BMJ Open最新文献

{"title":"Exploring whether home-based neuromodulation can boost the analgesic effects of exercise in people with knee osteoarthritis: protocol for a double-blinded, pilot randomised controlled trial.","authors":"Keeley R McNally, Simon Summers, Tasha R Stanton, James McAuley, Wei-Ju Chang, Nahian Chowdhury, Rocco Cavaleri","doi":"10.1136/bmjopen-2024-090523","DOIUrl":"10.1136/bmjopen-2024-090523","url":null,"abstract":"<p><strong>Introduction: </strong>Knee osteoarthritis (OA) represents a leading cause of disability globally. Exercise has been demonstrated to improve pain and function in people with knee OA. However, when in pain, commencement of exercise is difficult, and clinical effects with such interventions are often modest. Recently, transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, has been shown to bolster the pain-relieving effect of exercise in experimental settings. While promising, the utility of employing this approach beyond the research environment is yet to be elucidated. Therefore, this pilot study aims to investigate the feasibility, safety, adherence, tolerability and preliminary efficacy of tDCS and exercise in home-based settings to improve pain and function in people with knee OA.</p><p><strong>Methods and analysis: </strong>This protocol is for a pilot randomised, double-blinded, sham-controlled trial. 24 individuals with idiopathic knee OA will be randomised to receive either active tDCS+exercise (Intervention) or sham tDCS+exercise (Control) at home. Participants will receive 20 min of tDCS 5 days per week for the first 2 weeks of this 8-week trial. Participants in both groups will complete a lower limb strengthening programme 3 days per week for the entire 8 weeks. Outcome measures of feasibility (acceptability, satisfaction, retention), safety, adherence and tolerability will be assessed throughout the trial period, with clinical outcomes of pain and function assessed before and following the intervention. Feasibility, safety, adherence and tolerability outcomes will be explored descriptively using frequencies and percentages. To examine preliminary efficacy, within-group and between-group changes in pain and functional measures will be analysed.</p><p><strong>Ethics and dissemination: </strong>This protocol obtained ethical approval from the Queensland University of Technology Human Research Ethics Committee (HREA 2024-8302-20200). All participants will provide written informed consent. The findings of the study will be disseminated via journal publications and international conference proceedings.</p><p><strong>Trial registration number: </strong>ACTRN12624000397516p.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e090523"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of HIV prevention interventions targeting long-distance truck drivers: protocol for a systematic review and meta-analysis of global evidence.","authors":"Cyrus Mutie, Berrick Otieno, Kawira Kithuci, John Gachohi, Grace Mbuthia","doi":"10.1136/bmjopen-2024-090062","DOIUrl":"10.1136/bmjopen-2024-090062","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, long-distance truck drivers' (LDTDs) risk of exposure to HIV infections is higher compared with other populations in transit. Thus, several HIV prevention interventions have been implemented, though to a narrower extent compared with other most at-risk populations. Consequently, the effectiveness of such interventions is not well understood. Therefore, a review is warranted to inform policymakers on the most effective HIV prevention interventions targeted for LDTDs.</p><p><strong>Methods and analysis: </strong>The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines were followed. Original peer-reviewed interventional studies involving LDTDs of either gender aged above 18 years, and reporting findings on HIV prevention interventions from any part of the world will be included. Non-empirical research studies like systematic reviews, literature reviews and scoping reviews will be excluded. A comprehensive search will be done from PubMed, Cumulated Index to Nursing and Allied Health Literature and other five databases to identify eligible studies. The Rayyan online platform will be used for the screening of titles and abstracts. For the meta-analysis, a random-effects meta-analysis using the '<i>metafor</i>' package in R software will be done. Where specific studies may not report adequate data for meta-analysis, their findings will be presented qualitatively. The Cochrane Collaboration tool and Joanna Brigs Checklist will be used to assess the quality and risk of bias in the included studies.</p><p><strong>Ethics and dissemination: </strong>A formal ethical approval is not required for this systematic review and meta-analysis. The findings will be presented at scientific conferences and published in open-access peer-reviewed journals to reach policymakers, stakeholders and the scientific community.</p><p><strong>Prospero registration number: </strong>CRD42024505542.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e090062"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of underweight among returnee lactating mothers in Gedeb District, Southern Ethiopia: a case-control study.","authors":"Mahlet Birhane Estifanos, Abera Negesse Erku, Temesgen Muche Ewune, Hiwot Hailu Amare, Wagaye Alemu Zenebe, Taddese Alemu Zerfu","doi":"10.1136/bmjopen-2024-086114","DOIUrl":"10.1136/bmjopen-2024-086114","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the determinants of underweight among returnees lactating mothers in governmental health facilities of Gedeo zone, Southern Ethiopia.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Setting: </strong>Gedeb District governmental health facilities.</p><p><strong>Participants: </strong>A total of 264 returnees lactating mothers (88 cases and 176 controls) were randomly selected from four health institutions of Gedeb District.</p><p><strong>Outcome measures: </strong>Underweight was measured by anthropometric measurement weight/height². An institutional-based unmatched case-control study was conducted from 11 July 2022 to 20 September 2022. The study involved 264 returnee lactating mothers, with 88 classified as cases (body mass index, BMI<18.5 kg/m²) and 176 as controls (BMI 18.5-24.9 kg/m²). Participants were selected through simple random sampling from public health institutions. Data were collected on sociodemographic, reproductive and nutritional factors using structured questionnaires and anthropometric measurements. Bivariate and multivariable logistic regression analyses were performed to identify significant determinants of maternal underweight.</p><p><strong>Result: </strong>The study identified several key determinants of underweight. Returnee lactating mothers with a short birth interval (<24 months) were significantly more likely to be underweight (adjusted OR (AOR) 4.04, 95% CI 1.68 to 9.74). Unplanned pregnancies (AOR 7.60, 95% CI 3.14 to 18.41), home deliveries (AOR 5.81, 95% CI 2.09 to 16.14) and meals frequency <3 per day (AOR 2.51, 95% CI 1.12 to 5.63) were also strongly associated with increased risk of underweight. Inadequate dietary diversity (AOR 3.92, 95% CI 1.52 to 10.15) and food insecurity (AOR 4.72, 95% CI 1.77 to 12.61) further contributed to the risk. Poor socioeconomic status was associated with a higher likelihood of being underweight (AOR 4.38, 95% CI 1.49 to 12.82).</p><p><strong>Conclusion: </strong>The study highlights significant factors contributing to maternal underweight among returnee lactating mothers. Addressing short birth intervals, unplanned pregnancies, dietary diversity and food insecurity is crucial. Policy-makers should focus on targeted interventions to improve maternal health, with special emphasis on returnee lactating mothers. Enhanced healthcare access, nutritional support and socioeconomic development are essential for mitigating underweight and improving overall health outcomes.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e086114"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol: the 'Endoscope CRC' cohort, a prospective biobank study on the development and evaluation of diagnostic and prognostic biomarker profiles for colorectal cancer and premalignant lesions.","authors":"Hao Ran Cheng, Robert van Vorstenbosch, Daisy Jonkers, Adrian Masclee, Erik Schoon, Frederik J van Schooten, Agnieszka Smolinska, Zlatan Mujagic","doi":"10.1136/bmjopen-2023-083229","DOIUrl":"10.1136/bmjopen-2023-083229","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection of colorectal cancer (CRC) and clinically relevant (advanced) adenomas leads to a significant reduction of CRC-related mortality and morbidity. However, the faecal immunochemical test (FIT) suffers from a high number of false-positive results and is insensitive to detecting advanced adenomas, resulting in false-negative results for these premalignant lesions. Therefore, more accurate, non-invasive screening tools are needed for the detection and prognostication of colorectal neoplasia. Previous research on volatile organic compounds (VOCs) analysis in breath and faeces has shown to be promising potential biomarkers for this purpose. Several VOC-sampling methods, including breath sampling, have improved significantly over the recent years resulting in an increased reliability of measurements. Therefore, we aim to identify relevant VOC profiles in exhaled breath and faeces for the diagnosis of colorectal neoplasia while taking into account relevant confounding factors. Follow-up data will be used to identify relevant VOC profiles in exhaled breath and faeces for the prognostication of colorectal neoplasia. Finally, a biobank will be set up for future research questions on this topic.</p><p><strong>Methods and analysis: </strong>Subjects with positive FIT within the Dutch national CRC cancer screening programme are included. Subjects are asked to fill in questionnaires and exhaled breath, faeces and blood are sampled prior to colonoscopy. All subjects are asked to fill in follow-up questionnaires at years 1 and 5 of the study. In case of surveillance colonoscopies, subjects are asked to provide exhaled breath, faeces and blood prior to the colonoscopy again. Breath sampling is performed using the ReCIVA breath sampler. VOCs in breath and faeces are analysed using gas-chromatography-mass spectrometry (GC-MS). Raw GC-MS data is preprocessed and analysed using machine learning techniques.</p><p><strong>Ethics and dissemination: </strong>The study is approved by the medical ethics committee at the Maastricht University Medical Center (NL74844.068.20) in November 2021 and started inclusion in January 2022.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e083229"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes and practices regarding medication splitting and crushing among the general public in Jordan: a cross-sectional study.","authors":"Abdolelah Jaradat, Esra'a Ali Alomari, Mohammad Fouad Bayan, Abdallah Y Naser","doi":"10.1136/bmjopen-2024-087109","DOIUrl":"10.1136/bmjopen-2024-087109","url":null,"abstract":"<p><strong>Background: </strong>Splitting or crushing medications are used for dosage administration when a certain dose is not easily accessible. Understanding the splitting or crushing of medications is essential to guarantee safe medication administration since inappropriate handling might impact therapeutic efficacy, safety and patient outcomes.</p><p><strong>Objectives: </strong>This study intends to examine the practices, attitudes and knowledge of the Jordanian population regarding the splitting/crushing of medications.</p><p><strong>Study design and setting: </strong>This is a cross-sectional survey study conducted in Jordan between November 2022 and March 2023. The questionnaire tool was adapted from previous literature, and binary logistic regression analysis was used, to identify the predictors of participants' knowledge concerning medication splitting/crushing.</p><p><strong>Participants: </strong>A total of 1259 participants from the general public were involved, without restrictions on gender or age.</p><p><strong>Results: </strong>Around 22.2% of participants confirmed that tablet splitting/crushing is a useful way to reduce medication costs. 67.0% reported that they are not sure whether tablets are suitable for splitting/crushing/crushing. 75.8% reported that they refer to package leaflet information to check whether tablets are suitable for splitting/crushing. 84.8% correctly believed that scored tablets can be split, while unscored tablets cannot. 72.0% identified correctly that not all types of tablets and capsules can be split/crushed or dissolved. The mean knowledge score of study participants was 2.7 (SD: 1.5) out of 6, which is equal to 45% of the maximum attainable score and reflects a weak level of knowledge about tablet crushing. Those who hold a bachelor's degree and have an income level of JD500-JD1000 (which is equal to US$715-US$1428) were more likely to have knowledge about tablet crushing. Around 39.2% of the participants reported that they had split or crushed tablets to reach their desired dose, of which the vast majority (82.9%) were using scored tablets.</p><p><strong>Conclusion: </strong>Understanding of tablet-splitting and crushing techniques ought to be enhanced while encouraging prescribing practices that stress safety and well-informed decision-making. Patients should actively seek reliable sources of information, have an awareness of which tablets can be safely divided and actively engage with healthcare experts to receive appropriate guidance.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e087109"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with HPV vaccine acceptance and hesitancy in Africa: a systematic review protocol.","authors":"Edison Johannes Mavundza, Anelisa Jaca, Sara Cooper, Duduzile Edith Ndwandwe, Charles Shey Wiysonge","doi":"10.1136/bmjopen-2023-082592","DOIUrl":"10.1136/bmjopen-2023-082592","url":null,"abstract":"<p><strong>Introduction: </strong>Human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection worldwide. HPV vaccination is an important tool to prevent and control HPV infection and its complications. Despite carrying the severe burden of disease, HPV vaccine coverage in Africa remains low. The aim of the current review is to evaluate the factors associated with HPV vaccination acceptance among adolescent men and women, young men and women, parents/caregivers, men who have sex with men, healthcare workers and programme managers in Africa.</p><p><strong>Methods and analysis: </strong>We will include peer-reviewed quantitative studies. We will search PubMed, Scopus, PsycInfo, Web of Science and Cochrane Central Register of Controlled Trials, with no language restriction, to identify eligible studies. Two review authors will independently screen the titles and abstracts of the search output in Covidence to select potentially eligible studies. The same two reviewers will independently screen the full-text of all identified potentially eligible articles to identify studies meeting inclusion criteria. Two review authors will independently extract data from eligible studies using a predefined data extraction form. Two review authors will independently assess the risk of bias in each included study, using the Effective Public Health Practice Project 'Quality Assessment Tool for Quantitative Studies'. We will assess the quality of evidence using the method for Grading of Recommendations Assessment, Development and Evaluation.</p><p><strong>Ethics and dissemination: </strong>Ethical approval is not required for this study because we will use already published data. The results of this review will be disseminated through peer-reviewed publication and conference presentation.</p><p><strong>Prospero registration number: </strong>CRD42023475810.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e082592"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DYnamics of Contraception in Eswatini (DYCE): protocol for a high-frequency, longitudinal cell phone survey.","authors":"Abigail Greenleaf, Bonisile Nhlabatsi, Khophozile Mahlalela, Zandile Masangane, Mgcineni Ndlangamandla, Neena Philips, Harriet Nuwagaba-Biribonwoha","doi":"10.1136/bmjopen-2024-090686","DOIUrl":"10.1136/bmjopen-2024-090686","url":null,"abstract":"<p><strong>Introduction: </strong>By 2030, an estimated 42% of the world's adolescent girls and young women (AGYW) will live in sub-Saharan Africa (SSA), where a quarter of AGYW pregnancies are undesired and AGYW represent 75% of new HIV infections. Most AGYW in SSA use short-acting contraceptive methods, including many who rely solely on condoms, which results in variable patterns of protection against undesired pregnancies and HIV. Dynamics of contraceptive use and HIV prevention efforts are poorly understood but the DYnamics of Contraception in Eswatini study will contribute to the understanding of the complex relationship between sexual behaviours, risk perception and HIV and pregnancy prevention.</p><p><strong>Methods and analysis: </strong>All AGYW 18-24 years who participated in a 2021 nationally representative, population-based (face-to-face) HIV survey, consented to future research and provided a mobile phone number will be contacted for enrolment. Consenting AGYW will complete a baseline questionnaire and be surveyed biweekly for 2 years. The three objectives of the study are to (1) investigate how changing individual context (schooling, income, residential mobility) impact contraceptive use; (2) examine the relationship between pregnancy desires and contraceptive use and (3) test whether changes in a woman's perception of her HIV risk changes her probability of contraceptive use and HIV protective behaviours. Data collection will take place from March 2024 to March 2026 via computer-assisted telephone interviews. During recruitment (March-April 2024), two interviewers called 794 AGYW, of whom 326 completed the baseline questionnaire (41%) and 321 consented to biweekly follow-up (40% American Association for Public Opinion Research response rate #1). Analyses will mainly use hybrid within-between logistic regression models.</p><p><strong>Ethics and dissemination: </strong>This protocol was reviewed and approved by the Eswatini National Health Research Review Board in 2024 and Columbia University Medical Center Institutional Review Board in 2023. Findings from the study will inform the Eswatini Ministry of Health approaches to mitigating undesired pregnancies and HIV among AGYW. Second, few examples exist of high-frequency longitudinal data collection in SSA, and this study will contribute to the survey method knowledge. Finally, the rich dataset will available for secondary data analysis.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e090686"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of climate change-related food (in)security and food sovereignty in Canada's northern communities and the circumpolar region: a scoping review protocol.","authors":"Iva Seto, Nicholas Worby, Joanna Szurmak, David Gerstle, Rebecca Tough, Tracey Galloway","doi":"10.1136/bmjopen-2024-084403","DOIUrl":"10.1136/bmjopen-2024-084403","url":null,"abstract":"<p><strong>Introduction: </strong>Climate change impacts the circumpolar region (including northern Canada) at a greater magnitude than other parts of the world. This affects food (in)security as well as food sovereignty. This scoping review aims to map the methods of measuring food (in)security and food sovereignty across northern Canada and the circumpolar region in support of the Yukon Government's climate change adaptation strategy.</p><p><strong>Methods and analysis: </strong>We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, and work will be conducted according to the Joanna Briggs Institute (JBI) manual chapter on scoping reviews. Academic librarians develop the academic literature and grey literature search strategies, and the search strategies are further revised through iterative stages of peer review. The search strategy includes 7 academic literature databases, 11 grey literature databases, over 50 websites and the University of Toronto Libraries catalogue. Covidence, an evidence synthesis software, will be used for screening and extraction. The extraction chart will be developed and piloted by our team. A minimum of two reviewers will conduct screening, and conflicts will be resolved through discussion. Data will be extracted by one reviewer and verified by a second. Conflicts will be resolved through discussion or by a third reviewer.</p><p><strong>Ethics and dissemination: </strong>This project does not require ethical approval as it is secondary research; data will be extracted from published academic research papers, dissertations, and publicly available reports and documents. Our dissemination plan includes presentations at conferences, submission to international peer-reviewed journals and a workshop on the search strategies.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e084403"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of urinary stone composition among patients with urolithiasis: a retrospective study in China.","authors":"Bin Wang, Xujuan Zheng, Juan Xiong, Zhongyi Sun","doi":"10.1136/bmjopen-2023-079431","DOIUrl":"10.1136/bmjopen-2023-079431","url":null,"abstract":"<p><strong>Objective: </strong>To present the most recent data on urinary calculi characteristics in the southern region of China and explore the effects of sociodemographic, clinical and laboratory characteristics on stone composition to fill the research gap.</p><p><strong>Setting: </strong>A retrospective observational study was performed in Shenzhen between December 2019 and August 2022.</p><p><strong>Participants: </strong>A total of 858 calculi samples from patients with urolithiasis were analysed via infrared spectroscopy.</p><p><strong>Methods: </strong>The stone was classified by the European Association of Urology guidelines and the Mayo Clinic stone classification practices. Multivariate logistic regression models were conducted to evaluate the association between different characteristics and urinary stone composition.</p><p><strong>Results: </strong>We found that the majority of these patients with urolithiasis were under 60. Almost half of the stone samples (49.4%) were single constitute, and calcium oxalate stone accounted for the highest proportion (80.0%), followed by infection stone (10.0%) and uric acid stone (4.9%). Of these, 78.0% were collected from males, with a male-to-female ratio of 3.54:1; the majority (95.0%) of calculi localisation was in the upper urinary tract. Multivariate analysis found that age, gender, history of urolithiasis, kidney disease, anatomical location and urinary pH influenced urinary stone composition.</p><p><strong>Conclusions: </strong>The effective prevention of urolithiasis is the key to this working-age population. These findings may supply significant evidence for understanding the underlying aetiology of urolithiasis and offer clues for effectively preventing and treating urinary calculi.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e079431"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracytoplasmic sperm injection compared with in vitro fertilisation in patients with non-male factor infertility with low oocyte retrieval: a single-centre, retrospective cohort study.","authors":"Shaomi Zhu, Hengli Li, Zili Lv, Xin Liang, Liang Dong, Dongmei Tian","doi":"10.1136/bmjopen-2023-080688","DOIUrl":"10.1136/bmjopen-2023-080688","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) on the clinical outcomes of non-male factor patients aged >35 with three or fewer oocytes retrieved.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Reproductive centre of a university-affiliated hospital in China.</p><p><strong>Participants: </strong>547 women with non-male factor infertility who underwent assisted reproductive technology (ART) treatment with three or fewer oocytes retrieved were identified from June 2019 to May 2022. Of these 547 patients, 334 were treated with IVF and 213 with ICSI.</p><p><strong>Outcome measures: </strong>The primary outcomes were normal fertilisation rate, live birth rate per transfer and cumulative live birth rate per retrieval.</p><p><strong>Results: </strong>The baseline characteristics were comparable between the two groups, except for the proportion of primary infertility, which was higher in the ICSI group (17.66% vs 32.86%, p=0.000). Compared with the IVF group, the ICSI group showed higher normal fertilisation rate and lower cycle cancellation rate (65.99% vs 76.56%, p=0.002; 33.53% vs 24.41%, p=0.023). However, no significant differences were found in clinical pregnancy rate per transfer (23.86% vs 18.92%, p=0.545), miscarriage rate per fresh embryo transfer (19.05% vs 28.57%, p=0.595), live birth rate per transfer (17.05% vs 13.51%, p=0.623), cumulative clinical pregnancy rate per retrieval (12.87% vs 11.27%, p=0.576) and cumulative live birth rate per retrieval (9.28% vs 6.57%, p=0.261) between the two groups (p>0.05).</p><p><strong>Conclusions: </strong>In non-male factor ART cycles, ICSI was not associated with improved pregnancy outcomes in older women with a low number of oocytes retrieved. Routine use of ICSI is not recommended in older women who are infertile due to non-male factors.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e080688"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}