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Aspirin versus metformin in pregnancies at high risk of preterm pre-eclampsia in China (AVERT): protocol for a multicentre, double-blind, 3-arm randomised controlled trial
This study will compare the incidence of preterm-PE with delivery at <37 weeks’ gestation, as the primary outcome, of three different interventional groups: (1) aspirin 75 mg daily, (2) aspirin 150 mg daily and (3) aspirin 75 mg with metformin 1.5 g daily. 957 participants per treatment group are required to detect a significant difference of 59% in the reduction of the incidence of preterm-PE with 80% power and type I error of 5%. Pregnancy and neonatal outcomes will be collected and analysed. Ethics and dissemination Ethical approval for the study was obtained from the Joint Chinese University of Hong Kong&ndas...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Liu, J., Shen, L., Nguyen-Hoang, L., Zhou, Q., Wang, C. C., Lu, X., Sahota, D., Chong, K. C., Ying, H., Gu, W., Zhou, R., Yang, H., Jiang, Y., Chen, D., Li, X., Poon, L. Tags: Open access, Obstetrics & Gynaecology Obstetrics and gynaecology Source Type: research

Effect of metacognitive therapy on depression in patients with chronic disease: a protocol for a systematic review and meta-analysis
This article is a literature review that does not include patients’ identifiable information. Therefore, ethical approval is not required in this protocol. The findings of this systematic review and meta-analysis will be published in a peer-reviewed journal as well as presentations at relevant conferences. PROSPERO registration number CRD42023411105. (Source: BMJ Open)
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Zhang, Z., Wang, P., Gu, J., Zhang, Q., Sun, C., Wang, P. Tags: Open access, Mental health Source Type: research

Randomised controlled, patient-blinded, multicentre, superiority trial to evaluate the efficacy of the line-attached sheath-type traction device for endoscopic submucosal dissection in patients with superficial gastric neoplasms
Introduction EndoTrac is a line-attached sheath-type traction device that enables us to control the direction and the force of traction during endoscopic submucosal dissection (ESD). The efficacy of EndoTrac for gastric ESD has not been fully verified. Methods and analysis The G-Trac study is a multicentre (nine general hospitals and two university hospitals in Japan) collaborative trial assessing the efficacy of EndoTrac for gastric ESDs. Patients with superficial gastric neoplasms will be enrolled and randomly assigned to undergo either conventional ESD or EndoTrac ESD. Allocation will be stratified according to tumour ...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Abe, H., Sako, T., Yamamoto, Y., Ikeda, A., Kawara, F., Ose, T., Takao, T., Kitamura, Y., Ariyoshi, R., Morita, Y., Ishida, T., Ikegawa, T., Ishida, R., Yoshizaki, T., Sakaguchi, H., Toyonaga, T., Kodama, Y. Tags: Open access, Gastroenterology and hepatology Source Type: research

Evaluation of a manualised neurofeedback training in psychosomatic-psychotherapeutic outpatient treatment (Neuro-pp-out): study protocol for a clinical mixed-methods pilot study
Introduction Electroencephalographic neurofeedback (NFB), as a non-invasive form of brainwave training, has been shown to be effective in the treatment of various mental health disorders. However, only few results regarding manualised and standardised NFB trainings exist. This makes comparison as well as replication of studies difficult. Therefore, we developed a standard manual for NFB training in patients with mental health disorders attending a psychosomatic outpatient clinic. The current study aims at investigating the conduction of a standardised manual for NFB training in patients with mental health disorders. If suc...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Schmidt, K. L., Kowalski, A., Schweda, A., Dörrie, N., Skoda, E. M., Bäuerle, A., Teufel, M. Tags: Open access, Mental health Source Type: research

Restrictive use of Restraints and Delirium Duration in the Intensive Care Unit (R2D2-ICU): protocol for a French multicentre parallel-group open-label randomised controlled trial
Introduction Physical restraint (PR) is prescribed in patients receiving invasive mechanical ventilation in the intensive care unit (ICU) to avoid unplanned removal of medical devices. However, it is associated with an increased risk of delirium. We hypothesise that a restrictive use of PR, as compared with a systematic use, could reduce the duration of delirium in ICU patients receiving invasive mechanical ventilation. Methods and analysis The Restrictive use of Restraints and Delirium Duration in ICU (R2D2-ICU) study is a national multicentric, parallel-group, randomised (1:1) open-label, controlled, superiority trial, ...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Sonneville, R., Couffignal, C., Sigaud, F., Godard, V., Audibert, J., Contou, D., Celier, A., Djibre, M., Schmidt, J., Jaquet, P., Mekontso Dessap, A., Bourel, C., Bellot, R., Roy, C., Lamara, F., Essardy, F., Timsit, J.-F., Cornic, R., Bouadma, L., On be Tags: Open access, Intensive care Source Type: research

Shared decision-making for non-operative management versus operative management of hip fractures in selected frail older adults with a limited life expectancy: a protocol for a nationwide implementation study
This study aims to guide Dutch physicians and hospitals nationwide in a standardised implementation of shared decision-making regarding surgery or NOM in selected frail older adults with a hip fracture. Methods and analysis The patient population for implementation includes frail older adults aged ≥70 years with an acute proximal femoral fracture, nursing home care or a similar level of care elsewhere and at least one additional criterion (ie, malnutrition, severe mobility impairment or ASA≥4). The 2-year implementation study will be conducted in four phases. In phases 1 and 2, barriers and facilitators for implemen...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Zeelenberg, M. L., Oosterwijk, P. C., Willems, H. C., Gosens, T., Den Hartog, D., Joosse, P., Loggers, S. A. I., Nijdam, T. M., Pel-Littel, R. E., Polinder, S., Schuijt, H. J., Wijnen, H. H., Van der Velde, D., Van Lieshout, E. M. M., Verhofstad, M. H. J. Tags: Open access, Surgery Source Type: research

Linking genetic counseling communication skills to patient outcomes and experiences using a community-engagement and provider-engagement approach: research protocol for the GC-PRO mixed methods sequential explanatory study
This study aims to characterise GC communication skills using a novel and pragmatic measure and link variations in communication skills to patient-reported outcomes, across clinical specialties and with patients from diverse backgrounds in the USA. Our community-engagement and provider-engagement approach is crucial to develop recommendations for quality, culturally informed GC care, which are greatly needed to improve GC practice. Methods and analysis A mixed methods, sequential explanatory design will be used to collect and analyze: audio-recorded GC sessions in cancer, cardiac, and prenatal/reproductive genetic indicat...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Fisher, E. R., Cragun, D., Dedrick, R. F., Lumpkins, C. Y., Ramirez, M., Kaphingst, K. A., Petersen, A., MacFarlane, I. M., Redlinger-Grosse, K., Shire, A., Culhane-Pera, K. A., Zierhut, H. A. Tags: Open access, Genetics and genomics Source Type: research

Fetal alcohol spectrum disorder and attention deficit hyperactivity disorder stimulant trial in children: an N-of-1 pilot trial to compare stimulant to placebo (FASST): protocol
Introduction Fetal alcohol spectrum disorder (FASD) is a neurodevelopmental disorder caused by alcohol exposure during pregnancy. FASD is associated with neurodevelopmental deviations, and 50%–94% of children with FASD meet the Diagnostic and Statistical Manual of Mental Disorders-fifth edition diagnostic criteria for attention deficit hyperactivity disorder (ADHD). There is a paucity of evidence around medication efficacy for ADHD symptoms in children with FASD. This series of N-of-1 trials aims to provide pilot data on the feasibility of conducting N-of-1 trials in children with FASD and ADHD. Methods and analysis...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Crichton, A., Harris, K., McGree, J. M., Nikles, J., Anderson, P. J., Williams, K. Tags: Open access, Paediatrics Source Type: research

Decision-making for congenital anomalies diagnosed during pregnancy: a narrative review
ConclusionMany factors contribute to an individual ’s decision-making after a diagnosis of a fetal anomalies diagnosed in the second trimester of pregnancy, ranging from personal beliefs and goals to shared experiences of others and access to care. Understanding how sources of information may be deemed both as facilitators and barriers to differen t individuals during the decision-making process is important for healthcare providers in order to understand how to most effectively support patients. There is a dearth of information on training healthcare professionals to provide support to patients facing these decisions. (...
Source: Journal of Assisted Reproduction and Genetics - April 17, 2024 Category: Reproduction Medicine Source Type: research

Correction: Proceedings of the 2023 International Maternal and Newborn Health Conference
(Source: BMC Proceedings)
Source: BMC Proceedings - April 17, 2024 Category: Biomedical Science Source Type: research

Beyond medical knowledge: a didactic curriculum focused on knowledge, wisdom, and application
CONCLUSIONS: The results of this study suggest that this innovative educational model can have a positive impact on residents' perceptions of the learning environment, their educational outcomes, and faculty engagement. As residency education continues to evolve, the flipped classroom model offers an exciting avenue for enhancing the quality of residency education.PMID:38626478 | DOI:10.3171/2024.2.JNS232775 (Source: Journal of Neurosurgery)
Source: Journal of Neurosurgery - April 16, 2024 Category: Neurosurgery Authors: Katherine E McDaniel Alexander Suarez Dana G Rowe Brandon Bishop Joshua Jackson Alankrita Raghavan Caroline Folz Stephen Harward Brandon Smith Steven Cook C Rory Goodwin Source Type: research

Surgery for advanced neuroendocrine tumours of the small bowel: recommendations based on a consensus meeting of the European Society of Endocrine Surgeons (ESES)
CONCLUSION: This paper provides recommendations based on the best available evidence and expert opinion on the surgical management of locally advanced and metastatic small bowel neuroendocrine tumours.PMID:38626261 | DOI:10.1093/bjs/znae082 (Source: The British Journal of Surgery)
Source: The British Journal of Surgery - April 16, 2024 Category: Surgery Authors: Klaas Van Den Heede Dirk-Jan van Beek Sam Van Slycke Inne Borel Rinkes Olov Norl én Peter St ålberg Erik Nordenstr öm Source Type: research