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Mohamed M. Elbasheir (8997368), Ibrahim A. Karti (8997370), Elwaleed M. Elamin (8997372) · Figshare · 2020
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Mohamed M. Elbasheir (8997368), Ibrahim A. Karti (8997370), Elwaleed M. Elamin (8997372) · Figshare · 2020
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Cai Li (64412), Junting Chen (4036616), Jin Tan (1912840) et al. · Figshare · 2024
<div><p>Introduction</p><p>Self-management applications are cost-effective and scalable for epilepsy treatment. However, there is a limited long-term quantitative evidence regarding their effectiveness. The Transtheoretical Model (TTM) offers a psychological framework that tailors self-management plans to the individual’s stage of behavioral change. This approach aims to address utilization needs, reduce information overload, minimize the adverse effects of self-management, and enhance the overall effectiveness of interventions for individuals with epilepsy.</p><p>Methods and analysis</p><p>This will be a randomized, double-blind, the clinical trial involving two groups of adults diagnosed with epilepsy. In addition to treatment as usual (TAU), the intervention group will receive an intervention program constructed from TTM combined with self-management as part of the treatment plan. The control group will receive TAU only. Prior to the intervention, the participants will undergo an initial assessment to determine their current stage of behavioral change to facilitate the implementation of targeted behavior support strategies. Additionally, participants will receive weekly 30-minute educational videos on epilepsy. The goal is to enroll 160 adults who have been diagnosed with epilepsy for at least six months and are receiving medication. Data collection will encompass an assessment of C-ESMS, HADS, QOLIE-31, and LSSS. These parameters will be evaluated at baseline, as well as during follow-up periods at 1, 3, and 6 months post-intervention.</p><p>Discussion</p><p>Existing self-management interventions for people with epilepsy primarily focus on knowledge and psychological factors. Discrepancies in research design, intervention plans, and patient characteristics have contributed to inconsistent outcomes in previous studies. This study seeks to advance the field by integrating the TTM with empirically supported self-management practices. The delineation of behavioral change stages within the TTM framework is expected to form a structured intervention protocol. This study will inform standardized, evidence-based epilepsy care practices.</p></div>
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Laura C. Bonney (2697397), Robert J. Watson (1343463), Gillian S. Slack (5728145) et al. · Figshare · 2020
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Daniel Fernández-Baeza (20827122), Cristina González-Millán (312073), Germán Díaz-Ureña (20827125) · Figshare · 2025
<div> Tensiomyography (TMG) is a non-invasive device used to assess contractile and mechanical properties during an isometric muscle contraction. The purpose of this systematic review was two-fold: 1) to know the scientific evidence of hamstring muscles TMG parameters in professional football players during the competitive season, and 2) to establish the most-frequent values for the main TMG parameters in soccer players compared with the reference values of the TMG software. PRISMA guidelines were followed, and a systematic search was performed in the PubMed, Web of Science, and Sport Discus electronic databases with no date restrictions until November 2023. The studies considered for this meta-analysis were studies investigating professional soccer players between 20- and 29-years measured during the competitive season and reported tensiomyography-derived parameters such as contraction time and/or maximal displacement, and/or delay time, of the hamstring muscles (biceps femoris and semitendinosus). A total of 139 studies were identified and 12 studies were included in the systematic review and for the meta-analysis. All studies underwent a quality assessment using the Newcastle–Ottawa scale, and the NOS score varied from 7/9 to 8/9 in all studies, suggesting a good quality of all articles. Study results were analyzed using restricted maximum-likelihood and random-effects models. The main findings of the study are that of the six parameters analysed, three variables were found to differ significantly. Furthermore, the weighted mean values founded were biceps femoris (Tc 27.88, Dm 5.2, Td 23.72) and in semitendinosus (Dm 8.72, Td 25.25). TMG can serve as a valuable device for assessing neuromuscular function in soccer players. Furthermore, shows the most-frequent values of the biceps femoris and the semitendinosus, where different values in the TMG parameters can be observed between the synergistic muscles. </div>
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Joshua Ssebunnya (304581), Rutakumwa Rwamahe (18764909), Richard Mpango (4456126) et al. · Figshare · 2024
<p>Standards of how the HIV+D trial was designed, analyzed and interpreted.</p> <p>(DOCX)</p>
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Chido Dziva Chikwari (12002107), Katharina Kranzer (116027), Victoria Simms (25753) et al. · Figshare · 2024
<div><p>Youth living with HIV are at higher risk than adults of disengaging from HIV care. Differentiated models of care such as community delivery of antiretroviral therapy (ART) may improve treatment outcomes. We investigated outcomes across the HIV cascade among youth accessing HIV services in a community-based setting. This study was nested in a cluster-randomised controlled trial (CHIEDZA: Clinicaltrials.gov, Registration Number: NCT03719521) conducted in three provinces in Zimbabwe and aimed to investigate the impact of a youth-friendly community-based package of HIV services, integrated with sexual and reproductive health services for youth (16–24 years), on population-level HIV viral load (VL). HIV services included HIV testing, ART initiation and continuous care, VL testing, and adherence support. Overall 377 clients were newly diagnosed with HIV at CHIEDZA, and linkage to HIV care was confirmed for 265 (70.7%, 234 accessed care at CHIEDZA and 31 with other providers); of these 250 (94.3%) started ART. Among those starting ART at CHIEDZA who did not transfer out and had enough follow up time (>6 months), 38% (68/177) were lost-to-follow-up within six months. Viral suppression (HIV Viral Load <1000 copies/ml) among those who had a test at 6 months was 90% (96/107). In addition 1162 clients previously diagnosed with HIV accessed CHIEDZA; 714 (61.4%) had a VL test, of whom 565 (79.1%) were virally suppressed. This study shows that provision of differentiated services for youth in the community is feasible. Linkage to care and retention during the initial months of ART was the main challenge and needs concerted attention to achieve the ambitious 95-95-95 UNAIDS targets.</p></div>
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Sanjita Brito-Mutunayagam (20218455), David O. Hamilton (21637681), Elena Mitsi (5103737) et al. · Figshare · 2025
<div> Background <i>Streptococcus pneumoniae</i> (pneumococcus) and respiratory syncytial virus (RSV) are major causes of respiratory infections globally. Viral and bacterial co-infections are commonly observed in respiratory infections and there is evidence that these pathogens interact synergistically to evade host responses and lead to more severe disease. Notably, RSV seasonal outbreaks are associated with increased hospitalization and a subsequent peak in invasive pneumococcal disease cases, particularly in pediatric populations. Here, we summarize a protocol for a controlled human infection model aiming to evaluate pathogen interaction dynamics and immune responses in a combined pneumococcus and RSV model. The primary objective is to determine whether primary RSV challenge increases the risk of secondary pneumococcal colonization. Methods This is an open-label, multi-center, randomized controlled human co-infection study, inclusive of a pilot phase. Individuals will be randomized to primary inoculation with either pneumococcus (serotype 6B) or RSV (subtype RSV-A) intra-nasally on day 0 followed by a reciprocal challenge on day 7. During pilot phase A up to 10 participants will be monitored in an in-patient facility for 7–10 days following RSV-A challenge. If there are no safety concerns, we will then progress to an outpatient phase where participants will self-isolate at home. Clinical samples to be taken from participants include nasal swabs and washes for pathogen detection; and nasal cells, nasal lining fluid, and blood samples to examine mucosal and systemic immune responses. Discussion This work will lead to important scientific knowledge on the interaction and dynamics between pneumococcus and RSV. This knowledge could help inform pneumococcal and RSV vaccination strategies, particularly for groups at risk of developing severe pneumococcal and RSV disease. Trial registration The study is registered on ISRCTN (The UKs Clinical Study Registry). DOI <a href="https://doi.org/10.1186/ISRCTN12036902" target="_blank">https://doi.org/10.1186/ISRCTN12036902</a> </div>
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Instructors Glenn Monahan, B. S. Nancy Schultz · 2015
This assignment checklist will help you plan your work. Please check off items as you complete them. The instructors would prefer that you send all of your assignments to us in a single mailing.
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Jorge Iván Alvarado Sánchez (21387861), Laura Maria Castillo Morales (21387864), Yenny Rocio Cardenas Bolivar (18439102) et al. · Figshare · 2025
<div> Background Intensive care unit-acquired weakness (ICUAW) and post-intensive care syndrome (PICS) are significant complications among critically ill patients, leading to prolonged hospital stays, increased healthcare costs, and reduced quality of life. Early physical therapy in the ICU has shown promise in mitigating these adverse outcomes, yet randomized controlled trials (RCTs) evaluating the combined effects of physical, respiratory, occupational, and speech therapy initiated within the first 24–72 hours are lacking. Methods This single center, controlled clinical trial aims to establish the efficacy and safety of an early multimodal rehabilitation program (MRP) compared with a late MRP in mechanically ventilated patients admitted to the ICU. Adult patients (≥18 years) with a Barthel score ≥70 and requiring invasive mechanical ventilation for more than 24 hours will be included. Participants will be randomly assigned to early MRP, initiated within 24 hours post-intubation, or late MRP, starting 72 hours post-intubation. The primary outcome is the duration of mechanical ventilation. Safety will be assessed by comparing the number of adverse events between groups. The MRP includes passive and active interventions from physical, speech, respiratory, and occupational therapy teams. Therapy intensity and type are adjusted according to the patient’s Richmond Agitation-Sedation Scale (RASS) score. Patients with lower RASS scores (indicating deeper sedation) will receive primarily passive interventions (e.g., passive range-of-motion exercises), while those with higher RASS scores (indicating lighter sedation or alertness) will engage in more active therapies (e.g., active-assisted exercises and functional mobility activities). For patients with RASS ≥2, occupational therapy will focus on behavioral and environmental modulation, employing calming techniques, sensory stimuli, and cognitive tasks, with family education to support spatiotemporal orientation. This adaptive approach ensures patient safety and optimizes therapy based on the patient’s current sedation level and clinical condition. Dissemination The results will be published in peer-reviewed journals and presented at conferences. Trial registration ClinicalTrials.gov <a href="https://clinicaltrials.gov/study/NCT06133504" target="_blank">NCT06133504</a>. Registered on November 11, 2023. </div>
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Francesca Wanda Basile (19200457), Sedona Sweeney (319702), Maninder Pal Singh (8837459) et al. · Figshare · 2024
<div><p>Tuberculosis is a major infectious disease worldwide, but currently available diagnostics have suboptimal accuracy, particularly in patients unable to expectorate, and are often unavailable at the point-of-care in resource-limited settings. Test/treatment decision are, therefore, often made on clinical grounds. We hypothesized that contextual factors beyond disease probability may influence clinical decisions about when to test and when to treat for tuberculosis. This umbrella review aimed to identify such factors, and to develop a framework for uncertainty in tuberculosis clinical decision-making. Systematic reviews were searched in seven databases (MEDLINE, CINAHL Complete, Embase, Scopus, Cochrane, PROSPERO, Epistemonikos) using predetermined search criteria. Findings were classified as barriers and facilitators for testing or treatment decisions, and thematically analysed based on a multi-level model of uncertainty in health care. We included 27 reviews. Study designs and primary aims were heterogeneous, with seven meta-analyses and three qualitative evidence syntheses. Facilitators for decisions to test included providers’ advanced professional qualification and confidence in tests results, availability of automated diagnostics with quick turnaround times. Common barriers for requesting a diagnostic test included: poor provider tuberculosis knowledge, fear of acquiring tuberculosis through respiratory sampling, scarcity of healthcare resources, and complexity of specimen collection. Facilitators for empiric treatment included patients’ young age, severe sickness, and test inaccessibility. Main barriers to treatment included communication obstacles, providers’ high confidence in negative test results (irrespective of negative predictive value). Multiple sources of uncertainty were identified at the patient, provider, diagnostic test, and healthcare system levels. Complex determinants of uncertainty influenced decision-making. This could result in delayed or missed diagnosis and treatment opportunities. It is important to understand the variability associated with patient-provider clinical encounters and healthcare settings, clinicians’ attitudes, and experiences, as well as diagnostic test characteristics, to improve clinical practices, and allow an impactful introduction of novel diagnostics.</p></div>
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Manoja Kumar Das (8767068), Narendra Kumar Arora (9346702), Suresh Kumar Dalpath (8672532) et al. · Figshare · 2021
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Rida Shahzad (20148320), Arshad Mehmood (4232524), Danish Shabbir (20148323) et al. · Figshare · 2024
<div><p>Background</p><p>Diabetic retinopathy (DR) is a leading cause of blindness globally. The gold standard for DR screening is stereoscopic colour fundus photography with tabletop cameras. VistaView is a novel smartphone-based retinal camera which offers mydriatic retinal imaging. This study compares the diagnostic accuracy of the smartphone-based VistaView camera compared to a traditional desk mounted fundus camera (Triton Topcon). We also compare the agreement between graders for DR screening between VistaView images and Topcon images.</p><p>Methodology</p><p>This prospective study took place between December 2021 and June 2022 in Pakistan. Consecutive diabetic patients were imaged following mydriasis using both VistaView and Topcon cameras at the same sitting. All images were graded independently by two graders based on the International Classification of Diabetic Retinopathy (ICDR) criteria. Individual grades were assigned for severity of DR and maculopathy in each image. Diagnostic accuracy was calculated using the Topcon camera as the gold standard. Agreement between graders for each device was calculated as intraclass correlation coefficient (ICC) (95% CI) and Cohen’s weighted kappa (k).</p><p>Principal findings</p><p>A total of 1428 images were available from 371 patients with both cameras. After excluding ungradable images, a total of 1231 images were graded. The sensitivity of VistaView for any DR was 69.9% (95% CI 62.2–76.6%) while the specificity was 92.9% (95% CI 89.9–95.1%), and PPV and NPV were 80.5% (95% CI 73–86.4%) and 88.1% (95% CI 84.5–90.9) respectively. The sensitivity of VistaView for RDR was 69.7% (95% CI 61.7–76.8%) while the specificity was 94.2% (95% CI 91.3–96.1%), and PPV and NPV were 81.5% (95% CI 73.6–87.6%) and 89.4% (95% CI 86–92%) respectively. The sensitivity for detecting maculopathy in VistaView was 71.2% (95% CI 62.8–78.4%), while the specificity was 86.4% (82.6–89.4%). The PPV and NPV of detecting maculopathy were 63% (95% CI 54.9–70.5%) and 90.1% (95% CI 86.8–92.9%) respectively. For VistaView, the ICC of DR grades was 78% (95% CI, 75–82%) between the two graders and that of maculopathy grades was 66% (95% CI, 59–71%). The Cohen’s kappa for retinopathy grades of VistaView images was 0.61 (95% CI, 0.55–0.67, p<0.001), while that for maculopathy grades was 0.49 (95% CI 0.42–0.57, p<0.001). For images from the Topcon desktop camera, the ICC of DR grades was 85% (95% CI, 83–87%), while that of maculopathy grades was 79% (95% CI, 75–82%). The Cohen’s kappa for retinopathy grades of Topcon images was 0.68 (95% CI, 0.63–0.74, p<0.001), while that for maculopathy grades was 0.65 (95% CI, 0.58–0.72, p<0.001).</p><p>Conclusion</p><p>The VistaView offers moderate diagnostic accuracy for DR screening and may be used as a screening tool in LMIC.</p></div>
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Ryan Daniel Gotesman (18137085), Naomi Niznick (17022525), Brian Dewar (9553159) et al. · Figshare · 2024
<div><p>Background</p><p>Reversible cerebral vasoconstriction syndrome (RCVS) is a syndrome of recurrent thunderclap headaches and reversible vasoconstriction of the cerebral arteries on neuroimaging within 3 months of onset. Initial non-contrast computed tomography (CT) can reveal abnormalities such as ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage (SAH) can be present in patients with RCVS and may delay diagnosis.</p><p>Aims</p><p>We conducted a systematic review and meta-analysis in accordance with the PRISMA guidelines. We aimed to estimate the prevalence of imaging abnormalities on initial non-contrast CT head in adult patients with RCVS.</p><p>Data sources & eligibility criteria</p><p>We searched electronic databases including MEDLINE, EMBASE, and the Cochrane Register of Clinical Trials from inception to August 2, 2022. Eligible studies included articles reporting the prevalence of non-contrast CT abnormalities on initial neuroimaging in patients with RCVS, aged 18 and older. Case series, observational studies and clinical trials were included. Data was extracted directly from included papers using a standardized data charting form.</p><p>Results</p><p>The search yielded 722 titles with duplicates removed. Twenty studies that included 379 patients with RCVS met inclusion criteria. We classified non-contrast CT abnormalities as either ischemic stroke, ICH, or SAH. We pooled prevalence data using a random effects model with the inverse-variance weighted method. The most common imaging finding was SAH with a pooled prevalence of 24% (95% CI:17%-33%), followed by ICH at 14% (95% CI:8%-22%), and ischemic stroke at 10% (95% CI:7%-14%). The pooled prevalence of any of these imaging abnormalities on initial non-contrast CT was 31% (95% CI:23%-40%). Risk of bias was moderate to very-high-risk for case-series and low-risk for observational studies.</p><p>Conclusion</p><p>Our review demonstrates that one-third of patients with RCVS will have an abnormality on initial non-contrast CT head, including either an ischemic stroke, ICH, or SAH. These findings highlight the diagnostic challenges of RCVS imaging and contribute to our understanding of this disease.</p></div>
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Lauren S. Tailor (22486374), Hilary K. Brown (5500226), Jessie Cunningham (7519190) et al. · Figshare · 2025
<div> Objective The goal of this scoping review is to summarize how prior studies have measured antidepressant continuation/discontinuation prior to, during, and after pregnancy. Introduction Pregnant individuals and healthcare providers are faced with difficult decisions about whether to continue antidepressants in pregnancy due to the historical exclusion of pregnant women from clinical trials and the lack of rigorous evidence to support these decisions. Prior studies examining the effects of pre- and perinatal antidepressant use on perinatal outcomes using observational data have been inconsistent, primarily due to the binary (ever/never) categorization of exposure, which may not accurately reflect real-world use. Inclusion criteria The population for this review consists of pregnant individuals. The concept is the measurement of continued preconception, prenatal, and postpartum antidepressant use. We will include human studies (no restrictions on language or geographic location) with the following study designs: cohort studies, cross-sectional studies, case-control studies, and descriptive analyses or spontaneous reports that reference antidepressant use over time. Methods We will conduct a scoping review using the JBI (formerly Joanna Briggs Institute) manual for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-ScR). The search strategy will be performed using database-specific nomenclature in MEDLINE, EMBASE, PsycINFO, Cochrane, Web of Science, and Canada’s Drug Agency Grey Matters Guide for grey literature, limiting the final search to publications since 2022 to include contemporary data. Two independent reviewers will 1) screen titles/abstracts/full-texts and 2) extract data. Findings will summarize measurements of antidepressant continuation during the perinatal period, categorizing studies based on the descriptions of timing, duration, adherence, and exposure ascertainment. Conclusion This scoping review will establish the extent to which prior studies have been able to measure continued use to inform a clear definition of continued antidepressant exposure to be used in future studies. <b>Review registration:</b> Open Science Framework <a href="https://osf.io/2ewpq" target="_blank">https://osf.io/2ewpq</a> </div>
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Guimarães, Rita · Zenodo (CERN European Organization for Nuclear Research) · 2025
Checklist S1: PRISMA-ScR Checklist
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Obstetrics and Gynecology · 2015
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Obstetrics and Gynecology · 2013
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Journal of the Formosan Medical Association · 2025
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Journal of the Formosan Medical Association · 2018
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Journal of the Formosan Medical Association · 2019
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