bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of in-shoe plantar pressure and shear during walking for diabetic foot ulcer prevention
Authors: Tang Jinghua , Bader Dan L , Parker Daniel J , Forghany Saeed , Nester Christopher J , Moser David , Jiang Liudi 
Published: September 2023

Objective: To investigate reliability and changes of in-shoe plantar pressure and shear during walking at three cadences with two insole designs. This was a precursor to the investigation of plantar loading in people with diabetes for potential foot ulcer prevention. Method: A sensorised insole system, capable of measuring plantar pressure and shear at the heel, fifth metatarsal head (5MH), first metatarsal head (1MH) and hallux, was tested with ten healthy participants during level walking. Reliability was evaluated, using intra-class correlation coefficient (ICC), while varying the cadences and insole types. Percentage changes in pressure and shear relative to values obtained at self-selected cadence with a flat insole design were investigated. Results: Mean±standard deviation of maximum pressure, medial–lateral and anterior–posterior shear of up to 380±24kPa, 46±2kPa and –71±4kPa, respectively, were measured. The ICC in ranges of 0.762–0.973, 0.758–0.987 and 0.800–0.980 were obtained for pressure, anterior–posterior and medial–lateral shear, respectively. Opposite anterior–posterior shear directions between 5MH and 1MH (stretching), and between 1MH and hallux (pinching) were observed for some participants. Increasing cadence increased pressure and anterior–posterior shear (by up to +77%) but reduced medial–lateral shear at the heel and hallux (by up to –34%). Slower cadence increased anterior–posterior shear (+114%) but decreased medial–lateral shear (–46%) at the hallux. The use of a flexible contoured insole resulted in pressure reduction at the heel and 5MH but an increase in anterior–posterior shear at the heel (+69%) and hallux (+75%). Conclusion: The insole system demonstrated good reliability and is comparable to reported pressure-only systems. Pressure measurements were sensitive to changes in cadence and insole designs in ways that were consistent with the literature. However, our plantar shear showed localised shear changes with cadences and insoles for the first time, as well as stretching and pinching effects on plantar tissue. This opens new possibilities to investigate plantar tissue viability, loading characteristics and orthotic designs aimed towards foot ulcer prevention.
Predictors of obesity among school-age children in Debre Berhan City, Ethiopia
Authors: Ayele Abebe Nigussie , Mekonen Alemayehu Gonie , Seid AbdulWahhab , Mitikie Esubalew Guday , Abayneh Abrham Demis , Haile Mitiku Tefera 
Published: September 2023

Background
Obesity causes a serious diet-related chronic disease, including type-2 diabetes, cardiovascular disease, hypertension, osteoarthritis, and certain forms of cancer. In Sub- Saharan Africa including Ethiopia, most nutritional interventions mainly focused on a child undernutrition and ignored the impacts of obesity among children. In Ethiopia, the magnitude and associated factors of obesity among school-age children were not clearly described. Therefore this study assesses the predictors of obesity among school- age children in Debre Berhan City, Ethiopia, 2022.

Methods
A cross-sectional study design was conducted from June to July, 2022. Participants were selected by using multistage sampling method. Data were collected using pre-tested and structured questions. Data were coded and entered in Epi-data version 4.6 and exported and analyzed using SPSS version 25.

Result
A total of 600 children were participating in the study. The prevalence of obesity was 10.7% (95% CI: 8.3, 13.2). In this study, attending at private school (AOR = 4.24, 95% CI: 1.58, 11.32), children aged between 10-12years (AOR = 2.67, 95% CI: 1.30, 5.48), soft drink available in home (AOR = 2.27, 95% CI: 1.25,18.13), Loneliness (AOR = 1.67 95% CI: 1.12, 3.15) and mothers with occupational status of daily labour (AOR = 8.54 95% CI: 1.12, 65.39) were significantly associated with childhood obesity.

Conclusion
In this study, the overall magnitude of childhood obesity was (10.7%) which means one in eleven children and relatively high as compare to the EDHS survey. Therefore, more attention should be given to strengthening physical activities, providing nutritional education, and creating community awareness about healthy diets as well as other preventive measures.
A realist review of health passports for Autistic adults
Authors: Ellis Rebecca , Williams Kathryn , Brown Amy , Healer Eleanor , Grant Aimee 
Published: September 2023

Background
Autism is a normal part of cognitive diversity, resulting in communication and sensory processing differences, which can become disabling in a neurotypical world. Autistic people have an increased likelihood of physical and mental co-occurring conditions and die earlier than neurotypical peers. Inaccessible healthcare may contribute to this. Autism Health Passports (AHPs) are paper-based or digital tools which can be used to describe healthcare accessibility needs; they are recommended in UK clinical guidance. However, questions remained as to the theoretical underpinnings and effectiveness of AHPs.

Methods
We undertook a systematic literature search identifying studies focused on AHPs for adults (aged over 16 years) from five databases. Included literature was subjected to realist evaluation. Data were extracted using a standardised form, developed by the research team, which considered research design, study quality for realist review and the Context, Mechanisms and Outcomes (CMOs) associated with each AHP tool.

Findings
162 unique records were identified, and 13 items were included in the review. Only one item was considered high quality. Contextual factors focused on the inaccessibility of healthcare to Autistic patients and staff lack of confidence and training in supporting Autistic needs. Interventions were heterogeneous, with most sources reporting few details as to how they had been developed. The most frequently included contents were communication preferences. Mechanisms were often not stated or were inferred by the reviewers and lacked specificity. Outcomes were included in four studies and were primarily focused on AHP uptake, rather than Outcomes which measured impact.

Conclusion
There is insufficient evidence to conclude that AHPs reduce the health inequalities experienced by Autistic people. Using an AHP tool alone in a healthcare Context that does not meet Autistic needs, without the inclusion of the local Autistic community developing the tool, and a wider intervention to reduce known barriers to health inequality, may mean that AHPs do not trigger any Mechanisms, and thus cannot affect Outcomes.
Sexually transmitted infection knowledge among men who have sex with men in Nairobi, Kenya
Authors: Nyasani Delvin Kwamboka , Ondora Onyambu Meshack , Lunani Laura Lusike , Ombati Geoffrey Oino , Mutisya Elizabeth Mueni , Mutua Gaundensia Nzembi , Price Matt. A. , Osero Justus Osano 
Published: September 2023

BackgroundHigh rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, but there is little research on their STI knowledge. Our study sought to determine participants’ characteristics that contribute to either high or low STI knowledge among MSM in Nairobi, Kenya.MethodsWe mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding of STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as “low” and “high”, by splitting the group at <12 and ≥12 which was the mean.ResultsA total of 404 participants were interviewed between March and August 2020. The mean age was 25.2 (SD = 6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being versatile, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had multiple sexual partners. Participants scored an average of 12.2, SD 4.5. Multivariable backward elimination logistic regression revealed that participants who had tertiary education (aOR = 0.50, 95% CI 0.32–0.77), a higher income (aOR = 0.40, 95% CI 0.22–0.75) and were engaging in vaginal sex (aOR = 1.86, 95% CI 1.25–2.78) predicted significantly higher odds of high knowledge in the final multivariable model.ConclusionParticipant’s knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs.
The efficacy of inspiratory muscle training in patients with coronary artery disease: Protocol for a systematic review and meta-analysis
Authors: Kadoya Yoshito , Balamane Saad , Visintini Sarah , Chow Benjamin 
Published: September 2023

Background
Inspiratory muscle training (IMT) has been recognized as an effective form of training in patients with cardiovascular disease and heart failure. However, little is known about the efficacy of IMT in the treatment of patients with coronary artery disease (CAD). The aim of this systematic review will be to evaluate randomized controlled studies to understand the effect of IMT on CAD patients.

Method
We will include randomized controlled trials evaluating the efficacy of IMT in patients 18 years and older diagnosed with CAD. Crossover trials, cluster-randomized, quasi-randomized, and non-randomized trials will be excluded. Study search will be conducted in major databases (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and PEDro). The study intervention will be IMT independent of the duration, frequency, or intensity of training. The primary outcome will be quality of life, patient-reported health status, and all adverse events related to IMT. Secondary outcomes will include exercise capacity and respiratory muscle strength. The risk of bias will be evaluated based on the Cochrane Risk of Bias tool. Screening, data extraction, and quality assessment will be performed by two independent reviewers. If two or more studies are considered to be clinically homogeneous, a meta-analysis based on the random-effects model will be performed. The quality of evidence will be evaluated based on the GRADE approach.

Conclusion
This systematic review will improve our understanding of the effects of IMT on CAD patients and potentially establish IMT as an alternative form of exercise training for the treatment of CAD.

Trial registration
Study registration. OSF registries (https://osf.io/3ch7m). Date registered: May 10, 2022. Registration DOI: https://doi.org/10.17605/OSF.IO/GVMY7.
Examination of ELISA against PCR for assessing treatment efficacy against Cryptosporidium in a clinical trial context
Authors: Nyirenda James T. , Henrion Marc Y. R. , Nyasulu Vita , Msakwiza Mike , Nedi Wilfred , Thole Herbert , Phulusa Jacob , Toto Neema , Jere Khuzwayo C. , Winter Alex , Sawyer Leigh A. , Conrad Thomas , Hebert Donnie , Chen Crystal , Van Voorhis Wesley C. , Houpt Eric R. , Iroh Tam Pui-Ying , Operario Darwin J. 
Published: September 2023

Background
Cryptosporidium is a gastrointestinal pathogen that presents a serious opportunistic infection in immunocompromised individuals including those living with human immunodeficiency syndrome. The CRYPTOFAZ trial, previously published, was conducted in Malawi to evaluate the efficacy of clofazimine in response to an unmet need for drugs to treat cryptosporidiosis in HIV populations. A combination of rapid diagnostic tests, ELISA, qPCR, and conventional sequencing were employed to detect Cryptosporidium in 586 individuals during pre-screening and monitor oocyst shedding and identify enteric co-pathogens in 22 enrolled/randomized participants during the in-patient period and follow-up visits.

Methodology
Oocyst shedding as measured by qPCR was used to determine primary trial outcomes, however pathogen was detected even at trial days 41–55 in individuals randomized to either clofazimine or placebo arms of the study. Therefore, in this work we re-examine the trial outcomes and conclusions in light of data from the other diagnostics, particularly ELISA. ELISA data was normalized between experiments prior to comparison to qPCR. The amount of all identified enteric pathogens was examined to determine if co-pathogens other than Cryptosporidium were major causative agents to a participant’s diarrhea.

Conclusion
ELISA had higher sample-to-sample variability and proved to be equally or less sensitive than qPCR in detecting Cryptosporidium positive samples. Compared to qPCR, ELISA had equal or greater specificity in detecting Cryptosporidium negative samples. Sequencing identified several Cryptosporidium species including viatorum which has never been identified in Malawi and Southern Africa. In addition to Cryptosporidium, enterotoxigenic E. coli was also identified as a pathogen in diarrheagenic amounts in 4 out of 22 participants.
Enhancing healthcare at home for older people in rural and regional Australia: A protocol for co-creation to design and implement system change
Authors: Needham Cindy , Wheaton Nikita , Wong Shee Anna , McNamara Kevin , Malakellis Mary , Murray Margaret , Alston Laura , Peeters Anna , Ugalde Anna , Huggins Catherine , Yoong Serene , Allender Steven 
Published: September 2023

Background
World-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts.

Methods
We present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops.

Discussion
The protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia’s Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia.
Attitude and preventive practices of pressure ulcers among orthopedic nurses in a tertiary hospital in Ghana
Authors: Appiah Evans Osei , Appiah Stella , Oti-Boadi Ezekiel , Boadu Beatrice Ama , Kontoh Samuel , Adams Roland Iddrisu , Appiah Cyndi , Sarpong Collins 
Published: September 2023

Background
Pressure ulcers (PUs), which affect millions of people worldwide, are among the five most prevalent hospitalized cases causing adverse impairment. Nevertheless, pressure ulcers are largely preventable, and their management depends on their severity. The authors, therefore, explored the attitude and preventive practices of pressure ulcers among orthopedic nurses in a tertiary hospital in Ghana.

Methods
An exploratory descriptive qualitative approach was employed for this study to help researchers explore the attitude and practices toward PU (Pressure Ulcer). Purposive sampling approach was employed, and data was analyzed using thematic content analysis. The sample size for this study was 30 which was obtained based on saturation. Participants were engaged in face-to-face interviews which were transcribed verbatim.

Findings
Two themes and eight subthemes were generated from the analysis of this study. The two themes were preventive practices and attitude towards PU. The study identified that there were no specific protocols illustrated on the wards for managing pressure ulcers. Nevertheless, the study participants were keen on preventing pressure ulcers and hence engaged in practices such as early patients’ ambulation, early identification of PU signs, removing creases and crumps from patient beds, nutritional management for PU prevention, and dressing of PU wounds.

Conclusion
Practices of pressure ulcer management were highly valued by the orthopedics nurses. Hence, the nurses recommended the need for accepted guidelines on pressure ulcer management to be illustrated in the various orthopedic wards in the country.
Examining the meaning and methodological characteristics of the systematized review label: A scoping review protocol
Authors: Premji Zahra , Cabugos Leyla 
Published: September 2023

Introduction
A large portion of published evidence syntheses (ES) do not conform to established standards. There is a growing number of reviews labeled as a “systematized review”, but authors do not always identify specific methodological adaptations or specify the biases these may introduce.

Objective
The objective of this scoping review is to identify which methodological attributes common to evidence syntheses (ES) are implemented or referenced in published systematized reviews. It also aims to 1) identify and collate, where available, the reasons authors characterize their study as a systematized review 2) determine whether any justifications provided were based on resource constraints or research goals, and 3) describe common characteristics of systematized reviews.

Inclusion criteria
All articles that are titled as a systematized review, attempt a collocation and synthesis of existing literature, and include some methodology for their review process, will be included.

Materials and methods
A title search will be conducted for the terms “systematized” or “systematised” in proximity to the term “review” in a selection of scholarly sources that offer broad coverage of literature in many disciplines: Google Scholar, Lens, Web of Science Core Collection (Web of Science platform), Scopus (Elsevier platform), MEDLINE (Ovid platform). Screening and data extraction will be done in duplicate. Screening will be conducted in Covidence. Data extraction will be done in Google sheets. Data extraction elements will include common methodological characteristics relating to various steps of the evidence synthesis process. Descriptive, aggregate statistics, and categorization of reasons for selecting the systematized review type are the primary planned analysis for this review.

Data availability
This is a registered report protocol. The data collected in this research project will be made available in the Borealis repository (https://borealisdata.ca/) upon finalization of the study.
Asian-white disparities in obstetric anal sphincter injury: Protocol for a systematic review and meta-analysis
Authors: Park Meejin , Wanigaratne Susitha , D’Souza Rohan , Geoffrion Roxana , Williams Sarah A. , Muraca Giulia M. 
Published: September 2023

BackgroundObstetric anal sphincter injury (OASI) describes severe injury to the perineum and perineum and perianal muscles following birth and occurs in 4.4% to 6.0% of vaginal births in Canada. Studies from high-income countries have identified an increased risk of OASI in individuals who identify as Asian race versus those who identify as white. This protocol outlines a systematic review and meta-analysis which aims to determine the incidence of OASI in individuals living in high-income countries who identify as Asian versus those of white race/ethnicity. We hypothesize that the pooled incidence of OASI will be higher in Asian versus white birthing individuals.MethodsWe will search MEDLINE, OVID, Embase, Emcare and Cochrane databases from inception to 2022 for observational studies using keywords and controlled vocabulary terms related to race, ethnicity and OASI. Two reviewers will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and Meta-analysis of Observational Studies (MOOSE) recommendations. Meta-analysis will be performed using RevMan for dichotomous data using the random effects model and the odds ratio (OR) as effect measure with a 95% confidence interval (CI). Subgroup analysis will be performed based on Asian subgroups (e.g., South Asian, Filipino, Chinese, Japanese individuals). Study quality assessment will be performed using The Joanna Briggs Institute Critical Appraisal tools.DiscussionThe systematic review and meta-analysis that this protocol outlines will synthesize the extant literature to better estimate the rates of OASI in Asian and white populations in non-Asian, high-income settings and the relative risk of OASI between these two groups. This systematic summary of the evidence will inform the discrepancy in health outcomes experienced by Asian and white birthing individuals. If these findings suggest a disproportionate burden among Asians, they will be used to advocate for future studies to explore the causal mechanisms underlying this relationship, such as differential care provision, barriers to accessing care, and social and institutional racism. Ultimately, the findings of this review can be used to frame obstetric care guidelines and inform healthcare practices to ensure care that is equitable and accessible to diverse populations.