-funding PPIE during the trial design phase, we failed to anticipate the scale of parental treatment preference for or against antiseizure medication (ASMs) and consequent unwillingness to be randomised. Future studies should ensure more detailed and in-depth consultation to ascertain parent and/or patient preferences.More intense engagement with parents and children exploring their ideas about treatment preferences could, perhaps, have helped predict some recruitment issues. Infrequent seizures or screening children close to natural remission were possible explanations for non-consent. It is possible some clinicians were unintentionally unable to convey clinical equipoise influencing parental decision against participation. We wanted children to be involved in decisions about trial participation. However, despite having tailored written and video information to explain the trial to children we do not know whether these materials were viewed in each consent conversation or how much input children had towards parents’ decisions to participate. Novel methods such as parent/patient preference trials and/or discrete choice experiments may be the way forward.ConclusionThe importance of diligent consultation, the consideration of novel methods such as parent/patient preference trials and/or discrete choice experiments in studies examining the effectiveness of ASMs versus no-ASMs cannot be overemphasised even in the presence of widespread clinician equipoise.
Can multisite clinical trial results change clinical practice? Use of long-acting injectable risperidone nationally in the Veterans Health Administration
Authors: Rosenheck Robert , Anand Sonia T. , Kurtz Stephen G. , Hau Cynthia , Smedberg Diane , Pontzer James F. , Ferguson Ryan E. , Davis Cynthia R. 
Published: February 2023

Abstract

Background

Multisite practical clinical trials evaluate treatments in real-world practice. A multisite randomized Veterans Health Administration (VHA) cooperative study (CSP#555) published in 2011 compared the first long-acting injectable (LAI) second-generation antipsychotic (SGA), Risperidone Consta®, in veterans with a diagnosis of schizophrenia or schizoaffective disorder, to oral antipsychotics, with unexpected null results for effectiveness and cost-effectiveness. Whether null results of this type could change VHA practice has not been studied.

Methods
A longitudinal observational analysis was used to evaluate the impact of the trial findings on VHA clinical practices. National administrative data compared new starts on LAI risperidone during the 4 years before the publication of CSP#555 in 2011 to new starts on LAI risperidone during the 4 years after.

Results
Among 119,565 Veterans with the indicated diagnoses treated with antipsychotics from 2007 to 2015, the number and proportion of new starts on LAI risperidone declined significantly following the study publication, as did the total number of annual users and drug expenditures. However, data from 2007 to 2010 showed the decline in new starts actually preceded the publication of CSP#555. This change was likely explained by the increase in new starts, total use, and expenditures on a newer medicine, LAI paliperidone, a 4-week LAI treatment, in the 2 years prior to the publication of CSP#555.

Conclusions
The declining use of LAI risperidone likely primarily reflects the substitution of a longer-acting LAI SGA, paliperidone, that came to market 2 years before the study publication, a substitution that may have been reinforced by null CSP#555 study results for LAI risperidone.
Advanced practice physiotherapy care in emergency departments for patients with musculoskeletal disorders: a pragmatic cluster randomized controlled trial and cost analysis
Authors: Matifat E. , Berger Pelletier E. , Brison R. , Hébert L. J. , Roy J.-S. , Woodhouse L. , Berthelot S. , Daoust R. , Sirois M.-J. , Booth R. , Gagnon R. , Miller J. , Tousignant-Laflamme Y. , Emond M. , Perreault K. , Desmeules F. 
Published: February 2023

Abstract
Background
Advanced practice physiotherapy (APP) models of care where physiotherapists are primary contact emergency department (ED) providers are promising models of care to improve access, alleviate physicians’ burden, and offer efficient centered patient care for patients with minor musculoskeletal disorders (MSKD).

Objectives
To compare the effectiveness of an advanced practice physiotherapist (APPT)-led model of care with usual ED physician care for persons presenting with a minor MSKD, in terms of patient-related outcomes, health care resources utilization, and health care costs.

Methods
This trial is a multicenter stepped-wedge cluster randomized controlled trial (RCT) with a cost analysis. Six Canadian EDs (clusters) will be randomized to a treatment sequence where patients will either be managed by an ED APPT or receive usual ED physician care. Seven hundred forty-four adults with a minor MSKD will be recruited. The main outcome measure will be the Brief Pain Inventory Questionnaire. Secondary measures will include validated self-reported disability questionnaires, the EQ-5D-5L, and other health care utilization outcomes such as prescription of imaging tests and medication. Adverse events and re-visits to the ED for the same complaint will also be monitored. Health care costs will be measured from the perspective of the public health care system using time-driven activity-based costing. Outcomes will be collected at inclusion, at ED discharge, and at 4, 12, and 26 weeks following the initial ED visit. Per-protocol and intention-to-treat analyses will be performed using linear mixed models with a random effect for cluster and fixed effect for time.

Discussion
MSKD have a significant impact on health care systems. By providing innovative efficient pathways to access care, APP models of care could help relieve pressure in EDs while providing efficient care for adults with MSKD.

Trial registration
ClinicalTrials.govNCT05545917. Registered on September 19, 2022
Internet-based self-help intervention for procrastination: randomized control group trial protocol
Authors: Zhou Ying , Wang Jianhua 
Published: February 2023

Abstract
Background
Procrastination or “postponing until later” is a common phenomenon defined as the intentional delay in partaking in and finishing important activities despite negative outcomes potentially outweighing the positive. Procrastination adversely affects mental health, academic performance, and career achievement. Although studies on procrastination intervention methods and effectiveness exist, utility and cost-effectiveness are limited by various factors, including practitioner availability and skills, barriers to participant participation, and the time investment required by participants. Thus, internet-based interventions could increase the availability of evidence-based treatments for adult procrastination.

Methods
This study explored the efficacy of an online-based self-help intervention in the context of voluntary procrastination among undergraduate psychology students. The study design is a randomized controlled trial. Participants who self-reported procrastination-related problems and behaviours were included in the trial consisting of two groups; specifically, one group undergoing a self-directed internet-based intervention for coping with procrastination (N=160) and (2) another group with delayed access to the intervention programmes (waitlist control group; N=160). Follow-up assessments were scheduled 6 and 12 weeks after baseline, and the control group received the intervention after 12 weeks. Procrastination, measured by the Irrational Procrastination Scale and the Simple Procrastination Scale, was examined as the primary outcome. Meanwhile, secondary outcomes included susceptibility, stress, depression, anxiety, well-being, self-efficacy, time management strategies, self-control, cognition, and emotion regulation. Other measures comprised acceptability (e.g., intervention satisfaction, potential side effects, and expectations) and learning behaviour analysis to reflect adherence.

Discussion
This randomized controlled trial will provide data on the effectiveness of online interventions for adult procrastination. If deemed effective, this low-cost, high-coverage internet-based intervention could aid more people who seek to address their procrastination.

Trial registration
Chinese Clinical Trial Registry. https://www.chictr.org.cn/showproj.aspx?proj=171246.
Zoonotic parasites associated with predation by dogs and cats
Authors: Mendoza Roldan Jairo Alfonso , Otranto Domenico 
Published: February 2023

AbstractOne of the most common behaviors of cats that have an indoor/outdoor lifestyle is to bring hunted “gifts” to their owners, represented by small mammals, reptiles and birds. Access to the outdoors by dogs and cats may represent a problematic issue, since they may be at risk of diseases, traffic accidents and ingestion of toxins. Yet, the impact of this population of roaming dogs and cats predating wildlife is another concerning issue that receives less attention. Despite these risks, most owners still prefer to give outdoor access to their pets to allow them to express their “natural instincts,” such as hunting. Therefore, with a growing population of > 470 million dogs and 373 million cats worldwide, predation not only represents a threat to wildlife, but also a door of transmission for parasitic diseases, some of them of zoonotic concern. In this review, the role played by dogs, and especially cats, in the perpetuation of the biological life cycle of zoonotic parasites through the predation of rodents, reptiles and birds is discussed. Feral and domestics dogs and cats have contributed to the population collapse or extinction of > 63 species of reptiles, mammals and birds. Although the ecological impact of predation on wild populations is well documented, the zoonotic risk of transmission of parasitic diseases has not received significant attention. The parasitic diseases associated to predation vary from protozoan agents, such as toxoplasmosis, to cestodes like sparganosis and even nematodes such as toxocariasis. Raising awareness about predation as a risk of zoonotic parasitic infections in dogs and cats will aid to create responsible ownership and proper actions for controlling feral and free-roaming cat and dog populations worldwide.Graphical Abstract
High-intensity circuit training change serum myostatin but not myogenin in adolescents’ soccer players: a quasi-experimental study
Authors: Ziyaiyan Amirhosein , Kordi Mohammadreza , Hofmeister Martin , Chamari Karim , Moalla Wassim , Gaeini Abbas Ali 
Published: February 2023

AbstractBackgroundSkeletal muscle contractions due to exercise lead to the secretion of many proteins and proteoglycan peptides called myokines. Myostatin (MSTN) and Myogenin (MyoG) are two of the most important skeletal muscle growth regulatory factors related to myoblast differentiation and muscle hypertrophy. The present study aims at investigating the effects over eight weeks of high-intensity circuit training (HICT) on serum MyoG and MSTN in male soccer players.MethodThe present study is a quasi-experimental study on 21 male soccer players (Experimental group: n = 11, Control group: n = 10) (ages 15.0 ± 3.4 years, body mass 55.7 ± 7.8 kg, height 173.3 ± 8.0 cm, Body mass index 18.4 ± 1.9 kg m−2, maximum oxygen uptake 61.89 ± 3.01 ml kg−1and the peak height velocity 14.5 ± 0.3 years). Participants were randomly divided into two groups: training group and a control group. The first resting blood samples were obtained in the morning-fasting state, and the second blood samples were obtained after the maximum aerobic test at pre- and post-HICT.ResultsThere were non-significant differences in resting serum values of MyoG (p = 0.309,p > 0.05) but significant differences in resting serum values of MSTN between the training and control groups after eight weeks of HICT (p = 0.003,p < 0.05). No significant differences were observed between groups in the acute response of serum values of MyoG (p = 0.413,p < 0.05) and MSTN (p = 0.465,p < 0.05) to the maximum aerobic test after eight weeks of HICT.ConclusionThese results suggest that eight weeks of HICT can decrease the resting serum values of MSTN but not change the resting serum values of MyoG in male adolescent soccer players. Also, eight weeks of HICT does not affect the acute response of MSTN and MyoG after a maximum aerobic test.
The use of low-value imaging: the role of referral practice and access to imaging services in a representative area of Norway
Authors: Andersen Eivind Richter , Brandsæter Ingrid Øfsti , Hofmann Bjørn Morten , Kjelle Elin 
Published: February 2023

Abstract
Background
Even though imaging is essential to modern medicine, some examinations are of low value as they do not lead to any change in the management of the patient. The Choosing Wisely (CW) campaign aims to reduce the use of such services. In the Norwegian version of CW, specific magnetic resonance imaging (MRI) of the head, lower back, and knee are amongst others identified as potential low-value examinations. However, referral practice and access to imaging may drive low-value utilisation. By using registry data from 2019 and descriptive analysis, this study aimed to examine the role of referral practice and access to imaging on the use of specific CW-examinations in one representative area in Norway.

Results
A total of 237,554 examinations were performed by four public and two private imaging facilities located within the area. Forty-two percent (19,210/45,289) of all MRI examinations were related to CW. Private imaging centres performed most of the CW-imaging. A total of 3700 referrers were identified, and 2.3% were identified as “high-referrers,” accounting for 33% of all CW-examinations. Referrers’ experience did not influence imaging utilisation. A subset of referrers (“super-referrers,” 0.5%) accounted for 10% of CW-examinations. Distance to service had no impact on the use of CW-examinations.

Conclusions
This study provides valuable insight into the use of imaging and referral practice in one representative area in Norway. A great variation in referral practice was observed. Therefore, targeting referrers with high referral rates may be a promising strategy for reducing the use of low-value imaging.
The oxidative balance and stopover departure decisions in a medium- and a long-distance migrant
Authors: Eikenaar Cas , Ostolani Alessia , Brust Vera , Karwinkel Thiemo , Schmaljohann Heiko , Isaksson Caroline 
Published: February 2023

Abstract
Background
Birds have extremely elevated metabolic rates during migratory endurance flight and consequently can become physiologically exhausted. One feature of exhaustion is oxidative damage, which occurs when the antioxidant defense system is overwhelmed by the production of damaging reactive oxygen species (ROS). Migrating birds have been shown to decrease the amount of oxidative lipid damage during stopovers, relatively stationary periods in between migratory flights. It has therefore been argued that, in addition to accumulating fuel, one of the functions of stopover is to restore the oxidative balance. If this is so, we would expect that migrating birds are unlikely to resume migration from stopover when they still have high amounts of lipid damage.

Methods
To test this hypothesis, we measured parameters of the oxidative balance and related these to stopover departure decisions of song thrushes (Turdus philomelos) and northern wheatears (Oenanthe oenanthe), a medium- and long-distance songbird migrant, respectively. We measured malondialdehyde (MDA) concentration, a biomarker for oxidative lipid damage, and total non-enzymatic antioxidant capacity (AOX), an overall biomarker of protection against ROS. Stopover departure decisions were determined using a fully automated telemetry system set-up on our small island study site.

Results
The decision to resume migration was not related with MDA concentration in either study species, also not when this was corrected for circulating fatty acid concentrations. Similarly, AOX did not affect this decision, also not when corrected for uric-acid concentration. The time within the night when birds departed also was not affected by MDA concentration or AOX. However, confirming earlier observations, we found that in both species, fat individuals were more likely to depart than lean individuals, and fat northern wheatears departed earlier within the night than lean conspecifics. Northern wheatears additionally departed earlier in spring with more southerly winds.

Conclusions
We found no support for the idea that stopovers departure decisions are influenced by parameters of the oxidative balance. We discuss possible reasons for this unexpected finding.
Constraints in employing learning-oriented assessment in EFL classrooms: teachers’ perceptions
Authors: Jalilzadeh Kaveh , Coombe Christine 
Published: February 2023

AbstractLearning-oriented assessment has been called a practice that can be employed to increase the power of assessment practices in the classroom and one that has been said to promote efficient student learning. However, it is not always easy to employ learning-oriented assessment in English classes, because of a number of constraints. This study aimed at investigating the constraints which hinder teachers’ use of learning-oriented assessment in EFL classes. A phenomenological research method was used to explore the constraints associated with learning-oriented assessment. EFL teachers were selected through purposive sampling. The interviews were thematically coded into three main categories: teacher-related, institute-related, and learner-related constraints. It can be inferred that coordination among the different components of the curriculum is a necessary step that teachers need to take before attempting to employ LOA principles in their classes. Findings are theoretically and practically significant to EFL teachers and teacher educators as assessment instructors.