bluuebunny/crossref_metadata_2025 huggingface dataset:
A geography of UK museums
Authors: Ballatore Andrea , Candlin Fiona
Published: September 2022

Museums are important centres of heritage, culture, education, and tourism. These diverse institutions operate in different ways, reaching different audiences and managing varied collections. Thanks to a novel database of unprecedented completeness produced by the Mapping Museums project, this study provides a quantitative geography of museums in the UK, showing how about half of the sector had not been surveyed before. The presence of museums is mapped across several attributes, including museum size (estimated as yearly visits) and governance (government‐led, independent, or university‐led). Firstly, observing a snapshot of the sector in December 2017, we quantify and interpret the spatial distribution of museums, discussing its implications for access to museums, public service provision, resource allocation, and cultural tourism. Then, in a regional analysis, we study their density in relation to the local population, at the regional and Local Authority District scale, providing new evidence of the extent of spatial inequalities in the cultural sector, particularly relevant to a sector in which funding is mostly allocated at the regional level. At the crossing between human geography and museum studies, this inquiry reveals the centres and peripheries of this cultural sphere, providing fresh evidence of the presences and absences that shape cultural life across the UK.
Corneal diamond burr debridement for superficial non‐healing corneal ulcers in cats
Authors: Anastassiadis Zoe , Bayley Kellam David , Read Robert A.
Published: September 2022

Objective

To describe the clinical outcomes and efficacy of diamond burr debridement (DBD) treatment for corneal ulceration in cats.

Procedure(s)

Medical records of cats that received DBD at two private practices between 2015 and 2021 were retrospectively reviewed. DBD was performed using a battery‐powered, handheld motorized burr and a bandage contact lens was placed in 18/21 eyes. Corneal ulceration was considered resolved if the cornea was fluorescein negative with a stable epithelial surface. Recurrence was defined as return of corneal ulceration. Descriptive statistics and a Fisher's exact test were conducted on the study population.

Results

Twenty‐one eyes from 20 cats with superficial corneal ulcers refractory to medical treatment underwent DBD. Domestic and Burmese were the most commonly encountered breeds and the median age of affected cats was 8.83 years (range 0.5–20 years). Corneal ulceration was present for a median of 14 days prior to DBD. Healing was achieved in 81% of eyes; with four eyes failing to heal and requiring further intervention. Corneal sequestrum was reported in one case that failed to heal. Of the healed cases, three cases recurred (17.6%) at a mean of 116.3 days (range 79–135 days). Burmese were overrepresented (p < .001) in cases that failed to heal or recurred (6/7 eyes; 85.7%). The median postoperative follow‐up time was 93 days (range 6–1613 days).

Conclusions

Diamond burr debridement is a safe, non‐invasive treatment for corneal ulceration in cats but, compared with published results, it had a lower success rate than superficial lamellar keratectomy.
A cerebellar-prepontine circuit for tonic immobility triggered by an inescapable threat
Authors: Bhandiwad Ashwin A. , Chu Nickolas C. , Semenova Svetlana A. , Holmes George A. , Burgess Harold A.
Published: September 2022

Sudden changes in the environment are frequently perceived as threats and provoke defensive behavioral states. One such state is tonic immobility, a conserved defensive strategy characterized by powerful suppression of movement and motor reflexes. Tonic immobility has been associated with multiple brainstem regions, but the underlying circuit is unknown. Here, we demonstrate that a strong vibratory stimulus evokes tonic immobility in larval zebrafish defined by suppressed locomotion and sensorimotor responses. Using a circuit-breaking screen and targeted neuron ablations, we show that cerebellar granule cells and a cluster of glutamatergic ventral prepontine neurons (vPPNs) that express key stress-associated neuropeptides are critical components of the circuit that suppresses movement. The complete sensorimotor circuit transmits information from sensory ganglia through the cerebellum to vPPNs to regulate reticulospinal premotor neurons. These results show that cerebellar regulation of a neuropeptide-rich prepontine structure governs a conserved and ancestral defensive behavior that is triggered by an inescapable threat.
Metabolic and Morphotypic Trade-Offs within the Eco-Evolutionary Dynamics of Escherichia coli
Authors: Zlatkov Nikola , Näsman Moa Elsa Cecilia , Uhlin Bernt Eric
Published: September 2022

Aerobic use of citrate and filamentous growth are arbitrary cutoffs for the
Escherichia coli
species. The strains that exhibit them as stable phenotypes are called atypical.
Orthohantaviruses in Reservoir and Atypical Hosts in the Czech Republic: Spillover Infection and Indication of Virus-Specific Tissue Tropism
Authors: Hönig Václav , Kamiš Jan , Maršíková Aneta , Matějková Tereza , Stopka Pavel , Mácová Anna , Růžek Daniel , Kvičerová Jana
Published: September 2022

Orthohantaviruses (genus
Orthohantavirus
, family
Hantaviridae
) are a diverse group of globally distributed viruses that are closely associated with their natural hosts. Some orthohantaviruses are capable of infecting humans and causing severe disease.
Protocol for establishing a core outcome set for evaluation in studies of pulmonary exacerbations in people with cystic fibrosis
Authors: McLeod Charlie , Smyth Alan Robert , Messer Mitch , Schultz Andre , Wood Jamie , Norman Richard , Blyth Christopher C , Webb Steve , Elliott Zoe , Van Devanter Donald , Stephenson Anne L , Tong Allison , Snelling Thomas L
Published: September 2022

Introduction

Pulmonary exacerbations are associated with increased morbidity and mortality in people with cystic fibrosis (CF). There is no consensus about which outcomes should be evaluated in studies of pulmonary exacerbations or how these outcomes should be measured. Outcomes of importance to people with lived experience of the disease are frequently omitted or inconsistently reported in studies, which limits the value of such studies for informing practice and policy. To better standardise outcome reporting and measurement, we aim to develop a core outcome set for studies of pulmonary exacerbations in people with CF (COS-PEX) and consensus recommendations for measurement of core outcomes.

Methods and analysis

Preliminary work for development of COS-PEX has been reported, including (1) systematic reviews of outcomes and methods for measurement reported in existing studies of pulmonary exacerbations; (2) workshops with people affected by CF within Australia; and (3) a Bayesian knowledge expert elicitation workshop with health professionals to ascertain outcomes of importance. Here we describe a protocol for the additional stages required for COS-PEX development and consensus methods for measurement of core outcomes. These include (1) an international two-round online Delphi survey and (2) consensus workshops to review and endorse the proposed COS-PEX and to agree with methods for measurement.

Ethics and dissemination

National mutual ethics scheme approval has been provided by the Child and Adolescent Health Service Human Research Ethics Committee (RGS 4926). Results will be disseminated via consumer and research networks and peer-reviewed publications. This study is registered with the Core Outcome Measures in Effectiveness Trials database.
Feasibility of a pulmonary rehabilitation programme for patients with symptomatic chronic obstructive pulmonary disease in Georgia: a single-site, randomised controlled trial from the Breathe Well Group
Authors: Maglakelidze Mariam , Kurua Ia , Maglakelidze Nino , Maglakelidze Tamaz , Chkhaidze Ivane , Gogvadze Ketevan , Chkhaidze Natia , Beadle Helen , Redden-Rowley Kelly , Adab Peymane , Adams Rachel , Chi Chunhua , Cheng KK , Cooper Brendan , Correia-de-Sousa Jaime , Dickens Andrew P , Enocson Alexandra , Farley Amanda , Gale Nicola K , Jowett Sue , Martins Sonia , Rai Kiran , Sitch Alice J , Stavrikj Katarina , Stelmach Rafael , Turner Alice M , Williams Sian , Jordan Rachel E , Jolly Kate
Published: September 2022

Objectives

To assess the feasibility of delivering a culturally tailored pulmonary rehabilitation (PR) programme and conducting a definitive randomised controlled trial (RCT).

Design

A two-arm, randomised feasibility trial with a mixed-methods process evaluation.

Setting

Secondary care setting in Georgia, Europe.

Participants

People with symptomatic spirometry-confirmed chronic obstructive pulmonary disease recruited from primary and secondary care.

Interventions

Participants were randomised in a 1:1 ratio to a control group or intervention comprising 16 twice-weekly group PR sessions tailored to the Georgian setting.

Primary and secondary outcome measures

Feasibility of the interventionandRCT were assessed according to: study recruitment, consent and follow-up, intervention fidelity, adherence and acceptability, using questionnaires and measurements at baseline, programme end and 6 months, and through qualitative interviews.

Results

The study recruited 60 participants (as planned): 54 (90%) were male, 10 (17%) had a forced expiratory volume in 1 second of ≤50% predicted. The mean MRC Dyspnoea Score was 3.3 (SD 0.5), and mean St George’s Respiratory Questionnaire (SGRQ) 50.9 (SD 17.6). The rehabilitation specialists delivered the PR with fidelity. Thirteen (43.0%) participants attended at least 75% of the 16 planned sessions. Participants and rehabilitation specialists in the qualitative interviews reported that the programme was acceptable, but dropout rates were high in participants who lived outside Tbilisi and had to travel large distances. Outcome data were collected on 63.3% participants at 8 weeks and 88.0% participants at 6 months. Mean change in SGRQ total was −24.9 (95% CI −40.3 to –9.6) at programme end and −4.4 (95% CI −12.3 to 3.4) at 6 months follow-up for the intervention group and −0.5 (95% CI −8.1 to 7.0) and −8.1 (95% CI −16.5 to 0.3) for the usual care group at programme end and 6 months, respectively.

Conclusions

It was feasible to deliver the tailored PR intervention. Approaches to improve uptake and adherence warrant further research.

Trial registration number

ISRCTN16184185.
Black sickle cell patients’ lives matter: healthcare, long-term shielding and psychological distress during a racialised pandemic in England – a mixed-methods study
Authors: Berghs Maria J , Horne Francesca , Yates Scott , Graham Sadeh , Kemp Rachel , Webster Amy , Howson Carlton
Published: September 2022

Objective

To understand the psychological and social impact of shielding on people with sickle cell disorders and their carers in the Midlands region of England. This region was badly affected during the pandemic, with the city of Birmingham having some of the highest rates of COVID-19 deaths.

Design

A mixed-methods project with a quantitative survey on shielding and adapted SF36 V.2 questionnaire, which was supplemented by qualitative semistructured interviews analysed using interpretive phenomenological analysis (IPA).

Participants

Fifty-one participants who were predominantly of Black Caribbean or Black African heritage anonymously took part in the online survey. We supplemented this with eight in-depth semistructured interviews with adults with sickle cell disorders using IPA.

Results

The adapted 36-Item Short Form Survey (SF36) version 2 (V. 2) survey indicated worse quality of life and mental health. The open-ended questions from the adapted survey also identified shielding concerns about hospital care, pain management and knowledge of sickle cell by healthcare professionals. From the interviews, it emerged that the racialised element of the pandemic caused significant psychological distress for a population group that had to regularly access hospitals. It was noted that psychological health needs both during a pandemic and outside of it were poorly understood and became invisible in services. The psychological impact of experiences of hospital care as well as growing up with an invisible chronic condition were important to understand psychologically.
Randomised controlled trial evaluating the effects of screening and referral for social determinants of health on Veterans’ outcomes: protocol
Authors: Gurewich Deborah , Kressin Nancy , Bokhour Barbara G , Linsky Amy M , Dichter Melissa E , Hunt Kelly J , Fix Gemmae M , Niles Barbara L
Published: September 2022

Introduction

Health policy leaders recommend screening and referral (S&R) for unmet social needs (eg, food) in clinical settings, and the American Heart Association recently concluded that the most significant opportunities for reducing cardiovascular disease (CVD) death and disability lie with addressing the social determinants of CVD outcomes. A limited but promising evidence base supports these recommendations, but more rigorous research is needed to guide health care-based S&R efforts. Funded by the Veteran Health Administration (VA), the study described in this paper will assess the efficacy of S&R on Veterans’ connections to new resources to address social needs, reduction of unmet needs and health-related outcomes (adherence, utilisation and clinical outcomes).

Methods and analysis

We will conduct a 1-year mixed-methods randomised controlled trial at three VA sites, enrolling Veterans with CVD and CVD-risk. 880 Veterans experiencing one or more social needs will be randomised within each site (n=293 per site) to one of three study arms representing referral mechanisms of varying intensity (screening only, screening and provision of resource sheet(s), screening and provision of resource sheet(s) plus social work assistance). For each Veteran, we will examine associations of unmet social needs with health-related outcomes at baseline, and longitudinally compare the impact of each approach on connection to new resources (primary outcome) and follow-up outcomes over a 12-month period. We will additionally conduct qualitative interviews with key stakeholders, including Veterans to identify potential explanatory factors related to the relative success of the interventions.

Ethics and dissemination

Ethics approval was obtained from the VA Central Internal Review Board on 13 July 2021 (reference #: 20-07-Amendment No. 02). Findings will be disseminated through reports, lay summaries, policy briefs, academic publications, and conference presentations.

Trial registration number

NCT04977583.
Medical sharps in Portugal: a cross-sectional survey of disposal practices among the diabetic population
Authors: Corte-Real Ana Luísa , Duarte Leonor Luz , Teixeira Ana Luísa , Cunha Maria Vaz , Rebelo Catarina Calheno , Azevedo Ana Correia de , Pinto João Mário , Faria Andreia , Sacramento Sofia , Machado Filipa , Martinho-Dias Daniel , Taveira-Gomes Tiago
Published: September 2022

Objective

We aim to determine the disposal site for biohazardous materials resulting from diabetes surveillance and therapy.

Design

Cross-sectional study.

Setting

Five Portuguese primary care facilities.

Participants

We randomly sampled diabetic patients representative of five primary care facilities. Inclusion criteria consisted in patients≥18 years old with an active diagnosis of diabetes mellitus (DM). Patients unable to provide written informed consent were excluded.

Outcome measure

Sociodemographic variables, diabetes duration, type of treatment, medical sharps disposal practices and whether adequate disposal information were provided.

Results

A total of 1436 diabetics were included. Overall, 53.8% of diabetics conducted regular capillary glicemia measurements, although 45.3% of them had no medical indication. Statistically significant predictors of adequate disposal were not having an active professional status (p=0.011) and having a DM duration between 5 and 10 years (p=0.014). Only being professionally inactive remained an independent predictor after multivariate logistic regression. Less than a fifth of patients on injectable therapy report having been advised by healthcare staff regarding sharps disposal. Over a fifth of the latter report having received wrong advice. The majority of diabetics dispose of biohazardous materials in unsorted household waste (68.1% of needles/devices with needles and 71.6% of lancets). Other incorrect disposal sites identified were recycling bins, toilet and home accumulation. Only 19.1% of the needles/devices with needles and 13.1% of the lancets were disposed of at healthcare facilities.

Conclusions

Most diabetics have unsafe disposal practices for their biohazardous materials, mostly in unsorted household waste. We identified that being unemployed independently predicts adequate disposal of medical sharps and found evidence of low patient literacy on the topic, as well as poor patient education. Therefore, educating and raising awareness among healthcare professionals is crucial to address this public health issue.
South Asian Youth as Vaccine Agents of Change (SAY-VAC): evaluation of a public health programme to mobilise and empower South Asian youth to foster COVID-19 vaccine-related evidence-based dialogue in the Greater Toronto and Hamilton Area, Canada
Authors: Kandasamy Sujane , Ariyarajah Archchun , Limbachia Jayneel , An Derrick , Lopez Luke , Manoharan Baanu , Pacht Evan , Silver Adrienne , Uddandam Abhilash , Vansjalia Karan Mukesh , Williams Natalie C , Anand Sonia S
Published: September 2022

Objectives

There have been substantial amounts of misinformation surrounding the importance, safety and effectiveness of the COVID-19 vaccine. The impacts of this misinformation may be augmented as they circulate among ethnic communities, who may concurrently face other barriers related to vaccine uptake and access. To combat some of the key sources of COVID-19 vaccine misinformation among the South Asian communities of the Greater Toronto and Hamilton Area (GTHA), an interdisciplinary team of researchers and marketing experts established the South Asian Youth as Vaccine Agents of Change (SAY-VAC) programme to support and empower South Asian youth to disseminate COVID-19 vaccine information.

Design

Cross-sectional and one-group pretest–post-test design.

Setting

GTHA.

Participants

South Asian youth (18–29 years).

Intervention

The team partnered with grass-roots South Asian organisations to collaborate on shared objectives, curate key concerns, create video products regarding the COVID-19 vaccine that would resonate with the community, disseminate the products using established social media channels and evaluate the effectiveness of this effort.

Outcomes

We assessed the change in self-reported knowledge about the COVID-19 vaccine and participant confidence to facilitate a conversation around the COVID-19 vaccine using pre-post surveys, after the implementation of the SAY-VAC programme.

Results

In total, 30 South Asian youth (median age=23.2 years) from the GTHA participated in the programme. After completing the SAY-VAC programme, participants reported an increase in their self-reported knowledge regarding the COVID-19 vaccine from 73.3% to 100.0% (p=0.005), and their self-reported confidence to have a conversation about the vaccine with their unvaccinated community members increased from 63.6% to 100.0% (p=0.002). Overall, 51.9% of the participants reported being able to positively affect an unvaccinated/community member’s decision to get vaccinated.

Conclusions

The SAY-VAC programme highlights the importance of community partnerships in developing and disseminating culturally responsive health communication strategies. A constant assessment of the evidence and utilisation of non-traditional avenues to engage the public are essential.
Enhanced red blood cell distribution width to platelet ratio is a predictor of mortality in patients with sepsis: a propensity score matching analysis based on the MIMIC-IV database
Authors: Zhou Yuanjun , Zhong Liping , Chen Weiming , Liang Fei , Liao Yilin , Zhong Yuting
Published: September 2022

Objective

To explore the association between dynamic changes in red blood cell distribution width to platelet count ratio (RPR) during hospitalisation and short-term mortality in patients with sepsis.

Design

A retrospective cohort study using propensity score matching.

Setting

Intensive care units (ICUs) of Beth Israel Deaconess Medical Center.

Participants

A total of 8731 adult patients with sepsis were included in the study. The patients were identified from the ICU of the Medical Information Mart for Intensive Care database. The observed group included patients who experienced an increase in RPR of more than 30% during the first week of ICU admission, whereas the control group included the rest.

Main outcome and measure

Using propensity score matching, a matched control group was created. The primary outcome was 28-day mortality, and the length of hospital stay and in-hospital mortality were the secondary outcomes.

Results

The difference was evident in 28-day mortality between the two groups (85.8% vs 74.5%, p<0.001, Kaplan-Meier analysis, and HR=1.896, 95% CI=1.659 to 2.168, p<0.001, Cox regression). In the secondary outcomes, there was a significant difference in in-hospital mortality (p<0.001). In addition, the study discovered that the observed groups had a significantly longer hospital stay (p<0.001). Meanwhile, the results of subgroup analyses were consistent with those of the primary analyses.

Conclusions

In patients with sepsis, a significantly increased RPR is positively associated with the short-term death rate. Continuous RPR monitoring could be a valuable measure for predicting short-term mortality in patients with sepsis.
Methodology paper for the General Medicine Inpatient Initiative Medical Education Database (GEMINI MedED): a retrospective cohort study of internal medicine resident case-mix, clinical care and patient outcomes
Authors: Lam Andrew CL , Tang Brandon , Lalwani Anushka , Verma Amol A , Wong Brian M , Razak Fahad , Ginsburg Shiphra
Published: September 2022

Introduction

Unwarranted variation in patient care among physicians is associated with negative patient outcomes and increased healthcare costs. Care variation likely also exists for resident physicians. Despite the global movement towards outcomes-based and competency-based medical education, current assessment strategies in residency do not routinely incorporate clinical outcomes. The widespread use of electronic health records (EHRs) may enable the implementation of in-training assessments that incorporate clinical care and patient outcomes.

Methods and analysis

The General Medicine Inpatient Initiative Medical Education Database (GEMINI MedED) is a retrospective cohort study of senior residents (postgraduate year 2/3) enrolled in the University of Toronto Internal Medicine (IM) programme between 1 April 2010 and 31 December 2020. This study focuses on senior IM residents and patients they admit overnight to four academic hospitals. Senior IM residents are responsible for overseeing all overnight admissions; thus, care processes and outcomes for these clinical encounters can be at least partially attributed to the care they provide. Call schedules from each hospital, which list the date, location and senior resident on-call, will be used to link senior residents to EHR data of patients admitted during their on-call shifts. Patient data will be derived from the GEMINI database, which contains administrative (eg, demographic and disposition) and clinical data (eg, laboratory and radiological investigation results) for patients admitted to IM at the four academic hospitals. Overall, this study will examine three domains of resident practice: (1) case-mix variation across residents, hospitals and academic year, (2) resident-sensitive quality measures (EHR-derived metrics that are partially attributable to resident care) and (3) variations in patient outcomes across residents and factors that contribute to such variation.

Ethics and dissemination

GEMINI MedED was approved by the University of Toronto Ethics Board (RIS#39339). Results from this study will be presented in academic conferences and peer-reviewed journals.
Parental experiences of children with developmental dysplasia of the hip: a qualitative study
Authors: Theunissen WWES , van der Steen MC , van Veen MR , van Douveren FQMP , Witlox MA , Tolk JJ
Published: September 2022

Objective

The aim of this qualitative study was to explore the experiences of Dutch parents of children with developmental dysplasia of the hip (DDH), treated with a Pavlik harness, during the diagnostic and treatment process in the first year of life.

Design

A qualitative study by means of semistructured interviews was conducted between September and December 2020. Qualitative content analysis was applied to code, categorise and thematise data.

Setting

A large, tertiary referral centre for paediatric orthopaedics in the Netherlands.

Participants

A purposive sample of parents of children aged younger than 1 year, who were treated for DDH with a Pavlik harness, were interviewed until data saturation was achieved. A total of 20 interviews with 22 parents were conducted.

Results

Five main themes emerged: (1) positive experiences with professionals and peers, (2) insufficient information, (3) treatment concerns, (4) difficulties parenting and (5) emotional burden. Most prominent features that resonated across the interviews which led to insecurity by parents were: insufficient pre-hospital information, unfiltered online information and the lack of overview of the patient journey.

Conclusion

This study offers novel insights into parental experiences in DDH care. Parents were generally satisfied with DDH care provided by the hospital. The biggest challenges were to cope with (1) insufficient and unfiltered information, (2) the lack of patient journey overview and (3) practical problems and emotional doubts, which led to concerns during treatment. Future research and interventions should focus on optimising information provision and guidance with practical and emotional support for parents of children with DDH.
Assessing the short, intermediate and long-term health effects of COVID-19 on the survivors in Zambia: a prospective quantitative study protocol
Authors: Sialubanje Cephas , Kunka Evaristo , Sumbwa Phyllis Ingutu , Mukumbuta Nawa , Chibowa Margaret , Syakantu Gardner , Chikoya Laston , Mukonka Victor M
Published: September 2022

Introduction

Little is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health effects as well as the associated risk factors is scant. This study aims to determine the short, intermediate and long-term health effects of COVID-19 on the survivors and the associated risk factors.

Methods and analysis

We propose conducting a 24-month prospective quantitative study in 10 health facilities (2 specialist, 3 regional, 2 mission and 3 subdistrict hospitals) from Lusaka and Southern Province of Zambia. Health facilities will be those which served as COVID-19 treatment centres during the third wave (June–August 2021). Study participants will comprise a randomly selected cohort of 450 COVID-19 survivors who had mild or no symptoms (80%) and severe cases (20%). Using a questionnaire, respondent demographic, clinical and laboratory data will be collected at baseline and at a 3-month interval for 18 months using a questionnaire. Respondents’ medical records will be reviewed and data collected using a checklist. Descriptive statistics will be computed to summarise respondents’ characteristics and clinical outcomes. Bivariate analysis (Χ2 and t-test) will be conducted to test the association between respondent characteristics and clinical outcomes. Multivariate logistic regression analysis will be run to determine the risk factors for short, intermediate and long-term health effects; adjusted ORs will be computed to test the strength of the association (p<0.05).

Ethics and dissemination

Ethical approval was obtained from the University of Zambia Biomedical Research and the National Health Research Authority. Results will be disseminated to key stakeholders in Zambia, international open-access peer-reviewed journals, websites and international conferences, and likely lead to design of evidence-informed strategies to mitigate health effects of COVID-19 on survivors.
Melatonin for the prevention of postoperative delirium in older adults: a protocol for a systematic review and meta-analysis
Authors: Sewart Emma , Barnes Jonathan , Armstrong Richard A , Pufulete Maria , Hinchliffe Robert , Gibbison Ben , Mouton Ronelle
Published: September 2022

Introduction

Postoperative delirium (POD) is a major cause of morbidity, particularly in elderly patients. Melatonin has been suggested as a low-risk pharmacological intervention to help prevent POD. A previous systematic review found limited high-quality evidence to support the use of melatonin in the prevention of POD. Several further randomised studies have since been published. This systematic review aims to synthesise the evidence from randomised controlled trials (RCTs) examining the effect of melatonin on the prevention of POD in older adults.

Methods and analysis

A systematic search of RCTs of melatonin (any dose and formulation) in POD will be run across Embase, Medline, CINAHL and PsychInfo. RCTs published from January 1990 until the end of February 2022 and reporting outcomes for melatonin use to prevent POD in patients will be included. Screening of search results and data extraction from included articles will be performed by two independent reviewers. The primary outcome will be incidence of POD in older adults undergoing surgery. Secondary outcomes are delirium duration and length of hospital stay. The review will also describe the dosage, timing and administration regimes of melatonin therapy and as well as the scales and definitions used to describe POD. A registry review of ongoing trials will be also be performed. For the meta-analysis, data will be pooled using a random effects model to generate a forest plot and obtain an odds ratio (OR) for the incidence of POD. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Ethics and dissemination

No ethical approval is required. This review will be disseminated via peer-reviewed manuscript and conferences. The results will be used as the basis of work to optimise this intervention for future trials in surgical populations.

PROSPERO registration number

This review is registered with PROSPERO (CRD42021285019).
Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020
Authors: Msukwa Malango T , MacLachlan Ellen W , Gugsa Salem T , Theu Joe , Namakhoma Ireen , Bangara Fred , Blair Christopher L , Payne Danielle , Curran Kathryn G , Arons Melissa , Namachapa Khumbo , Wadonda Nellie , Kabaghe Alinune N , Dobbs Trudy , Shanmugam Vedapuri , Kim Evelyn , Auld Andrew , Babaye Yusuf , O'Malley Gabrielle , Nyirenda Rose , Bello George
Published: September 2022

Objectives

In Malawi, a recent infection testing algorithm (RITA) is used to characterise infections of persons newly diagnosed with HIV as recent or long term. This paper shares results from recent HIV infection surveillance and describes distribution and predictors.

Setting

Data from 155 health facilities in 11 districts in Malawi were pooled from September 2019 to March 2020.

Participants

Eligible participants were ≥13 years, and newly diagnosed with HIV. Clients had RITA recent infections if the rapid test for recent infection (RTRI) test result was recent and viral load (VL) ≥1000 copies/mL; if VL was <1000 copies/mL the RTRI result was reclassified as long-term. Results were stratified by age, sex, pregnancy/breastfeeding status and district.

Results

13 838 persons consented to RTRI testing and 12 703 had valid RTRI test results and VL results after excluding clients not newly HIV-positive, RTRI negative or missing data (n=1135). A total of 12 365 of the 12 703 were included in the analysis after excluding those whose RTRI results were reclassified as long term (n=338/784 or 43.1%). The remainder, 446/12 703 or 3.5%, met the definition of RITA recent infection. The highest percentage of recent infections was among breastfeeding women (crude OR (COR) 3.2; 95% CI 2.0 to 5.0), young people aged 15–24 years (COR 1.6; 95% CI 1.3 to 1.9) and persons who reported a negative HIV test within the past 12 months (COR 3.3; 95% CI 2.6 to 4.2). Factors associated with recent infection in multivariable analysis included being a non-pregnant female (adjusted OR (AOR) 1.4; 95% CI 1.2 to 1.8), a breastfeeding female (AOR 2.2; 95% CI 1.4 to 3.5), aged 15–24 years (AOR 1.6; 95% CI 1.3 to 1.9) and residents of Machinga (AOR 2.0; 95% CI 1.2 to 3.5) and Mzimba (AOR 2.4; 95% CI 1.3 to 4.5) districts.

Conclusions

Malawi’s recent HIV infection surveillance system demonstrated high uptake and identified sub-populations of new HIV diagnoses with a higher percentage of recent infections.
Early interventions for post-traumatic stress following musculoskeletal trauma: protocol for a systematic review and meta-analysis
Authors: Jadhakhan Ferozkhan , Evans David , Falla Deborah
Published: September 2022

Introduction

Post-traumatic stress symptoms (PTSS) can be triggered following exposure to a traumatic event, such as violence, disasters, serious accidents and injury. Little is known about which interventions provide the greatest benefit for PTSS. This systematic review aims to estimate the effects of early interventions on PTSS following musculoskeletal trauma.

Methods/analysis

Development of this review protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. This review will include randomised controlled trials and non-randomised controlled studies evaluating the effect of early (within 3 months of a traumatic event) non-pharmacological and non-surgical interventions on PTSS in adults (aged ≥18 years). MEDLINE, PsycINFO, Embase, CINAHL, Zetoc, PROSPERO, Web of Science, PubMed and Google Scholar, as well as key journals/grey literature, will be searched from inception to 31 July 2022. Only articles published in English will be considered. Two independent reviewers will search, screen studies, extract data and assess risk of bias using the Cochrane Risk of Bias tool V.2 (RoB 2) and the Risk Of Bias in Non-randomised Studies of Interventions (ROBINS-I), respectively. Mean difference or standardised mean difference (SMD) will be extracted with accompanying 95% CIs and p values where these are reported. Group effect size will be extracted and reported. Symptoms of PTSS will be ascertained using SMDs (continuous) and diagnosis of PTSS using risk ratio (dichotomous). If possible, study results will be pooled into a meta-analysis. A narrative synthesis of the results will be presented if heterogeneity is high. The overall quality of evidence and risk of bias will be assessed using the Grading of Recommendations Assessment, Development and Evaluation, RoB 2 and ROBINS-I guidelines, respectively.

Ethics and dissemination

Ethical approval is not required for this systematic review since data from published studies will be used. This review is expected to provide a better understanding of the effect of early intervention for PTSS following musculoskeletal trauma. Findings of this review will be disseminated in peer-reviewed publications and through national and international conferences.

PROSPERO registration number

CRD42022333905
Effect of a mHealth exercise intervention compared with supervised exercise therapy in osteoarthritis management: protocol of the DigiOA trial
Authors: Martinsen Lars , Østerås Nina , Moseng Tuva , Tveter Anne Therese
Published: September 2022

Introduction

Soaring prevalence of hip and knee osteoarthritis (OA) inflicts high costs on the healthcare system. A further rise in the OA incidence is expected, generating increased demand of care potentially challenging accessibility and threatening to overwhelm the healthcare system. Innovative solutions that may improve accessibility to recommended OA care for patients in primary care and maintain healthcare sustainability are warranted. Digitalising home exercise therapy may be one such solution. The primary aim of this study is to evaluate the effectiveness of a mobile health app providing digitalised home exercises, compared with supervised exercise therapy in patients with OA. Second, we will evaluate the cost-efficiency of the intervention and explore potential differences in outcome and adherence to exercises in the experimental treatment group.

Methods and analysis

A two-armed non-inferiority randomised controlled trial will be conducted. In total, 156 patients with hip and/or knee OA will be recruited from physiotherapy clinics in primary care in Norway. Following patient education, patients will be randomised to either 6 weeks of standard treatment (2 weekly sessions of supervised exercise therapy) or experimental treatment (home exercises via the Virtual Training (VT) app). Primary outcome is the proportion of Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responders at 6 weeks. Secondary outcomes include physical performance, patient-reported outcomes related to pain, fatigue, disease activity, physical function, mental health, health related quality of life, self-efficacy, utilisation of healthcare services and medication, digital competence and use of apps.

Ethics and dissemination

Patients will sign an informed consent form before participating in the trial. Approval has been granted by the Regional Ethics Committee (201105) and Data Protection Officer at Diakonhjemmet Hospital (00221). Patient research partners will contribute in all parts of the study.

Trial registration number

NCT04767854.
Role of the electrocardiogram in the risk stratification of pulmonary hypertension
Authors: Hendriks Paul M , Kauling Robert M , Geenen Laurie W , Eindhoven Jannet A , Roos-Hesselink Jolien W , Boomars Karin A , van den Bosch Annemien E
Published: September 2022

Introduction

The prognosis of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) remains dismal. Better risk prediction is needed. This study investigated the prognostic value of ECG characteristics.

Methods

In this single-centre prospective study, consecutive treatment-naïve patients with PAH or CTEPH were included at time of diagnosis. From the 12-lead ECG, obtained at baseline, the following parameters were collected: heart rate (HR), rhythm, QRS axis, conduction times, P-top amplitudes in II, R-top and S-wave amplitudes in V1 and V5 and repolarisation disorders. Associations between the ECG and transplant-free survival was assessed by Kaplan-Meier curves and Cox-proportional hazard regressions.

Results

In total, 140 patients were included (median age: 60.7 years, 63.6% female). The ECG was abnormal in 86.2%: sinus rhythm was not present in 9.3%, right QRS axis was observed in 47.8%, mean QRS duration was 101±17 ms. Only 42.5% of the patients had normal repolarisation, 34.5% had right ventricular strain and 14.4% non-specific repolarisation disorders. Over a median follow-up time of 3.49 (IQR: 1.37–6.42) years, 45 patients (32.5%) died or underwent lung transplantation. Transplant-free survival was worse in patients presenting with an abnormal ECG (64.0% vs 86.0%; p=0.037). The following ECG characteristics were associated with all-cause mortality or lung transplantation: heart rate (HR 1.02, 95% CI: 1.00 to 1.05), QRS duration >120 ms (HR 2.61, 95% CI: 1.01 to 6.71) and S-wave amplitude in V5 (HR 1.10, 95% CI: 1.04 to 1.17).

Conclusion

Only 13.8% of patients with PAH and CTEPH presented with a normal ECG, which is associated with favourable outcome. The ECG provides additional prognostic value to current clinical parameters and should be considered in risk prediction.
A Human-in-the-Loop Segmented Mixed-Effects Modeling Method for Analyzing Wearables Data
Authors: Srinivasan Karthik , Currim Faiz , Ram Sudha
Published: September 2022

Wearables are an important source of big data, as they provide real-time high-resolution data logs of health indicators of individuals. Higher-order associations between pairs of variables is common in wearables data. Representing higher-order association curves as piecewise linear segments in a regression model makes them more interpretable. However, existing methods for identifying the change points for segmented modeling either overfit or have low external validity for wearables data containing repeated measures. Therefore, we propose a human-in-the-loop method for segmented modeling of higher-order pairwise associations between variables in wearables data. Our method uses the smooth function estimated by a generalized additive mixed model to allow the analyst to annotate change point estimates for a segmented mixed-effects model, and thereafter employs Brent's constrained optimization procedure to fine-tune the manually provided estimates. We validate our method using three real-world wearables datasets. Our method not only outperforms state-of-the-art modeling methods in terms of prediction performance but also provides more interpretable results. Our study contributes to health data science in terms of developing a new method for interpretable modeling of wearables data. Our analysis uncovers interesting insights on higher-order associations for health researchers.
Pathogenesis of Zika Virus Infection
Authors: Giraldo Maria I. , Gonzalez-Orozco Maria , Rajsbaum Ricardo
Published: September 2022

Zika virus (ZIKV) is an emerging virus from the Flaviviridae family that is transmitted to humans by mosquito vectors and represents an important health problem. Infections in pregnant women are of major concern because of potential devastating consequences during pregnancy and have been associated with microcephaly in newborns. ZIKV has a unique ability to use the host machinery to promote viral replication in a tissue-specific manner, resulting in characteristic pathological disorders. Recent studies have proposed that the host ubiquitin system acts as a major determinant of ZIKV tropism by providing the virus with an enhanced ability to enter new cells. In addition, ZIKV has developed mechanisms to evade the host immune response, thereby allowing the establishment of viral persistence and enhancing viral pathogenesis. We discuss recent reports on the mechanisms used by ZIKV to replicate efficiently, and we highlight potential new areas of research for the development of therapeutic approaches.
Lysosomal Ion Channels: What Are They Good For and Are They Druggable Targets?
Authors: Riederer Erika , Cang Chunlei , Ren Dejian
Published: September 2022

Lysosomes play fundamental roles in material digestion, cellular clearance, recycling, exocytosis, wound repair, Ca2+signaling, nutrient signaling, and gene expression regulation. The organelle also serves as a hub for important signaling networks involving the mTOR and AKT kinases. Electrophysiological recording and molecular and structural studies in the past decade have uncovered several unique lysosomal ion channels and transporters, including TPCs, TMEM175, TRPMLs, CLN7, and CLC-7. They underlie the organelle's permeability to major ions, including K+, Na+, H+, Ca2+, and Cl−. The channels are regulated by numerous cellular factors, ranging from H+in the lumen and voltage across the lysosomal membrane to ATP in the cytosol to growth factors outside the cell. Genetic variations in the channel/transporter genes are associated with diseases that include lysosomal storage diseases and neurodegenerative diseases. Recent studies with human genetics and channel activators suggest that lysosomal channels may be attractive targets for the development of therapeutics for the prevention of and intervention in human diseases.
On the Mechanical and Lattice Dynamic Properties of Nanostructure Pentanary GaxIn1−xPySbzAs1−y−z Alloy Lattice Matched to InP Substrate
Authors: Elkenany Elkenany B. , Alfrnwani O. A. , Degheidy A. R.
Published: September 2022

The influence of composition on the energy band structure, mechanical properties, acoustic velocities, and optical phonon frequencies of the GaxIn1−xPySbzAs1−y−z alloy lattice matched to the InP substrate has been studied. To investigate the electronic structure and mechanical characteristics of the alloy under consideration, the empirical pseudo-potential method (EPM) was used. In this study, we consider the virtual crystal approximation (VCA). A good agreement between our results and the widely accessible published values was obtained. Our findings will serve as a crucial source for the next works. It has not been thoroughly investigated how composition affects the mechanical properties, optical phonon frequencies, and acoustic velocities of the researched alloys. Consequently, we were interested in these properties as they were affected by composition.
Syndecan-4 is More Sensitive in Detecting Hypertensive Left Ventricular Diastolic Dysfunction in 2K2C Rats
Authors: Dai Wenyue , Liu Yanqiu , Yao Fengjuan , Li Wei , Liu Jia , Li Cuiling , Liu Donghong
Published: September 2022

Objective. The aim of this study was to investigate the changes of syndecan-4 (SDC-4) during the hypertensive period in two kidney-two clip (2K2C) hypertension rats and compare them to brain natriuretic peptide (BNP) and the echocardiographic parameters for diastolic function evaluation in the rat model of 2K2C hypertension. Methods. A total of 36 Sprague–Dawley (SD) rats were used in this study. Hypertension was induced in 21 by 2K2C surgery, and 15 were sham-operated. Both the 2K2C hypertension group (n = 21) and the sham-operated group (n = 15) were equally divided into 3 subgroups according to the schedules (week 4, week 8, and week 12). Serum SDC-4 and BNP were detected by ELISA, and echocardiography indexes were acquired. Results. The level of SDC-4 and cardiac fibrosis increased gradually as the experiment was processed, and BNP, Tei index, and E/E′ followed to be raised as high blood pressure was maintained after four weeks in the 2K2C hypertension rats. In the earlier 4 weeks, only SDC-4 and cardiac fibrosis were significantly increased in 2K2C hypertensive rats in comparison with normotensive rats. And it was shown that SDC-4 was positively correlated with BNP level during the entire study (r = 0.762,

p
<
0.01

). Conclusion. SDC-4 increases gradually during the process of diastolic dysfunction in 2K2C hypertensive rats. SDC-4 is the earliest biomarker reflecting diastolic dysfunction in this model, superior to E/E′ and the Tei index. Our results indicate that serum SDC-4 could act as an early biomarker to show diastolic dysfunction.
Diverse Exact Soliton Solutions of the Time Fractional Clannish Random Walker’s Parabolic Equation via Dual Novel Techniques
Authors: Siddique Imran , Mehdi Khush Bukht , Akbar M. Ali , Khalifa Hamiden Abd El-Wahed , Zafar Asim
Published: September 2022

In this article, we acquire a variety of new exact traveling wave solutions in the form of trigonometric, hyperbolic, and rational functions for the nonlinear time-fractional Clannish Random Walker’s Parabolic (CRWP) equation in the sense of beta-derivative by employing the two modified methods, namely, modified

G

′

/

G

2

−

expansion method and modified

F
−

expansion method. The obtained solutions are verified for aforesaid equations through symbolic soft computations. To promote the essential propagated features, some investigated solutions are exhibited in the form of 2D and 3D graphics by passing on the precise values to the parameters under the constrain conditions. The obtained solutions show that the presented methods are effective, straight forward, and reliable as compared to other methods. These methods can also be used to extract the novel exact traveling wave solutions for solving any types of integer and fractional differential equations arising in mathematical physics.