bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endometrial Origins of Stillbirth (EOS), a case–control study of menstrual fluid to understand and prevent preterm stillbirth and associated adverse pregnancy outcomes: study protocol
Authors: Tindal Kirstin , Filby Caitlin E , Gargett Caroline E , Cousins Fiona , Palmer Kirsten Rebecca , Vollenhoven Beverley , Davies-Tuck Miranda 
Published: July 2023

IntroductionCurrent research aimed at understanding and preventing stillbirth focuses almost exclusively on the role of the placenta. The underlying origins of poor placental function leading to stillbirth, however, remain poorly understood. There is evidence demonstrating that the endometrial environment in which the embryo implants impacts not only the establishment of pregnancy but also the development of some pregnancy outcomes. Menstrual fluid has recently been applied to the study of menstrual disorders such as heavy menstrual bleeding or endometriosis, however, it has great potential in the study of adverse pregnancy outcomes. This study aims to identify differences in menstrual fluid and menstrual cycle characteristics of women who have experienced preterm stillbirth and other associated adverse pregnancy outcomes, compared with those who have not. The association between menstrual fluid composition and menstrual cycle characteristics will also be determined.Methods and analysisThis is a case–control study of women who have experienced a late miscarriage, spontaneous preterm birth or preterm stillbirth or a pregnancy complicated by placental insufficiency (fetal growth restriction or pre-eclampsia), compared with those who have had a healthy term birth. Cases will be matched for maternal age, body mass index and gravidity. Participants will not currently be on hormonal therapy. Women will be provided with a menstrual cup and will collect their sample on day 2 of menstruation. Primary exposure measures include morphological and functional differences in decidualisation of the endometrium (cell types, immune cell subpopulations and protein composition secreted from the decidualised endometrium). Women will complete a menstrual history survey to capture menstrual cycle length, regularity, level of pain and heaviness of flow.Ethics and disseminationEthics approval was obtained from Monash University Human Research Ethics Committee (27900) on 14/07/2021 and will be conducted in accordance with these conditions. Findings from this study will be disseminated through peer-reviewed publications and conference presentations.
Study protocol for a cluster-randomised controlled trial of hybrid parents and health workers adaptive intervention for optimal routine childhood immunisation coverage in the communities of Ebonyi state, Nigeria: the AGINTOPIC trial protocol
Authors: Omale Ugwu I , Ewah Richard L , Amuzie Chidinma I , Ikegwuonu Cordis O , Nkwo Glory E , Iwegbulam Chimaobi C , Ekwuazi Louisa C 
Published: July 2023

IntroductionVaccine-preventable infectious diseases (VPDs) are major causes of morbidity/mortality among children under 5 years of age worldwide and in Nigeria/Ebonyi state. Routine childhood immunisation is an invaluable prevention strategy for many VPDs. Due to suboptimal coverage and untimely receipt/delay in receipt of vaccinations, outbreaks of VPDs such as measles, yellow fever, diphtheria and others continue to reoccur around the world and in Nigeria/Ebonyi state. This study aims to evaluate the effectiveness of hybrid parents and health workers adaptive intervention in increasing the optimal/timely (cumulative age-appropriate) routine childhood immunisation coverage in the communities in Ebonyi state, Nigeria.Methods and analysesA two-arm, parallel, open label, covariate-constrained cluster-randomised controlled trial with 1:1 allocation of 16 geographical clusters (the nearest catchment areas for at least one public primary healthcare (PHC) facility with at least 500 households or a population size of 3000) will be used to evaluate the effects of hybrid/combined parents and PHC workers adaptive engagement compared with control. The primary outcomes are the optimal/timely (cumulative age-appropriate) receipt of the recommended vaccines in the routine childhood immunisation schedule by children aged 5–9 completed months and 10–11 completed months and the age-appropriate vaccines receipt score for the recommended vaccines. The outcomes will be measured through a population-based household survey of at least 15 children aged 5–9 and 10–11 months per cluster at baseline and at the end of the study using a structured interviewer-administered questionnaire in KoBoCollect installed in android devices. All analyses will be done using a cluster-level method on as-randomised basis.Ethics and disseminationEthical approval for the trial was obtained from the Ebonyi State Health Research and Ethics Committee (EBSHREC/01/06/2022–31/05/2023) and verbal consent will be obtained from participants. Study findings will be reported at local/national and international levels as appropriate.Trial registration numberISRCTN59811905.
Compliance with ecological momentary assessment programmes in the elderly: a systematic review and meta-analysis
Authors: Yao Lin , Yang Yiqun , Wang Zhi , Pan Xi , Xu Lan 
Published: July 2023

ObjectiveEcological momentary assessment (EMA) refers to the repeated sampling of information about an individual’s symptoms and behaviours, enabling the capture of ecologically meaningful real-time information in a timely manner. Compliance with EMA is critical in determining the validity of an assessment. However, there is limited evidence related to how the elderly comply with EMA programmes or the factors that are associated with compliance.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, the Cochrane Library and Web of Science were searched up to 17 July 2022.Eligibility criteriaWe included observational studies on EMA in the elderly reported in English.Data extraction and synthesisTwo investigators independently performed screening and data extraction. Discrepancies were resolved by discussion or a third investigator. A systematic review was carried out to characterise the basic characteristics of the participants and EMA programmes. Random-effects meta-analysis was conducted to assess overall compliance and to explore factors associated with differences in compliance among the elderly.ResultsA total of 20 studies with 2047 participants were included in the systematic review and meta-analysis. Meta-analysis showed that the combined compliance rate was 86.41% (95% CI: 77.38% to 92.20%; I2=96.4%; p<0.001). Subgroup analysis revealed high levels of heterogeneity in terms of the methods used to assess population classification, assessment method and assessment frequency, although these may not be the sources of heterogeneity. Meta-regression analysis showed that population classification and assessment period might have a significant impact on heterogeneity (p<0.05). Egger’s test indicated significant publication bias (p<0.001).ConclusionsCompliance with EMA programmes is high in the elderly. It is recommended that scholars design reasonable EMA programmes according to the health status of the elderly in the future.
Evaluation framework study assessing the role, applicability and adherence to good practice of planning support tools for allocation of development aid for health in low-income and middle-income countries
Authors: Megiddo Itamar , Blair Shona , Sabei Davood , Ruiz Francis , Morton Alexander D 
Published: July 2023

ObjectivesAllocation of development aid for health is controversial and challenging. In recent years, several planning-software tools have promised to help decision-makers align resource allocation with their objectives, more clearly connect prioritisation to evidence and local circumstances, and increase transparency and comparability. We aim to explore these tools to provide insight into their fitness for purpose and suggest future directions to fulfil that promise.DesignWe identified seven tools that met the inclusion criteria and developed an evaluation framework to compare them along two dimensions for assessing fitness for purpose: ability to produce analyses adhering to principles laid out in the International Decisions Support Initiative (iDSI) Reference Case for health economic evaluations; and resources required, including expertise and time. We extracted information from documentation and tool use and sent this information to tool developers for confirmation.ResultsWe categorise the tools into evidence-generating ones, evidence-syntheses ones and process support ones. Tools’ fitness for purpose varies by the context, technical capacity and time limitation. The tools adhere to several reference case principles but often not to all of them. The source and underlying assumptions of prepopulated data are often opaque. Comparing vertical interventions across diseases and health system strengthening ones remains challenging.ConclusionsThe plethora of tools that aid priority setting in different ways is encouraging. Developers and users should place further emphasis on their ability to produce analyses that adhere to prioritisation principles. Opportunities for further development include using evidence-generating tools and multicriteria decision analysis approaches complimentarily. However, maintaining tool simplicity should also be considered to allow wider access.
Impact of wearable device-based interventions with feedback for increasing daily walking activity and physical capacities in cardiovascular patients: a systematic review and meta-analysis of randomised controlled trials
Authors: Heizmann Anne-Noëlle , Chapelle Céline , Laporte Silvy , Roche Frederic , Hupin David , Le Hello Claire 
Published: July 2023

ObjectiveTo systematically review randomised controlled trials (RCTs) using a wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in patients with cardiovascular disease (CVD).DesignSystematic review and meta-analysis of RCTs.Data sourcesPubMed, Embase and Web of Science from inception to June 2022.Eligibility criteriaRandomised controlled studies including patients with CVD over 18 years of age at the end of a cardiac rehabilitation programme comparing an intervention group using a wearable physical activity monitoring device with feedback with usual care or with a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walk test (6-MWT) or a change in peak oxygen uptake (V̇O2peak) as endpoints.ResultsSixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardised mean difference (SMD) 0.85; 95% CI (0.42; 1.27); p<0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI (0.18; 1.82); p<0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI (0.27; 1.16); p<0.01), but no significant interaction was found between subgroups (p=0.55). 6-MWT distance and V̇O2peakshowed only small effects (SMD 0.34; 95% CI (−0.11; 0.80); p=0.02 and SMD 0.54; 95% CI (0.03; 1.03); p=0.07, respectively).ConclusionThe use of wearable physical activity monitoring devices appears to help patients with CVD to increase their daily walking activity and thus their physical activity, particularly in the short term.PROSPERO registration numberCRD42022300423.
Dexmedetomidine after deep brain stimulation for prevention of delirium in elderly patients with Parkinson’s disease: protocol for a single-centre, randomised, double-blind, placebo-controlled trial in China
Authors: Yao Jingxin , Shen Zhongyuan , Jin Hailong , Ma Tingting , Wang Jie , Li Shu , Zeng Min , Liu Xiaoyuan , Peng Yuming 
Published: July 2023

IntroductionParkinson’s disease is one of the most common neurodegenerative diseases. Deep brain stimulation (DBS) can improve motor symptoms in patients with middle and late Parkinson’s disease, reduce the use of levodopa, and thus reduce drug-related side effects. Postoperative delirium can significantly reduce the short-term and long-term quality of life in elderly patients, which can be alleviated by dexmedetomidine (DEX). However, whether prophylactic DEX could reduce the incidence of postoperative delirium in patients with Parkinson’s disease was still unknown.Methods and analysisThis is a single-centre, randomised, double-blinded, placebo-controlled group trial. A total of 292 patients aged 60 years and above elected for DBS will be stratified according to DBS procedure, subthalamic nucleus or globus pallidus interna, then randomly allocated to the DEX group or the placebo control group with a 1:1 ratio, respectively. In the DEX group, patients will be injected with the DEX continuously with an electronic pump at a rate of 0.1 µg/kg/hour for 48 hours at the beginning of general anaesthesia induction. In the control group, normal saline will be administered at the same rate for patients as in the DEX group. The primary endpoint is the incidence of postoperative delirium within 5 days after surgery. Postoperative delirium is assessed by the combination of the Richmond Anxiety Scale and the Confusion Assessment Method (CAM) for the intensive care unit or the 3-minute diagnostic interview for CAM as applicable. The secondary endpoints include the incidence of adverse events and non-delirium complications, the length of stay in the intensive care unit and hospital and all-cause 30-day mortality after the operation.Ethics and disseminationThe protocol has been approved by the Ethics Committee of Beijing Tiantan Hospital of Capital Medical University (KY2022-003-03). The results of this study will be disseminated through presentation at scientific conferences and publication in scientific journals.Trial registration numberNCT05197439.
Magnitude of hypertension and its association with obesity among employees of Wallaga University, Ethiopia: a cross-sectional study
Authors: Feyisa Bikila Regassa , Tamiru Afework , Debelo Sidise , Feyisa Ilili , Tola Edosa Kifle , Tolesa Edosa Jabesa , Negeri Asefa , Shibiru Tesfaye , Galata Alemtsehay , Biru Bayise 
Published: July 2023

ObjectiveTo determine the magnitude of hypertension, its association with obesity and the associated factors among employees of Wallaga University, Ethiopia.Design, setting and participantsThis institution-based cross-sectional study was employed among 588 employees of the university. Respondents were selected by stratified random sampling technique and interviewed with the aid of a structured questionnaire.The main outcome measuredHypertension and obesity were measured using WHO Stepwise approach and recommendations. We used a stratified random sampling technique to select 588 employees of the university from 3 August 2021 to 15 October 2021. A structured questionnaire and anthropometric measurements were used for data collection. Multivariable logistic regression analysis was used to determine factors independently associated with hypertension. A p value less than or equal to 0.05 and its 95% confidence level was used to declare the statistical significance.ResultsA total of 578 participants consented and completed the study, giving a response rate of 98.3%. The mean age of the respondents was 31.78 years with SD of 5.4. The overall prevalence of hypertension, general obesity and central obesity was 14.4% (95% CI 11.6% to 17.5%), 31.3% (95% CI 27.6% to 35.3%) and 37% (95% CI 33.1% to 41.1%), respectively. Obesity was significantly associated with hypertension (adjusted OR (AOR): 6.3; 95% CI 2.60 to 8.19). Age range from 35 to 46 (AOR 7.01; 95% CI 1.56 to 31.74), age ≥46 years (AOR 8.45; 95% CI 1.14 to 62.04), being non-academic staff (AOR 2.74; 95% CI 1.56 to 4.81), having additional income (AOR 2.48; 95% CI 1.08 to 5.70), physical inactivity (AOR 2.36; 95% CI 1.44 to 3.88) and poor practice of dietary salt consumption (AOR 1.65; 95% CI 1.01 to 2.87) were factors associated with hypertension.ConclusionOne in seven, more than two in seven and nearly two in six of the employees of Wallaga University were hypertensive, centrally obese and generally obese, respectively. There was a positive association between obesity and hypertension. Comprehensive awareness creation and devising workplace intervention strategies are highly recommended to reduce the hypertension burden and associated obesity.
Protocol for scoping review to identify and characterise surgery, obstetric, trauma and anaesthesia care in Ugandan health policy databases
Authors: Kasagga Brian , Takoutsing Berjo Dongmo , Balumuka Darius , Ambangira Fortunate , Kasozi Derrick , Namiiro Margaret Amelia , Sekyanzi John , Chebet Isaac , Namatovu Jean Kizito , Namazzi Mercy , Sadiq Yusuf , Mutatina Boniface , Obuku Ekwaro A , Elobu Emmanuel Alex 
Published: July 2023

IntroductionDiseases addressed by surgical, obstetric, trauma and anaesthesia (SOTA) care are rising globally due to an anticipated rise in the burden of non-communicable diseases and road traffic accidents. Low- and middle-income countries (LMICs) disproportionately bear the brunt. Evidence-based policies and political commitment are required to reverse this trend. The Lancet Commission of Global Surgery proposed National Surgical and Obstetric and Anaesthesia Plans (NSOAPs) to alleviate the respective SOTA burdens in LMICs. NSOAPs success leverages comprehensive stakeholder engagement and appropriate health policy analyses and recommendations. As Uganda embarks on its NSOAP development, policy prioritisation in Uganda remains unexplored. We, therefore, seek to determine the priority given to SOTA care in Uganda’s healthcare policy and systems-relevant documents.Methods and analysisWe will conduct a scoping review of SOTA health policy and system-relevant documents produced between 2000 and 2022 using the Arksey and O’Malley methodological framework and additional guidance from the Joanna Briggs Institute Reviewer’s manual. These documents will be sought from the websites of SOTA stakeholders by hand searching. We shall also search from Google Scholar and PubMed using well-defined search strategies. The Knowledge Management Portal for the Ugandan Ministry of Health, which was created to provide evidence-based decision-making data, is the primary source. The rest of the sources will include the following: other repositories like websites of relevant government institutions, international and national non-governmental organisations, professional associations and councils, and religious and medical bureaus. Data retrieved from the eligible policy and decision-making documents will include the year of publication, the global surgery specialty mentioned, the NSOAP surgical system domain, the national priority area involved and funding. The data will be collected in a preformed extraction sheet. Two independent reviewers will screen the collected data, and results will be presented as counts and their respective proportions. The findings will be reported narratively using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews.Ethics and disseminationThis study will generate evidence-based information on the state of SOTA care in Uganda’s health policy, which will inform NSOAP development in this nation. The review’s findings will be presented to the Ministry of Health planning task force. The study will also be disseminated through a peer-reviewed publication; oral and poster presentations at local, regional, national and international conferences and over social media.
Inequitable treatment as perceived by international medical graduates (IMGs): a scoping review
Authors: Healey Sunita Joann Rebecca , Fakes Kristy , Nair Balakrishnan R 
Published: July 2023

ObjectivesThis scoping review seeks to detail experiences of inequitable treatment, as self-reported by international medical graduates (IMGs), across time and location.DesignScoping review.Search strategyThree academic medical databases (MEDLINE, SCOPUS and PSYCINFO) and grey literature (GOOGLE SCHOLAR) were systematically searched for studies reporting first-hand IMG experiences of perceived inequitable treatment in the workplace: discrimination, prejudice or bias. Original (in English) qualitative, quantitative, mixed studies or inquiry-based reports from inception until 31 December 2022, which documented direct involvement of IMGs in the data were eligible for inclusion in the review. Systematic reviews, scoping reviews, letters, editorials, news items and commentaries were excluded. Study characteristics and common themes were identified and analysed through an iterative process.ResultsWe found 33 publications representing 31 studies from USA, Australia, UK, Canada, Germany, Finland, South Africa, Austria, Ireland and Saudi Arabia, published between 1982 and 2022. Common themes identified by extraction were: (1) inadequate professional recognition, including unmatched assigned work or pay; (2) perceived lack of choice and opportunities such as limited freedoms and perceived control over own future; (3) marginalisation—subtle interpersonal exclusions, stereotypes and stigma; (4) favouring of local graduates; (5) verbal insults, culturally or racially insensitive or offensive comments; and (6) harsher sanctions. Other themes identified were effects on well-being and proposed solutions to inequity.ConclusionsThis study found evidence that IMGs believe they are subject to numerous common inequitable workplace experiences and that these experiences have self-reported repercussions on well-being and career trajectory. Further research is needed to substantiate correlations and causality in relation to outcomes of well-being and differential career attainment. Furthermore, research into support for IMGs and the creation of more equitable workforce environments is also recommended.