bluuebunny/crossref_metadata_2025 huggingface dataset:
Surviving birth at high altitude
Authors: Heath‐Freudenthal Alexandra , Estrada Alejandra , von Alvensleben Inge , Julian Colleen G.
Published: March 2024

This Symposium Review examines challenges to surviving birth and infancy at high altitudes. Chronic exposure to the environmental hypoxia of high altitudes increases the incidence of maternal vascular disorders of pregnancy characterized by placental insufficiency, restricted fetal growth and preterm delivery, and impairs pulmonary vascular health during infancy. While each condition independently contributes to excess morbidity and mortality in early life, evidence indicates vascular disorders of pregnancy and infantile pulmonary vascular dysfunction are intertwined. By integrating our recent scientific and clinical observations in Bolivia with existing literature, we propose potential avenues to reduce the infant mortality burden at high altitudes and reduce pulmonary vascular disease in highland neonates, and emphasize the need for further research to address unresolved questions.

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Pacemaking in the lymphatic system
Authors: Davis Michael J. , Zawieja Scott D.
Published: March 2024

Lymphatic collecting vessels exhibit spontaneous phasic contractions that are critical for lymph propulsion and tissue fluid homeostasis. This rhythmic activity is driven by action potentials conducted across the lymphatic muscle cell (LMC) layer to produce entrained contractions. The contraction frequency of a lymphatic collecting vessel displays exquisite mechanosensitivity, with a dynamic range from <1 to >20 contractions per minute. A myogenic pacemaker mechanism intrinsic to the LMCs was initially postulated to account for pressure‐dependent chronotropy. Further interrogation into the cellular constituents of the lymphatic vessel wall identified non‐muscle cell populations that shared some characteristics with interstitial cells of Cajal, which have pacemaker functions in the gastrointestinal and lower urinary tracts, thus raising the possibility of a non‐muscle cell pacemaker. However, recent genetic knockout studies in mice support LMCs and a myogenic origin of the pacemaker activity. LMCs exhibit stochastic, but pressure‐sensitive, sarcoplasmic reticulum calcium release (puffs and waves) from IP3R1 receptors, which couple to the calcium‐activated chloride channel Anoctamin 1, causing depolarisation. The resulting electrical activity integrates across the highly coupled lymphatic muscle electrical syncytia through connexin 45 to modulate diastolic depolarisation. However, multiple other cation channels may also contribute to the ionic pacemaking cycle. Upon reaching threshold, a voltage‐gated calcium channel‐dependent action potential fires, resulting in a nearly synchronous calcium global calcium flash within the LMC layer to drive an entrained contraction. This review summarizes the key ion channels potentially responsible for the pressure‐dependent chronotropy of lymphatic collecting vessels and various mechanisms of IP3R1 regulation that could contribute to frequency tuning.

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Rotating Flow and Heat Transfer Characteristics of a Novel Cooling Channel for Gas Turbine Blade Trailing Edge With Diamond-Type TPMS Structures
Authors: Yeranee Kirttayoth , Xu Chao , Rao Yu , Chen Jianian , Zhang Yueliang
Published: March 2024

This work designs a Diamond-type triply periodic minimal surface (TPMS) structure that exhibits excellent thermomechanical properties in a gas turbine blade trailing edge to enhance thermal performance and improve heat transfer uniformity. Since the velocity and temperature distributions are altered in the rotating trailing edge channel, the flow and heat transfer characteristics of the baseline pin fin and Diamond TPMS models are numerically investigated at the Reynolds number of 10,000 and the rotation numbers of 0.0–0.28. Compared to the baseline model, the Diamond TPMS network significantly decreases recirculation flow at the inner wall, improving heat transfer, especially at the tip and outlet regions. Although the Diamond TPMS model incurs substantial pressure losses from 191% to 234%, it yields significantly higher overall heat transfer than the pin fins by 179%. Consequently, the thermal performance increased by 93.4%. The flow fluctuations due to the rotating effects are minor in the Diamond TPMS architecture, considerably reducing the differences in heat transfer between the leading and trailing walls. The differences in the wetted-area averaged Nusselt number of the baseline and Diamond TPMS models within the studied rotation numbers are 8.5–14.4% and about 8.5%, respectively. Moreover, the Diamond TPMS structure reduces the differences in heat transfer between the root and tip regions at the outlet by up to 80% compared to the pin fins. This improvement helps protect the trailing edge from thermal failure, thereby potentially prolonging the gas turbine blade's lifetime.
Cadence Paradox in Cycling—Part 1: Maximal Lactate Steady State and Carbohydrate Utilization Dependent on Cycling Cadence
Authors: Beneke Ralph , Granseyer Marisa , Leithäuser Renate M.
Published: March 2024

Purpose: To assess (1) whether and how a higher maximal lactate steady state (MLSS) at higher cycling cadence (RPM) comes along with higher absolute and/or fractional carbohydrate combustion (CHOMLSS), respectively, and (2) whether there is an interrelation between potential RPM-dependent MLSS effects and the maximally achievable RPM (RPMMAX). Methods: Twelve healthy males performed incremental load tests to determine peak power, peak oxygen uptake, and 30-minute MLSS tests at 50 and 100 per minute, respectively, to assess RPM-dependent MLSS, corresponding power output, CHOMLSS responses, and 6-second sprints to measure RPMMAX. Results: Peak power, peak carbon dioxide production, and power output at MLSS were lower (P = .000, ω2 = 0.922; P = .044, ω2 > 0.275; and P = .016, ω2 = 0.373) at 100 per minute than at 50 per minute. With 6.0 (1.5) versus 3.8 (1.2) mmol·L−1, MLSS was higher (P = .000, ω2 = 0.771) at 100 per minute than at 50 per minute. No corresponding RPM-dependent differences were found in oxygen uptake at MLSS, carbon dioxide production at MLSS, respiratory exchange ratio at MLSS, CHOMLSS, or fraction of oxygen uptake used for CHO at MLSS, respectively. There was no correlation between the RPM-dependent difference in MLSS and RPMMAX. Conclusions: The present study extends the previous finding of a consistently higher MLSS at higher RPM by indicating (1) that at fully established MLSS conditions, respiration and CHOMLSS management do not differ significantly between 100 per minute and 50 per minute, and (2) that linear correlation models did not identify linear interdependencies between RPM-dependent MLSS conditions and RPMMAX.
Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study
Authors: Usta Ozdemir Hande , Kitis Ali , Ardıc Fazıl Necdet
Published: March 2024

We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.
Nature Games: Traditional Indigenous Games and Environmental Stewardship in Oceania
Authors: Fabian Tom , Osmond Gary , Phillips Murray G.
Published: March 2024

Traditional games are often situated in counter distinction to modern sport forms and are not well understood in Western society or scholarship. However, from these games, we have the opportunity to learn much about local play and physical culture. This article focuses on traditional Indigenous games in Oceania and how they can be used as a lens for the development of environmental stewardship or ecological sensibilities. The aims of this study are twofold: (1) to lay a foundation for future research in this area and (2) to situate traditional games within the broader sport ecology conversation. By deconstructing the embodied nature of traditional games and overviewing the histories of environmentalism in Oceania, a more grounded claim can be made for the relevance of traditional games within sport and leisure studies scholarship, including sport history, sport sociology, sport anthropology, and sport ecology. The nature games of Oceania yield diverse insights into Indigenous epistemologies, ecological sensibilities, and how outdoor play can be understood as a form of climate action.
Prognostic factors and prediction models for hospitalisation and all-cause mortality in adults presenting to primary care with a lower respiratory tract infection: a systematic review
Authors: Rijk Merijn H , Platteel Tamara N , van den Berg Teun M C , Geersing Geert-Jan , Little Paul , Rutten Frans H , van Smeden Maarten , Venekamp Roderick P
Published: March 2024

Objective

To identify and synthesise relevant existing prognostic factors (PF) and prediction models (PM) for hospitalisation and all-cause mortality within 90 days in primary care patients with acute lower respiratory tract infections (LRTI).

Design

Systematic review.

Methods

Systematic searches of MEDLINE, Embase and the Cochrane Library were performed. All PF and PM studies on the risk of hospitalisation or all-cause mortality within 90 days in adult primary care LRTI patients were included. The risk of bias was assessed using the Quality in Prognostic Studies tool and Prediction Model Risk Of Bias Assessment Tool tools for PF and PM studies, respectively. The results of included PF and PM studies were descriptively summarised.

Results

Of 2799 unique records identified, 16 were included: 9 PF studies, 6 PM studies and 1 combination of both. The risk of bias was judged high for all studies, mainly due to limitations in the analysis domain. Based on reported multivariable associations in PF studies, increasing age, sex, current smoking, diabetes, a history of stroke, cancer or heart failure, previous hospitalisation, influenza vaccination (negative association), current use of systemic corticosteroids, recent antibiotic use, respiratory rate ≥25/min and diagnosis of pneumonia were identified as most promising candidate predictors. One newly developed PM was externally validated (c statistic 0.74, 95% CI 0.71 to 0.78) whereas the previously hospital-derived CRB-65 was externally validated in primary care in five studies (c statistic ranging from 0.72 (95% CI 0.63 to 0.81) to 0.79 (95% CI 0.65 to 0.92)). None of the PM studies reported measures of model calibration.

Conclusions

Implementation of existing models for individualised risk prediction of 90-day hospitalisation or mortality in primary care LRTI patients in everyday practice is hampered by incomplete assessment of model performance. The identified candidate predictors provide useful information for clinicians and warrant consideration when developing or updating PMs using state-of-the-art development and validation techniques.

PROSPERO registration number

CRD42022341233.
Exploring the syndemic interaction between social, environmental and structural contexts of HIV infection in peri-mining areas in South Africa: a qualitative study
Authors: Chimoyi Lucy , Ndini Pretty , Oladimeji Matthew , Seatlholo Nieser , Mawokomatanda Kudzai , Charalambous Salome , Setswe Geoffrey
Published: March 2024

Objective

To explore the syndemic interaction between social, environmental, and structural contexts and HIV infection in peri-mining areas in South Africa.

Design

Mixed qualitative methods consisting of in-depth interviews (IDIs) and focus group discussions (FGDs) exploring the interaction between HIV infection and the social, environmental and structural factors affecting people living in the peri-mining areas of South Africa. Themes were analysed following the syndemic theoretical framework.

Setting

Participants were recruited from three mining companies and locations in the peri-mining communities surrounding the mining companies in Limpopo, Mpumalanga, and Northern Cape provinces.

Participants

Inclusion criteria included mineworkers, healthcare workers, female sex workers (FSWs), injection drug users (IDUs), and other community members, ≥18 years, living in the peri-mining area at the time of participation. Three FGDs were conducted (n=30): 13 men and 17 women aged 18–55 years. IDIs were conducted with 45 participants: mineworkers (n=10), healthcare workers (n=11), FSWs (n=15), truck drivers (n=4) and IDUs (n=5).

Results

The findings from this study indicate that a syndemic of four socio-behavioural factors is associated with HIV acquisition in peri-mining areas. These are migrancy, accessibility to alcohol and substance use, commercial and transactional sex, and uptake of HIV prevention services.

Conclusions

Our findings have implications for HIV prevention programmes in mining companies, which rely on male condom usage promotion. More emphasis on better education about HIV prevalence, transmission and up-to-date prevention alternatives, such as pre-exposure prophylaxis for mineworkers is recommended. Furthermore, collaboration with community-based organisations is recommended to wholly address the syndemic factors influencing HIV transmission in peri-mining communities.
Characteristics of constipation screening and assessment tools: a scoping review protocol
Authors: Odgaard Lene , Rasmussen Anne A , Feo Rebecca , Kristensen Pia Kjær
Published: March 2024

Introduction

Constipation is a common and significant burden on individuals and healthcare systems. Accurate assessment of constipation severity and symptom improvement are vital aspects of caring for patients with constipation. Therefore, nurses and allied healthcare professionals should possess knowledge regarding the characteristics of constipation assessment tools (ie, aim, scope, definition of constipation, content, structure, mode, administration time and context of use). However, existing reviews summarising characteristics of tools have been restricted to chronic constipation and self-reported measures. Furthermore, they have not included literature published after 2011. This scoping review aims to identify and comprehensibly map the characteristics of available tools for screening and assessment of constipation in order to manage the nursing care need related to constipation within any healthcare or research context and any patient group.

Methods and analysis

This review will include primary research articles, methodological papers and clinical guidelines using tools for constipation screening and assessment, pertinent to nursing care management. It is not limited to a specific population or healthcare setting. Databases to be searched include PubMed, Embase, CINAHL, ProQuest, ClinicalKey and Google Scholar. To identify grey literature, national health services in selected countries will be searched. Papers written in English, Nordic language or German will be included. The reviewers will independently review the retrieved citations against the inclusion criteria, and data from included papers will be extracted using a data extraction form developed for this review. The scoping review will be conducted following the Joanna Briggs Institute Guidelines. The results will be presented in a table accompanied by a narrative summary.

Ethics and dissemination

Ethical approval is not required, as no individual patient data are included. Findings will be shared and discussed with relevant stakeholders and disseminated through peer-reviewed publications and conference presentations. The protocol is registered on Open Science Framework (registration number: osf.io/h2vzd).
Psychoeducational interventions for people living with chronic communicable disease: a systematic review
Authors: Burke Aoife , Davoren Martin P , Arensman Ella , Harrington Janas M
Published: March 2024

Objective

Psychoeducation is increasingly recognised for its value in facilitating adaption to a chronic disease diagnosis. This study aimed to synthesise available literature on the psychoeducation interventions available to adults living with chronic communicable disease.

Methods

PubMed, CINAHL, Embase, SocINDEX, PsycINFO and PsycArticles were systematically searched up to May 2023. Peer-reviewed studies, published in English, investigating the impact of psychoeducational interventions on adults living with chronic communicable disease were included, across a range of outcome measures. Narrative synthesis was performed. The Effective Public Health Practice Project tool and Critical Appraisal Skills Programme tool were used to assess risk of bias.

Results

In total, 22 studies were included in the review. The majority (n=16) of study populations focused on people living with HIV, followed by hepatitis C (n=5) and genital herpes (n=1). Interventions were delivered online (n=2), via telephone (n=1) and in-person (n=19). The majority of interventions were delivered in group sessions (n=16) and studies emphasised the value of group cohesion for social support, encouraging participants to share their own knowledge in addition to standard didactic presentations. Four studies facilitated peer-led delivery of the psychoeducation. Studies aiming to improve psychological well-being were beneficial in reducing depressive symptoms and/or emotional distress or showed improvement in the participant group overall. There was some evidence to suggest psychoeducation can improve readiness to attend treatment and medication adherence.

Conclusion

The findings of this review highlight potential benefits of psychoeducation but indicate more robust clinical trials will be required to examine their effectiveness and elucidate the mechanisms by which they best operate. Future interventions incorporating a broader focus on resilience enhancement and coping skills specific to stigmatisation could more comprehensively serve the needs of adults living with chronic communicable disease, particularly with HIV. The role of peer support in group psychoeducation merits further exploration.

PROSPERO registration number

CRD42021243058.
Prepregnancy body mass index and other risk factors for early-onset and late-onset haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome: a population-based retrospective cohort study in British Columbia, Canada
Authors: Wang Li Qing , Bone Jeffrey N , Muraca Giulia M , Razaz Neda , Joseph K S , Lisonkova Sarka
Published: March 2024

Background

Obesity increases risk of pre-eclampsia, but the association with haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is understudied.

Objective

To examine the association between prepregnancy body mass index (BMI) and HELLP syndrome, including early-onset versus late-onset disease.

Study design

A retrospective cohort study using population-based data.

Setting

British Columbia, Canada, 2008/2009–2019/2020.

Population

All pregnancies resulting in live births or stillbirths at ≥20 weeks’ gestation.

Methods

BMI categories (kg/m2) included underweight (<18.5), normal (18.5–24.9), overweight (25.0–29.9) and obese (≥30.0). Rates of early-onset and late-onset HELLP syndrome (<34 vs ≥34 weeks, respectively) were calculated per 1000 ongoing pregnancies at 20 and 34 weeks’ gestation, respectively. Cox regression was used to assess the associations between risk factors (eg, BMI, maternal age and parity) and early-onset versus late-onset HELLP syndrome.

Main outcome measures

Early-onset and late-onset HELLP syndrome.

Results

The rates of HELLP syndrome per 1000 women were 2.8 overall (1116 cases among 391 941 women), and 1.9, 2.5, 3.2 and 4.0 in underweight, normal BMI, overweight and obese categories, respectively. Overall, gestational age-specific rates of HELLP syndrome increased with prepregnancy BMI. Obesity (compared with normal BMI) was more strongly associated with early-onset HELLP syndrome (adjusted HR (AHR) 2.24 (95% CI 1.65 to 3.04) than with late-onset HELLP syndrome (AHR 1.48, 95% CI 1.23 to 1.80) (p value for interaction 0.025). Chronic hypertension, multiple gestation, bleeding (<20 weeks’ gestation and antepartum) also showed differing AHRs between early-onset versus late-onset HELLP syndrome.

Conclusions

Prepregnancy BMI is positively associated with HELLP syndrome and the association is stronger with early-onset HELLP syndrome. Associations with early-onset and late-onset HELLP syndrome differed for some risk factors, suggesting possible differences in aetiological mechanisms.
Comparing blastocyst euploid rates between the progestin-primed and gonadotrophin-releasing hormone antagonist protocols in aneuploidy genetic testing: a randomised trial protocol
Authors: Li He , Yu Min , Zhang Wenbi , Chen Junling , Chen Hua , Lu Xiang , Li Lu , Ng Ernest H Y , Sun Xiaoxi
Published: March 2024

Introduction

Progestin can inhibit the pituitary luteinising hormone (LH) surge during ovarian stimulation for in vitro fertilisation (IVF) and studies show progestin-primed ovarian stimulation (PPOS) is effective in blocking the LH surge in IVF. More and more centres are using PPOS because this regimen appears simpler and cheaper. This study aims to compare the euploidy rate of blastocysts following the PPOS protocol and the gonadotropin-releasing hormone antagonist protocol in women undergoing preimplantation genetic testing for aneuploidy (PGT-A).

Methods/analysis

This is a randomised trial. A total of 400 women undergoing PGT-A will be enrolled and randomised according to a computer-generated randomisation list to either (1) the antagonist group: an antagonist given once daily from day 6 of ovarian stimulation till the day of the ovulation trigger; or (2) the PPOS group: dydrogesterone from the first day of ovarian stimulation till the day of ovulation trigger. The primary outcome is the euploidy rate of blastocysts.

Ethics/dissemination

An ethical approval was granted from the ethics committee of assisted reproductive medicine in Shanghai JiAi Genetics and IVF institute (JIAIE2020-03). A written informed consent will be obtained from each woman before any study procedure is performed, according to good clinical practice. The results of this randomised trial will be disseminated in a peer-reviewed journal.

Trial registration number

NCT04414748.
Non-linear relationship between pulse pressure and the risk of pre-diabetes: a secondary retrospective Chinese cohort study
Authors: Cao Changchun , Han Yong , Hu Haofei , He Yongcheng , Luo Jiao
Published: March 2024

Objective

Previous research has shown that pulse pressure (PP) has a significant role in the start and development of type 2 diabetes mellitus. However, there is little proof that PP and pre-diabetes mellitus (Pre-DM) are related. Our study aimed to investigate the relationship between PP and incident pre-DM in a substantial cohort of Chinese participants.

Design

The ‘DATADRYAD’ database (www.Datadryad.org) was used to retrieve the data for this secondary retrospective cohort analysis.

Participants

Data from 182 672 Chinese individuals who participated in the medical examination programme were recorded in this retrospective cohort study between 2010 and 2016 across 32 sites and 11 cities in China.

Setting

PP assessed at baseline and incident pre-DM during follow-up were the target-independent and dependent variables. The association between PP and pre-DM was investigated using Cox proportional hazards regression.

Primary outcome measures

The outcome was incident pre-DM. Impaired fasting glucose levels (fasting blood glucose between 5.6 and 6.9 mmol/L) were used to define pre-DM.

Results

After controlling for confounding variables, PP was positively correlated with incident pre-DM among Chinese adults (HR 1.009, 95% CI 1.007 to 1.010). Additionally, at a PP inflection point of 29 mm Hg, a non-linear connection between the PP and incident pre-DM was discovered. Increased PP was an independent risk factor for developing pre-DM when PP was greater than 29 mm Hg. However, their association was not significant when PP was less than 29 mm Hg. According to subgroup analyses, females, never-smokers and non-obesity correlated more significantly with PP and pre-DM.

Conclusion

We discovered that higher PP independently correlated with pre-DM risk in this study of Chinese participants. The connection between PP and incident pre-DM was also non-linear. High PP levels were related to a higher risk of pre-DM when PP was above 29 mm Hg.

Article focus

Our study investigated the relationship between PP and incident pre-DM in a secondary retrospective cohort of Chinese participants.
Return of participant-level clinical trial results to participants: pilot of a simplified centralised approach
Authors: Hoffman Eric , Gaglianone Suzanne , Ketema Rahel , Tu Wangshu , Peay Holly , Clemens Paula , Dang Utkarsh , Conklin Laurie
Published: March 2024

Objectives

Public access databases such as clinicaltrials.gov achieve dissemination of clinical trial design and aggregated study results. However, return of participant-level data is rarely done. A key barrier includes the proprietary ownership of data by the sponsor. Additionally, investigators may not have access to centralised data, and per International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) Good Clinical Practice, must maintain the confidentiality of participants. This study piloted an approach to return both individual and aggregate clinical trial data to parents of children participating in a series of open-label clinical trials.

Setting and design

A small biotech company obtained central ethics approval (centralised institutional review board [IRB], non-exempt). The study was advertised via parent advocacy groups. Parents of trial participants were offered the option to contact an employee (coordinator) within the company, requesting return of their child’s study results. Ethics approval covered participation in six countries. The study focused on the sequential clinical trials of vamorolone VBP15-002 (NCT02760264) and VBP15-003 (NCT02760277) (post-results).

Interventions

Contact initiated by the parent enabled the coordinator to obtain informed consent (and separate General Data Protection Regulations consent), with phone translation when needed. Using date of birth and study site location provided by the parent, the data manager reported the participant number to the coordinator. The coordinator retrieved and compiled data, along with an aggregate summary, which was mailed via a password protected and encrypted memory device to the parent. Prereturn and postreturn surveys were sent to consented parents (n=19; 40% of 48 total trial participants) and investigators.

Results

Prereturn surveys indicated a request for as much data as offered, in all formats offered. Postreturn survey showed high satisfaction with the process and data returned. Survey of the physician site investigators (n=10; 100% participation of investigators) voiced general satisfaction with the process, with some reservations.

Conclusions

This pilot study demonstrates an innovative, cost-effective, centralised and labour conservative approach to return of participant-level and aggregate data to participants in studies.
Defining the hidden burden of disease in rural communities in Bangladesh, Cambodia and Thailand: a cross-sectional household health survey protocol
Authors: Zhang Meiwen , Htun Nan Shwe Nwe , Islam Shayla , Sen Aninda , Islam Akramul , Neogi Amit Kumer , Tripura Rupam , Dysoley Lek , Perrone Carlo , Chew Rusheng , Batty Elizabeth M , Thongpiam Watcharintorn , Wongsantichon Jantana , Menggred Chonticha , Zaman Sazid Ibna , Waithira Naomi , Blacksell Stuart , Liverani Marco , Lee Sue , Maude Richard James , Day Nicholas P J , Lubell Yoel , Peto Thomas Julian
Published: March 2024

Introduction

In low-income and middle-income countries in Southeast Asia, the burden of diseases among rural population remains poorly understood, posing a challenge for effective healthcare prioritisation and resource allocation. Addressing this knowledge gap, the South and Southeast Asia Community-based Trials Network (SEACTN) will undertake a survey that aims to determine the prevalence of a wide range of non-communicable and communicable diseases, as one of the key initiatives of its first project—the Rural Febrile Illness project (RFI). This survey, alongside other RFI studies that explore fever aetiology, leading causes of mortality, and establishing village and health facility maps and profiles, will provide an updated epidemiological background of the rural areas where the network is operational.

Methods and analysis

During 2022–2023, a cross-sectional household survey will be conducted across three SEACTN sites in Bangladesh, Cambodia and Thailand. Using a two-stage cluster-sampling approach, we will employ a probability-proportional-to-size sample method for village, and a simple random sample for household, selection, enrolling all members from the selected households. Approximately 1500 participants will be enrolled per country. Participants will undergo questionnaire interview, physical examination and haemoglobin point-of-care testing. Blood samples will be collected and sent to central laboratories to test for chronic and acute infections, and biomarkers associated with cardiovascular disease, and diabetes. Prevalences will be presented as an overall estimate by country, and stratified and compared across sites and participants’ sociodemographic characteristics. Associations between disease status, risk factors and other characteristics will be explored.

Ethics and dissemination

This study protocol has been approved by the Oxford Tropical Research Ethics Committee, National Research Ethics Committee of Bangladesh Medical Research Council, the Cambodian National Ethics Committee for Health Research, the Chiang Rai Provincial Public Health Research Ethical Committee. The results will be disseminated via the local health authorities and partners, peer-reviewed journals and conference presentations.

Trial registration number

NCT05389540.
Association of the triglyceride-glucose index with severity of coronary stenosis and in-hospital mortality in patients with acute ST elevation myocardial infarction after percutaneous coronary intervention: a multicentre retrospective analysis cohort study
Authors: Lu Xin , Lin Xin , Cai Yingying , Zhang Xiaoxiao , Meng Haoyu , Chen Weiwei , Yu Peng , Chen Xiaohu
Published: March 2024

Objectives

To explore the impact of the triglyceride-glucose (TyG) index on the severity of coronary stenosis and the risk of in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).

Design

A multicentre retrospective cohort study.

Setting

Patients with STEMI undergoing PCI from three centres in China from 2015 to 2019.

Participants

A total of 1491 individuals presenting with STEMI were enrolled.

Primary outcome measure

The degree of coronary stenosis was quantified by the Gensini score (GS). The association between the TyG index and the severity of coronary stenosis was explored by using a logistic regression analysis. Cox proportional hazards regression analyses were used to investigate the associations between the variables and in-hospital mortality.

Results

We found a significant correlation between the TyG index and the degree of coronary stenosis in the present study. The TyG index was an independent risk factor for the severity of coronary stenosis (OR 2.003, p<0.001). Using the lowest tertile of the TyG (T1) group as a reference, the adjusted ORs for the T2 group and the T3 group and a high GS were 1.732 (p<0.001), 1.968 (p<0.001), respectively, and all p for trend <0.001. For predicting a high GS, the TyG index’s area under the curve was 0.668 (95% CI 0.635 to 0.700, p<0.001). Additionally, the TyG index was further demonstrated to be an independent predictor of in-hospital mortality in patients with STEMI (HR 1.525, p<0.001).

Conclusions

The TyG index was associated with the severity of coronary stenosis and all-cause in-hospital mortality in patients with STEMI, which may help physicians precisely risk-stratify patients and implement individualised treatment.
Prostate Cancer Survivorship Essentials for men with prostate cancer on androgen deprivation therapy: protocol for a randomised controlled trial of a tele-based nurse-led survivorship care intervention (PCEssentials Hormone Therapy Study)
Authors: Green Anna , Newton Robert U , Smith David P , Tuffaha Haitham , Galvão Daniel A , Heathcote Peter , Patel Manish I , Christie David , Egger Sam , Sara Sally AM , Heneka Nicole , Chambers Suzanne K , Dunn Jeff
Published: March 2024

Introduction

Androgen deprivation therapy (ADT) is commonly used to treat men with locally advanced or metastatic prostate cancer. Men receiving ADT experience numerous side effects and frequently report unmet supportive care needs. An essential part of quality cancer care is survivorship care. To date, an optimal effective approach to survivorship care for men with prostate cancer on ADT has not been described. This protocol describes a randomised trial of tele-based nurse-led survivorship that addresses this knowledge gap: (1) determine the effectiveness of a nurse-led survivorship care intervention (PCEssentials), relative to usual care, for improving health-related quality of life (HR-QoL) in men with prostate cancer undergoing ADT and (2) evaluate PCEssentials implementation strategies and outcomes, including cost-effectiveness, compared with usual care.

Methods and analysis

This is an effectiveness-implementation hybrid (type 1) trial with participants randomised to one of two arms: (1) minimally enhanced usual care and (2) nurse-led prostate cancer survivorship essentials (PCEssentials) delivered over four tele-based sessions, with a booster session 5 months after session 1. Eligible participants are Australian men with prostate cancer commencing ADT and expected to be on ADT for a minimum of 12 months. Participants are followed up at 3, 6 and 12 months postrecruitment. Primary outcomes are HR-QoL and self-efficacy. Secondary outcomes are psychological distress, insomnia, fatigue and physical activity. A concurrent process evaluation with participants and study stakeholders will be undertaken to determine effectiveness of delivery of PCEssentials.

Ethics and dissemination

Ethics approval was obtained from the Metro South Health HREC (HREC/2021/QMS/79429). All participants are required to provide written informed consent. Outcomes of this trial will be published in peer-reviewed journals. The findings will be presented at conferences and meetings, local hospital departments, participating organisations/clinical services, and university seminars, and communicated at community and consumer-led forums.

Trial registration number

ACTRN12622000025730.
Development and validation of an assessment tool for adult simulated ultrasound-guided fascia iliaca block: a prospective monocentric study
Authors: Guyader Frederic-Pierre , Violeau Mathieu , Guenezan Jérémy , Guechi Youcef , Breque Cyril , Betoulle-Masset Pauline , Faure Jean-Pierre , Oriot Denis , Ghazali Daniel Aiham
Published: March 2024

Background

Fascia iliaca block (FIB) is an effective technique for analgesia. While FIB using ultrasound is preferred, there is no current standardised training technique or assessment scale. We aimed to create a valid and reliable tool to assess ultrasound-guided FIB.

Method

This prospective observational study was conducted in the ABS-Lab simulation centre, University of Poitiers, France between 26–29 October and 14–17 December 2021. Psychometric testing included validity analysis and reliability between two independent observers. Content validity was established using the Delphi method. Three rounds of feedback were required to reach consensus. To validate the scale, 26 residents and 24 emergency physicians performed a simulated FIB on SIMLIFE, a simulator using a pulsated, revascularised and reventilated cadaver. Validity was tested using Cronbach’s α coefficient for internal consistency. Comparative and Spearman’s correlation analysis was performed to determine whether the scale discriminated by learner experience with FIB and professional status. Reliability was analysed using the intraclass correlation (ICC) coefficient and a correlation score using linear regression (R2).

Results

The final 30-item scale had 8 parts scoring 30 points: patient positioning, preparation of aseptic and tools, anatomical and ultrasound identification, local anaesthesia, needle insertion, injection, final ultrasound control and signs of local anaesthetic systemic toxicity. Psychometric characteristics were as follows: Cronbach’s α was 0.83, ICC was 0.96 and R2was 0.91. The performance score was significantly higher for learners with FIB experience compared with those without experience: 26.5 (22.0; 29.0) vs 22.5 (16.0; 26.0), respectively (p=0.02). There was a significant difference between emergency residents’ and emergency physicians’ scores: 20.5 (17.0; 25.0) vs 27.0 (26.0; 29.0), respectively (p=0.0001). The performance was correlated with clinical experience (Rho=0.858, p<0.0001).

Conclusion

This assessment scale was found to be valid, reliable and able to identify different levels of experience with ultrasound-guided FIB.
Phase-space analysis of torsion-coupled dilatonic ghost condensate
Authors: Gonzalez-Espinoza Manuel , Otalora Giovanni , Leyva Yoelsy , Saavedra Joel
Published: March 2024

We studied the cosmological dynamics of a dilatonic ghost condensate field as a source of dark energy, which is non-minimally coupled to gravity through torsion. We performed a detailed phase-space analysis by finding all the critical points and their stability conditions. Also, we compared our results with the latest H(z) and Supernovae Ia observational data. In particular, we found the conditions for the existence of scaling regimes during the dark matter era. Furthermore, we obtained the conditions for a successful exit from the scaling regime, such that, at late times, the universe tends towards an attractor point describing the dark energy-dominated era. These intriguing features can allow us to alleviate the energy scale problem of dark energy since, during a scaling regime, the field energy density is not necessarily negligible at early times.
Identification of a Novel Circadian Rhythm-Related Signature for Predicting Prognosis and Therapies in Hepatocellular Carcinoma Based on Bulk and Single-Cell RNA Sequencing
Authors: Liu Gai , Luo YuRong , Liu JunHao , Yang Ti , Ma Zengxin , Sun Jia , Zhou WenJun , Li Hailiang , Wen Jianfan , Zeng Xiancheng
Published: March 2024

Background. Circadian rhythm disruption involves tumorigenesis and tumor progression. However, the influences of circadian rhythm on the tumor microenvironment (TME) and the prognosis of hepatocellular carcinoma (HCC) are unknown. Methods. Bulk RNA-seq and single-cell RNA-seq from TCGA, ICGC, and GEO were used to comprehensively identify prognostic circadian control cells and circadian rhythm associated genes (CRRGs) using R and Python packages. Besides, the circadian rhythm-related prognostic signature was identified and validated. The biological function, immune infiltration, and therapeutic response associated with circadian rhythm-related (CR) risk were detected. Results. A total of 252 differentially expressed CRRGs in HCC were identified, and HCC with a high CR score revealed poor survival. We annotated 11 major cell types in TME; immune cells (B cells, myeloid, CD4+ cells, CD8+ cells, NK cells, Tregs) with high CR score, and hepatocyte, bio-potent cells, fibroblasts, and endothelial cells with low CR score were identified. Moreover, five CRRGs (RPL29, PFKFB3, RPS7, SLC6A6, and RPLP2) were selected and validated as the prognostic signature in HCC. The risk score was calculated based on the prognostic signature, and patients then were divided into high-risk and low-risk groups according to the median value of the risk score. High risk is linked to several metabolism-related pathways and canonical cancer-related pathways and is negatively associated with immunotherapeutic responses and positively associated with some chemotherapeutic drugs. Conclusion. Our finding provides the novel circadian rhythm-related prognostic signature and represents a novel viable “time-dependent” therapeutic option for HCC treatment.
A Review of the Prospective Effects of Spacing and Varieties on Onion Yield and Yield Components (Allium cepa L.) in Ethiopia
Authors: Gelaye Yohannes , Nakachew Kelemu , Ali Solomon
Published: March 2024

Onion (Allium cepa L.) is the most important commercial vegetable crop widely grown throughout the world. It is also an important bulb crop in Ethiopia. However, its production and productivity are restricted by different factors, including biotic and abiotic stresses. This review investigates the potential impacts of spacing and varieties on onion yield and yield components in Ethiopia. Countries around the world are producing onion for its nutritional value, medicinal properties, minerals, proteins, and carbohydrates. In terms of production, onion ranks second only after tomatoes. The average onion yield in Ethiopia is estimated to be 8.8 tons/ha, while in the world, it is approximately 19.7 tons/ha. Inappropriate spacing and inadequate onion varieties are some of the limitations widely described for yield variation in Ethiopia. Thus, to control the size, shape, and yield of onion bulbs, spacing determination and variety improvement are some of the techniques currently employed in Ethiopia. Adama red, Bombay red, and red creole are some of the known varieties in the country, and the intrarow spacings for Adama red and Bombay red are reported to be 4 cm and 6 cm, respectively. Different spacing between onion plants affects how much they produce and other factors such as size and quality, depending on the variety. It is important to assess whether changing spacing makes sense from both a farming and economic standpoint, alongside considering other agricultural methods.
Galleria mellonella Invertebrate Model Mirrors the Pathogenic Potential of Mycoplasma alligatoris within the Natural Host
Authors: Burne Alexandra M. , Richey Lauren J. , Schoeb Trenton R. , Brown Mary B.
Published: March 2024

Most mycoplasmal infections result in chronic, clinically silent disease. In direct contrast, Mycoplasma alligatoris elicits a fulminant, multisystem disease in the natural host, Alligator mississippiensis (American alligator). The goals of the study were to better understand the disease in the natural host and to determine if the invertebrate model G. mellonella could serve as a surrogate alternate host. The survival of alligators infected intratracheally was dose dependent (p = 0.0003), ranging from no mortality (102 CFU) to 100% mortality (108 CFU), with 60% mortality at the 104 and 105 CFU infectious dose. Microbial load in blood, joints, and brain was dose dependent, regardless of whether alligators were infected intratracheally or intravenously (p  < 0.002). Weight loss was similarly impacted (p  < 0.001). Experimental infection of the invertebrate Galleria mellonella mirrored the result in the natural host. In a dose response infection study, both larval survival curves and successful pupation curves were significantly different (p ≤ 0.0001) and dose dependent. Infected insects did not emerge as moths (p  < 0.0001). Here, we describe the first study investigating G. mellonella as a surrogate model to assess the pathogenic potential of M. alligatoris. G. mellonella survival was dose dependent and impacted life stage outcome.
The Diagnostic Evaluation of the SINEH Cardiopulmonary Triage Scale and the Emergency Severity Index in the Emergency Department: A Comparative Study
Authors: VatanKhah Mahbobeh , Malekzadeh Javad , Sharifi Mohammad-Davood , Mirhaghi Amir
Published: March 2024

Introduction. The diagnostic evaluation of the emergency severity index (ESI) in the triage of patients with cardiopulmonary complaints has a high sensitivity but a low specificity in the emergency department (ED). Therefore, triage scales with more accurate diagnostic evaluation are required. As a result, accuracy of the SINEH triage scale (SinTS) and the ESI was compared to compare mistriage of critically ill patients with cardiopulmonary complaints. Methods. This descriptive, analytical and cross-sectional study was conducted between December 2022 and April 2023. In this study, two nurses independently examined each patient using two triage scales. The admission unit and length of hospital stay were also recorded. The outcome was classified as high-risk admission (cardiac care unit and intensive care unit) and low-risk admission (internal unit or discharge from the ED). Undertriage and overtiage were defined as high-risk admission with triage level 3 and 4 and low-risk admission with triage level 1 or 2, respectively. A panel of experts evaluated content validity of SinTS and kappa designating agreement on relevance reported. The inter-rater reliability of two scales was also reported. Results. Finally, the study included 145 patients. The average age of the patients studied was 61.35 years. SinTS has a total mistriage of 29.63%, with 4.13% being undertriage and 25.5% being overtriage. In ESI, the total mistriage is 66.8%, with 1.3% being undertriage and 65.5% being overtriage. The undertriage of the two scales did not differ significantly by admission unit (p=0.26), but the overtriage of the two methods did (p=0.001). The sensitivity, specificity, and accuracy of SinTS were 86.3%, 63.37%, and 72.27%, respectively, while those of ESI were 95.4%, 5.94%, and 32.79%, respectively. Conclusion. SINEH triage scale has achieved the optimal accuracy in recognizing the acuity of the patients with chest pain and dyspnea by using SpO2, pressure of end-tidal carbon dioxide, troponin I, and peak expiratory flow. When triaging patients with chest pain and dyspnea, SinTS may exhibit a higher level of accuracy compared to ESI. More research is needed to improve accuracy of triage scales in patient with cardiopulmonary complaints.