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bioRxiv2019

The effects of a 6-week core exercises on swimming performance of national level swimmers

The aim of this study was to assess the impact of a 6-week specialized training program aimed at strengthening core muscles to improve the effectiveness of selected elements of a swimming race in group of elite polish swimmers. Sixteen male national and international level swimmers (21.6 {+/-} 2.2 years) participated in the research. The competitors were randomly assigned to 1 of 2 groups before the data collection process: an experimental (EG, n = 8) and control (CG, n = 8) group. Both groups of swimmers carried out the same training program in the water environment (volume and intensity), while swimmers from EG additionally carried out the specific core muscle training. The task of the swimmers was an individual swim of 50 meters freestyle, during which the kinematic parameters of start, turn and swimming techniques were recorded using the video camera system. In both groups a minor increase in the flight phase was observed during the start (EG=0.06 m, 1.8%; p=0.088; CG = 0.08 m, 2.7%; p=0.013). The time of the distance 5 m after the turn and the recorded average speed of swimming this distance in EG statistically significant improved accordingly 0.1 s (-28.6%; p<0.001) and 3.56 m{middle dot}s-1 (23.2%; p=0.001). In EG, a statistically significant improvement in 50-m freestyle performance was observed by 0.3 s (-1.2%, p = 0.001). The results of the research show that the implementation of isolated strength of the stabilizing muscles seems to be a valuable addition to the standard training of swimmers.

scientific communication and education↗

bioRxiv2019

Tracking self-citations in academic publishing

Citation metrics have value because they aim to make scientific assessment a level playing field, but urgent transparency-based adjustments are necessary to ensure that measurements yield the most accurate picture of impact and excellence. One problematic area is the handling of self-citations, which are either excluded or inappropriately accounted for when using bibliometric indicators for research evaluation. Here, in favor of openly tracking self-citations we report on self-referencing behavior among various academic disciplines as captured by the curated Clarivate Analytics Web of Science database. Specifically, we examined the behavior of 385,616 authors grouped into 15 subject areas like Biology, Chemistry, Science & Technology, Engineering, and Physics. These authors have published 3,240,973 papers that have accumulated 90,806,462 citations, roughly five percent of which are self-citations. Up until now, very little is known about the buildup of self-citations at the author-level and in field-specific contexts. Our view is that hiding self-citation data is indefensible and needlessly confuses any attempts to understand the bibliometric impact of ones work. Instead we urge academics to embrace visibility of citation data in a community of peers, which relies on nuance and openness rather than curated scorekeeping.

scientific communication and education↗

bioRxiv2019

Handling and Packaging of Medical Bags at the Acute Disaster Site Under High Temperature Conditions

The handling of medical bags in high temperature disaster sites has not been fully evaluated. In this study, medical bags were assessed in the closed, semi-opened, and opened state, with and without heat insulating material (HIM) and a coolant. The bags were heated for 300 minutes at 35 or 40{degrees}C, and the internal temperature was measured. closed and semi-opened bags were able to limit temperature increases in the central part of the bag at both 35 and 40{degrees}C to a greater extent than opened bags. When coolant and HIM were used in closed and semi-opened bags, the internal temperature was significantly lower than that seen in the opened state at 40{degrees}C (P < 0.01 and P < 0.001, respectively). In conclusion, in high temperature disaster sites, medical bags should be maintained in a semi-opened or closed state using a HIM and coolant.

scientific communication and education↗

bioRxiv2019

Tackling misinformation in agriculture

Farmers are encouraged to embrace digital media to fill the voids caused by the privatisation of Agricultural Knowledge and Information Systems. Widespread sustainable agriculture misinformation undermines the role of science, participatory research, and evidence-based decision making. Simply providing information is insufficient, misinformation is tackled by creating a network that fosters accurate information exchange. Here I used Twitter and blended learning technologies to create a research partnership with farmers based on their beliefs that earthworms indicate good soils management. Through co-design, farmers transformed this symbol into a systematic field observation network, assessing earthworm populations to the ecological group level. Our community (#WorldWormWeek) revealed the falsehoods in misinformation such as: "Farmers around the world have been turning their fields into subterranean deserts". This social learning network was resilient to further misinformation by the national press. Real data trends were fundamentally different to predictions made by science advancing models of global earthworm populations. Anecic earthworms (including middens) were absent in 1 in 5 fields, directly informing management practices to avoid soil biological pitfalls in no-tillage adoption. Simplistic earthworm counts to indicate soil health are rendered obsolete, a depth of information exchange can be achieved by building science-farmer partnerships using digital communications and co-designed frameworks. However, the scientific consensus, whilst generally positive about the research impact, revealed 42 % scientists rated this research as "not at all useful" or "slightly useful" to scientists. This reveals the hopeless situation where the co-production of knowledge and feedback loop linking farming-science is not broadly considered science advancing, and brought #Wormscience to an end. The next step would have been to optimize Lumbricus terrestris biocontrol actions targeting the soil-borne crop pathogen Fusarium spp. and detoxification of its mycotoxins, to reduce fungicide dependency in staple crop production; aligned with societal sustainable agriculture aspirations.

scientific communication and education↗

bioRxiv2019

An instrument to assess HIV-related knowledge and adjustment to HIV+ status, and their association with anti-retroviral adherence

BackgroundFindings on the association between health literacy and anti-retroviral (ARV) adherence are inconsistent. Health literacy is usually operationalized with simple tests of basic literacy, but more complex conceptions of health literacy include content knowledge. People living with chronic illness also conceptualize and experience illness in ways other than biomedical or mechanistic models of disease. ObjectiveThere are no instruments that comprehensively assess knowledge of people living with HIV concerning HIV disease and treatment; or psychological adjustment to being HIV+. Little is known about the relationship between factual knowledge, or positive identification as HIV+, and anti-retroviral (ARV) adherence. MethodsFormative work with in-depth semi-structured interviews, and cognitive testing, to develop a structured instrument assessing HIV-related knowledge, and personal meanings of living with HIV. Pilot administration of the instrument to a convenience sample of 101 respondents. Key ResultsRespondents varied considerably in their expressed need for in-depth knowledge, the accuracy of their understanding of relevant scientific concepts and facts about ARV treatment, and psychological adjustment and acceptance of HIV+ status. Most knowledge domains were not significantly related to self-reported ARV adherence, but accurate knowledge specifically about ARV treatment was (r=0.25, p=.02), as was an adapted version of the Need for Cognition scale (r=.256, p=.012). Negative feelings about living with HIV (r=.33, p=.0012), and medication taking (r=.276, p=.008) were significantly associated with non-adherence. ConclusionThe instrument may be useful in diagnosing addressable reasons for non-adherence, as a component of psychoeducational interventions, and for evaluation of such interventions. PLAIN LANGUAGE SUMMARYWe developed a questionnaire for people with HIV. General knowledge about HIV wasnt related to whether people took their medications, but specific information about treatment was. People with lots of bad feelings about living with HIV were less likely to take medications as prescribed. People who liked to think more about their decisions were more likely to take their medications.

scientific communication and education↗

bioRxiv2020

"Running with cancer": a qualitative study to evaluate barriers and motivations in running for female oncological patients.

Nowadays, it is widely acknowledged that low physical activity levels are associated with an increase in terms of both disease recurrence and mortality in cancer survivors. In this light, deciphering those factors able to hamper or facilitate an active lifestyle is crucial in order to increase patients adherence to physical activity. The purpose of this study was to explore barriers and motivations in a sample of female oncological patients, practising running using the ecological model and compare them with healthy controls. Focus group interviews were conducted at Verona University. Participants were 12 female cancer survivors and 7 matched healthy controls who had participated at "Run for Science" project. The interviews were transcribed verbatim and analyzed using content analysis. Two main themes, motivations and barriers were found. About motivations, three sub-themes were identified: personal, interpersonal and environmental/organizational factors. Regarding barriers, another sub-theme was recognized: community/policy factors. Compare to healthy controls, survivors expressed motivations and barriers specifically related to their oncological disease. Running was a challenge with their cancer and a hope to give to other patients. Main barriers were represented by treatment-related side effects, inexperienced trainers and external factors, e.g. delivery of incorrect information. Running program dedicated to oncological patients should consider intrinsic obstacles, related to cancer and its treatment, offering a personalized intervention performed by qualified trainers, together with a motivational approach able to improve participants adherence to an active lifestyle.

scientific communication and education↗

bioRxiv2020

The extent and drivers of gender imbalance in neuroscience reference lists

Like many scientific disciplines, neuroscience has increasingly attempted to confront pervasive gender imbalances within the field. While much of the conversation has centered around publishing and conference participation, recent research in other fields has called attention to the prevalence of gender bias in citation practices. Because of the downstream effects that citations can have on visibility and career advancement, understanding and eliminating gender bias in citation practices is vital for addressing inequity in a scientific community. In this study, we sought to determine whether there is evidence of gender bias in the citation practices of neuroscientists. Using data from five top neuroscience journals, we find that reference lists tend to include more papers with men as first and last author than would be expected if gender were not a factor in referencing. Importantly, we show that this overcitation of men and undercitation of women is driven largely by the citation practices of men, and is increasing over time as the field becomes more diverse. We develop a co-authorship network to assess homophily in researchers’ social networks, and we find that men tend to overcite men even when their social networks are representative. We discuss possible mechanisms and consider how individual researchers might address these findings in their own practices.View Full Text

scientific communication and education↗

bioRxiv2020

"Pain in my heart": Understanding perinatal depression among women living with HIV in Malawi

BackgroundPerinatal depression (PND) can interfere with HIV care engagement and outcomes. We examined experiences of PND among women living with HIV (WLWH) in Malawi. MethodsWe screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the Edinburgh Postnatal Depression Scale (EPDS). We conducted interviews with 24 women experiencing PND and analyzed data using inductive and deductive coding and narrative analysis. ResultsWomen experienced a double burden of physical and mental illness, expressed as pain in ones heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key contributor to developing PND. This development was influenced by stigmatization and social support. ConclusionsThese findings highlight the need to recognize the mental health implications of routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally appropriate mental health interventions are needed in settings with a high HIV burden.

scientific communication and education↗

bioRxiv2020

Physiotherapist and Podiatrist Independent Prescribing in the United Kingdom: A quasi experimental study

BackgroundIncreasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health professionals including physiotherapists and podiatrists. Aim: to compare outcomes of Physiotherapist and Podiatrist Independent Prescriber (PP-IP) patients with those of Physiotherapist and Podiatrist non-prescribers (PP-NPs). Outcome measures included patient satisfaction, ease of access to services, quality of life and cost implications. Design: a quasi-experimental, post-test control group design Methods: Using mixed methods outcomes were compared between 7 sites where care was provided from a PP-IP (3 podiatrist and 4 physiotherapist IPs) and 7 sites from a PP-NP (3 podiatrist and 4 physiotherapist NPs). Patients were followed up for 2 months (2015-2016). Results: 489 patients were recruited: n=243 IP sites, and n=246 NP sites. Independent prescribing was found to be highly acceptable, and equivalent in terms of quality of life (p>0.05) and patient satisfaction (p[≤]0.05) compared to care provided by NPs. PP-IP care delivery was found to be more resource intensive than NP-PP, with longer consultation duration for IPs (around 6.5 mins), and a higher proportion of physiotherapy patients discussed with medical colleagues (around 9.5 minutes). ConclusionThis study provides new knowledge that PP-IPs provide high levels of care. PP-IP care delivery was found to be more resource intensive. Further research is required to explore cost effectiveness. A more focussed exploration within each profession using targeted outcome measures would enable a more robust comparison, inform future developments around the world and help ensure non-doctor prescribing is recognised as an effective way to alleviate shortfalls in the global workforce.

scientific communication and education↗

bioRxiv2020

Moderating Effect of Social Support on Role Conflict and Job Satisfaction Among Nurses with Multiple Roles

Registered nurses perform multiple roles in their lives at work, at home, and at school when they decide to pursue various types of advanced degrees. Work-family conflict was found to be negatively correlated with job satisfaction among nurses. This study aimed to determine the moderating effect of social support on the relationship between role conflicts and job satisfaction among registered nurses in mainland China. The study had a cross-sectional correlational design. Convenience sampling was applied to recruit 320 nurses with multiple roles from 8 nursing universities and 3 hospitals in China between January and August 2017. SPSS (version 20.0) software and PROCESS program was used to examine to moderating effect of social support between the relationship of role conflicts and job satisfaction. It was found that role conflicts were negatively correlated with job satisfaction. Support from work and support from family negatively moderated the relationship between role conflicts and job satisfaction. These findings suggest that support from family, coworkers and nursing administrators, and the implementation of school- and family-friendly policies would help nurses who are pursuing further nursing degrees to handle their multiple roles and improve their job satisfaction.

scientific communication and education↗

bioRxiv2020

Long weekend sleep is linked to stronger academic performance in male but not female pharmacy students

Introduction Poor sleep hygiene portends loss of physical and mental stamina. Therefore, maintaining a regular sleep/wake schedule on both weekdays and weekends is highly recommended. However, this advice runs contrary to the habits of university students, who may only experience recovery sleep if they sleep late on weekends. Pharmacy students at Duquesne University sit for frequent examinations, typically commencing at 7:30 AM, and they complain about fatigue. Here, we tested the central hypothesis that longer sleep durations on weekdays and weekends are linked to stronger academic performance in Pharmacy students.Methods Students in their first professional year were administered three surveys to collect data on sleep habits and factors that might influence sleep, such as roommates, long commute times, and sleep interruptions. GPAs were collected from the Dean’s office, with permission from the students.Results Longer weekend—but not weekday—sleep durations were significantly correlated with higher cumulative GPAs in men and not in women. Women achieved slightly higher cumulative GPAs than men. Students who fell asleep within 15 minutes of going to bed had higher professional-phase GPAs than those who fell asleep after an hour or more.Conclusion Our observations cannot establish causal links, but, given the body of prior evidence on the salutary properties of sleep, men in this cohort may reap benefit from recovery sleep on weekends. Rather than recommending that students force themselves awake early on weekends in an attempt to maintain a consistent sleep routine, the real-life habits of students should be given consideration.View Full Text

scientific communication and education↗

bioRxiv2020

Rigor and Transparency Index, a new metric of quality for assessing biological and medical science methods.

The reproducibility crisis in science is a multifaceted problem involving practices and incentives, both in the laboratory and in publication. Fortunately, some of the root causes are known and can be addressed by scientists and authors alike. After careful consideration of the available literature, the National Institutes of Health identified several key problems with the way that scientists conduct and report their research and introduced guidelines to improve the rigor and reproducibility of pre-clinical studies. Many journals have implemented policies addressing these same criteria. We currently have, however, no comprehensive data on how these guidelines are impacting the reporting of research. Using SciScore, an automated tool developed to review the methods sections of manuscripts for the presence of criteria associated with the NIH and other reporting guidelines, e.g., ARRIVE, RRIDs, we have analyzed ~1.6 million PubMed Central papers to determine the degree to which articles were addressing these criteria. The tool scores each paper on a ten point scale identifying sentences that are associated with compliance with criteria associated with increased rigor (5 pts) and those associated with key resource identification and authentication (5 pts). From these data, we have built the Rigor and Transparency Index, which is the average score for analyzed papers in a particular journal. Our analyses show that the average score over all journals has increased since 1997, but remains below five, indicating that less than half of the rigor and reproducibility criteria are routinely addressed by authors. To analyze the data further, we examined the prevalence of individual criteria across the literature, e.g., the reporting of a subject’s sex (21-37% of studies between 1997 and 2019), the inclusion of sample size calculations (2-10%), whether the study addressed blinding (3-9%), or the identifiability of key biological resources such as antibodies (11-43%), transgenic organisms (14-22%), and cell lines (33-39%). The greatest increase in prevalence for rigor criteria was seen in the use of randomization of subjects (10-30%), while software tool identifiability improved the most among key resource types (42-87%). We further analyzed individual journals over time that had implemented specific author guidelines covering rigor criteria, and found that in some journals, they had a big impact, whereas in others they did not. We speculate that unless they are enforced, author guidelines alone do little to improve the number of criteria addressed by authors. Our Rigor and Transparency Index did not correlate with the impact factors of journals.View Full Text

scientific communication and education↗

bioRxiv2020

Spinach growers value host resistance and synthetic fungicides in the fight against downy mildew

California spinach growers struggle to manage spinach downy mildew disease. The disease is especially difficult in the organic crop, which currently relies on resistant varieties to maintain disease-free crop. Alternative control measures are available, but it is not clear how growers perceive the efficacy of these methods. It is also not clear who growers contact to find out information on spinach downy mildew disease management. In this study, we conducted an online survey of people involved in spinach production, asking about their beliefs in the efficacy of different control methods and who they contact frequently to discuss spinach downy mildew control. We found that respondents were most positive about the efficacy of resistant varieties and synthetic pesticides, with much lower perceived efficacy for the practices of disking diseased fields, roguing diseased plants, and organic pesticides. Growers most frequently contacted pest control advisors (PCAs) about management strategies for spinach downy mildew. These results suggest that respondents are most confident about the efficacy of resistant varieties and synthetic pesticides and may be hesitant to adopt new control strategies like organic pesticides. The results also suggest that future extension efforts can be focused on PCAs to reach the most stakeholders with up to date research on downy mildew control.

scientific communication and education↗

bioRxiv2020

Risk Factors for Chikungunya Outbreak in Kebridhar City, Somali Ethiopia, 2019. Unmatched Case-Control Study

BackgroundChikungunya Virus is a Ribose Nucleic Acid (RNA) virus transmitted by a mosquito bite. Aedes Aegypti and Aedes Albopictus are responsible vectors for Chikungunya Virus transmission. CHIKV outbreaks are characterized by rapid spread and infection rates as high as 75%. A combination of health system efforts and healthy behavior practices by the community is essential for effective control. MethodsUnmatched case control study was done to identify risk factors of this outbreak. One case to two controls ratios was calculated. All cases during the study period (74 cases) and 148 controls were included in the study. Bivariate and multivariable analysis were implemented. Serum samples were tested by Real Time Polymerase Chain Reaction at Ethiopian Public Health Institute laboratory. ResultsA total of 74 chikungunya fever cases were reported starting from 19th May 2019 to 8th June 2019. Not using bed net at day time sleeping (P- value < 0.001, AOR 20.8, 95CI 6.4 - 66.7), presence of open water holding container (P- value 0.023, AOR 4, 95CI 1.2 - 13.5), presence of larvae in water holding container (P- value 0.015, AOR 4.8, 95CI 1.4 - 16.8), ill person with similar sign and symptoms in the family or neighbors (P- value <0.001, AOR 27.9, 95CI 6.5 - 120.4) and wearing not full body cover clothes (P- value 0.002, AOR 8.1, 95CI 2.2 - 30.1) were significant risk factors. ConclusionUsing bed nets at day time sleeping, cover the water holding containers, wearing full body cover cloths are protective factors.

scientific communication and education↗

bioRxiv2020

Effects of sustained inflation pressure during neonatal cardiopulmonary resuscitation of asphyxiated piglets

ObjectiveSustained inflation (SI) during chest compression (CC = CC+SI) significantly reduces time to return of spontaneous circulation (ROSC) compared to 3:1 compression-to-ventilation ratio during neonatal resuscitation. However, the optimal peak inflation pressure (PIP) of SI during CC+SI to improve ROSC and hemodynamic recovery in severely asphyxiated piglets is unknown. AimTo examine if different PIPs of SI during CC+SI will improve ROSC and hemodynamic recovery in severely asphyxiated piglets. Intervention and measurementsTwenty-nine newborn piglets (1-3 days old) were anesthetized, intubated, instrumented and exposed to 30-min normocapnic hypoxia followed by asphyxia. Piglets were randomized into four groups: CC+SI with a PIP of 10 cmH2O (CC+SI_PIP_10, n=8), a PIP of 20 cmH2O (CC+SI_PIP_20, n=8), a PIP of 30 cmH2O (CC+SI_PIP_30, n=8), and a sham-operated control group (n=5). Heart rate, arterial blood pressure, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. Main resultsBaseline parameters were similar between all groups. There was no difference in asphyxiation (duration and degree) between intervention groups. PIP correlated positively with tidal volume and inversely with exhaled CO2 during cardiopulmonary resuscitation. Time to ROSC and rate of ROSC were similar between piglets resuscitated with CC+SI_PIP_10, CC+SI_PIP_20, and CC+SI_PIP_30 cmH2O: median (IQR) 75 (63-193) sec, 94 (78-210) sec, and 85 (70-90) sec; 5/8 (63%), 7/8 (88%), and 3/8 (38%) (p=0.56 and p=0.12, respectively). All piglets that achieved ROSC survived to four hours post-resuscitation. Piglets resuscitated with CC+SI_PIP_30 cmH2O exhibited increased concentrations of pro-inflammatory cytokines interleukin-1{beta} and tumour necrosis factor- in the frontoparietal cerebral cortex (both p<0.05 vs. sham-operated controls). ConclusionsIn asphyxiated term newborn piglets resuscitated by CC+SI, the use of different PIPs resulted in similar time to ROSC, but PIP at 30 cmH2O showed a larger VT delivery, lower exhaled CO2 and increased tissue inflammatory markers in the brain.

scientific communication and education↗

bioRxiv2020

A systematic review of scientific research focused on farmers in agricultural adaptation to climate change (2008-2017)

Due to the severe consequences of climate change, associated risks to global food security, and the contribution of agriculture to greenhouse gas emissions, agriculture must necessarily adapt to meet these challenges. Many studies have therefore sought to investigate agricultural adaptation to climate change, and as key stakeholders in agriculture, farmers play a vital role in this process. There is a rapidly increasing corpus of scholarship on agricultural adaptation to climate change, with many studies beginning to incorporate survey methods to examine farmer perceptions and adaptation responses. Nevertheless, in-depth understanding of farmers worldwide is inadequate due to insufficiently robust methodologies, socio-economic disparities, and unequal geographic distribution. In this study, we searched and reviewed the existing peer-reviewed, English-language scientific articles published between 2008 and 2017 on agricultural adaptation to climate change that have incorporated farmers into their research methodologies. The main findings include the following: (1) a small but increasing number of studies focus on farmers in climate change adaptation; (2) the global geographic distribution of the reviewed studies is uneven, and many of the most vulnerable nations (e.g., lower-income/agricultural-dependent economies) have no representation at all; (3) there were diverse rationales and methods for incorporating farmers into the studies, and many of the methodological differences were due to practical and logistical limitations in lower-income/agricultural-dependent nations; and (4) studies were from multiple academic fields, indicating the need for more interdisciplinary collaboration moving forward because agricultural adaptation to climate change is too complex for a single discipline to fully explore. Although English is increasingly recognized as the "international language of science," due to the challenge of language segmentation limiting broader understanding of global scholarship whenever possible, future reviews should be jointly conducted in both English and non-English languages.

scientific communication and education↗

bioRxiv2020

Peer review and preprint policies are unclear at most major journals

Clear and findable publishing policies are important for authors to choose appropriate journals for publication. We investigated the clarity of policies of 171 major academic journals across disciplines regarding peer review and preprinting. 31.6% of journals surveyed do not provide information on the type of peer review they use. Information on whether preprints can be posted or not is unclear in 39.2% of journals. 58.5% of journals offer no clear information on whether reviewer identities are revealed to authors. Around 75% of journals have no clear policy on co-reviewing, citation of preprints, and publication of reviewer identities. Information regarding practices of Open Peer Review is even more scarce, with <20% of journals providing clear information. Having found a lack of clear information, we conclude by examining the implications this has for researchers (especially early career) and the spread of open research practices.View Full Text

scientific communication and education↗

bioRxiv2020

Probiotics for the prevention of antibiotic-associated adverse events in children - a systematic review to inform development of a core outcome set

IntroductionRoutine use of probiotics during antibiotic therapy in children remains a subject of discussion. To facilitate synthesis of individual study results and guideline formulation, it is important to assess predefined, similar, and clinically important outcomes. Core outcome sets are a proposed solution for this issue. Aim of this review was to document choice, design, and heterogeneity of outcomes in studies that assessed the effects of probiotics used for the prevention of antibiotic-associated adverse events in children. MethodsA systematic literature search covering three major databases was performed. Trials that evaluated oral probiotics use concomitant with antibiotic therapy in children were included. Data on outcome definitions, measurement instruments, and follow-up were extracted. The outcomes were assigned to predefined core areas and domains. Data were analyzed descriptively. ResultsThirty-six trials were included in this review. Diarrhea, the most commonly reported outcome, had diagnostic criteria clearly defined only in 20 trials. In total, sixteen different definitions of diarrhea were identified. Diarrhea duration, severity and etiology were reported in 8, 4 and 6 studies, respectively. Nineteen studies assessed gastrointestinal symptoms other than diarrhea. Seven studies reported outcomes related to resource use or the economic impact of the intervention. Only 2 studies assessed outcomes related to life impact. None of the studies predefined adverse events of probiotic use. ConclusionsIdentified outcomes were characterized by substantial heterogeneity. Majority of outcomes were not designed to evaluate endpoints of real-life relevance. Results from this review suggest the need for a new core outcome set consisting of outcomes important for decision-making.

scientific communication and education↗