bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evaluation of RBM implementation in not-for-profit sector of Zimbabwe during COVID-19
Authors: Mushayi Wellington , Dar Javaid , Mpundu Mubanga 
Published: January 2025

Background: Results-based management (RBM) aims to enhance accountability, transparency and effectiveness in the allocation and utilisation of resources. In the not-for-profit sector, particularly among non-governmental organisations (NGOs), RBM has been pivotal in ensuring interventions are aligned with organisational goals and community needs, thereby maximising impact. The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the not-for-profit sector in Zimbabwe by causing unprecedented challenges such as restrictions on movement, supply chain disruptions and economic downturns.Objectives: This study examines the impact of the pandemic on the implementation of RBM within the not-for-profit sector in Zimbabwe.Method: A concurrent mixed methods approach was employed, using a survey of 190 not-for-profit organisations (NPOs), in-depth interviews and focus group discussions with NPO staff.Results: The findings reveal essential influences of COVID-19 on NPOs’ ability to implement RBM, identifying key factors influencing effectiveness during the pandemic, including organisational flexibility, donor support and communication strategies. Additionally, it highlights the need for strengthened capacities, such as data analysis skills and potentially adjusted incentive structures to support effective RBM.Conclusion: The study underscores the inherent challenges of RBM during a crisis, including uncertainty, competing priorities and the potential focus on short-term relief.Contribution: This research contributes to a greater understanding of the challenges and opportunities for NPOs implementing RBM during a global crisis. The findings offer valuable insights for NPOs, donors and policymakers to strengthen RBM practices and ensure continued effectiveness in achieving impactful results.
Therapeutic Effectiveness and Safety of Activated Charcoal in Poisoning Management in Emergency Settings: A Systematic Review and Meta-analysis
Authors: Jrayed Roz Hamdan , Alshangiti Safia Ali , Alhassan Rakan Aref , Alanazi Nouf Obaidullah , Mahfooz Hajer Ali Bin , Alfaris Raseel Khalil , Ahbail Ali Ahmad , Alawad Fatema Hani , Mohaini Mohammad Al , Aldanyowi Saud Nayef 
Published: January 2025

Abstract

Background and Objectives:
The management of acute poisoning is crucial in emergency medicine, necessitating prompt and effective interventions to minimise harm and enhance patient outcomes. Activated charcoal (AC) has long been utilised for its ability to adsorb toxins within the gastrointestinal tract. Despite its widespread use, debates persist regarding its efficacy and safety. This study aims to comprehensively evaluate the therapeutic effectiveness and safety profile of AC in contemporary poisoning management through a systematic review and meta-analysis.

Methods:
A systematic search was conducted in PubMed, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials and Scopus databases until December 2023. Randomised controlled trials (RCTs) assessing AC intervention in poisoned patients were included in the study. Data extraction, risk of bias assessment and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Efficacy outcomes included drug plasma concentration, area under the curve (AUC), time to peak serum drug level and hospital stay. Safety outcomes comprised mortality, vomiting and cardiac arrhythmia.

Results:
Thirteen RCTs involving 5059 patients were included in the study. Meta-analysis revealed a significant decrease in drug plasma concentration (P = 0.002) and AUC (P < 0.0001) favouring AC intervention. No significant differences were observed in time to peak serum drug level (P = 0.59) and hospital stay (P = 0.34). Safety analysis showed no significant difference in mortality (P = 0.25), whereas cardiac arrhythmia incidence was significantly lower with AC (P = 0.004). Vomiting incidence did not significantly difference between groups (P = 0.33).

Conclusion:
This study provides robust evidence supporting the efficacy and safety of AC in treating poisoned patients. AC administration led to reduced drug plasma concentration and AUC, with no significant impact on hospital stay. Mortality rates did not differ significantly, but AC was associated with a lower incidence of cardiac arrhythmia. Healthcare providers can confidently integrate AC into poisoning management protocols to improve patient outcomes. Further research should focus on standardising protocols and exploring optimal dosing regimens and formulations.
Effectiveness of Non-pharmacological Interventions for Chronic Non-specific Lower Back Pain in Family Medicine Practices: A Systematic Review and Meta-analysis
Authors: Alhomidani Ali Abdullah , Alanazi Haya Hamdi , Almutairi Rasha Hadi , Almutairi Abdulrahman Shudayyid , Al-Sulami Hisham Abdulrahman , Alarifi Ahmad Ibrahim , Almutairi Mohammed Shudayyid , Alanazi Hamad Obaid , Alawad Fatema Hani , Aldanyowi Saud Nayef Salem 
Published: January 2025

Abstract

Background:
Advancements in health care have led to increased life expectancy, but the rising prevalence of chronic conditions challenges maintaining a high quality of life (QoL). Chronic non-specific low back pain (CNSLBP) is a complex condition with psychosocial factors influencing its impact on QoL.

Objective:
This study conducted a meta-analysis to assess the effectiveness of non-pharmacological interventions for CNSLBP.

Materials and Methods:
Data extraction included study characteristics, participant details, interventions, outcomes and funding sources. Quality assessment was performed using the Cochrane risk of bias tool for randomised controlled trials. Statistical analyses employed R software, assessing heterogeneity with Cochrane Q and I
2, utilising random-effects and common effect models. Publication bias was evaluated using funnel plots and Egger’s test.

Results:
The meta-analysis on non-pharmacological interventions for Visual Analogue Scale (VAS) scores revealed significant heterogeneity, leading to the use of a random-effects model. Despite this (τ2 = 97.83%, I² = 97.83%), the overall effect size remained statistically significant at 2.2588 (95% confidence interval [CI]: 1.8276–2.6899, P < 0.0001), suggesting a meaningful impact. Similarly, for Roland–Morris Disability Questionnaire (RMDQ) scores, a random-effects model was used due to significant heterogeneity (Q-statistic P < 0.0001), with an overall effect size of 3.0427 (95% CI: 1.9190–4.1664, P < 0.0001).

Discussion:
Variability in outcomes was anticipated due to differences in treatment approaches and sample sizes. The findings contribute valuable evidence supporting the effectiveness of non-pharmacological interventions in managing CNSLBP, despite its complexity. These insights aid evidence-based decision-making for clinicians, offering potential improvements in QoL for individuals with CNSLBP.

Conclusion:
In the context of increasing chronic conditions, particularly CNSLBP, this meta-analysis underscores the significant impact of non-pharmacological interventions on VAS and RMDQ scores. Despite observed heterogeneity, the findings provide robust evidence supporting the effectiveness of these interventions, enhancing the QoL for individuals dealing with CNSLBP. These insights contribute to informed decision-making for health-care professionals and highlight the ongoing importance of non-pharmacological strategies in managing chronic low back pain.
Assessing the Efficacy of Adaptive Servo-ventilation in Heart Failure Patients: A Systematic Review
Authors: Aleid Abdulsalam Mohammed , Alqerafi Ahmed Abdulaziz , Alhejaili Ibrahim Saad , Alsaedi Marwan Nasser , Almutairi Danah Mohsen A. , Al Shankiti Hind Ameen M. , Almaslamani Norah Waleed , Qader Ali Mohamed , Al Mohaini Mohammad 
Published: January 2025

Abstract

Background:
Central sleep apnoea (CSA) is a sleep-disordered breathing issue characterised by inadequate breathing episodes during sleep without respiratory effort. Disruptions in the central nervous system’s signalling to respiratory muscles cause inadequate ventilation and impaired gas exchange. CSA is rare in the general population but prevalent in heart failure patients. Treatment options include lifestyle changes, positive airway pressure therapy and pharmacological interventions. Adaptive servo-ventilation (ASV), a specialised form of positive airway pressure therapy, dynamically adjusts pressure based on the patient’s breathing patterns, providing tailored ventilation support for CSA patients. This innovative approach helps prevent apnoeas and hypopnoeas, ensuring the airway remains open during sleep.

Methods:
We conducted a comprehensive search across four electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Scopus and Web of Science) up until March 2024, to identify pertinent studies evaluating the efficacy of adaptive servo-ventilation (ASV) in the treatment of CSA in patients with heart failure. The quality of evidence from trials was assessed using ROB1. Data from the included studies were extracted into a uniform online sheet and analysed using RevMan 5.4.

Results:
Our search led to the identification of 9 studies involving a total of 3135 patients. The meta-analysis results demonstrated that ASV exhibited no statistically significant difference compared to controls regarding left ventricular ejection fraction (mean difference [MD] =2.55, 95% confidence interval [CI] [ − 0.29, 5.40] with P value of the overall effect of 0.08. Results showed significant heterogeneity (P < 0.0001, I
2 = 83%). Moreover, it showed no difference regarding left ventricular end-diastolic and systolic volumes (MD= −1.63, 95% CI [−10.09.6.82], with P = 0.70) and (MD= −0.97, 95% CI [−5.47, 3.79], with P = 0.69), respectively, with no detected heterogeneity.

Conclusion:
In the first meta-analysis, assessing the cardiovascular outcomes of ASV in the treatment of CSA on patients with heart failure. ASV, although not significantly impacting key cardiac parameters or clinical endpoints, showed potential benefits in specific domains for certain heart failure subgroups; further research is needed to clarify its role in heart failure management and identify optimal patient populations for ASV intervention.
Does Ketamine Reduce Postoperative Pain and Agitation in Septorhinoplasty? A Systematic Review and Meta-analysis
Authors: Aleid Abdulsalam Mohammed , Alqahtani Anas Khalid , Alharbi Raghad Khalifah , Alahmari Ghala Saeed , Asiri Shatha Mohammed , Alshehri Yara Ahmed , Al-Shaker Shahad Shaker , Alyahya Khalid Abdultaif , Barnawi Mohammad 
Published: January 2025

Abstract

Background:
Agitation and pain following rhino plastic surgery lead to complications that delay recovery and affect patients quality of life. Ketamine is established drug in anaesthesia induction and analgesic agent. It is investigated for the prevention of agitation in children yet it is recently investigated for the prevention of post-operative agitation in adults following rhinoplasty. We conducted this systematic review and meta-analysis of randomised controlled trials to summarise and conclude its role in sub anaesthetic dose for the prevention of agitation and pain relief.

Methods:
In our research, we explored four digital platforms (Cochrane Central Register of Controlled Trials, PubMed, Scopus and Web of Science) until April 2024, searching for relevant articles that assessed the efficacy of ketamine in managing post-operative pain and agitation. The quality of the trials was evaluated using the risk of bias 2 tool. The data from the selected studies were extracted into a standardised online form and analysed with RevMan 5.4.

Results:
This study included six studies with a total sample size of 558 patients. We included randomised clinical trials assessing the efficacy of ketamine for pain and agitation management after rhinoplasty, septoplasty, or rhinoseptoplasty. All included studies were of high quality. Results of meta-analysis showed statistically significant reduction in pain score and incidence of agitation post-operative (standardised mean difference = −0.85, 95% confidence interval [CI] [ − 1.26, −0.43], P < 0.0001), (risk ratio = 0.22, 95% CI [0.06, 0.78], P = 0.02), respectively. In addition, meta-analysis showed reduced analgesic requirements after surgery and treatment with ketamine was associated with less risk of nausea and vomiting.

Conclusion:
This systematic review and meta-analysis highlights ketamine’s potential benefits in post-surgery pain management and agitation reduction but emphasises the need for additional research with diverse and consistent samples to confirm these findings and examine possible side effects such as post-operative nausea and vomiting due to the observed heterogeneity amongst studies.
Efficacy of Raloxifene versus Alendronate in Postmenopausal Women with Osteoporosis: Systematic Review and Meta-analysis
Authors: Alrobeishy Aljohara Khalid , Alkharouby Hamzah Ahmed , Ahmed Rufaida Alhafiz Alsayed M. , Alsabt Ghazlan Yaqoub 
Published: January 2025

Abstract

Background:
This systematic review aims to address the comparative incidence of vertebral fractures between selective oestrogen receptor modulators (SERMs), specifically raloxifene and bisphosphonates, notably Alendronate, in postmenopausal women diagnosed with osteoporosis. With the growing prevalence of osteoporosis and the diverse pharmacological options available, understanding the relative fracture outcomes associated with these two commonly prescribed medications is crucial for informed clinical decision-making.

Methods:
To examine the efficacy of raloxifene, SERM, compared to alendronate for post-menopausal women with osteoporosis focusing on vertebral fracture. We conducted a thorough search within four databases: Cochrane Central Register of Controlled Trials, PubMed, Science Direct, and Web of Science, up to April 2024. To assess the quality of evidence from the trials, we employed the Risk of Bias 1 tool. The data obtained from the relevant studies were then meticulously transferred into a uniform online format. Finally, we utilised RevMan 5.4 software for the analysis of these data.

Results:
A detailed search of databases yielded the identification of 7 studies (5 clinical trials and 2 retrospective observational studies) with a total sample size of 417,625 participants. Results of meta-analysis showed that alendronate showed superior effect compared to raloxifene in reducing incidence of vertebral fracture (risk ratio = 0.92, 95% confidence interval [CI] [0.87, 0.98], P = 0.008) and increasing BMD of lumbar spine at weeks 12 and 24 (mean difference [MD] =3.6% change, 95% CI [5.41, 1.79], P < 0.001) and (MD = 3.71% change, 95% CI [5.50, 1.93], P < 0.0001) respectively. Similar results were detected at BMD of total hip and femoral neck outcomes.

Conclusion:
The meta-analysis demonstrates that alendronate is more effective than raloxifene in treating osteoporosis, with lower vertebral fracture risk and increased bone mineral density in vital areas. These findings underscore the significance of selecting appropriate interventions for osteoporosis management, which can greatly impact patients’ bone health and overall well-being. Further research should concentrate on long-term consequences, side effects and innovative treatments for osteoporosis.
Efficacy and Safety of Netarsudil versus Timolol in Glaucoma Patients: A Systematic Review and Meta-analysis
Authors: Elyas Shahad Kamal , Alqahtani Alwaleed Abdulhadi , Alshamekh Lujain Ahmed , Alyahya Nafad Nasser , Alhassoun Reefal Ali , Albinsaad Loai Saleh 
Published: January 2025

Abstract

Background:
Rho-Kinase Inhibitor (RKIs) showed competitive efficacy in reducing intraocular pressure (IOP) in recently published large randomised controlled trials compared to first-line treatment of glaucoma, prostaglandin analogues and beta blockers. Yet there is no published meta-analysis which summarises and gives a conclusion about its efficacy and adverse events, except for one with reported statistical heterogeneity. We conducted this systematic review and meta-analysis to evaluate the efficacy of RKI compared to timolol in reducing IOP.

Methods:
We conducted an extensive search within four electronic databases, namely, Cochrane Central Register of Controlled Trials, PubMed, Scopus and Web of Science, up until April 2024. Our aim was to identify pertinent studies that evaluated the efficacy and safety of netarsudil in contrast to timolol for the treatment of open-angle glaucoma and ocular hypertension. The quality of evidence from these trials was assessed using the risk of bias 2 tool. Subsequently, data from the selected studies were systematically extracted into a uniform online sheet and analysed using RevMan 5.4 software.

Results:
Our search led to the identification of 4 clinical trials involving a total of 2305 patients. The meta-analysis results demonstrated that netarsudil showed better IOP reduction at 4:0 am after 2 weeks (mean difference [MD] = −0.56, 95% confidence interval [CI] [ − 0.88, −0.25], P = 0.0005), however, results of pooled effect at 8:00 am after 6 weeks and 3 months showed statistically significant difference favouring timolol over netarsudil (MD = 0.58, 95% CI [0.23, 0.92], P = 0.0010) and (MD = 0.69, 95% CI [0.34, 1.04], P = 0.0001), respectively. In addition, at 10:00 am, results of pooled effect after 3 months showed a statistically significant difference favouring timolol over netarsudil (MD = 0.34, 95% CI [0.03, 0.65], P = 0.03).

Conclusion:
In conclusion, the study highlights the importance of time-specific and safe glaucoma treatment strategies, with timolol’s long-term effectiveness at 8:00 am and 10:00 am and netarsudil’s short-term effectiveness at 4:00 pm, while prioritising timolol’s better safety profile.
Is Zinc Supplementation Effective in Reducing Neonatal Jaundice? A Systematic Review and Meta-analysis of Randomised Controlled Trials
Authors: Almarhoon Fatimah Mujahid , Aljarwan Rafeef Mohammed , Alzahrani Saleh Ahmed , Alotaibi Hamad Fahad , Alshehri Abdulaziz Mohammed Abdullah , Alabdely Mona Hail , Alqasim Ghadah Saud , Alhodibi Mostafa Habeeb 
Published: January 2025

Abstract

Background:
Neonatal jaundice, a common condition in new-borns characterised by elevated bilirubin levels, poses significant public health concerns due to its potential for neurological complications if left untreated. Zinc supplementation has been proposed to reduce bilirubin levels by enhancing bilirubin conjugation and excretion. This study aims to systematically evaluate the efficacy of zinc supplementation in reducing the incidence and severity of neonatal jaundice through a meta-analysis of randomised controlled trials.

Methods:
We conducted a thorough investigation by carefully examining various databases, including PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials, until September 2024. The aim of our study was to identify the research assessing the effectiveness of zinc supplementation versus a placebo for neonatal jaundice. The primary objective of the study was to evaluate total serum bilirubin levels and the duration of phototherapy required. We employed the ROB2 methodology to assess the quality of the evidence, thereby ensuring the reliability of the conclusions derived from these studies. The data were systematically organised in a standardised online format and analysed with RevMan 5.4.

Results:
Systematic review and meta-analysis confirmed 16 clinical trials (n = 1915 patients) evaluating zinc supplementation versus placebo in relation to bilirubin levels and phototherapy outcomes. The results indicated no statistically significant differences in total serum bilirubin at various time points (mean difference [MD] = −0.71, P = 0.12; MD = −0.41, P = 0.15; MD = −0.63, P = 0.24; MD = −0.38, P = 0.10; MD = −0.15, P = 0.40) compared to placebo. However, zinc supplementation significantly reduced the duration of phototherapy (MD = −4.34 h, P < 0.00001). Analysis of secondary outcomes revealed no significant differences in the incidence of hyperbilirubinaemia (risk ratio [RR] =1.12, P = 0.48), requirements for phototherapy (RR = 0.90, P = 0.69) or associated side effects such as vomiting (RR = 0.99, P = 0.98), diarrhoea (RR = 0.84, P = 0.68) and skin rash (RR = 1.28, P = 0.62).

Conclusion:
Zinc supplementation did not significantly reduce total serum bilirubin levels or the incidence of hyperbilirubinaemia in neonates with jaundice. However, it was associated with a shorter duration of phototherapy, suggesting a potential role as an adjunct treatment. Further research is required to confirm these findings and establish clinical guidelines for the use of zinc in managing neonatal jaundice.
A Systematic Review and Meta-analysis Comparing between Active Intervention versus Conservative Management after Rotator Cuff Injury
Authors: Aleid Abdulsalam Mohammed , Almutawa Khalid Mohammed , Alghofaily Warif Nasser , Naser Nebras Zakareya Abdulwahab , Alsabhawi Abdullah Hamad , Almutleeg Zainab Hussain , Albinsaad Loai , Alqahtani Ali Zafer Ali , Aldanyowi Saud Nayef Salem 
Published: January 2025

Abstract

Background:
It is still uncertain when passive or active range of motion (ROM) should be initiated following arthroscopic rotator cuff (RC) surgery. After arthroscopic RC repair, early versus delayed passive and active ROM procedures were assessed in this systematic review and meta-analysis. This study’s objective is to thoroughly examine the literature on the results of postoperative active/passive arthroscopic RC repair rehabilitation protocols: early versus delayed.

Methods:
We conducted this systematic review and meta-analysis in accordance with the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions as well as adhering to the recommendations set forth by the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement.

Results and Conclusion:
The main result of this meta-analysis was that there was a statistically significant difference between conservative management versus early mobilisation in terms of forward elevation at 3-month follow-up, external rotation at 3-month follow-up and incidence of Constant-Murley Score at 6-month follow-up and there was no difference in terms of incidence of retear.