bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Multi-Stage Approaches for Wind Farm Layout Optimization
Authors: Yang Puyi , Najafi Hamidreza
Published: February 2022

The wind farm layout optimization (WFLO) problem is a complex and nonconvex optimization problem. Even though many different heuristic algorithms and mathematical programming methods have been tested and discussed, there is no consensus about which algorithm is the most suitable approach for solving WFLO problems. Every algorithm presents its own advantages and disadvantages in solving different optimization problems; thus, multi-stage approaches may combine the advantages of multiple algorithms and offer superior performance. One multi-stage approach used for solving WFLO problems is to apply an algorithm in the first stage to produce an optimized layout which serves as the initial condition for a second-stage algorithm to perform further refinement. This paper presents a comparison between two types of multi-stage methods: the Heuristic-Gradient-based (H-G) model which consists of a heuristic algorithm in stage 1 and a gradient-based algorithm in stage 2 and the Discrete-Continuous (D-C) model which consists of a heuristic algorithm in the discrete scheme in stage 1 and an algorithm in the continuous scheme in stage 2. Annual energy production (AEP) is used as the objective function while the computational time associated with each approach is documented. Three scenarios are investigated in this paper with different complexity in the wind conditions. It was observed that the D-C models provide the optimal solutions with an average of 0.67% higher AEP and an average of 6.2% lower computational time in comparison with the H-G models. The results from this study provide a basis for selecting a proper optimization algorithm for solving WFLO problems which can lead to a significant increase in the overall annual energy production and a large reduction in computational time.
Weldability and the Effect on Heat-Affected Zone Microstructure of a High Hardenability Boron Steel Compared to SAE 1045 After Shielded Metal Arc Welding
Authors: Oliveira José Gustavo de , Alves Antonio do Nascimento Silva , Casanova Jaime , Jose de Carvalho Jeferson , Brandi Sérgio Duarte
Published: February 2022

One of the steels commonly used in the industry in mechanical devices, tools, and structural steels is SAE 1045. A possible replacement for this alloy is SAE 15B30 with similar mechanical properties and has been used in the automotive and construction industry. To select an alloy, care is needed, for example, weldability. Making a comparative study of these alloys, can boron steel replace SAE 1045? Knowing that boron steels have high hardenability but may have improved weldability due to the low carbon equivalent. Therefore, it is extremely important to know the factors that can interfere with the quality of the final product after the welding processes, as the mechanical properties and microstructures in the heat-affected zone (HAZ) may change. Knowing that in the automotive and civil sector we have several welding processes, it is extremely important to know the results of a boron steel after a welding process; thus, this work intends to compare the weldability of SAE 15B30 and SAE 1045 welded by shielded metal arc welding (SMAW) and also to analyze the microstructural changes after welding by optical microscopy, scanning electron microscopy, and its relationship with hardness using the test of Vickers microhardness. To perform the welds, both in SAE 1045 steel and in SAE 15B30 steel, the butt joint with a V-shaped chamfer was chosen. The results showed that the boron steel, with high hardenability, obtained a microstructure with bainite in the coarse-grained heat-affected zone (CGHAZ), unlike SAE 1045, which presented pearlitic microstructure. In addition, the hardness of boron steel increased by approximately 90% over the base metal (BM), and the hardness of SAE 1045 increased close to 50% over the BM.
Readability of the Disablement in the Physically Active Scale in Pediatric Athletes: A Preliminary Investigation
Authors: Marshall Ashley N. , Lam Kenneth C.
Published: February 2022

The Disablement in the Physically Active scale (DPA) is a patient-reported outcome measure that is used to evaluate health-related quality of life in athletic and highly functional patient populations. However, its appropriateness for pediatric athletes is unknown. The purpose of this study was to examine the readability of the DPA in pediatric athletes. On average, athletes reported that they had difficulty reading 20.2% of each domain and 81.8% of the scale domains exceeded the fifth-grade reading-level threshold. These findings suggest that the DPA may not be appropriate for pediatric athletes. Future research is warranted to develop a pediatric version of the DPA, utilizing the results of this study for guidance.
High-throughput glycolytic inhibitor discovery targeting glioblastoma by graphite dots–assisted LDI mass spectrometry
Authors: Shi Rui , Pan Peichen , Lv Rui , Ma Chongqing , Wu Enhui , Guo Ruochen , Zhao Zhihao , Song Hexing , Zhou Joe , Liu Yang , Xu Guoqiang , Hou Tingjun , Kang Zhenhui , Liu Jian
Published: February 2022

Malignant tumors will become vulnerable if their uncontrolled biosynthesis and energy consumption engaged in metabolic reprogramming can be cut off. Here, we report finding a glycolytic inhibitor targeting glioblastoma with graphite dots–assisted laser desorption/ionization mass spectrometry as an integrated drug screening and pharmacokinetic platform (GLMSD). We have performed high-throughput virtual screening to narrow an initial library of 240,000 compounds down to the docking of 40 compounds and identified five previously unknown chemical scaffolds as promising hexokinase-2 inhibitors. The best inhibitor (Compd 27) can regulate the reprogrammed metabolic pathway in U87 glioma cells (median inhibitory concentration ~ 11.3 μM) for tumor suppression. Highly effective therapy against glioblastoma has been demonstrated in both subcutaneous and orthotopic brain tumors by synergizing Compd 27 and temozolomide. Our glycolytic inhibitor discovery can inspire personalized medicine targeting reprogrammed metabolisms of malignant tumors. GLMSD enables large, high-quality data for next-generation artificial intelligence–aided drug development.
Sunlight-driven dissolution is a major fate of oil at sea
Authors: Freeman Danielle Haas , Ward Collin P.
Published: February 2022

Oxygenation reactions initiated by sunlight can transform insoluble components of crude oil at sea into water-soluble products, a process called photo-dissolution. First reported a half century ago, photo-dissolution has never been included in spill models because key parameters required for rate modeling were unknown, including the wavelength and photon dose dependence. Here, we experimentally quantified photo-dissolution as a function of wavelength and photon dose, making possible a sensitivity analysis of environmental variables in hypothetical spill scenarios and a mass balance assessment for the 2010
Deepwater Horizon
(DwH) spill. The sensitivity analysis revealed that rates were most sensitive to oil slick thickness, season/latitude, and wavelength and less sensitive to photon dose. We estimate that 3 to 17% (best estimate 8%) of DwH surface oil was subject to photo-dissolution, comparable in magnitude to other widely recognized fate processes. Our findings invite a critical reevaluation of surface oil budgets for both DwH and future spills at sea.
Release of CHK-2 from PPM-1.D anchorage schedules meiotic entry
Authors: Baudrimont Antoine , Paouneskou Dimitra , Mohammad Ariz , Lichtenberger Raffael , Blundon Joshua , Kim Yumi , Hartl Markus , Falk Sebastian , Schedl Tim , Jantsch Verena
Published: February 2022

Transition from the stem/progenitor cell fate to meiosis is mediated by several redundant posttranscriptional regulatory pathways in
Caenorhabditis elegans
. Interfering with all three branches causes tumorous germ lines. SCF
PROM-1
comprises one branch and mediates a scheduled degradation step at entry into meiosis.
prom-1
mutants show defects in the timely initiation of meiotic prophase I events, resulting in high rates of embryonic lethality. Here, we identify the phosphatase PPM-1.D/Wip1 as crucial substrate for PROM-1. We report that PPM-1.D antagonizes CHK-2 kinase, a key regulator for meiotic prophase initiation, including DNA double-strand breaks, chromosome pairing, and synaptonemal complex formation. We propose that PPM-1.D controls the amount of active CHK-2 via both catalytic and noncatalytic activities; notably, noncatalytic regulation seems to be crucial at meiotic entry. PPM-1.D sequesters CHK-2 at the nuclear periphery, and programmed SCF
PROM-1
–mediated degradation of PPM-1.D liberates the kinase and promotes meiotic entry.
Ex vivo enzymatic treatment converts blood type A donor lungs into universal blood type lungs
Authors: Wang Aizhou , Ribeiro Rafaela V. P. , Ali Aadil , Brambate Edson , Abdelnour-Berchtold Etienne , Michaelsen Vinicius , Zhang Yu , Rahfeld Peter , Moon Haisle , Gokhale Hemant , Gazzalle Anajara , Pal Prodipto , Liu Mingyao , Waddell Thomas K. , Cserti-Gazdewich Christine , Tinckam Kathryn , Kizhakkedathu Jayachandran N. , West Lori , Keshavjee Shaf , Withers Stephen G. , Cypel Marcelo
Published: February 2022

Donor organ allocation is dependent on ABO matching, restricting the opportunity for some patients to receive a life-saving transplant. The enzymes FpGalNAc deacetylase and FpGalactosaminidase, used in combination, have been described to effectively convert group A (ABO-A) red blood cells (RBCs) to group O (ABO-O). Here, we study the safety and preclinical efficacy of using these enzymes to remove A antigen (A-Ag) from human donor lungs using ex vivo lung perfusion (EVLP). First, the ability of these enzymes to remove A-Ag in organ perfusate solutions was examined on five human ABO-A1 RBC samples and three human aortae after static incubation. The enzymes removed greater than 99 and 90% A-Ag from RBCs and aortae, respectively, at concentrations as low as 1 μg/ml. Eight ABO-A1 human lungs were then treated by EVLP. Baseline analyses of A-Ag in lungs revealed expression predominantly in the endothelial and epithelial cells. EVLP of lungs with enzyme-containing perfusate removed over 97% of endothelial A-Ag within 4 hours. No treatment-related acute lung toxicity was observed. An ABO-incompatible transplant was then simulated with an ex vivo model of antibody-mediated rejection using ABO-O plasma as the surrogate for the recipient circulation using three donor lungs. The treatment of donor lungs minimized antibody binding, complement deposition, and antibody-mediated injury as compared with control lungs. These results show that depletion of donor lung A-Ag can be achieved with EVLP treatment. This strategy has the potential to expand ABO-incompatible lung transplantation and lead to improvements in fairness of organ allocation.
Human Milk Oligosaccharides versus Streptococcus: How a Human-Made Natural Product Protects Us from Pathogens
Authors: Lyon Laurie M. , Doran Kelly S.
Published: February 2022

Group B
Streptococcus
(GBS) is a Gram-positive bacterium that colonizes the lower gastrointestinal tract, and in females, the urogenital tract, in up to 30% of healthy adults. However, GBS is a leading cause of mortality and morbidity in newborns, due to ascending infection of the womb or by neonatal acquisition during vaginal passage.
Converting the E. coli Isochorismatase Nicotinamidase into γ-Lactamase
Authors: Guo Xiaoyan , Chang Licao , Jin Haibo , Zhu Junge , Tao Yong , Wu Sheng , Wang Jianjun
Published: February 2022

γ-Lactamases are important enzymatic catalysts in preparing optically pure γ-lactam enantiomers, which are high-value chiral intermediates. Different studies have presumed that the isochorismatase superfamily is a candidate to obtain novel (+) γ-lactamases.
A Multiwell-Plate Caenorhabditis elegans Assay for Assessing the Therapeutic Potential of Bacteriophages against Clinical Pathogens
Authors: Manohar Prasanth , Loh Belinda , Elangovan Namasivayam , Loganathan Archana , Nachimuthu Ramesh , Leptihn Sebastian
Published: February 2022

Validating the efficacy and safety of phages prior to clinical application is crucial to see phage therapy in practice. Current animal models include mice and insect larvae, which pose ethical or technical challenges.
Characterization of a Conjugative Multidrug Resistance IncP-2 Megaplasmid, pPAG5, from a Clinical Pseudomonas aeruginosa Isolate
Authors: Li Meng , Guan Congcong , Song Gaoyu , Gao Xiaoxi , Yang Weina , Wang Tietao , Zhang Yani
Published: February 2022

The emergence and spread of plasmid-associated multidrug resistance in bacterial pathogens is a key global threat to public health. It is important to understand the mechanisms of the formation and evolution of these plasmids in patients, hospitals, and the environment.
WHO standards-based tool to measure women’s views on the quality of care around the time of childbirth at facility level in the WHO European region: development and validation in Italy
Authors: Lazzerini Marzia , Argentini Giorgia , Mariani Ilaria , Covi Benedetta , Semenzato Chiara , Lincetto Ornella , Muzigaba Moise , Valente Emanuelle Pessa
Published: February 2022

Objectives

A comprehensive WHO standards-based tool to measure women’s perceived quality of maternal and newborn care (QMNC) in health facilities is needed to allow for comparisons of data across settings and over time. This paper describes the development of such a tool, and its validation in Italy.

Design

A multiphase, mixed-methods study involving qualitative and quantitative research methods.

Setting

Nine health facilities in Italy.

Methods

The questionnaire was developed in six phases: (1) Defining the scope, characteristics and a potential list of measures for the tool; (2) initial content and construct validation; (3) first field testing to assess acceptability and perceived utility for end-users (1244 women, 35 decision makers) and further explore construct validity; (4) content optimisation and score development; (5) assessment of face validity, intrarater reliability and internal consistency and (6) second field testing in nine maternity hospitals (4295 women, 78 decision-makers).

Results

The final version of the tool included 116 questions accounting for 99 out of the 350 of the extended lists of WHO Quality Measures. Observed face validity was very good, with 100% agreement for 101 (87%) questions and Kappa exceeding 0.60 for remaining ones. Reliability was good, with either high agreement or Kappa exceeding 0.60 for all items. Cronbach alpha values ranged from 0.84 to 0.88, indicating very good internal consistency. Acceptability across seven hospitals was good (mean response rate: 57.4%, 95% CI 44.4% to 70.5%). The questionnaire proved to be useful, driving the development of actions plan to improve the QMNC in each facility.

Conclusions

Study findings suggest that the tool has good content, construct, face validity, intrarater reliability and internal consistency, while being acceptable and useful. Therefore, it could be used in health facilities in Italy and similar context. More research should investigate how effectively use the tool in different countries for improving the QMNC.
Social disparities in the first wave of COVID-19 incidence rates in Germany: a county-scale explainable machine learning approach
Authors: Doblhammer Gabriele , Reinke Constantin , Kreft Daniel
Published: February 2022

Objectives

Knowledge about the socioeconomic spread of the first wave of COVID-19 infections in Germany is scattered across different studies. We explored whether COVID-19 incidence rates differed between counties according to their socioeconomic characteristics using a wide range of indicators.

Data and method

We used data from the Robert Koch-Institute (RKI) on 204 217 COVID-19 diagnoses in the total German population of 83.1 million, distinguishing five distinct periods between 1 January and 23 July 2020. For each period, we calculated age-standardised incidence rates of COVID-19 diagnoses on the county level and characterised the counties by 166 macro variables. We trained gradient boosting models to predict the age-standardised incidence rates with the macrostructures of the counties and used SHapley Additive exPlanations (SHAP) values to characterise the 20 most prominent features in terms of negative/positive correlations with the outcome variable.

Results

The first COVID-19 wave started as a disease in wealthy rural counties in southern Germany and ventured into poorer urban and agricultural counties during the course of the first wave. High age-standardised incidence in low socioeconomic status (SES) counties became more pronounced from the second lockdown period onwards, when wealthy counties appeared to be better protected. Features related to economic and educational characteristics of the young population in a county played an important role at the beginning of the pandemic up to the second lockdown phase, as did features related to the population living in nursing homes; those related to international migration and a large proportion of foreigners living in a county became important in the postlockdown period.

Conclusion

High mobility of high SES groups may drive the pandemic at the beginning of waves, while mitigation measures and beliefs about the seriousness of the pandemic as well as the compliance with mitigation measures may put lower SES groups at higher risks later on.
Influence of information provided prior to switching from Humira to biosimilar adalimumab on UK patients’ satisfaction: a cross-sectional survey by patient organisations
Authors: Kaneko Kayoko , Prieto-Alhambra Daniel , Jacklin Clare , Bosworth Ailsa , Dickinson Sally , Berry Sarah , McAteer Helen , Taylor Peter C
Published: February 2022

Objectives

To investigate the perceptions and experiences of people with specific immune-mediated inflammatory diseases during the process of switching from Humira to biosimilar adalimumab.

Design

Cross-sectional survey.

Setting

An anonymised, self-administered, web-based survey.

Participants

The participants were drawn from members and non-members of either the National Rheumatoid Arthritis Society, the National Axial Spondyloarthritis Society, Crohn’s and Colitis UK, or Psoriasis Association. Birdshot Uveitis Society and Olivia’s Vision also signposted to the survey links.

Results

A total of 899 people living with various immune mediated inflammatory diseases participated in this survey. Thirty-four per cent of respondents reported poor overall satisfaction with their biosimilar adalimumab after the switch, associated with complaints related to the switching process including lack of shared decision making, scarcity of information provided by or signposted to by the department instigating the switch as well as lack of training with the new injection device. Where training with the new device had been provided, there were significantly reduced reports of pain when injecting the new biosimilar (OR 0.20, 95% CI 0.07 to 0.55), side effects (OR 0.17, 95% CI 0.06 to 0.47) and difficulty in using the new injection device (OR 0.25, 95% CI 0.15 to 0.41). Self-reported side effects were reduced by (OR 0.13, 95% CI 0.05 to 0.38) when written information was provided by healthcare professionals and by (OR 0.15, 95% CI 0.05 to 0.42) with provision of verbal information. Difficulty in using the new injection device was also reduced by provision of satisfactory information such as written documents (OR 0.38, 95% CI 0.23 to 0.63) or by verbal communication with healthcare professionals (OR 0.45, 95% CI 0.27 to 0.73). Finally, provision of satisfactory written or verbal information was associated with a reduction in any negative perception regarding symptom control with the new biosimilar by (OR 0.05, 95% CI 0.004 to 0.57) and by (OR 0.15, 95% CI 0.03 to 0.84), respectively.

Conclusions

Patient reported experiences of the process of switching from originator to biosimilar emphasise the importance of clear communication, training and information in order to optimise perception and maximise achievable outcomes with the new treatment.
Level of knowledge, attitude and practice towards diabetes among nationals and long-term residents of Qatar: a cross-sectional study
Authors: Al-Mutawaa Kholoud Ateeq , Farghaly Aiman Hussein , Nasir Rehana , Loares Alma Malvar , Skaroni Ioanna , Al-Thani Mohammed , Abou-Samra Abdul-Badi
Published: February 2022

Objectives

This study examines the levels of knowledge, attitude and practices (KAP) towards diabetes among Qatar nationals and long-term residents and its association with participants’ selected demographics.

Setting

A cross-sectional study conducted in public areas in all the eight municipalities of Qatar from July to October 2018.

Participants

2400 participants from the general public (nationals and long-term residents) stratified by gender, age and nationality across all geographic locations in Qatar.

Primary and secondary outcome measures

Responses were scored from 0% to 100% and KAP scores were classified as low (0%–49%), intermediate (50%–74%) or high (75%–100%). Analyses and comparisons were performed using descriptive statistics and χ2 test at 5% level.

Results

Most participants (54%) had an intermediate overall KAP score, 43% had a low score and only 3% had a high score. The knowledge scores were the lowest among participants, 69% had low, 29% had intermediate and only 2% had high scores. Participants scored better in attitude and practice; the percentages of participants who scored high, intermediate and low were 32%, 55% and 13% for attitude, and 37%, 33% and 30% for practice, respectively. Except for age, level of knowledge significantly varied by gender, nationality and diabetes-related diagnosis (p<0.001); attitude and practice levels differed significantly in all four factors. Areas where participants were deficient include: diabetes types, risk factors, signs and symptoms, complications, recommended daily exercise, normal fasting glucose level, preventive measures, management and control and understanding about complexity of diabetes.

Conclusions

Participants generally have intermediate levels of positive attitudes and practices towards diabetes but low knowledge in diabetes-related factors. The data suggest that future communications should focus on educating the public and conduct mass campaigns about diabetes to improve knowledge especially targeting men and women, and both nationals and expatriates.
NHS Health Check programme: a rapid review update
Authors: Tanner L , Kenny RPW , Still M , Ling J , Pearson F , Thompson K , Bhardwaj-Gosling R
Published: February 2022

Objective

To update a rapid review published in 2017, which evaluated the NHS Health Check programme.

Methods

An enlarged body of evidence was used to readdress six research objectives from a rapid review published in 2017, relating to the uptake, patient experiences and effectiveness of the NHS Health Check programme. Data sources included MEDLINE, PubMed, Embase, Health Management Information Consortium (HMIC), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Global Health, PsycINFO, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the ISRCTN registry, Web of Science, Science Citation Index, The Cochrane Library, NHS Evidence, OpenGrey and hand searching article reference lists. These searches identified records from between January 1996 and December 2019. Screening, data extraction and quality appraisal using the Critical Appraisals Skills Programme checklists were performed in duplicate. Grading of Recommendations Assessment, Development and Evaluations was implemented. Data were synthesised narratively.

Results

697 studies were identified, and 29 new studies included in the review update. The number of published studies on the uptake, patient experiences and effectiveness of the NHS Health Check programme has increased by 43% since the rapid review published in 2017. However, findings from the original review remain largely unchanged. NHS Health Checks led to an overall increase in the detection of raised risk factors and morbidities including diabetes mellitus, hypertension, raised blood pressure, cholesterol and chronic kidney disease. Individuals most likely to attend the NHS Health Check programme included women, persons aged ≥60 years and those from more socioeconomically advantaged backgrounds. Opportunistic invitations increased uptake among men, younger persons and those with a higher deprivation level.

Conclusions

Although results are inconsistent between studies, the NHS Health Check programme is associated with increased detection of heightened cardiovascular disease risk factors and diagnoses. Uptake varied between population subgroups. Opportunistic invitations may increase uptake.
Can natural language processing models extract and classify instances of interpersonal violence in mental healthcare electronic records: an applied evaluative study
Authors: Botelle Riley , Bhavsar Vishal , Kadra-Scalzo Giouliana , Mascio Aurelie , Williams Marcus V , Roberts Angus , Velupillai Sumithra , Stewart Robert
Published: February 2022

Objective

This paper evaluates the application of a natural language processing (NLP) model for extracting clinical text referring to interpersonal violence using electronic health records (EHRs) from a large mental healthcare provider.

Design

A multidisciplinary team iteratively developed guidelines for annotating clinical text referring to violence. Keywords were used to generate a dataset which was annotated (ie, classified as affirmed, negated or irrelevant) for: presence of violence, patient status (ie, as perpetrator, witness and/or victim of violence) and violence type (domestic, physical and/or sexual). An NLP approach using a pretrained transformer model, BioBERT (Bidirectional Encoder Representations from Transformers for Biomedical Text Mining) was fine-tuned on the annotated dataset and evaluated using 10-fold cross-validation.

Setting

We used the Clinical Records Interactive Search (CRIS) database, comprising over 500 000 de-identified EHRs of patients within the South London and Maudsley NHS Foundation Trust, a specialist mental healthcare provider serving an urban catchment area.

Participants

Searches of CRIS were carried out based on 17 predefined keywords. Randomly selected text fragments were taken from the results for each keyword, amounting to 3771 text fragments from the records of 2832 patients.

Outcome measures

We estimated precision, recall and F1 score for each NLP model. We examined sociodemographic and clinical variables in patients giving rise to the text data, and frequencies for each annotated violence characteristic.

Results

Binary classification models were developed for six labels (violence presence, perpetrator, victim, domestic, physical and sexual). Among annotations affirmed for the presence of any violence, 78% (1724) referred to physical violence, 61% (1350) referred to patients as perpetrator and 33% (731) to domestic violence. NLP models’ precision ranged from 89% (perpetrator) to 98% (sexual); recall ranged from 89% (victim, perpetrator) to 97% (sexual).

Conclusions

State of the art NLP models can extract and classify clinical text on violence from EHRs at acceptable levels of scale, efficiency and accuracy.
Effectiveness of virtual reality-based interventions in rehabilitation management of breast cancer survivors: protocol of a systematic review and meta-analysis
Authors: Bu Xiaofan , Ng Peter H F , Chen Qi , Cheng Andy S K , Xu Wenjing , Tong Ying , Tang Qingping , Liu Xiangyu
Published: February 2022

Introduction

Breast cancer is the leading cause of global cancer incidence and represents 11.7% of all new cancer cases. However, breast cancer survivors (BCS) suffer from many intense physical and psychological symptoms, functional deficits and adverse effects during and after treatment, significantly affecting their quality of life. Virtual reality (VR) technology uses computer technology to create an interactive three-dimensional world by visual, audio and touch simulation and is being used in breast cancer rehabilitation management. This paper reports on the protocol for a systematic review and meta-analysis exploring the efficacy of VR-based interventions in the rehabilitation management of BCS.

Methods and analysis

This protocol for conducting a systematic review and meta-analysis was prepared according to the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. Web of Science, PubMed, Embase, CINAHL, Cochrane Central Register of Controlled Trials, CNKI, Wanfang, VIP and SinoMed will be used in the search. The search will include randomised controlled trials, quasi-experimental studies and case-controlled trials published in English and Chinese. Further, the risk of bias of the studies included in the systematic review and meta-analysis will be assessed using the Cochrane risk-of-bias tool. The statistical program Review Manager V.5.3 will be used in the meta-analysis. The I² test will be used to determine statistical heterogeneity among the included studies.

Ethics and dissemination

Ethics approval will not be needed because the data to be used in this systematic review and meta-analysis will be extracted from published studies. The systematic review and meta-analysis will focus on whether VR-based interventions are effective in the rehabilitation management of BCS. It will be disseminated by publication in a peer-reviewed journal.

PROSPERO registration number

CRD42021250727.
Implementation and prospective evaluation of the Country Heart Attack Prevention model of care to improve attendance and completion of cardiac rehabilitation for patients with cardiovascular diseases living in rural Australia: a study protocol
Authors: Beleigoli Alline , Nicholls Stephen J , Brown Alex , Chew Derek P , Beltrame John , Maeder Anthony , Maher Carol , Versace Vincent L , Hendriks Jeroen M , Tideman Philip , Kaambwa Billingsley , Zeitz Christopher , Prichard Ivanka J , Tavella Rosanna , Tirimacco Rosy , Keech Wendy , Astley Carolyn , Govin Kay , Nesbitt Katie , Du Huiyun , Champion Stephanie , Pinero de Plaza Maria Alejandra , Lynch Imelda , Poulsen Vanessa , Ludlow Marie , Wanguhu Ken , Meyer Hendrika , Krollig Ali , Gebremichael Lemlem , Green Chloe , Clark Robyn A
Published: February 2022

Introduction

Despite extensive evidence of its benefits and recommendation by guidelines, cardiac rehabilitation (CR) remains highly underused with only 20%–50% of eligible patients participating. We aim to implement and evaluate the Country Heart Attack Prevention (CHAP) model of care to improve CR attendance and completion for rural and remote participants.

Methods and analysis

CHAP will apply the model for large-scale knowledge translation to develop and implement a model of care to CR in rural Australia. Partnering with patients, clinicians and health service managers, we will codevelop new approaches and refine/expand existing ones to address known barriers to CR attendance. CHAP will codesign a web-based CR programme with patients expanding their choices to CR attendance. To increase referral rates, CHAP will promote endorsement of CR among clinicians and develop an electronic system that automatises referrals of in-hospital eligible patients to CR. A business model that includes reimbursement of CR delivered in primary care by Medicare will enable sustainable access to CR. To promote CR quality improvement, professional development interventions and an accreditation programme of CR services and programmes will be developed. To evaluate 12-month CR attendance/completion (primary outcome), clinical and cost-effectiveness (secondary outcomes) between patients exposed (n=1223) and not exposed (n=3669) to CHAP, we will apply a multidesign approach that encompasses a prospective cohort study, a pre-post study and a comprehensive economic evaluation.

Ethics and dissemination

This study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (HREC/20/SAC/78) and by the Department for Health and Wellbeing Human Research Ethics Committee (2021/HRE00270), which approved a waiver of informed consent. Findings and dissemination to patients and clinicians will be through a public website, online educational sessions and scientific publications. Deidentified data will be available from the corresponding author on reasonable request.

Trial registration number

ACTRN12621000222842.
Impact of public health insurance coverage of novel anticancer medication on medical expenditure and patient affordability in a provincial medical centre of China: a propensity score-matching analysis with the quasi-experimental design
Authors: Diao Yifan , Lin Mengbo , Xu Kai , Huang Ji , Wu Xiongwei , Li Mingshuang , Sun Jing , Li Hong
Published: February 2022

Introduction

Little is known about the impact of the government’s efforts in having novel anticancer medicines covered by the public health insurance system in China. This study targeted the above policy implemented in Fujian province in 2017, analysed the policy impact on the medical expenditure of cancer treatment and patient affordability based on the clinical data of Fujian provincial medical centre.

Methods

The study included 253 human epidermal growth factor receptor 2-positive patients with breast cancer who completed at least one course of trastuzumab treatment extracted from the hospital health information system of the provincial medical centre of Fujian. We adopted the propensity score-matching method to mimic a quasi-experimental design to estimate the impact of the public health insurance coverage policy on all the indicated patients with a before–after comparison of the total breast cancer-associated direct medical expenditures for a standard course of treatment or maintenance treatment and the proportionate patient out-of-pocket (OOP) expenditure based on the real clinical data.

Results

We found evidence of an association between the public health insurance coverage of novel breast cancer medication and the reductions of the medical expenditure by US$18661.02 (95% CI 13 836.57 to 28 201.45), and the proportionate patient OOP expenditure by 24% (95% CI0.20 to 0.27). The medical expenditure and the proportionate patient OOP expenditure might be generally reduced.

Conclusions

The coverage of innovative antibreast cancer medicines by the public health insurance was found to be associated with a reduction of the medical expenditure and share of patient OOP expenditure for cancer treatment of the indicated patients. Patients with lower ability-to-pay did not benefit well from the coverage policy. To maximise the welfare of the public health insurance coverage of novel anticancer medication, the study called for strengthened health insurance benefit packages of the rural patient and the patient enrolled in the urban and rural resident health insurance programme, who might have lower ability-to-pay and need more support from the public security system.
Effectiveness of transcranial direct current stimulation on hand dexterity in stroke patients: a protocol for a systematic review and meta-analysis
Authors: Alabdulaali Lulwa , Hickman Lydia , Punt T David , Jenkinson Ned
Published: February 2022

Introduction

Hand dexterity is the ability to execute the skilful movements using the hand and fingers. It is commonly impaired poststroke resulting in a profound deterioration in the quality of life for patients with stroke. Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation, which has gained a popularity as an adjunct therapy in recovering motor dysfunction poststroke. Promising results have been gained from applying tDCS in combination with motor rehabilitation, however, the outcome of tDCS on the upper limb motor function poststroke has been varied. Different results are potentially related to the discrepancy of the area of brain stimulation. Therefore, we aim to enhance the application of tDCS to improve its effectiveness in recovering hand dexterity through testing our hypothesis that stimulating the primary motor cortex could improve fine dexterity more than gross dexterity.

Methods and analysis

This protocol has been reported according to Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols guidelines. CENTRAL, MEDLINE, EMBASE, SCOPUS, Web of Science and CINAHL databases will be searched with no restriction in language and publication date. The selected studies will be randomised controlled trial investigating the effect of tDCS alone or in combination with motor rehabilitation in improving hand dexterity of patients with stroke with upper limb hemiparesis. The outcomes of interest are fine and gross hand dexterity measures. Two independent reviewers will assess the eligibility of the study, extract data and appraise the methodological quality. The data will be pooled in a meta-analysis if applicable or interpreted narratively. Grading of Recommendations, Assessment, Development and Evaluation approach will be used to assess the overall quality of evidence for the fine and gross dexterity measures.

Ethics and dissemination

Ethical approval is not required for this study. The dissemination plan is to publish the results in a peer-review journal and presenting results in a conference.

PROSPERO registration number

CRD42021262186.
Obesity among children and adolescents in Qatar: protocol for a scoping review
Authors: Alisi Mariam
Published: February 2022

Introduction

Approximately half of the school-aged children are overweight or obese in Qatar. Childhood obesity is associated with health conditions in adulthood, such as hypertension, diabetes, metabolic defects, cardiovascular risks and psychological challenges. Existing obesity studies have limitations; thus, there is a need for further research with improved quality, wider representation of population including children and adolescents and methodological diversity. As Qatar moves towards a preventive evidence-based approach in tackling obesity, this scoping review aims to support the efforts of obesity prevention among children and adolescents in Qatar by providing an up-to-date research map that systematically highlights existing knowledge, research gaps and methodological range. In addition, this will be the first scoping review that analyses how obesity research has evolved in Qatar since 2000.

Methods and analysis

This scoping review follows the guidelines of Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews for both developing the protocol and reporting the findings. It will use the System for the Unified Management, Assessment and Review of Information-JBI software for synthesis. The review will include any study in Arabic or English published between 1 January 2000 and 31 December 2021 on obesity/overweight among children and/or adolescents in Qatar. Studies without specific data on the concept of obesity, the population of children and adolescents or the context of Qatar will be excluded. The following databases will be searched: PubMed, Embase, Web of Science, IBSS, Scopus, J-STOR, APA PsycNET and Google Scholar. In addition, Arabic literature via Dar Almanthomah, Dar Almanhal and E-Marefah will be searched. A search strategy to identify grey literature will be adopted for a wider reach. The screening process will be conducted by two independent reviewers. Extracted data will be analysed descriptively and analytically using simple frequency counts and qualitative content analysis. The results will be presented using maps, tables and diagrams.

Ethics and dissemination

Ethics approval is not required as data will be collected from publicly available published research. The results of this review will be disseminated via a peer-reviewed publication, national and international conferences, workshops and knowledge mobilisation activities among key stakeholders.
Validating risk models versus age alone for atrial fibrillation in a young Dutch population cohort: should atrial fibrillation risk prediction be expanded to younger community members?
Authors: Himmelreich Jelle C L , Harskamp Ralf E , Geelhoed Bastiaan , Virdone Saverio , Lucassen Wim A M , Gansevoort Ron T , Rienstra Michiel
Published: February 2022

Background

Advancing age is the primary selection criterion for community screening for atrial fibrillation (AF), with selection often restricted to those aged ≥65 years. If multivariable models were shown to have considerable additional value over age alone in predicting AF risk among younger individuals, AF screening could be expanded to patients with lower age, but with high AF risk as per a validated risk model.

Methods

We validated risk models CHARGE-AF (Cohorts for Heart and Aging Research in Genomic Epidemiology model for AF) and FHS-AF (Framingham Heart Study model for AF), and risk scores CHA2DS2-VASc and CHA2DS2-VA, and presented their predictive abilities for 5-year and 10-year AF risk versus that of age alone in a young Dutch population cohort (PREVEND) free from AF at baseline. We assessed discrimination by the C-statistic and calibration by the calibration plot and stratified Kaplan-Meier plot using survey-weighted Cox models.

Results

During 5-year and 10-year follow-up there were n=98 (2.46/1000 person-years) and n=249 (3.29/1000 person-years) new AF cases, respectively, among 8265 participants with mean age 49±13 years. CHARGE-AF and FHS-AF both showed good discrimination for 5-year and 10-year AF (C-statistic range 0.83–0.86) with accurate calibration for 5-year AF, but overestimation of 10-year AF risk in highest-risk individuals. CHA2DS2-VASc and CHA2DS2-VA relatively underperformed. Age alone showed similar discrimination to that of CHARGE-AF and FHS-AF both in the overall, young PREVEND cohort and in subgroups for lower age and lower stroke risk.

Conclusion

Multivariable models accurately discriminate for 5-year and 10-year AF risk among young European community-dwelling individuals. However, their additional discriminatory value over age alone was limited. Selection strategies for primary AF screening using multivariable models should not be expanded to younger individuals.
MicroRNAs associated with chronic kidney disease in the general population and high-risk subgroups: protocol for a systematic review and meta-analysis
Authors: Motshwari Dipuo Dephney , Matshazi Don Makwakiwe , Erasmus Rajiv , Kengne AP , Matsha Tandi E , George Cindy
Published: February 2022

Introduction

Chronic kidney disease (CKD) is a significant health and economic burden, owing to its ever-increasing global prevalence. Due to the limitations in the current diagnostic methods, CKD is frequently diagnosed at advanced stages, where there is an increased risk of cardiovascular complications and end-stage kidney disease. As such, there has been considerable interest in microRNAs (miRNAs) as potential markers for CKD detection. This review seeks to identify all miRNAs associated with CKD and/or markers of kidney function or kidney damage in the general population and high-risk subgroups, and explore their expression profiles in these populations.

Methods and analysis

A systematic search of published literature will be conducted for observational studies that report on miRNAs associated with CKD or kidney function or kidney damage markers (serum creatinine and cystatin C, estimated glomerular filtration rate and urinary albumin excretion) in adult humans. The electronic database search will be restricted to English and French publications up to 31 October 2021. Two investigators will independently screen and identify studies for inclusion, as well as extract data from eligible studies. Risk-of-bias and methodological quality will be assessed by the Newcastle-Ottawa Quality Assessment Scale for observational studies and Grading of Recommendations Assessment, Development and Evaluation tools. Appropriate meta-analytic techniques will be used to pool estimates from studies with similar miRNAs, overall and by major characteristics, including by country or region, sample size, gender and risk-of-bias score. Heterogeneity of the estimates across studies will be quantified and publication bias investigated. This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guidelines.

Ethics and dissemination

This study design does not require formal ethical clearance and findings will be published in a peer-reviewed journal.

Conclusion

This review will provide the expression pattern of miRNAs associated with CKD. This will allow for further research into the identified miRNAs, which could later be used as biomarkers for prediction and early detection of CKD, monitoring of disease progression to advanced stages and as potential therapeutic targets.

PROSPERO registration number

CRD42021270028.
Lung cancer distress: screening thermometer meta-analysis
Authors: Zhang Lemeng , Liu Xiaohong , Tong Fei , Zou Ran , Peng Wanglian , Yang Hui , Huang Xufen , Yi Lili , Wen Minni , Jiang Ling , Liu Feng
Published: February 2022

Objectives

The distress is associated with the life quality and prognosis of patients with lung cancer. Distress thermometer (DT) has been widely recommended for distress screening. This study was conducted to summarise the positive rate of distress in patients with lung cancer using DT screenings.

Methods

The PubMed, Embase, PsyclNFO and Cochrane Library databases were comprehensively searched to identify all eligible studies published before 31 December 2021. Studies were eligible if they were published in peer-reviewed literature and evaluated distress levels by DT.

Results

Ten eligible studies, including a total of 2111 patients, were included in this analysis, and their methodological quality was moderate. The pooled positive rate of distress in patients with lung cancer was 49.04% (95% CI 41.51% to 56.60%). The subgroup analysis revealed that the distress positive rate was significantly different (p<0.05) across North America, Europe and China with values of 53.33% (95% CI 45.22% to 61.37%), 43.81% (95% CI 31.57% to 56.43%) and 38.57% (95% CI 33.89% to 43.41%), respectively. Moreover, the distress positive rate was significantly different between men and women (p<0.05). Additionally, in terms of histological type, clinical tumour, node, metastasis stage, previous treatment and DT threshold, the distress positive rate had no significant differences. No significant publication bias was identified by Begg’s funnel plot and Egger’s test.

Conclusions

The summarised distress positive rate was high and was significantly different according to gender and region. DT screening should be recommended for routine clinical practice and more attention should be given towards distress management.
Towards the development on new high capacity tensiometers capable of measuring soil matric suction beyond 3 MPa
Authors: Mendes Joao , Najdi Abdallah , Encalada David , Prat Pere C. , Ledesma Alberto
Published: February 2022

High capacity tensiometers (HCT) are the only type of sensors in existence that can measure soil matric suction directly and are regarded to be the most accurate and reliable technique for the study of suction evolution in unsaturated soils. The measurement with HCTs is possible due to their design, composed of ceramic filter with a specific air entry value (AEV), small water reservoir, and pressure transducer. Where, the AEV of the ceramic filter, more precisely the largest pore size within the ceramic, plays the most important role in controlling the measuring range of HCTs. Specifically, decreasing the largest pore size within the ceramic results in an increase in the measuring range. In this work, a new development in HCTs is presented whereby the ceramic filter in HCTs was replaced from the typically used 1.5 MPa AEV ceramic filter with a new alumina ceramic filter with an estimated AEV of 3.5 MPa. To assess the performance of the new ceramic filter, similar designed HCTs were assembled with the Soilmoisture Equipment Corp. 1.5 MPa AEV and the new alumina ceramic filters. Early results show that the maximum measuring matric suction range is beyond 3 MPa for HCTs assembled with the new alumina ceramic filter.