Peer-reviewed Publications Research Articles

Study protocol: optical coherence tomography angiography for the detection of neovascular age-related macular degeneration: a comprehensive multicentre diagnostic accuracy study in the UK—the ATHENA study

IntroductionThe diagnosis of neovascular age-related macular degeneration (nAMD), the leading cause of visual impairment in the developed world, relies on the interpretation of various imaging tests of the retina. These...

Understanding the interaction between support and social participation for people with physical disabilities: a scoping review protocol

IntroductionAround the world, the disability rights movements and the social model of disability have placed emphasis on the importance of social participation for people with disability. People with physical disability...

Protocol for the Development and Analysis of the Oxford and Reading Cognitive Comorbidity, Frailty and Ageing Research Database-Electronic Patient Records (ORCHARD-EPR)

BackgroundHospital electronic patient records (EPRs) offer the opportunity to exploit large-scale routinely acquired data at relatively low cost and without selection. EPRs provide considerably richer data, and in real-time, than...

Clinical dimensions of people with co-occurring obsessive-compulsive and related disorders and multiple sclerosis: a scoping review protocol

IntroductionMultiple sclerosis (MS) is an immune-mediated demyelinating disease with a significant burden of neuropsychiatric sequelae. These symptoms, including depression and anxiety, are predictors of morbidity and mortality in people with...

Designing relational feedback: a rapid review and qualitative synthesis

Feedback has long been considered a significant lever to enhance learning experience and success in higher education. However, students have shown much discontent with the current feedback practice. Feedback experienced as a relational process in which students feel recognized and valued is perceived as paramount for helping support the uptake of feedback and promote positive learning dispositions. However, little attention has been paid to suggesting how instructors in higher educational institutions can facilitate relational feedback. In response, we conducted a rapid literature review with a particular focus on the creation of feedback content. In total, 17 peer-reviewed publications on relational feedback are included. Based on a qualitative analysis of these papers, we developed a framework of 12 characteristics for offering relational feedback. These 12 characteristics were further categorised into four types of feedback conductive to a relational process, including (i) clarifying performance, (ii) suggesting improvement, (iii) inviting further communication, and (iv) evoking positive emotions. We examined how each of these characteristics supports the relational aspects of feedback. Based on the qualitative analysis results, we offered practical recommendations for instructors to apply relational feedback in their pedagogical practices.

The Female Global Scholars Program: A mixed-methods evaluation of a novel intervention to promote the retention and advancement of women in global health research.

Fewer than 25% of global health leadership positions worldwide are held by women, adversely impacting women's health and widening gendered health disparities. The Female Global Scholars (FGS) Program, established in 2018 at Weill Cornell Medicine, is a two-year hybrid training and peer-mentorship program that promotes the retention and advancement of early-career female investigators conducting health research in low- and middle-income countries (LMICs). The purpose of this study is to determine the impact of the FGS Program on individual career advancement, academic productivity, and research self-efficacy. This mixed-methods study followed an explanatory sequential design. Participants completed an electronic survey collecting information on demographics, academic milestones, and research skill competency. Survey data were descriptively analyzed using R (Version 1.4.1106). In-depth interviews explored perceptions of the impact of the FGS Program on career development. The authors independently reviewed and thematically analyzed de-identified transcripts using NVivo (Version 13). In June 2022, twelve participants completed the survey. The median age was 40 years; 90% carried an MD, PhD, or other post-graduate degree. Since joining the FGS Program, respondents achieved a combined total of eight awarded grants, five academic promotions, 12 oral scientific presentations and 35 first-author peer-reviewed publications. Thematic analysis identified four overarching themes: gaining confidence through mimicry; improved self-efficacy to address gendered challenges; real-world application of scientific and career development skills; and building multi-disciplinary communities in a protected female-only space. We demonstrate that this low-cost training and mentorship program successfully addresses critical barriers that impede women's advancement in global health research. Our data may inform the adaptation of this initiative across other academic institutions.

Knowledge management in the agriculture sector: a systematic literature review

ABSTRACT The agriculture sector is becoming increasingly important, with knowledge management (KM) seen as a vital component. This paper uses a systematic literature review of 44 peer-reviewed publications, in KM and non-KM journals, to examine how KM processes are used in agricultural research. Studies were mostly published in non-KM journals resulting in an absence of KM theory. Three key themes were identified as important for KM research in agriculture: stakeholder heterogeneity, informality of contexts and the presence of indigenous knowledge. All three themes affected the processes of knowledge creation, codification, transfer, sharing, and application. While agriculture provides a unique context for KM research, there is a need for a more nuanced understanding of how KM can be applied to create a future research framework that can be cumulatively built upon. To help achieve this, the paper also identifies several research gaps and suggests future research directions.

Remote sensing applications for prescribed burn research

Prescribed burning is a key management strategy within fire-adapted systems, and improved monitoring approaches are needed to evaluate its effectiveness in achieving social-ecological outcomes. Remote sensing provides opportunities to analyse the impacts of prescribed burning, yet a comprehensive understanding of the applications of remote sensing for prescribed burn research is lacking. We conduct a literature review of 120 peer-reviewed publications to synthesise the research aims, methodologies, limitations and future directions of remote sensing for the analysis of prescribed fire. Studies evaluating management outcomes found prescribed burning effective for wildfire risk reduction, yet few analysed co-benefits or trade-offs with other management goals. Most studies use passive, spaceborne, low spatial resolution sensors, characterised in the literature as consistent and accessible data sources but limited in detecting small, low-severity and short-duration fires characteristic of prescribed burns. In contrast, active remote sensing approaches including LiDAR are less frequently employed, but show promise for highly accurate, spatially explicit 3D vegetation and fuel load mapping. Remote sensing advances toward higher spatial resolution, more frequent revisit, denser spectral sampling and more data across the electromagnetic spectrum are critical to advancing prescribed fire research, addressing current methodological gaps, and improving fuels and fire management capacity.

Sedation modality in acute respiratory distress syndrome: does method of sedation affect length of stay, outcomes, or adverse events? A systematic review

IntroductionAcute respiratory distress syndrome (ARDS) is a life-threatening, diffuse inflammatory pulmonary condition characterised by the Berlin criteria. Incidence of ARDS is estimated at 2.5–19% globally with high mortality and morbidity....

To modulate or to skip: De-escalating PARP inhibitor maintenance therapy in ovarian cancer using adaptive therapy

Toxicity and emerging drug resistance pose important challenges in poly-adenosine ribose polymerase inhibitor (PARPi) maintenance therapy of ovarian cancer. We propose that adaptive therapy, which dynamically reduces treatment based on the tumor dynamics, might alleviate both issues. Utilizing invitro time-lapse microscopy and stepwise model selection, we calibrate and validate a differential equation mathematical model, which we leverage to test different plausible adaptive treatment schedules. Our model indicates that adjusting the dosage, rather than skipping treatments, is more effective at reducing drug use while maintaining efficacy due to a delay in cell kill and a diminishing dose-response relationship. Invivo pilot experiments confirm this conclusion. Although our focus is toxicity mitigation, reducing drug use may also delay resistance. This study enhances our understanding of PARPi treatment scheduling and illustrates the first steps in developing adaptive therapies for new treatment settings. A record of this paper's transparent peer review process is included in the supplemental information.

OPerative versus non-opERAtive management of isolated ULNAr diaphyseal fractures (OPERA-Ulna): protocol for a randomized controlled trial.

Isolated fractures of the ulnar diaphysis are uncommon, occurring at a rate of 0.02 to 0.04 per 1,000 cases. Despite their infrequency, these fractures commonly give rise to complications, such as nonunion, limited forearm pronation and supination, restricted elbow range of motion, radioulnar synostosis, and prolonged pain. Treatment options for this injury remain a topic of debate, with limited research available and no consensus on the optimal approach. Therefore, this trial aims to compare clinical, radiological, and functional outcomes of two treatment methods: open reduction and internal fixation (ORIF) versus nonoperative treatment in patients with isolated ulnar diaphyseal fractures. This will be a multicentre, open-label, parallel randomized clinical trial (under National Clinical Trial number NCT01123447), accompanied by a parallel prospective cohort group for patients who meet the inclusion criteria, but decline randomization. Eligible patients will be randomized to one of the two treatment groups: 1) nonoperative treatment with closed reduction and below-elbow casting; or 2) surgical treatment with ORIF utilizing a limited contact dynamic compression plate and screw construct. The primary outcome measured will be the Disabilities of the Arm, Shoulder and Hand questionnaire score at 12 months post-injury. Additionally, functional outcomes will be assessed using the 36-Item Short Form Health Survey and pain visual analogue scale, allowing for a comparison of outcomes between groups. Secondary outcome measures will encompass clinical outcomes such as range of motion and grip strength, radiological parameters including time to union, as well as economic outcomes assessed from enrolment to 12 months post-injury. This trial has been approved by the lead site Conjoint Health Research Ethics Board (CHREB; REB14-2004) and local ethics boards at each participating site. Findings from the trial will be disseminated through presentations at regional, national, and international scientific conferences and public forums. The primary results and secondary findings will be submitted for peer-reviewed publication.

Exploring the path to optimal diabetes care by unravelling the contextual factors affecting access, utilisation, and quality of primary health care in West Africa: A scoping review protocol.

The prevalence of diabetes in West Africa is increasing, posing a major public health threat. An estimated 24 million Africans have diabetes, with rates in West Africa around 2-6% and projected to rise 129% by 2045 according to the WHO. Over 90% of cases are Type 2 diabetes (IDF, World Bank). As diabetes is ambulatory care sensitive, good primary care is crucial to reduce complications and mortality. However, research on factors influencing diabetes primary care access, utilisation and quality in West Africa remains limited despite growing disease burden. While research has emphasised diabetes prevalence and risk factors in West Africa, there remains limited evidence on contextual influences on primary care. This scoping review aims to address these evidence gaps. Using the established methodology by Arksey and O'Malley, this scoping review will undergo six stages. The review will adopt the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) guidelines to ensure methodological rigour. We will search four electronic databases and search through grey literature sources to thoroughly explore the topic. The identified articles will undergo thorough screening. We will collect data using a standardised data extraction form that covers study characteristics, population demographics, and study methods. The study will identify key themes and sub-themes related to primary healthcare access, utilisation, and quality. We will then analyse and summarise the data using a narrative synthesis approach. The findings and conclusive report will be finished and sent to a peer-reviewed publication within six months. This review protocol aims to systematically examine and assess the factors that impact the access, utilisation, and standard of primary healthcare services for diabetes in West Africa.

Land use modified impacts of global change factors on soil microbial structure and function: A global hierarchical meta-analysis

Nitrogen cycling in terrestrial ecosystems is critical for biodiversity, vegetation productivity and biogeochemical cycling. However, little is known about the response of functional nitrogen cycle genes to global change factors in soils under different land uses. Here, we conducted a multiple hierarchical mixed effects meta-analyses of global change factors (GCFs) including warming (W+), mean altered precipitation (MAP+/−), elevated carbon dioxide concentrations (eCO2), and nitrogen addition (N+), using 2706 observations extracted from 200 peer-reviewed publications. The results showed that GCFs had significant and different effects on soil microbial communities under different types of land use. Under different land use types, such as Wetland, Tundra, Grassland, Forest, Desert and Agriculture, the richness and diversity of soil microbial communities will change accordingly due to differences in vegetation cover, soil management practices and environmental conditions. Notably, soil bacterial diversity is positively correlated with richness, but soil fungal diversity is negatively correlated with richness, when differences are driven by GCFs. For functional genes involved in nitrification, eCO2 in agricultural soils and the interaction of N+ with other GCFs in grassland soils stimulate an increase in the abundance of the AOA-amoA gene. In agricultural soil, MAP+ increases the abundance of nifH. W+ in agricultural soils and N+ in grassland soils decreased the abundance of nifH. The abundance of the genes nirS and nirK, involved in denitrification, was mainly negatively affected by W+ and positively affected by eCO2 in agricultural soil, but negatively affected by N+ in grassland soil. This meta-analysis was important for subsequent research related to global climate change. Considering data limitations, it is recommended to conduct multiple long-term integrated observational experiments to establish a scientific basis for addressing global changes in this context.

Current Aspects of Medical Rehabilitation of Patients with Cancer Related Lymphedema of Extremities: a Narrative Review

INTRODUCTION. Over the past decades, in developed countries and in the Russian Federation, there has been an increase in the number of patients with secondary lymphedema who have undergone surgical treatment with dissection of regional lymph nodes and radiation therapy for various forms of gynecological cancer in women and prostate cancer in men, as well as breast cancer. AIM. Search and analysis of the results of previously published randomized controlled trials (RCTs) of the effectiveness of various non-drug rehabilitation methods in patients with lymphedema of the extremities who underwent radical treatment for cancer of various locations. MATERIALS AND METHODS. A search was conducted and studied publications in international scientific peer-reviewed publications (PEDro Database) on medical rehabilitation for cancer treatment-related lymphedema (LSPR) for the period from 1996 to December 2023 using the keywords “lymphedema”, “rehabilitation”. 145 RCTs focused on medical rehabilitation and conservative treatment of LSPR. DISCUSSION. Lifestyle correction and psychosocial interventions are recommended to improve the quality of life of patients. Studies have found that early activation, various physical exercises with a slow increase in loads under the supervision of a physical therapist are safe and help increase endurance, strength and range of motion in a limb with lymphatic edema. The clinical effectiveness of therapeutic exercises in the pool has been proven, manifested in the reduction of edema in patients with LSPR. The effectiveness of compression products with Velcro technology as an alternative to rigid low-stretch bandages in patients with LSPR has been confirmed. The anti-edematous and anti-inflammatory effects of low-intensity laser therapy and magnetic therapy in the rehabilitation of patients with LSLR have been proven. Alternating pneumatic compression (APC) is recommended as an adjuvant treatment in addition to comprehensive decongestant therapy. Preference should be given to the use of technologies of advanced hardware lymphatic drainage methods that imitate manual techniques. CONCLUSION. To improve the physical and socio-psychological functioning of patients with LSPR, an integrated approach is required, including lifestyle changes, psychological correction, compression therapy, modern exercise therapy techniques, and safe physiotherapeutic technologies. Conducted scientific research indicates the high effectiveness of the use of manual and hardware lymphatic drainage techniques, while the use of PPC is more economical and accessible, and does not require the involvement of specialists who know the expensive method of manual lymphatic drainage.

EXPLORING ARTS-BASED METHODS IN UNPAID CAREGIVING CONTEXTS: A SCOPING REVIEW

Introduction:Unpaid caregiving plays a crucial role in supporting older adults, requiring innovative approaches to understand and enhance caregivers' experiences. Research Objectives: As a response, this scoping review investigates the application of arts-based methods in understanding the caregiving experience, as well as the advantages and limitations of these methods in providing care to diverse populations. Methodology: Building on Arksey and O’Malley's framework, our methodology draws from the Joanna Briggs Institute approach. Eligibility criteria encompassed peer-reviewed publications in English from 2007 to 2022, focusing on unpaid caregivers, arts-based methods, and caregiving experiences. Six comprehensive databases were queried, with the initial searches yielding 761 articles. Full text screening of 66 papers resulted in 19 papers for inclusion in the scoping review. Results: Analysis of the literature revealed the multifaceted applications of arts-based methods in understanding and supporting unpaid caregivers. These encompassed a wide range of creative techniques, such as visual arts, photo elicitation, storytelling, and performance – which provided insights into the emotional, psychological, and social dimensions of caregiving. Findings highlighted the potential for arts-based methods to enhance caregiver well-being, foster self-reflection and self-care, and promote dialogue. Nonetheless, there were notable gaps. Racial and ethnic diversity was often neglected in the studies (addressed in 3 of 19), underscoring the necessity for tailored interventions and methodological considerations for diverse populations. Importantly, dementia caregiving received substantial attention (12 of 19). Final Considerations: This scoping review highlights the growing interest in integrating arts-based methods into caregiving research and interventions amongst qualitative and mixed methods approaches. By mapping out the landscape of existing literature, this review underscores the need for further exploration and methodological refinement to harness the full potential of creative techniques in advancing our understanding of unpaid caregivers' lived experiences. Arts-based approaches hold promise in providing a nuanced and holistic perspective on unpaid caregiving experiences.

Integration of Smart Home and Building Automation Systems in Virtual Reality and Robotics-Based Technological Environment for Neurorehabilitation: A Pilot Study Protocol.

Technological innovation has revolutionized healthcare, particularly in neurological rehabilitation, where it has been used to address chronic conditions. Smart home and building automation (SH&BA) technologies offer promising solutions for managing chronic disabilities associated with such conditions. This single group, pre-post longitudinal pilot study, part of the H2020 HosmartAI project, aims to explore the integration of smart home technologies into neurorehabilitation. Eighty subjects will be enrolled from IRCCS San Camillo Hospital (Venice, Italy) and will receive rehabilitation treatment through virtual reality (VR) and robotics devices for 15 h per day, 5 days a week for 3 weeks in the HosmartAI Room (HR), equipped with SH&BA devices measuring the environment. The study seeks to optimize patient outcomes and refine rehabilitation practices. Findings will be disseminated through peer-reviewed publications and scientific meetings, contributing to advancements in neurological rehabilitation and guiding future research.

Comprehensive literature review on stakeholder prospects, responsibilities, and quality performance measurement in sustainable supply chain governance

The sustainable Governance of supply chains has become essential for businesses trying to balance economic success and ecological and ethical imperatives in an era of increased environmental awareness and social responsibility. Many stakeholders are pressuring companies to integrate sustainability into their supply chains as environmental degradation and social inequality worsen. Therefore, it is essential to include non-traditional supply chain stakeholders, such as competitors and non-governmental organizations, in supply chain operations to produce an SSCG. This comprehensive literature review synthesizes and examines the current body of information on stakeholder prospects, responsibilities, and measuring quality performance in sustainable supply chain governance. Therefore, this study's primary objective is to clearly show how SSC practices are related to stakeholder roles and responsibilities. A thorough literature examination was conducted, and 40 peer-reviewed journal publications from 2019 to 2023 were included. In this work, expectations, as stated in scholarly literature, are methodically categorized, and any gaps are reviewed critically. A reasonable explanation for stakeholders' discontent with the sustainability performance measurement and evaluation methods used nowadays is that, as the literature review demonstrates, stakeholder expectations have yet to be considered. The findings indicate that many external and internal supply chain stakeholders drive, enable, or check the application of sustainable supply chain Governance techniques.While governments and non-governmental organizations are essential drivers of sustainable supply chain Governance techniques, research can also help with their implementation. Furthermore, proactive interaction with external supply chain stakeholders improves organizational learning by boosting understanding and awareness of sustainability and developing knowledge.

Assessment of effectiveness and impact of universal prophylaxis with nirsevimab for prevention of hospitalizations due to respiratory syncytial virus in infants. The NIRSE-GAL study protocol

ABSTRACT Nirsevimab has been recently licensed for universal RSV prophylaxis in infants. NIRSE-GAL is a three-year population-based study initiated in Galicia in September 2023. It aims to evaluate nirsevimab effectiveness against RSV-related hospitalizations lower respiratory tract infections (LRTI), severe RSV, all-cause LRTI, and all-cause hospitalization. NIRSE-GAL also aims to estimate nirsevimab impact on primary healthcare use in the short and mid-term, children’s wheezing and asthma, and medical prescriptions for RSV. The immunization campaigns will be scheduled based on the expected start week for the RSV season and will last the whole season. Immunization will be offered to: i) infants born during the campaign (seasonal), ii) infants < 6 months at the start of the campaign (catch-up), and iii) infants with high-risk factors, aged 6–24 months at the start of the campaign (high-risk). The follow-up period will start: i) the immunization date for all immunized infants, ii) the start of the campaign, for the non-immunized catch-up or high-risk groups, or iii) the birthdate for the non-immunized seasonal group. Infants will be followed up until outcome occurrence, death, or end of study. Nirsevimab effectiveness will be estimated using Poisson and Cox regression models. Sensitivity and stratified analyses will be undertaken. The number of averted cases and the number needed to immunize will be estimated. Immunization failure and nirsevimab safety will be monitored. NIRSE-GAL was approved by the ethics committee of Galicia (CEIC 2023–377) and registered in ClinicalTrials.gov (ID: NCT06180993). Findings will be mainly shared via peer-reviewed publications and scientific conferences.

Exploring community participation in vectorborne disease control in Southeast Asia: a scoping review protocol

IntroductionVector borne diseases (VBDs) present significant public health challenges in Southeast Asia (SEA), and the increasing number of cases threatens vulnerable communities. Inadequate vector control and management have been linked...

Litter decomposition rate response to multiple global change factors: A meta-analysis

Anthropogenic global change fundamentally impacts ecosystem biogeochemical cycling. Although litter decomposition is a crucial component of carbon (C) cycling, its response to diverse global change factors (GCFs) remains uncertain. In this research, we synthesized 1706 observations from 260 peer-reviewed publications to elucidate the effects of GCFs on litter decomposition rate (k) and the contribution of different variables to them. Overall, nitrogen (N) addition and drought significantly decreased k (−3.3 and −17.7%, respectively), phosphorus (P) addition, warming, and increased precipitation significantly increased k (6.7, 8.2, and 11.6%, respectively), while elevated CO2 had an insignificant effect on k (−0.6%). Combined GCFs had no significant effect on k except for warming*drought, and all combined factors mainly exhibited antagonistic interactions. Further analysis showed that k responses to GCFs were influenced by initial litter quality (C, N, C:N, P, cellulose, lignin, and vegetation types), soil properties (soil organic C, soil total N, soil total P, soil respiration and microbial biomass C), environmental factors (latitude, longitude, annual mean temperature, annual mean precipitation, ecosystem type, and climate type), and experimental methods (experiment type, richness, treatment method, fertilizer form, fertilizer rate, and experimental duration). Initial litter quality predominantly governed the k response to N addition (53.5%), while soil properties were more significant in regulating the P addition response (44.8%). Environmental factors largely determined k responses to warming, drought, and increased precipitation (50.6, 54.7, 46.9%). Moreover, the experimental methodology also played an important role in regulating k responses to GCFs, which explained 8.6, 23.6, 31.1, 23.7, and 29.7% of the variation of the responses of k to N addition, P addition, warming, drought, and increased precipitation. This meta-analysis offers improved global-scale nutrient cycling predictions under climate change and underscores the need for long-term, multi-factor, methodologically standardized experiments to accurately predict the influence of GCFs on litter decomposition.