Study Design Research Articles

DEVELOPMENT OF A MOBILE APPLICATION FOR LEARNING BASIC TECHNOLOGY CONCEPTS IN UPPER-BASIC SCHOOLS

Despite the quick advancements in technology, students still have to attend demanding in-person classes. However, students can get curriculum-based instruction remotely via mobile devices. As a result, a mobile application was developed for usage in Nigerian upper basic schools using the ASSDURE (Analysis, Statement of Objectives, Design, Development, Utilization, Response, and Evaluation) paradigm. This study's model-type design and development research included a single-group pre-test-post-test design. The population consisted of students from upper-basic schools in Nigeria, specifically from upper-basic school two. Findings indicated that the developed application improved students' academic performance, as evidenced by their respective pre- and post-test performance percentage scores of 53.0% and 66.4%. The mobile app received positive evaluations from experts in instructional design, basic technology, and educational technology, with scores of 85%, 79.7%, and 88.3%, respectively. The study's conclusions indicate that the developed application is appropriate for educational purposes. It is inferred that pupils will perform better academically. Thus, among other things, it was proposed that mobile applications be included in basic technology instruction.

Comment on “Solar parks can enhance bird diversity in agricultural landscape” by Jarčuška et al.

This commentary critiques the methodology, interpretation of results, and broader implications of a study by Jarčuška et al. (2024). We argue that the study's design and analysis fail to conclusively demonstrate any causal link between solar parks and bird diversity or community composition. Furthermore, focusing solely on species diversity and community composition, the study overlooks the importance of functional diversity and functional structure of communities in assessing the ecological impacts of solar parks on agricultural ecosystems. By exposing these shortcomings and recommending well-established methods for future research, we aim to ensure robust and informative studies that guide balanced decision-making for conservation and all stakeholders.

THE SAFETY AND OUTCOME OF ACUTE ISCHAEMIC STROKE PATIENTS WITH COVID-19 TREATED WITH INTRAVENOUS RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR: A SYSTEMATIC REVIEW

Background: Strokes associated with SARS-CoV-2 may be linked to increased mortality rates. The utilization of intravenous thrombolysis is anticipated to enhance the clinical results in such patients. Moreover, emerging evidence underscores the importance of evaluating the safety and effectiveness of intravenous thrombolysis in individuals suffering from Acute Ischaemic Stroke along with COVID-19. Objective: To assess the safety and effectiveness of intravenous thrombolysis in Acute Ischaemic Stroke patients with COVID-19. Methods: A systematic literature search (Pubmed, Elsevier, and Cochrane database) with keywords (((intravenous thrombolysis) AND (acute ischemic stroke)) AND (covid-19)) AND (outcome))). We selected research studies for evaluation based on specific inclusion and eligibility criteria. Two independent reviewers then proceeded to extract and analyze various data points, including the name of the first author, the year of publication, the study's design, the National Institute of Health Stroke Scale (NIHSS) scores at admission and post-treatment, hospitalization-related mortality, and the occurrence of hemorrhagic transformation. Results: Three studies (n=153 patients) were included, mostly men with advanced age with the most common comorbidity being hypertension. Median of NIHSS Score of subjects on admission is 11, 12, and 13, with interquartile range from 3 to 20 (minor to severe stroke). The mRS at discharge and 1 month after admission is: 0–2 pts in 57 patients, ≥2 in 43 patient. Hemorrhagic transformation involved 3.23% of patients from total samples, death within hospitalization and 1-month mortality were in 23 patients (15%). In numerous studies, there was inadequate data available to determine the precise reason for mortality. Conclusion: Following IV-rTPA therapy, our COVID-19 infection subjects' mRS scores ranged from mild to moderate disability. Fifteen percents of all subjects died, and 3.23% of subjects experienced hemorrhagic transformation. However, majority of our subjects have high median NIHSS scores at admission, advanced age, complicated with baseline risk factors as high blood pressure, diabetes, and hyperlipidemia.

Influential factors associated with core competencies of diabetes specialist nurses and correlation with self-directed learning ability: A cross-sectional study.

This study aimed to investigate the current status of the core competencies and self-directed learning ability of diabetes specialist nurses and to explore the relationship between these core competencies and their self-directed learning ability. A cross-sectional survey design was used. This cross-sectional study was conducted via a web-based questionnaire platform in China from January 14 to April 24, 2023. The survey included a general information questionnaire, a diabetes specialist nurses' core competencies self-assessment scale, and a nursing staff's self-directed learning ability evaluation scale. The data was collected online. Descriptive, correlation and multiple linear regression analyses were conducted using SPSS 26.0 software. 118 diabetes specialist nurses from 11 cities participated in this study. A positive correlation was observed between the core competencies of diabetes specialist nurses and their self-directed learning ability. The characteristics affecting the core competencies of diabetes specialist nurses included age, participation in external learning and communication and self-directed learning. The training of diabetes specialist nurses can focus on core competencies, and the ability to self-direct learning can be used as an entry point to customize feasible theoretical and practical courses. The training system can further improve diabetes specialist nurses' core competencies and self-directed learning abilities. A reference can be established that nursing managers and nursing educators can use to develop training programs for specialist nurses by validating the link between their core competencies and self-directed learning skills. Participants were involved solely in the data collection process. No participant contributions were required for the study's design, outcome measurement or implementation.

Capillaroscopic abnormalities in systemic lupus erythematosus and its association with clinical manifestation

IntroductionCapillaroscopy is a non-invasive tool used to evaluate microcirculation and determine whether a Raynaud's phenomenon is primary or secondary. Capillaroscopic changes are well-described in systemic sclerosis; however, these alterations have been less studied in other autoimmune diseases. ObjectiveThe aim of this study is to determine videocapillaroscopic alterations in lupus, and its association with clinical manifestations. Materials and methodsA cross-sectional study with analytical intention was performed. Videocapillaroscopy and medical evaluations were performed on 76 patients with lupus, according to SLICC 2012 classificatory criteria, from January to June 2019. Chi2, Fisher, and Mann–Whitney U tests were used to evaluate association, and the prevalence ratios (PR) were determined. A multivariate analysis was performed. ResultsSeventy-one (93.4%) of the patients were female with a median age of 33.5 years (interquartile range [IQR]: 27–44.8); the median lupus duration was 84 months (IQR: 30–168). The main clinical manifestations were articular, cutaneous, hematological, and Raynaud's phenomenon. A non-specific pattern was found in 43 patients (56.6%), and a systemic sclerosis-like pattern was found in 7 patients (9.2%). In bivariate and multivariate analyses, Raynaud episodes occurring more than once a week (PR 1.24; 95% CI: 1.13–1.33) were more frequent in patients with a sclerosis-like or a non-specific pattern. ConclusionLupus patients frequently have videocapillaroscopic alterations with non-specific and systemic sclerosis like patterns, which are more common in patients with Raynaud's phenomenon that occurs more than once a week. Due to the study's design, it is impossible to determine causality.

N-Stearoylethanolamine Exerts Cardioprotective Effects in Old Rats.

Aging is associated with the slowing down of metabolic processes, diminished physiological processes, changes in hormonal activity and increasing exposure to oxidative stress factors and chronic inflammation. The endocannabinoid system (ECS) is a major signaling network that plays a pro-homeostatic role in the central and peripheral organs of the human body. A class of minor lipids, N-acylethanolamines (NAEs), which do not activate cannabinoid receptors, except for anandamide, but can potentiate the action of endocannabinoids and have a wide spectrum of biological activity and significant adaptogenic potential, belongs to ECS. The results of different studies over the past decades have established the protective effect of NAE on many pathological conditions. This study aimed to investigate the cardioprotective effects of C18:0 NAE- N-stearoylethanolamine (NSE) in aged rats. In this study, we focused on investigating the effects of C18:0 NAE- N-stearoylethanolamine (NSE) on the intensity of oxidative/ nitrosative stress, antioxidant potential, lipoprotein profile and inflammation markers of blood plasma, phospholipid composition and age-related morphological changes of old rat heart tissues. The study was conducted on Sprague Dawley male laboratory rats. The three groups of rats were involved in the study design. The first group consisted of young rats aged 4 months (n=10). The second (n=10) and third (n=10) groups included old rats aged of 18 months. Rats from the third group were administered a per os aqueous suspension of NSE at a dose of 50 mg/kg of body weight daily for 10 days. All groups of rats were kept on a standard vivarium diet. The blood plasma, serum, and heart of rats were used for biochemical and histological analysis. The cardioprotective effect of N-stearoylethanolamine in old rats was established, which was expressed in the normalization of the antioxidant system condition and the level of proinflammatory cytokines, positive modulation of blood plasma and lipoprotein profile, normalization of heart tissue lipid composition, and significant reduction in age-related myocardium morphological changes. The revealed effects of N-stearoylethanolamine can become the basis for developing a new drug for use in complex therapy to improve the quality of life of older people.

Linking Diabetic Retinopathy Severity to Coronary Artery Disease Risk Factors in Type 2 Diabetic Patients.

Diabetes mellitus (DM) is a common metabolic disorder characterized by hyperglycemia, leading to chronic complications, notably cardiovascular diseases such as coronary artery disease (CAD). Diabetic retinopathy (DR), a leading cause of blindness, may serve as a non-invasive marker for CAD. This study investigates the correlation between DR and CAD to explore its diagnostic potential in diabetic populations. A cross-sectional study was conducted over one year in a general hospital, involving 100 type 2 DM patients with retinopathy. DR was classified as mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, or proliferative retinopathy, based on fundus examinations. Data on age, duration of diabetes, cholesterol levels, glycated hemoglobin (HbA1C), and ECG (electrocardiography) findings were collected. Statistical analysis included frequency analysis, chi-square tests for association between categorical variables, and significance testing with p-values. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States). Descriptive statistics were characterized by categorical and continuous variables. The chi-square test determined associations between qualitative variables, with significance set at p<0.05. The mean age of patients was 57.13 ± 8.51 years. Age and duration of diabetes were significant predictors of retinopathy severity (p<0.001). Proliferative retinopathy was found exclusively in patients over 70 years. Lower cholesterol levels (<200 mg/dL) were significantly associated with less severe retinopathy (p=0.033), whereas higher cholesterol levels (>200 mg/dL) did not show a statistically significant association with retinopathy severity (p=0.772). Patients with HbA1C levels between 6.5% and 8.5% predominantly had milder forms of retinopathy, as indicated by the significant p-value (<0.001). In contrast, patients with HbA1C levels above 8.5% are more likely to have severe NPDR or proliferative diabetic retinopathy (PDR), but this association was not statistically significant (p=0.582). ECG abnormalities increased with retinopathy severity (p=0.002). Hypertension was significantly linked to cardiac changes in retinopathy patients (p<0.001), while smoking and family history of CAD were not significant factors.This study's cross-sectional design limits causality inference. The single-center sample of 100 patients may not be broadly generalizable. Reliance on self-reported data introduces potential recall bias, and confounding factors such as diet, physical activity, and additional comorbidities were not accounted for. The lack of a control group further limits comparative analysis. Future longitudinal studies with larger, diverse samples are needed. Retinopathy in DM patients is significantly associated with cardiac changes and other risk factors such as hypertension, dyslipidemia, and poor glycemic control. Aggressive management of these factors is essential. Retinopathy can serve as a predictor of CAD in diabetic patients.

Formulation, Optimization and In-Vivo Characterization of Thermosensitive In-Situ Nasal Gel Loaded with Bacoside a for Treatment of Epilepsy.

The intranasal route has demonstrated superior systemic bioavailability due to its extensive surface area, the porous nature of the endothelial membrane, substantial blood flow, and circumvention of first-pass metabolism. In traditional medicinal practices, Bacopa monnieri, also known as Brahmi, is known for its benefits in enhancing cognitive functions and potential effects in epilepsy. This study aimed to develop and optimize a thermosensitive in-situ nasal gel for delivering Bacoside A, the principal active compound extracted from Bacopa monnieri. The formulation incorporated Poloxamer 407 as a thermogelling agent and HPMC K4M as the Mucoadhesive polymer. A 32-factorial design approach was employed for Optimization. Among the formulations. F7 exhibited the most efficient Ex-vivo permeation through the nasal mucosa, achieving 94.69 ± 2.54% permeation, and underwent a sol-gel transition at approximately 30.48°C. The study's factorial design revealed that gelling temperature and mucoadhesive strength were critical factors influencing performance. The potential of in-situ nasal Gel (Optimized Batch-F7) for the treatment of epilepsy was demonstrated in an in-vivo investigation using a PTZ-induced convulsion model. This formulation decreased both the occurrence and intensity of seizures. The optimized formulation F7 showcases significant promise as an effective nasal delivery system for Bacoside A, offering enhanced bioavailability and potentially increased efficacy in epilepsy treatment.

Impact of Corporate Governance on Voluntary Disclosure of Nigerian-Listed Industrial Goods Companies

This study investigates the impact of corporate governance on voluntary disclosure of Nigerian-listed industrial goods companies. Expo-facto was employed as the study's research design. For a period of fifteen (15) years, from 2007 to 2021, the study used data from secondary sources included in the yearly reports and accounts of the listed manufacturers of industrial goods. The population of the study consisted of thirteen (13) industrial product companies that are listed on the Nigerian stock exchange. As of December 31, 2021, a sample of 10 Nigerian industrial goods businesses that are publicly traded was used. Additionally, regression using Ordinary List Square (OLS) was used to analyze the data. The findings indicate that Board Independence, Board Gender, Board Experience, Board management ownership and chief executive officer duality have statistically significant and favourable effects on the voluntary disclosure of listed Nigerian industrial goods companies. However, it was discovered that there is statistically no positive link between VLD and any of the study's explanatory variables, with the exception of BEXP and BGND. According to the study's findings, improving corporate governance systems can encourage voluntary disclosure, which can increase corporate transparency and boost corporate accountability for Nigerian manufacturers of industrial goods. The results of this study are also helpful for market participants, such as investors, regulators, and others, in the Nigerian capital markets.

The Effect of Purified Catechins from Gambier on the Physico-Chemical Characteristics of Functional Solid Shampoo

Gambier is a natural product that contains high amounts of cathechin. Cathechin has bioavailability as an antimicrobial such as fungus. Dandruff is a problem on the human scalp caused by fungus where this condition can be treated by using shampoo.The purpose of this study was to ascertain how the properties of solid shampoo were affected by the catechin extract from Gambier. This study's design comprised three replicates and five treatments in a fully randomized fashion. Catechin extract was added to the shampoo in amounts of 0, 1, 2, 3, and 4% of the total contents. Evaluations were conducted on the created shampoo's chemical, physical, and organoleptic properties. By the measurement of pH, percentage of solid content, foam height, texture, color, and scent revealed that the addition of gambier catechin extract could had a substantial influence (α = 5%) but not for dirt dispersal. Adding 4% of Gambier's catechin extract to the solid shampoo resulted in the optimal concentration. Further studies are needed to ascertain the specific role of the Gambier catechin extract in solid shampoo in order to fully appreciate the benefits of using it in shampoo products.

Analysis of influential factors on surgical outcomes in pediatric femur neck fractures: a single-institution retrospective study.

This retrospective study aimed to evaluate surgical outcomes and identify influential factors in pediatric femoral neck fractures. A total of 25 hips from 23 pediatric patients who underwent surgical intervention for femoral neck fractures were included. Data encompassing patient demographics, fracture types, surgical techniques, complications, and follow-up outcomes were analyzed retrospectively. Factors such as fracture displacement, timing of surgery, fixation methods, and reduction quality were assessed concerning postoperative complications. Falling from a height accounted for 48% of the trauma mechanisms, and avascular necrosis (AVN) was the most prevalent complication (4 hips). Although fracture displacement, bad reduction quality, and delayed surgery were more common among complicated cases, statistical significance was not attained. The study noted an association between presence of avascular necrosis and worse clinical results(rho: 0.428, p: 0.05, CI: 95%). Surgical treatment yielded favorable clinical outcomes; however, limitations due to the study's retrospective design, limited sample size, and single-center approach underscore the necessity for larger multicenter studies. Our findings emphasize the need for comprehensive investigations to better understand and manage pediatric femoral neck fractures, especially regarding factors influencing AVN and long-term outcomes.

A Research Update on Factors Influencing Second Language Acquisition: Native Languages and Learning Difficulty

Learning a second language is a complex process that is influenced by a variety of factors, including the learner's first language. This study investigates the reasons behind language learning decisions made by speakers of different native tongues and investigates whether the difficulty of learning a second language is related to the difficulty of learning the first language. Psychological development, career advancement, and cultural fusion are some of the reasons why language learning is desirable. Additionally, by highlighting potential challenges and resources, it examines the linguistic gap between the target language and the originating language.The study's research design, datagathering strategies, and analytic approaches are all covered in the methodology section.The findings improve knowledge of the interactions between first-language acquisition and secondlanguage learning, direct methods of teaching languages, and promote effective multilingual communication.

Predictors of type of powered mobility aid for patients: a retrospective study in a Singapore acute hospital

Purpose Rehabilitation professionals prescribe patients with suitable powered mobility aids (PMAs) based on patient characteristics, e.g., age and mobility. However, there is paucity of literature examining patient characteristics associated with PMA types in Asian contexts. This research aims to study (i) characteristics of Singapore PMA users and (ii) correlations between characteristics and two PMA types – motorised wheelchairs and powered scooters. It is hypothesised that patients’ age, mobility status and medical conditions have correlations with PMA types. Methodology A cross-sectional, retrospective study design was used to investigate characteristics of patients (age ≥ 21 years) at Tan Tock Seng Hospital Occupational Therapy Seating Clinic between 2017 and 2019. Comparisons of proportions of motorised wheelchair users versus powered scooter users based on characteristics were analysed using Chi-square test. Subsequently, statistically significant patient characteristics were selected for a multiple logistic regression. Results Among 352 patients, 21% and 79% were prescribed motorised wheelchairs and powered scooters, respectively. Patients aged 61–90 years were twice those aged 21–60 years. Males were double of females. Patients of (i) an older age, (ii) more ambulant, (iii) independent in transfers and (iv) in activities of daily living (ADLs), were more likely powered scooter users. Conversely, patients of (i) a younger age, (ii) less ambulant, (iii) require assistance in transfers and (iv) in ADLs were more likely motorised wheelchair users. Patients’ gender and caregiver status showed no statistically significant correlations with PMA types. Conclusions Rehabilitation professionals could consider patients’ age, mobility status, transfer status and ADL status when prescribing PMA for Asian populations.

Exploring Activity Interests of Older People with Low-Income

ABSTRACT Older people living on low incomes may experience inequitable access to activities they find interesting because they may live in homes with even fewer resources and may not be able to afford to participate in the activities they enjoy. The aim of this study was to explore the interests of older people living on low incomes living in residential homes. We used a cross-sectional analytic study design and the Interest Checklist to investigate the activity interests of 82 older people with low incomes in 9 residential homes in Cape Town, South Africa. Findings revealed 27 activities they were most interested in, within five categories: musical, everyday, social, free time, and religious or cultural activities. There were few statistically significant differences between men and women, or between residents with different levels of independence. Understanding the interests of older people with low incomes is a first step toward creating opportunities for participation, and growing well-developed individual interests.

Communicating Study Design Trade-offs in Software Engineering

Reflecting on the limitations of a study is a crucial part of the research process. In software engineering studies, this reflection is typically conveyed through discussions of study limitations or threats to validity. In current practice, such discussions seldom provide sufficient insight to understand the rationale for decisions taken before and during the study, and their implications. We revisit the practice of discussing study limitations and threats to validity and identify its weaknesses. We propose to refocus this practice of self-reflection to a discussion centered on the notion of trade-offs . We argue that documenting trade-offs allows researchers to clarify how the benefits of their study design decisions outweigh the costs of possible alternatives. We present guidelines for reporting trade-offs in a way that promotes a fair and dispassionate assessment of researchers’ work.

The relationship between flat foot and lower limb muscle strength in teenage basketball athletes

Background: Teenage basketball athletes may experience problems with lower limb muscle strength, which can affect their performance due to factors such as the shape of the arches pedis, muscle length and shortness, fatigue levels, muscle contraction ability, and the presence of flat feet, where the medial arch is flattened against the ground. This study aimed to determine the relationship between flat feet and lower limb muscle strength in adolescent basketball athletes in Tabanan Regency. Methods: This study's design was observational analytic with a cross-sectional study direction. It was conducted at junior high and high schools in Tabanan Regency and involved 62 teenage basketball athletes. The inclusion criteria were basketball athletes with flat feet aged 14-17, while the exclusion criteria were a history of fracture or lower limb injury. Lower limb muscle strength was measured using a leg dynamometer, while flat foot was assessed using a wet footprint test. Results: The result of the association test using Spearman’s Rho Test obtained a correlation coefficient value (r) -0.173, which means a unidirectional relationship with a very weak correlation level with a p-value=0.180 (p&lt;0.05), which means there is no significant relationship. Conclusion: There was no relationship between flat foot and lower limb muscle strength in teenage basketball athletes. The correlation coefficient value indicates a unidirectional relationship with a very weak correlation level.

The impact of bullying and cyberbullying on mental health: a systematic review

Bullying, including cyberbullying, has a devastating impact on mental health, particularly among adolescents. This literature study aims to identify mental health issues caused by bullying and cyberbullying. A systematic review was conducted in the last five years using the keywords "bullying, cyberbullying, mental health, adolescent" and the population, intervention, comparison, outcome, study design (PICOS) framework within Scopus (29 articles), ProQuest (187 articles), Science Direct (193 articles), and SAGE (58 articles) published databases in the last five years using the keywords of “bullying, cyberbullying, mental health, adolescent”. The selected articles are those applying quantitative and longitudinal studies published in 2018-2022 in which study participants were adolescents who had experiences as victims of bullying and cyberbullying. The 25 articles met the inclusion criteria for review. Based on the results of the review of the article, it was found that mental health problems can occur in all roles in bullying and cyberbullying, but the highest is in the role of victim. Mental health problems that occur in victims include anxiety, stress, depression, low self-esteem, suicidal ideation, and suicide attempts. Based on these results, different interventions are needed for the roles involved in bullying and cyberbullying, especially for victims, because psychological problems are more common in victims.

Prevalence and incidence of oral cancer and pre-cancerous lesions in indigenous populations: a systematic review protocol.

This review will determine the prevalence and incidence of oral cancer and pre-cancerous lesions in indigenous populations. There are approximately 476 million indigenous individuals worldwide. Oral cancer affected over 350,000 people globally in 2018, with approximately 80% of cases occurring in the indigenous population. Moreover, the incidence of pre-cancerous lesions is high in this population, accounting for 48.3%. Limited evidence exists regarding the burden of oral cancer among indigenous populations despite research on oral health disparities in this group. Studies on the burden of oral cancer and pre-cancerous lesions in indigenous groups, considering rates, ratios (prevalence or mortality), or survival proportions, will be considered for inclusion. There will be no limitations on study design, language, age, gender, or geography. We will exclude studies that only identify, diagnose, or screen oral cancer and pre-cancerous lesions without mentioning prevalence and incidence. This review will follow the JBI methodology for systematic reviews of prevalence and incidence. Databases to be searched will include MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Central Register of Controlled Trials, Scopus, and Dentistry and Oral Sciences Source (EBSCOhost). ProQuest Dissertations and Theses, OAIster, International Association for Dental Research conference abstracts, Google Scholar, government reports, and cancer registry reports will also be screened for unpublished studies. Two reviewers will independently screen articles, and data will be extracted using a customized form. Narrative data synthesis will be conducted and, where appropriate, meta-analysis will be performed. Methodological quality will be assessed using JBI's critical appraisal tool for prevalence studies. PROSPERO CRD42023402858.

Using theater as an innovative knowledge translation approach for health research: a scoping review protocol.

The objective of this review is to synthesize the existing literature on how theater has been used as a knowledge translation approach for health research and to identify the outcome measures employed for evaluation as well as the facilitators/challenges related to this approach. The use of arts-based knowledge translation methods is relatively new in health research but has already shown to have positive impacts on knowledge, attitudes, policy, and practice. Specifically, theater has proven to be an effective approach for communicating research findings in a way that stimulates thought and discussion on important health-related topics. This review will include scholarly literature on how theater is being used as a knowledge translation approach for health research. The review will not impose any limitations related to demographic variables, health issues, or settings. The review will consider papers using any study design, and will also consider other literature, such as protocols, descriptive papers, unpublished papers, and evaluation reports. This review will be conducted in accordance with the JBI methodology for scoping reviews. The databases to be searched will include CINAHL (EBSCOhost), Embase, MEDLINE (Ovid), Academic Search Premier (EBSCOhost), and Scopus. Google/Google Scholar and ProQuest Dissertations and Theses will also be searched for unpublished studies and gray literature. All literature identified in the search will be screened by 2 independent reviewers and the results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The data extracted from the included literature will be presented in both tabular and narrative format. Open Science Framework https://osf.io/gbcpj.

Successful Implementation of the AIUM Standardized 4-Year Residency Ultrasound Curriculum in Obstetrics and Gynecology: Lessons Learned and Way Forward.

Significant disparities in sonographic education exist in Obstetrics and Gynecology programs in the United States. To address the lack of standardization in ultrasound teaching, the American Institute of Ultrasound in Medicine (AIUM) assembled a multi-society task force in 2018 that resulted in the publication of a Consensus Report outlining a standardized ultrasound curriculum and competency assessment. The primary objective of the study was to implement the AUIM standardized curriculum within an Obstetrics and Gynecology residency program at a tertiary medical center, and report on the early implementation experience. The secondary objective was to assess current national practices in ultrasound training in Obstetrics and Gynecology residency programs. Study design was an effectiveness-implementation hybrid study of a structured ultrasound educational program based on the 2018 AIUM Consensus Report. The theoretical portion of the curriculum consisted of 26 hours of didactic lectures distributed over 4 years. For the practical component, residents received instruction from faculty and sonographers and independently acquired the required images as part of their regular clinical work. Simulator app access was also provided for additional opportunities to practice and acquire images. Deidentified images for the required competencies were uploaded to a WhatsApp group for review. Theoretical knowledge was assessed with a series of multiple-choice exams. Practical skills were assessed through grading of images submitted through WhatsApp as well as direct observations of resident scans. At the completion of 4 years, the assessment of both theoretical knowledge and practical skills was carried out using the ISUOG Basic Training Examination. National patterns in the area of ultrasound education were assessed with a four-question electronic survey of Obstetrics and Gynecology program directors in the United States. Analysis of both portions of the study was primarily descriptive. Four Obstetrics and Gynecology residents completed the curriculum spanning postgraduate years 1 through 4. The number of competencies completed ranged from 7 to 19 out of 41. All of the residents passed the theoretical and practical components of the ISUOG Basic Training Examination. For the residency program director survey portion of the study, response rate was 20% (59 of 290). Among the respondents, 55.9% reported having a structured curriculum and 34.4% reported implementing the AIUM curriculum. The two most commonly cited obstacles to implementation of structured ultrasound teaching were uncertainty with how to start the process (49.2%) and lack of faculty engagement (49.2%). Implementation of the AIUM Curriculum within the framework of an Obstetrics and Gynecology residency program at a tertiary medical center is feasible. In our experimental group, completion of the curriculum resulted in passing of an internationally recognized validated assessment. Obstacles to implementation in our program included a wide range of engagement and participation among residents, and limited opportunities to obtain some of the required competencies. Identification of obstacles to implementation from the perspective of residency program directors is critical for developing targeted approaches to ensure widespread implementation. Successful standardized validated sonographic training of graduating Obstetrics and Gynecology residents is crucial for this operator-dependent modality that has tremendous implications on patient safety and clinical care.