Research Training Research Articles

The next generation of physician-researchers: undergraduate medical students’ and residents’ attitudes, challenges, and approaches towards addressing them

Abstract Background Undergraduate medical education and residency training are critical periods for conducting research. Medical diagnoses and therapies are direct results of successful research efforts that have advanced several scientific fields. This review highlights the importance of incorporating scientific research training into the curricula of undergraduate medical education and residency programs. Methods We utilized key databases such as PubMed, Web of Science, and Google Scholar to conduct a narrative review of English-language articles published between 2002 and 2024. Ultimately, we selected 49 studies that examined the attitudes of undergraduate medical students and residents toward research, the common challenges they encounter while participating in research activities, and the strategies that support and encourage their involvement, all in alignment with our study objectives and keywords. In addition, we identified several relevant themes, including the value of research experience in shaping well-rounded medical professionals; the integrity of research practices in residency selection, which addresses concerns such as the arms race and misrepresentation, as well as the balance between quality and quantity; striking a balance between research and clinical training while promoting equity and inclusion; and effective programs and mentorship strategies to enhance research engagement. Results Translating the positive attitudes of undergraduate medical students and residents into improved knowledge and practice necessitates the development of structured mentoring programs and advanced training systems. Institutions must provide the necessary tools, guidance, and support to overcome research barriers. This will help establish an environment in undergraduate medical education and residency training that values research, facilitates access to it, and integrates it into the curriculum. Conclusions To address the critical shortage of physician-researchers and improve evidence-based medical practice, it is crucial for medical schools to focus on research education and create avenues for student involvement. By tackling research challenges and implementing supportive strategies, these efforts empower the next generation of physician-researchers to embrace research, contribute to medical progress, and uphold the highest standards of patient care.

Addressing barriers to post-graduate research training in low resource settings: an innovative approach in an institution of higher learning in Kenya

BackgroundNumerous barriers hinder health research training in Post-Graduate Medical Education Programs, especially in developing countries. Research training is pivotal for medical residency, providing essential knowledge and skills for dissertation completion, fostering evidence-based medical practice, and nurturing future independent clinical researchers. A holistic approach to research education is imperative to surmount these barriers. We describe here a dissertation-centric research curriculum, delivered longitudinally, an innovative strategy undertaken by Aga Khan University's Medical College in East Africa (AKU-MCEA) to deliver postgraduate research.MethodsA review of AKU-MCEA post-graduate research methods curriculum was conducted based on implementing Departments' experience, institutional policies, and residency program output.Program implementationThe Master of Medicine program requires a well-executed dissertation for graduation. Residents undergo structured research training across four modules, with interactive sessions and workshops supporting their research milestones. Protected time allows residents to develop and report on their dissertation work. Faculty receive specialized training in dissertation supervision to ensure residents benefit from expert guidance in producing high-quality research.OutcomesThis approach achieves a dissertation completion and graduation rate of 98–100%. Notably, 68.5% (n = 126) of those who graduated in 2013–2023 have published two or more papers (i.e., range 2–36) in their current portfolio, demonstrating a commitment to ongoing research endeavors even after graduation. Residents' research covers diverse themes and is disseminated through departmental presentations, university-wide Faculty Academic Rounds, peer-reviewed journals, conferences, and the Annual Early Career Researchers symposium.Lessons learntA comprehensive approach featuring a structured research curriculum, longitudinal delivery with predetermined milestones, dedicated supervision, financial and resource support, protected research time, ongoing faculty development in dissertation supervision, and clear institutional research policies accelerates dissertation completion and enhances effective research dissemination.

Early scientific research training links to the innovation ability of medical undergraduates and postgraduates

Scientific research training (SRT) is crucial for fostering skills and innovation in college students. However, the status of SRT in medical undergraduates and postgraduates, as well as the impact of early SRT on students’ innovation abilities, remain largely unknown. This study assessed the role of SRT in culturing innovation abilities among medical students. The results revealed that undergraduates exhibited a greater understanding of scientific research compared to postgraduates. Notably, undergraduates demonstrated a higher level of understanding of SRT in contrast to postgraduates (81.26% vs. 56.97%). A significant proportion (>70%) of undergraduates had engaged in research activities early in their academic journey, with an average participation duration exceeding 1 year. Moreover, undergraduates initiated their involvement in SRT during the first- and second- year of undergraduates, which was earlier than postgraduates. Personal interest emerged as a primary motivator for engaging in SRT, with postgraduates exhibiting higher research aspirations and achieving greater research outcomes. Postgraduates also received more substantial guidance from advisors, leading to enhanced academic performance compared to undergraduates (90.7% vs. 67.59%). Interestingly, students expressed satisfaction with laboratory conditions and attributed their academic success to personal efforts. These findings underscore the importance of early SRT in cultivating the innovation abilities of medical students.

Finally, a Researcher Development and Education Skills Framework for an Open University

While there is an ongoing advocacy for transformative higher education through a collaborative research culture in a national university system (Almores, 2024; Cubillan, 2024), there lacks an explicit and unified framework for researcher development of valuable skills and competencies to inform its typology of research training, supervision and mentoring (Villanueva, 2024). We propose a researcher development and education framework to benefit open and distance elearning programs, or ODeL programs situated in the national university’s Open University constituent unit with a wide reach of students locally and in Southeast Asia (Alfonso, 2019). The framework is a by-product of our sustained intellectual and intertextual networking, engagements with an international network of researchers in doctoral education and consultations with teacher-researchers and other stakeholders in an open university. The framework is underpinned by the identity-trajectory theory, self-determination theory and the community of inquiry for learning community building in harnessing positive research student experiences (Villanueva & Eacersall, 2024). Key areas of the framework are namely, research as a personal and scholarly practice, a reflective practice, a collaborative practice and a technology-enabled practice. Surrounding these key areas are shared values of: (i) excellence, rigor and creativity; (ii) agency and wellbeing; (iii) sense of community, social responsibility and service to others; and, (iv) integrity, agency and future-ready. Further validation of the framework was conducted through focused group discussions across three faculties of study. Collaborative reflections among faculty members and research students were undertaken to further define specific research competencies as well as mindsets. A natural outcome was the conceptualization of three courses pilot-test the application of the framework in varied learning spaces for a range of learners within the Open University unit. MyPORTAL Course 1 is a formal course for graduate-level students crafting their personalized learning plans for selected research-related outputs while ASCEND Course 2 is non-formal short course for professional research staff and students to navigate their academic writing and research with the use of Generative AIs. WORKSPACE Course 3 is a self-paced micro-course as an opportunity for faculty members to spend dedicated sensemaking on current practices in mentoring and research supervision. These courses are meant to operationalize intentional learning alliance and community building to harness researcher identity development and sense of agency among research students in ODeL programs. Further research is recommended in launching these courses and towards the creation of graduate research support teams with researcher development specialists and volunteer research trainers and learning designers. The teams are meant to go beyond administerial functions to ensure exemplary pedagogy and practices, benefiting both research supervisors and their students. The study all the more highlights the Open University’s unique identity as a progressive driver of innovation and within a dominant residential-based university system’s seeking to translate the transformative education rhetoric into actual practice at the program and course levels. Finally, we lay our claim of an ODeL research culture that is truly open, collaborative and future-ready.

Combining the SSD Target Identification Algorithm with the 3d-Cnn Architecture for Transfer Learning Research in Basketball Training

Combining the SSD Target Identification Algorithm with the 3d-Cnn Architecture for Transfer Learning Research in Basketball Training

Toward a Conceptual Model of Academic Translation Competence

ABSTRACTDifferent cultures have distinct conceptions of knowledge and ways of defining, generating and communicating knowledge. Therefore, multilingualism in academia has been shown to be instrumental in preserving the various systems of knowledge, equality of opportunity in science and enhancing the international competitiveness of scholars whose native language is not the lingua franca. The actors of translation and the strategies they work with (domestication and foreignisation) play a unique role in this, as their decisions may foster or hinder linguistic and epistemic diversity. Despite its pronounced significance, however, relatively little is known about the stereotypical competences required for academic translation. As translation in science is not merely a philological issue, this conceptual study follows a consilient approach and integrates the outcomes of research from several disciplines and research perspectives to propose a theory‐based, multi‐componential model of academic translation competence as a macrocompetence. Based on the model, a conceptual definition of the construct of academic translation competence is provided to identify what exactly is to be observed and measured for its study and to generate preliminary hypotheses related to the construct. The study has implications not only for the theory, practice and training of academic translation but also for the disciplinary training of researchers.

Biomedical researchers' perspectives on the reproducibility of research.

We conducted an international cross-sectional survey of biomedical researchers' perspectives on the reproducibility of research. This study builds on a widely cited 2016 survey on reproducibility and provides a biomedical-specific and contemporary perspective on reproducibility. To sample the community, we randomly selected 400 journals indexed in MEDLINE, from which we extracted the author names and emails from all articles published between October 1, 2020 and October 1, 2021. We invited participants to complete an anonymous online survey which collected basic demographic information, perceptions about a reproducibility crisis, perceived causes of irreproducibility of research results, experience conducting reproducibility studies, and knowledge of funding and training for research on reproducibility. A total of 1,924 participants accessed our survey, of which 1,630 provided useable responses (response rate 7% of 23,234). Key findings include that 72% of participants agreed there was a reproducibility crisis in biomedicine, with 27% of participants indicating the crisis was "significant." The leading perceived cause of irreproducibility was a "pressure to publish" with 62% of participants indicating it "always" or "very often" contributes. About half of the participants (54%) had run a replication of their own previously published study while slightly more (57%) had run a replication of another researcher's study. Just 16% of participants indicated their institution had established procedures to enhance the reproducibility of biomedical research and 67% felt their institution valued new research over replication studies. Participants also reported few opportunities to obtain funding to attempt to reproduce a study and 83% perceived it would be harder to do so than to get funding to do a novel study. Our results may be used to guide training and interventions to improve research reproducibility and to monitor rates of reproducibility over time. The findings are also relevant to policy makers and academic leadership looking to create incentives and research cultures that support reproducibility and value research quality.

Research Training: Research Attitudes and Skills in Public Management Students from a Peruvian University

Research has consolidated itself as a key element in the advancement of science and academic development, while simultaneously emerging as a transcendental activity that enables, among other achievements, the attainment of professional degrees and titles. This study examines the relationship between research skills and attitude towards research. The design was non-experimental, applied to a probabilistic sample of 240 students. Two questionnaires were utilized to assess attitudes and research skills. A highly significant positive correlation was found through the statistical procedure Rho Spearman = 0.594 and p-value 0.001. These results corroborated previous studies that outline significantly associated factors, confirming that the importance of research skills is necessary and part of an appropriate attitude towards research that facilitates the development of skills applicable in academic, personal, and professional spheres. Research activity is essential for the growth of critical and highly capable individuals, capable of significantly enhancing their performance in various activities. Received: 14 June 2024 / Accepted: 28 October 2024 / Published: 05 November 2024

A scientific research training programme for teaching biomedical students to identify the horizontal transfer of antibiotic resistance genes.

Worldwide prevalence of multi-antibiotic resistant bacteria is rapidly increasing, and the education of undergraduates and graduates about antibiotic resistance and its associated horizontal gene transfer is critical in the general effort to confront the spread of antibiotic resistance. In this study, a deeper understanding of antibiotic resistance and horizontal gene transfer was achieved by biomedical undergraduate students through a scientific research programme. The enthusiasm of students to participate in the training programme was very high, and results revealed that each student could identify the antibiotic resistance integrative and conjugative element from the Stenotrophomonas maltophilia MER1 genome. Each student could also draw the phylogenetic relationship of the antibiotic resistance integrative and conjugative element. In addition, students proved the horizontal transfer of antibiotic resistance genes from S. maltophilia MER1 to Escherichia coli strain 25DN through conjugation and PCR assays. Each group of students was able to obtain the expected results, indicating that the outcome of the scientific research programme was highly reproducible. This programme improved the theoretical knowledge about antibiotic resistance and horizontal gene transfer and the research skills of biomedical sciences students. Through this programme, students learned that antibiotic resistance genes can be horizontally transferred among different bacteria, laying a solid foundation for students to value the importance of the appropriate use of antibiotics in their future work and life.

Psychological and Pedagogical Support for Future Technology Teachers in the Educational-Scientific-Production Cluster

The article examines the importance of psychological and pedagogical support in the training process of future technology teachers, particularly in the context of modern educational challenges and the full-scale war. This support is aimed at developing emotional intelligence, stress resilience, preventing professional burnout, improving communication skills, and providing supervision. The research emphasizes the formation of teachers' professional identity, as well as their ability for self-analysis and self-reflection. Special attention is given to methods of coping with emotional stress during the war, including relaxation techniques, stress management, the use of positive thinking, and maintaining a work-life balance. The article is based on the experience of the Social and Psychological Center of the Lviv Educational-Scientific-Production Cluster, which focuses its efforts on supporting future teachers through supervision, training, and consultations. The cluster integrates theoretical knowledge, scientific research, and practical training for specialists in the fields of vocational education and production. This model of teacher training is aimed at enhancing their qualifications, developing professional competencies, and adapting to the demands of the modern labor market. The study explores the key stages of teacher training, which include foundational theoretical preparation, scientific research, practical internships at production enterprises, and further professional development. Special attention is paid to the implementation of innovative teaching approaches and the use of modern technologies that enable future teachers not only to master new teaching methodologies but also to integrate contemporary production processes into educational programs.

Training research data management experts

Training research data management experts

Open science practices among authors published in complementary, alternative, and integrative medicine journals: An international, cross-sectional survey.

Open science practices aim to increase transparency in research and increase research availability through open data, open access platforms, and public access. Due to the increasing popularity of complementary, alternative, and integrative medicine (CAIM) research, our study aims to explore current open science practices and perceived barriers among CAIM researchers in their own respective research articles. We conducted an international cross-sectional online survey that was sent to authors that published articles in MEDLINE-indexed journals categorized under the broad subject of "Complementary Therapies" or articles indexed under the MeSH term "Complementary Therapies." Articles were extracted to obtain the names and emails of all corresponding authors. Eight thousand seven hundred eighty-six researchers were emailed our survey, which included questions regarding participants' familiarity with open science practices, their open science practices, and perceived barriers to open science in CAIM with respect to participants' most recently published article. Basic descriptive statistics was generated based on the quantitative data. The survey was completed by 292 participants (3.32% response rate). Results indicate that the majority of participants were "very familiar" (n = 83, 31.68%) or "moderately familiar" (n = 83, 31.68%) with the concept of open science practices while creating their study. Open access publishing was the most familiar to participants, with 51.96% (n = 136) of survey respondents publishing with open access. Despite participants being familiar with other open science practices, the actual implementation of these practices was low. Common barriers participants experienced in implementing open science practices include not knowing where to share the study materials, where to share the data, or not knowing how to make a preprint. Although participants responded that they were familiar with the concept of open science practices, the actual implementation and uses of these practices were low. Barriers included a lack of overall knowledge about open science, and an overall lack of funding or institutional support. Future efforts should aim to explore how to implement methods to improve open science training for CAIM researchers.

Effect of Beta-Alanine Supplementation on Maximal Intensity Exercise in Trained Young Male Individuals: A Systematic Review and Meta-Analysis.

Beta-alanine is a nonessential amino acid that is commonly used to improve exercise performance. It could influence the buffering of hydrogen ions produced during intense exercise and delay fatigue, providing a substrate for increased synthesis of intramuscular carnosine. This systematic review evaluates the effects of beta-alanine supplementation on maximal intensity exercise in trained, young, male individuals. Six databases were searched on August 10, 2023, to identify randomized, double-blinded, placebo-controlled trials investigating the effect of chronic beta-alanine supplementation in trained male individuals with an age range of 18-40years. Studies evaluating exercise performance through maximal or supramaximal intensity efforts falling within the 0.5-10min duration were included. A total of 18 individual studies were analyzed, employing 18 exercise test protocols and 15 outcome measures in 331 participants. A significant (p = .01) result was observed with an overall effect size of 0.39 (95% confidence interval [CI] [0.09, 0.69]), in favor of beta-alanine supplementation versus placebo. Results indicate significant effects at 4weeks of supplementation, effect size 0.34 (95% CI [0.02, 0.67], p = .04); 4-10min of maximal effort, effect size 0.55 (95% CI [0.07, 1.04], p = .03); and a high beta-alanine dosage of 5.6-6.4g per day, effect size 0.35 (95% CI [0.09, 0.62], p = .009). The results provide insights into which exercise modality will benefit the most, and which dosage protocols and durations stand to provide the greatest ergogenic effects. This may be used to inform further research, and professional or recreational training design, and optimization of supplementation strategies.

Petroleum Engineering Research Shifts Focus From Oil and Gas to New Horizons

Undergraduate education in petroleum engineering (PE) has survived the latest downturn in the industry, and enrollment has started to show an uptick in numbers. However, a different trend is evident in graduate training and academic research: the number of researchers being trained in oil and gas topics is drastically dropping. The story can be summarized in Fig. 1. Funding trends in PE departments have been shifting away from oil and gas research. These shifts require large investments in skill-building, expertise, and laboratory infrastructure, which makes it much harder to reverse the trend. Consequently, the shift may permanently alter the identity of PE departments, something that will not impact only graduate education but could alter the overall identity of these departments and the workforce they train. The data shared in Fig. 1c shows that more than 50% of the 2023 research awards, which will fund graduate students earning degrees between 2025 and 2026, are going to be invested in geothermal, carbon management, hydrogen, emissions, and other topics that do not support improving oil and gas resource extraction. While 73% of the 2023 MSc and PhD graduates still studied oil and gas topics around reservoir, production, fracturing, and drilling, as shown in Fig. 1a, this number is expected to drop to under 50% for 2026 graduates. Fig. 1b reveals the accelerated trend of this transition, where only 65% of the publications generated from these departments in 2023 covered oil and gas topics. Under 60% of the 2024 and 2025 graduates who published in 2023 are building expertise in oil and gas research and development. The team collected data to study the trends over the past 10 years. It included over $137 million in external research funding and over 1,900 thesis/dissertations, in addition to over 1,100 publications in 2023. More details about these numbers can be found in SPE 220735. The trends in graduate training and research funding over the past 10 years are shown in Fig. 2, where the axis for graduate training is shifted by 3 years to account for the lag between the date funding was received and the graduation date for the students it supported. When looking at numbers rather than percentages (Fig. 3), oil and gas research funding to four of the major PE departments in the US dropped from $30 million in 2014 to under $10 million in 2023 as shown in Fig. 3a. Funding in these departments now hovers at around $20 million, where the gap was filled by transitioning to the study of sustainable geoenergy topics relating to carbon and hydrogen storage and the extraction of geothermal energy, as shown in Fig. 3b.

An integrative literature review: design and stages of peace group counselling as peace counselor/educator strategies for fostering a peace mindset

Counsellors as peace educators are to foster a peaceful mindset to students. However, not every peace counsellor shares peaceful thinking with clients or students with problems as a gap. Peace group leaders can integrate counselling as a science with religion through the design and stages of peace group counselling (PGC). This research aims to design and organize PGC stages to facilitate peaceful thinking patterns in peace counsellors/educators (PC/E) to foster peaceful thinking patterns. Integrative literature review as a research model by collecting data through documentation with relevant books and journals, then analyzing it descriptively and qualitatively. The research findings found that the PC/E's duties as imams (group leaders) and kaffah individuals have therapeutic abilities. PC/E combines peaceful thinking with help from God. The PGC process has three stages: initial, work, and the final. The work stages combine the sub-stages of peace counselling, starting from rational, exploring the root causes of peaceful thoughts, self-reflection, seeking, and searching for peaceful thought patterns, looking for different forms and behaviors of peaceful thought patterns towards God's teachings as a novelty, and ending with evaluation and follow-up. PC/E implements the PGC design and stages so that individuals can cultivate a peaceful mindset through training and experimental research.

Mental healthcare experiences and preferences among lesbian, gay, bisexual, transgender, and/or queer/people of color: A scoping review of qualitative research and recommendations for provider training.

Mental healthcare experiences and preferences among lesbian, gay, bisexual, transgender, and/or queer/people of color: A scoping review of qualitative research and recommendations for provider training.

A Pilot Project to Promote Research Competency in Medical Students Through Journal Clubs: Mixed Methods Study.

Undergraduate medical students often lack hands-on research experience and fundamental scientific research skills, limiting their exposure to the practical aspects of scientific investigation. The Cerrahpasa Neuroscience Society introduced a program to address this deficiency and facilitate student-led research. The primary goal of this initiative was to enhance medical students' research output by enabling them to generate and publish peer-reviewed papers within the framework of this pilot project. The project aimed to provide an accessible, global model for research training through structured journal clubs, mentorship from experienced peers, and resource access. In January 2022, a total of 30 volunteer students from various Turkish medical schools participated in this course-based undergraduate research experience program. Students self-organized into 2 groups according to their preferred study type: original research or systematic review. Two final-year students with prior research experience led the project, developing training modules using selected materials. The project was implemented entirely online, with participants completing training modules before using their newly acquired theoretical knowledge to perform assigned tasks. Based on student feedback, the project timeline was adjusted to allow for greater flexibility in meeting deadlines. Despite these adjustments, participants successfully completed their tasks, applying the theoretical knowledge they had gained to their respective assignments. As of April 2024, the initiative has culminated in 3 published papers and 3 more under peer review. The project has also seen an increase in student interest in further involvement and self-paced learning. This initiative leverages globally accessible resources for research training, effectively fostering research competency among participants. It has successfully demonstrated the potential for undergraduates to contribute to medical research output and paved the way for a self-sustaining, student-led research program. Despite some logistical challenges, the project provided valuable insights for future implementations, showcasing the potential for students to engage in meaningful, publishable research.

Centering equity, diversity, and inclusion in youth digital mental health: findings from a research, policy, and practice knowledge exchange workshop

BackgroundYouth mental health service organizations continue to rapidly broaden their use of virtual care and digital mental health interventions as well as leverage artificial intelligence and other technologies to inform care decisions. However, many of these digital services have failed to alleviate persistent mental health disparities among equity-seeking populations and in some instances have exacerbated them. Transdisciplinary and intersectional knowledge exchange is greatly needed to address structural barriers to digital mental health engagement, develop and evaluate interventions with historically underserved communities, and ultimately promote more accessible, useful, and equitable care.MethodsTo that end, the Digital, Inclusive, Virtual, and Equitable Research Training in Mental Health Platform (DIVERT), the Maritime Strategy for Patient Oriented Research (SPOR) SUPPORT (Support for People and Patient-Oriented Research and Trials) Unit and IWK Mental Health Program invited researchers, policymakers, interprofessional mental health practitioners, trainees, computer scientists, health system administrators, community leaders and youth advocates to participate in a knowledge exchange workshop. The workshop aimed to (a) highlight local research and innovation in youth-focused digital mental health services; (b) learn more about current policy and practice issues in inclusive digital mental health for youth in Canada, (c) participate in generating action recommendations to address challenges to inclusive, diverse and equitable digital mental health services, and (d) to synthesize cross-sector feedback to inform future training curriculum, policy, strategic planning and to stimulate new lines of patient-oriented research.ResultsEleven challenge themes emerged related to white-colonial normativity, lack of cultural humility, inaccessibility and affordability of participating in the digital world, lack of youth and community involvement, risks of too much digital time in youth's lives, and lack of scientific evidence derived from equity-deserving communities. Nine action recommendations focused on diversifying research and development funding, policy and standards, youth and community led promotion, long-term trust-building and collaboration, and needing to callout and advocate against unsafe digital services and processes.ConclusionKey policy, training and practice implications are discussed.

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth.

Retained placenta is a potentially life-threatening condition because of its association with postpartum haemorrhage. Manual removal of the placenta increases the likelihood of infectious complications of the uterine cavity. So, prophylactic antibiotics are recommended by some experts, and commonly administered to reduce these risks. However, the evidence supporting this decision is limited. This review aims to assess the effectiveness of prophylactic antibiotics for manual removal of retained placenta after vaginal birth. To compare the effectiveness and adverse effects of routine prophylactic antibiotics for the manual removal of placenta after vaginal birth. To identify appropriate prophylactic antibiotic regimens. For this update, we searched CENTRAL, MEDLINE, Embase, CINAHL, and two trials registries, in addition to screening the reference lists of retrieved studies and systematic reviews. The last search was 14 May 2024. All randomised controlled trials and non-randomised studies comparing prophylactic antibiotics to no treatment or to another prophylactic antibiotic to prevent postpartum endometritis after manual removal of placenta after vaginal birth. The critical outcome in our review was postpartum endometritis. Other important outcomes were puerperal morbidity, perineal infection, duration of hospital stay, sepsis, any infection, blood loss, postpartum haemorrhage, secondary postpartum haemorrhage, readmission to hospital, adverse effects of the drugs, women's satisfaction, and neonatal outcomes, such as jaundice, sepsis, neonatal intensive care unit admission, et cetera. The risk of bias was assessed at the outcome level. We used the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool to assess the risk of bias in non-randomised studies. We carried out statistical analysis using Review Manager. We used a fixed-effect meta-analysis to synthesise the results, and GRADE to assess the certainty of the evidence. We included four retrospective cohort studies with a total of 974 participants. Studies were conducted in Germany, Bulgaria, Norway, and Israel, between 1983 and 2017. Prophylactic antibiotics versus no antibiotics was the only comparison in our analysis. Postpartum endometritis We do not know whether prophylactic antibiotics have an impact on postpartum endometritis (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.48 to 1.85; 4 studies, 974 participants; very low-certainty evidence). Postpartum haemorrhage The evidence suggests that prophylactic antibiotics may result in little to no difference in postpartum haemorrhage (RR 1.00, 95% CI 0.78 to 1.29; 1 study, 325 participants; low-certainty evidence). Neonatal intensive care unit admission (NICU) The evidence suggests that prophylactic antibiotics may result in little to no difference in NICU admission of the neonate (RR 0.86, 95% CI 0.29 to 2.61; 1 study, 353 participants; low-certainty evidence). There were no data available for other important outcomes, including puerperal morbidity, perineal infection, duration of hospital stay, sepsis, any infection, blood loss, secondary postpartum haemorrhage, readmission to hospital, adverse effects of drugs, women's satisfaction, or neonatal outcomes of jaundice or sepsis. There is very uncertain evidence supporting the use of prophylactic antibiotics for manual removal of placenta for preventing postpartum endometritis. The evidence suggests that prophylactic antibiotics result in little to no difference in postpartum haemorrhage or admission to a neonatal intensive care unit. There were no available data on other important outcomes. Multicentre, randomised controlled trials comparing antibiotic prophylaxis and placebo or no antibiotic, or one antibiotic and another, for manual removal of placenta in vaginal birth are needed to provide more robust evidence. This systematic review received support from the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP). Protocol and previous versions are available at https://10.1002/14651858.CD004904.pub3.

Physiological adaptations in small-side games combined with speed-endurance training: analyzing heart rate and rate of perceived exertion

Background and Study Aim. Monitoring physiological responses during training is crucial for understanding how athletes adapt to various exercise intensities. However, the specific effects of combining Small-Sided Game (SSG) and Speed-Endurance Training (SET) on these parameters require the search for more effective solutions. This study aims to determine the effect of combined SSG and SET on heart rate (HR) and rate of perceived exertion (RPE). Material and Methods. This quantitative research employed an experimental method with a weekly pretest-posttest design. The study population consisted of eighty-two members of the Unesa Soccer Student Activity Unit. A sample of eighteen individuals was selected through simple random sampling. The sample had the following characteristics: age 20±0.69 years, weight 65±9.54 kg, height 165.22±4.31 cm, and BMI 22.82±1.92. Data were collected using the Polar H-10 device, and RPE interviews were conducted ten minutes after each training session. Data analysis was performed using paired sample t-tests and Wilcoxon tests. Results. The results showed a significant difference in HR for pair 1 (p = 0.037), but no significant differences for pair 2 (p = 0.058) or pair 3 (p = 0.076). However, the results for RPE indicated significant differences in pair 1 (p = 0.001), pair 2 (p = 0.004), and pair 3 (p = 0.002). The combination of SSG and SET led to an increase in HR during the first and second weeks. In the third week, HR decreased. RPE increased from the first to the second week. It then stabilized in the third and fourth weeks, indicating a consistent level of effort. The decrease in HR during the third week, despite the same effort level, suggests that the athletes successfully adapted to the training program. Conclusions. The combination of SSG and SET demonstrates potential as an effective training method for improving both physiological performance and adaptation in athletes. These findings offer valuable insights into how athletes respond to structured training programs, providing a foundation for future research and practical applications in sports training. The results contribute to a deeper understanding of the role that specific training combinations play in athlete development and recovery.