bluuebunny/crossref_metadata_2025 huggingface dataset:
Repronormativity in cisgender men's reasons why they would not use womb transplant technology to become pregnant
Authors: Mary‐Jane Jace Mavuso Jabulile
Published: December 2022

Much reproductive scholarship presumes that cisgender men do not wish to become pregnant. And within scholarly discussions on womb transplant technology in particular, cis men's desires to be pregnant are constructed as ‘insubstantial’, and cis men are positioned as neither desiring nor requiring womb transplant technology. Repronormativity, including the assumption that pregnancy and gestational desire are antithetical to cis masculinity/manhood, underpins both bodies of work. As part of a study that sought to visibilise, and analyse narratives of, cis men's desires to be pregnant and/or gestational parents, six cis men were asked whether they would use womb transplant technology to enable their pregnancy if womb transplant technology included men as recipients. The majority of participants said they would not do so, giving different reasons. Using a narrative‐discursive approach to analyse their responses, I argue that their varied responses disrupt and re‐circulate normative discourses on sex/gender, pregnancy, parenthood, and (assisted) reproduction. Ultimately, their varied reasons trouble the normative assumption that cis men do not want to be pregnant and would not take up the opportunity to do so, because they are men.
Serological and molecular characterisation of the most prevalent weak D variants in Croatian population
Authors: Stanic Hana Safic , Galic Zrinka Kruhonja , Dogic Vesna , Bingulac‐Popovic Jasna , Jukic Irena
Published: December 2022

Introduction

Existence of hundreds ofRHDgene variants contributes to variable D antigen expression and inconsistencies in reporting theRHDresults. The aim of the study was to determine the serological and molecular characteristics of the most prevalentRHDalleles encoding serologically weak D variants.

Material and Methods

Blood donors (n = 145 924) were typed for D antigen using the direct serologic micromethod. Nonreactive samples were analysed in IAT method with the IgM/IgG anti‐D monoclonal blend, and 0,2% (n = 263) confirmed weak D antigen expression. After genomic DNA extraction (Qiaqen, Germany),RHDgenotyping was performed usingin housereagents and PCR‐SSP kits (Inno‐Train, Germany).

Results

The prevalence of serologically weak D in blood donor population was 0.2% (n = 263).RHDgenotyping confirmed weak D allele in 92.4% and partial D allele in 7.6%. The most common was weak D type 1 (49.7%) followed by weak D type 3 (24.7%) and type 2 (9.5%). Relatively high frequency was detected for weak D type 14 (4.6%) and type 64 (2.3%). In the category of partial D phenotypes, only DVI variant was found. Direct typing has shown great variability in the strength of reactions with different clones of anti‐D reagents.

Conclusion

Weak D type 1 is the most common weak D variant in Croatian blood donor population. The frequency of D variants and distribution of Rh phenotypes in our study was in concordance with other studies. It has been shown that serological methods and the combination of clones used, cannot distinguish variant D types, which justifies the use of molecular methods.
The Role of Significant Others on International Students’ Agency in Chinese Learning: Translanguaging Lens
Authors: Zhao Kunpeng
Published: December 2022

This paper is based on a case study conducted on the international students’ agentic choices and actions in response to such significant others’ impact on their competency, confidence and achievements towards Chinese learning through being engaged in translanguaging pedagogical practices. In the study, the data was collected from a photo-elicitation interview in the form of a focus group among the student participants. The data analysis revealed that the participants tended to display peer-directed, teacher-facilitated and community member-reinforced agency towards speeding up their self-understanding competency in class, improving self-learning efficacy after class, and enhancing self-awareness of tones, as a result of interacting with diverse significant others in translanguaging space. Correspondingly, this study illustrated three categories of significant others, including class peers, native Chinese teachers and members of Chinese-speaking communities who can exert the influences on enacting international students’ agency towards Chinese learning in a flexible, efficient and critical way. These findings offer an insight into shaping an overseas learners’ agency-oriented approach to make Chinese as a learnable language from a translanguaging perspective. Furthermore, the concept of significant others is linked to the field of international Chinese language education. Thus, it is expected to provide some contributory implications to native and non-native Chinese teachers, educators and researchers, particularly on paying more attention to such emergent interactions between significant others and international students’ agentic emotions, feelings and attitudes towards learning of Chinese language in different circumstances.
Simulation of Heat and Mass Transfer in Pulverized Coal Boiler Based on Gaseous Combustion Through Phase Separation Technique
Authors: Ma Gui-Yang , Wan Guang-Zhong , Li Yang , Chen Hong-Wei , Zhang Shan-Shan
Published: December 2022

In order to meet the current environmental protection ultra-low pollutant emission requirements, one-step combustion is changed into two-step combustion by split-phase gasification combustion technology, and double-furnace structure, graded air distribution, calcium injection desulfurization, and combined denitrification with selective non-catalytic reduction (SNCR) and selective catalytic reduction (SCR) are adopted to reduce pollutant emissions. ansys was used to establish a two-dimensional steady-state structure model of pulverized coal boiler with a double-furnace. Finite element analysis was carried out on the combustion in 54 MW, 56 MW, and 58 MW working conditions under different calcium-sulfur (Ca/S) ratios. The results showed that the desulfurization efficiency increased gradually when the Ca/S ratio was between 1.0 and 2.6 under the three working conditions. The desulfurization efficiency has no noticeable change when it is between 2.6 and 2.8, and begins to decline when it is greater than 2.8. The optimal calcium-sulfur ratio is obtained when the calcium-sulfur ratio is 2.6, and the SO2 concentration at the outlet of the furnace is reduced to 0.0001 mg/m3. By controlling the highest temperature in the furnace and adjusting the amount of denitrification agent, the nitrogen oxide emission at the outlet of the furnace is reduced to 0.87 mg/m3.
Printability and Overall Cooling Performance of Additively Manufactured Holes With Inlet and Exit Rounding
Authors: Veley Emma M. , Thole Karen A. , Furgeson Michael T. , Bogard David G.
Published: December 2022

To improve cooling effectiveness of gas turbine hardware, various film cooling hole shapes have previously been researched. Unique design modifications have recently been made possible through the design freedom allotted by additive manufacturing (AM). As one example, creating a rounded inlet for a film-cooling hole can mitigate separation at the inlet. This study explores various geometric features by exploiting the uses of additive manufacturing for shaped film cooling holes at engine scale. Both printability and cooling performance were evaluated. Resulting from this study, additively manufactured holes with hole inlet and exit rounding were printed with some variations from the design intent (DI). The largest deviations from the design intent occurred from dross roughness features located on the leeward side of the hole inlet. The measured overall effectiveness indicated that an as-built inlet fillet decreased in-hole convection as well as decreased jet mixing compared to the as-built sharp inlet. Including an exit fillet, which prevented an overbuilt diffuser exit, was also found to decrease jet mixing. A particular insight gained from this study is the importance of the convective cooling within the hole to the overall cooling performance. In-hole roughness, which is a result of additive manufacturing, increased convective cooling within the holes but also increased jet mixing as the coolant exited the hole. The increased jet mixing caused low overall effectiveness downstream of injection.
Evaluation of Adjoint-Optimized Holes—Part I Baseline Performance
Authors: Gutierrez Daniel , Yoon Christopher , Furgeson Michael T. , Veley Emma M. , Bogard David G. , Thole Karen A.
Published: December 2022

With the advent of the use of additive manufacturing to build gas turbine components, the design space for new hole geometries is essentially unlimited. Recently, a computational adjoint-based optimization method was used to design shaped film cooling holes fed by internal co-flow and cross-flow channels. The associated Reynolds-averaged Navier–Stokes computations predicted that the holes optimized for use with cross-flow (X-AOpt) and co-flow (Co-AOpt) would significantly increase adiabatic effectiveness. However, only the X-AOpt hole was tested experimentally in this previous study. Though the experimentally measured performance for this hole was much less than computationally predicted, it still had a 75% improved performance compared to the conventional 7-7-7-shaped hole. In the current study, the X-AOpt and Co-AOpt-shaped holes were experimentally evaluated using measurements of adiabatic effectiveness and overall cooling effectiveness. Coolant was fed to the holes with an internal co-flow channel. For reference, experiments were also conducted with the baseline 7-7-7-shaped hole, and a 15-15-1-shaped hole (shown in a previous study to be the optimum expansion angles for a shaped hole). Furthermore, overall cooling effectiveness measurements were made with engine-scale models to evaluate the performance of additively manufactured (AM) X-AOpt and Co-AOpt holes with a realistic metal build. Results from this study confirmed that the X-AOpt hole had a 75% increase in adiabatic effectiveness compared to the 7-7-7-shaped hole. However, the Co-AOpt hole had only a 30% increase in adiabatic effectiveness, substantially less than had been computationally predicted. Measurements of overall cooling effectiveness for the engine-scale models and the large-scale models followed similar trends.
Modification of nitrile hydratase from Rhodococcus erythropolis CCM2595 by semirational design to enhance its substrate affinity
Authors: Wang Li , Cui Baocheng , Qiu Keyuan , Huang Jiao , Liang Changhai
Published: December 2022

Nitrile hydratase (NHase, EC 4.2.1.84) is an excellent biocatalyst that catalyzes the hydration of nitrile substances to their corresponding amides. Given its catalytic specificity and eco-friendliness, NHase has extensive applications in the chemical, pharmaceutical, and cosmetic industries. To improve the affinity between Rhodococcus erythropolis CCM2595-derived NHase (ReNHase) and adiponitrile, this study used a semirational design to improve the efficiency of ReNHase in catalyzing the generation of 5-cyanopentanamide from adiponitrile. Enzyme kinetics analysis showed that Km of the mutant ReNHaseB:G196Y was 3.265 mmol l−1, which was lower than that of the wild-type NHase. The affinity of the mutant ReNHaseB:G196Y to adiponitrile was increased by 36.35%, and the efficiency of the mutant ReNHaseB:G196Y in catalyzing adiponitrile to 5-cyanopentamide was increased by 10.11%. The analysis of the enzyme-substrate interaction showed that the hydrogen bond length of the mutant ReNHaseB:G196Y to adiponitrile was shortened by 0.59 Å, which enhanced the interaction between the mutant and adiponitrile and, thereby, increased the substrate affinity. Similarly, the structural analysis showed that the amino acid flexibility near the mutation site of ReNHaseB:G196Y was increased, which enhanced the binding force between the enzyme and adiponitrile. Our work may provide a new theoretical basis for the modification of substrate affinity of NHase and increase the possibility of industrial applications of the enzyme.
Amplitude-modulation forward masking for listeners with and without hearing loss
Authors: Svec Adam , Wojtczak Magdalena , Nelson Peggy B.
Published: December 2022

Amplitude-modulation (AM) forward masking was measured for listeners with normal hearing and sensorineural hearing loss at 4000 and 1000 Hz, using continuous and noncontinuous masker and signal carriers, respectively. A low-fluctuation noise (LFN) carrier was used for the “continuous carrier” conditions. An unmodulated low-fluctuation noise (U-LFN), an unmodulated Gaussian noise (U-GN), and an amplitude-modulation low-fluctuation noise (AM-LFN) were maskers for the “noncontinuous carrier” conditions. As predicted, U-GN yielded more masking than U-LFN and similar masking to AM-LFN, suggesting that U-GN resulted in AM forward masking. Contrary to predictions, no differences in masked thresholds were observed between listener groups.
A Systematic Review Investigating the Effects of Implementing Game-Based Approaches in School-Based Physical Education Among Primary School Children
Authors: Yan Jin , Jones Brad , Smith Jordan J. , Morgan Philip , Eather Narelle
Published: December 2022

Purpose: To evaluate the effectiveness of game-based approaches on game performance, fundamental movement skills, health-related indicators, and physical activity outcomes among children (5–12 years) when delivered in the primary physical education school setting. Method: A systematic search of six electronic databases without date limitation was conducted on June 11, 2021. Results: Among included studies (N = 17), positive outcomes were found for children’s game performance, fundamental movement skills, physical and mental health, and/or physical activity. Game-based approaches intervention success appears to be related to the contents of teacher training, especially the inclusion of a theory-based syllabus, mentoring, and reflection sessions. Conclusions: The findings of this review confirm that hybrid sport education-invasion games interventions delivered in primary schools are beneficial for improving a range of student outcomes. To improve physical self-perception, intrinsic motivation, well-being, physiological, and potential psychological outcomes for children, it is necessary to explore more game-based approaches’ longitudinal and intervention research with high quality.
The human signal peptidase complex acts as a quality control enzyme for membrane proteins
Authors: Zanotti Andrea , Coelho João P. L. , Kaylani Dinah , Singh Gurdeep , Tauber Marina , Hitzenberger Manuel , Avci Dönem , Zacharias Martin , Russell Robert B. , Lemberg Marius K. , Feige Matthias J.
Published: December 2022

Cells need to detect and degrade faulty membrane proteins to maintain homeostasis. In this study, we identify a previously unknown function of the human signal peptidase complex (SPC)—the enzyme that removes endoplasmic reticulum (ER) signal peptides—as a membrane protein quality control factor. We show that the SPC cleaves membrane proteins that fail to correctly fold or assemble into their native complexes at otherwise hidden cleavage sites, which our study reveals to be abundant in the human membrane proteome. This posttranslocational cleavage synergizes with ER-associated degradation to sustain membrane protein homeostasis and contributes to cellular fitness. Cryptic SPC cleavage sites thus serve as predetermined breaking points that, when exposed, help to target misfolded or surplus proteins for degradation, thereby maintaining a healthy membrane proteome.
Meet the Huxleys
The Huxleys: An Intimate History of Evolution
Alison Bashford
University of Chicago Press, 2022. 576 pp.
Authors: Hale Piers J.
Published: December 2022

A historian traces the scientific family’s complicated lives and influential legacies
Triggering rare HIV antibodies by vaccination
Authors: Moore Penny L.
Published: December 2022

Clinical trial shows that an HIV vaccine can elicit rare antibodies, but there is more to do
Meeting the ancestors
Authors: Curry Andrew
Published: December 2022

DNA from a medieval German cemetery opens a window on the history of today’s largest Jewish population
CRISPR is so popular even viruses may use it
Authors: Leslie Mitch
Published: December 2022

Thousands of phages appear to have stolen the gene-cutting mechanism
Europe pledges to launch Mars rover delayed by war
Authors: Clery Daniel
Published: December 2022

Replacing Russian launcher and lander means probe won’t reach Mars until 2030
New look at jaw fossil rewrites centuries-old bird history
Authors: Vogel Gretchen
Published: December 2022

Specimen flips evolutionary order of two key groups
Collaborative Two-Stage Exams Benefit Students in a Biology Laboratory Course
Authors: Meaders Clara L. , Vega Yalila
Published: December 2022

Collaborative two-stage exams provide an effective mechanism to incorporate group work into summative course assessments. We implemented these exams in an upper-level biology laboratory course over two terms, one with online exams and one with in-person exams.
Subtle Longitudinal Alterations in Env Sequence Potentiate Differences in Sensitivity to Broadly Neutralizing Antibodies following Acute HIV-1 Subtype C Infection
Authors: Mandizvo Tawanda , Gumede Nombali , Ndlovu Bongiwe , Ndlovu Siphiwe , Mann Jaclyn K. , Chopera Denis R. , Singh Lanish , Dong Krista L. , Walker Bruce D. , Ndhlovu Zaza M. , Lavine Christy L. , Seaman Michael S. , Gounder Kamini , Ndung’u Thumbi
Published: December 2022

Broadly neutralizing antibodies (bNAbs) have potential clinical utility in HIV-1 prevention and cure strategies. However, bNAbs target diverse epitopes on the HIV-1 envelope and the virus may evolve to evade immune responses.
Antibiotic Profiles and Draft Genome Sequences of Kerstersia gyiorum, Providencia stuartii, Providencia vermicola, and Alcaligenes faecalis Strains Recovered from Soft Tissue Biopsy Samples in Ghana
Authors: Egyir Beverly , Owusu Felicia , Owusu-Nyantakyi Christian , Amuasi Grebstad Rabbi , Boateng William , Kodom Sarkodie , Mohktar Quaneeta , Nilsson Pernille , Adu Bright , Hendriksen Rene S.
Published: December 2022

Whole-genome sequence data for clinically relevant Gram-negative bacteria from the African continent are scarce. In this report, we present the draft genome sequence data and antibiograms of four species, namely,
Kerstersia gyiorum
,
Providencia vermicola
,
Providencia stuartii
, and
Alcaligenes faecalis
, that were recovered from human soft tissue biopsy samples.
Complete Genome Sequence of Lacticaseibacillus paracasei Strain VHProbi O44, Isolated from Feces from a Healthy Baby
Authors: Wang Qian , Cui Hongchang , Guo Chaoqun , Duan Zhi
Published: December 2022

Lacticaseibacillus paracasei
strain VHProbi O44 is a Chinese commercial lactic acid bacterium with several probiotic functions. The whole genome contains a chromosome and three plasmids.
RNA Viruses Linked to Eukaryotic Hosts in Thawed Permafrost
Authors: Wu Ruonan , Bottos Eric M. , Danna Vincent G. , Stegen James C. , Jansson Janet K. , Davison Michelle R.
Published: December 2022

Permafrost is thawing at a rapid pace in the Arctic with largely unknown consequences on ecological processes that are fundamental to Arctic ecosystems. This is the first study to determine the composition of RNA viruses in thawed permafrost.
Cec4-Derived Peptide Inhibits Planktonic and Biofilm-Associated Methicillin Resistant Staphylococcus epidermidis
Authors: Mao Chengju , Wang Yue , Yang Yifan , Li Lu , Yuan Kexin , Cao Huijun , Qiu Zhilang , Guo Guo , Wu Jianwei , Peng Jian
Published: December 2022

S. epidermidis
is one of the most important pathogens of graft-related infection and hospital-acquired infection. The growing problem of antibiotic resistance, as well as the emergence of bacterial pathogenicity, highlights the need for antimicrobials with new modes of action.
Guar Gum Stimulates Biogenic Sulfide Production in Microbial Communities Derived from UK Fractured Shale Production Fluids
Authors: Cliffe Lisa , Hernandez-Becerra Natali , Boothman Christopher , Eden Bob , Lloyd Jonathan R. , Nixon Sophie L.
Published: December 2022

Shale gas exploitation relies on hydraulic fracturing, which often involves a range of chemical additives in the injection fluid. However, relatively little is known about how these additives influence fractured shale microbial communities.
Chest compressions in newborn infants: a scoping review
Authors: Ramachandran Shalini , Bruckner Marlies , Wyckoff Myra H , Schmölzer Georg M
Published: December 2022

Aim

The International Liaison Committee on Resuscitation Neonatal Life Support Task Force undertook a scoping review of the literature to identify evidence relating to neonatal cardiopulmonary resuscitation.

Methods

MEDLINE complete, EMBASE and Cochrane database of Systematic reviews were searched from inception to November 2021. Two authors screened titles and abstracts and full text reviewed. Studies were eligible for inclusion if they were peer-reviewed and assessed one of five aspects of chest compression in the newborn infant including: (1) heart rate thresholds to start chest compressions (CC), (2) compression to ventilation ratio (C:V ratio), (3) CC technique, (4) oxygen use during CC and 5) feedback devices to optimise CC.

Results

Seventy-four studies were included (n=46 simulation, n=24 animal and n=4 clinical studies); 22/74 were related to compression to ventilation ratios, 29/74 examined optimal technique to perform CC, 7/74 examined oxygen delivery and 15/74 described feedback devices during neonatal CC.

Conclusion

There were very few clinical studies and mostly manikin and animal studies. The findings either reinforced or were insufficient to change previous recommendations which included to start CC if heart rate remains <60/min despite adequate ventilation, using a 3:1 C:V ratio, the two-thumb encircling technique and 100% oxygen during CC.
Asymptomatic pulmonary cryptococcosis presenting with mixed lesions of infiltrative and nodular shadow in an immunocompromised patient
Authors: Ito Takanori , Kanai Osamu , Moriyoshi Koki , Fujita Kohei
Published: December 2022

Pulmonary cryptococcosis (PC) is a rare fungal lung infection that usually occurs in immunocompromised hosts. We report a rare case of PC with asymptomatic and mixed lesions of infiltrative and nodular shadows. A woman in her 50s with a 7-year history of methotrexate treatment for rheumatoid arthritis (RA) presented with abnormal chest shadows on annual examination. Chest CT revealed two tiny nodules and two infiltrative shadows in the right lower lobe of the lung. We suspected lung cancer, cryptogenic organising pneumonia or RA-interstitial lung disease. However, transbronchial lung biopsy and positivity for serum cryptococcal antigen confirmed the diagnosis of PC. We initiated treatment with fluconazole, which drastically reduced the chest shadows without any adverse events. Since PC can present with several pulmonary shadows, it should be considered as a differential diagnosis of any pulmonary lesion.
Incidence and prevalence of hamstring injuries in field-based team sports: a systematic review and meta-analysis of 5952 injuries from over 7 million exposure hours
Authors: Maniar Nirav , Carmichael Declan Singleton , Hickey Jack Thomas , Timmins Ryan Gregory , San Jose Argell Joseph , Dickson Jessica , Opar David
Published: December 2022

Objective

This study aimed to systematically review and meta-analyse the incidence and prevalence of hamstring injuries in field-based team sports. A secondary aim was to determine the impact of other potential effect moderators (match vs training; sport; playing surface; cohort age, mass and stature; and year when data was collected) on the incidence of hamstring injury in field-based team sports.

Design

Systematic review and meta-analysis.

Data sources

CINAHL, Cochrane Library, MEDLINE Complete (EBSCO), Embase, Web of Science and SPORTDiscus databases were searched from database inception to 5 August 2020.

Eligibility criteria

Prospective cohort studies that assessed the incidence of hamstring injuries in field-based team sports.

Method

Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria then assessed for methodological quality using the Critical Appraisal Tool for prevalence studies. Meta-analysis was used to pool data across studies, with meta-regression used where possible.

Results

Sixty-three articles were included in the meta-analysis, encompassing 5952 injuries and 7 262 168 hours of exposure across six field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling and Australian football). Hamstring injury incidence was 0.81 per 1000 hours, representing 10% of all injuries. Prevalence for a 9-month period was 13%, increasing 1.13-fold for every additional month of observation (p=0.004). Hamstring injury incidence increased 6.4% for every 1 year of increased average cohort age, was 9.4-fold higher in match compared with training scenarios (p=0.003) and was 1.5-fold higher on grass compared with artificial turf surfaces (p<0.001). Hamstring injury incidence was not significantly moderated by average cohort mass (p=0.542) or stature (p=0.593), was not significantly different between sports (p=0.150) and has not significantly changed over the last 30 years (p=0.269).

Conclusion

Hamstring injury represents 10% of all injuries in field-based team sports, with 13% of the athletes experiencing a hamstring injury over a 9-month period most commonly during matches. More work is needed to reduce the incidence of hamstring injury in field-based team sports.

PROSPERO registration number

CRD42020200022.
Effectiveness of mRNA-1273, BNT162b2, and BBIBP-CorV vaccines against infection and mortality in children in Argentina, during predominance of delta and omicron covid-19 variants: test negative, case-control study
Authors: Castelli Juan Manuel , Rearte Analia , Olszevicki Santiago , Voto Carla , Del Valle Juarez María , Pesce Martina , Iovane Agustina Natalia , Paz Mercedes , Chaparro María Eugenia , Buyayisqui Maria Pia , Markiewicz María Belén , Landoni Mariana , Giovacchini Carlos María , Vizzotti Carla
Published: December 2022

Objective

To estimate the effectiveness of a two dose vaccine schedule (mRNA-1273, BNT162b2, and BBIBP-CorV) against SARS-CoV-2 infection and covid-19 related death and short term waning of immunity in children (3-11 years old) and adolescents (12-17 years old) during periods of delta and omicron variant predominance in Argentina.

Design

Test negative, case-control study.

Setting

Database of the National Surveillance System and the Nominalized Federal Vaccination Registry of Argentina.

Participants

844 460
c
hildren and adolescents without previous SARS-CoV-2 infection eligible to receive primary vaccination schedule who were tested for SARS-CoV-2 by polymerase chain reaction or rapid antigen test from September 2021 to April 2022. After matching with their corresponding controls, 139 321 (60.3%) of 231 181 cases remained for analysis.

Exposures

Two dose mRNA-1273, BNT162b2, and BBIBP-CorV vaccination schedule.

Main outcome measures

SARS-CoV-2 infection and covid-19 related death. Conditional logistic regression was used to estimate the odds of SARS-CoV-2 infection among two dose vaccinated and unvaccinated participants. Vaccine effectiveness was estimated as (1–odds ratio)×100%.

Results

Estimated vaccine effectiveness against SARS-CoV-2 infection was 61.2% (95% confidence interval 56.4% to 65.5%) in children and 66.8% (63.9% to 69.5%) in adolescents during the delta dominant period and 15.9% (13.2% to 18.6%) and 26.0% (23.2% to 28.8%), respectively, when omicron was dominant. Vaccine effectiveness declined over time, especially during the omicron period, from 37.6% (34.2% to 40.8%) at 15-30 days after vaccination to 2.0% (1.8% to 5.6%) after ≥60 days in children and from 55.8% (52.4% to 59.0%) to 12.4% (8.6% to 16.1%) in adolescents.

Vaccine effectiveness against death related to SARS-CoV-2 infection during omicron predominance was 66.9% (6.4% to 89.8%) in children and 97.6% (81.0% to 99.7%) in adolescents.

Conclusions

Vaccine effectiveness in preventing mortality remained high in children and adolescents regardless of the circulating variant. Vaccine effectiveness in preventing SARS-CoV-2 infection in the short term after vaccination was lower during omicron predominance and decreasing sharply over time.

Trial registration

National Registry of Health Research IS003720.
Impact of digital interdisciplinary consultation on secondary care referrals by general practitioners: a protocol for a stepped-wedge cluster randomised controlled trial
Authors: Sanavro Sanne , van der Worp Henk , Jansen Danielle , Stoffelen Joke , Schers Henk , Postma Maarten , Koning Paul , de Boer Michiel , Janus Guus , Blanker Marco H
Published: December 2022

Introduction

Optimal collaboration between general practice and hospital care is crucial to maintain affordable and sustainable access to healthcare for the entire population. General practitioners (GPs) are the gatekeepers to specialist care and patients will visit hospitals mostly only after referral. However, a substantial part of these referrals may be inappropriate, as communication between GPs and medical specialists can be challenging and referring patients may be the most obvious action for a GP to perform.

A new digital platform (Prisma) connects GPs and specialists in interdisciplinary groups and facilitates asynchronous, accessible and fast teleconsultation within the group. No previous research has been done to evaluate the impact of this new platform on the referral rates to the hospital.

Methods and analysis

A stepped-wedge randomised controlled trial (RCT) will be performed in Zwolle region in the Netherlands to analyse the effect of introduction of the platform on rate of inappropriate referrals to orthopaedic surgery. In four steps, GPs in the region will be given access to the platform. GPs will be part of the control condition until randomisation to the intervention. According to our sample size calculation, we need to include 18 practices with 1008 patients presenting with hip and knee symptoms. Routine care data of hospital registrations will be analysed to calculate the rate of inappropriate referrals (primary outcome). Secondary outcome are costs, primary and secondary care workload, posted cases and user satisfaction. Alongside this quantitative analysis, we will evaluate patient experience, facilitators and barriers for use of the platform.

Ethics and dissemination

The medical ethics review board of University Medical Center Groningen (UMCG), the Netherlands (METc-number: 2021/288) has confirmed that the Medical Research Involving Human Subjects Act (WMO) does not apply to the process evaluation because the study does not involve randomisation of patients or different medical treatments (letter number: M21.275351).

Trial registration number

NL9704.
Prevention of young infant infections using oral azithromycin in labour in Fiji (Bulabula MaPei): study protocol of a randomised control trial
Authors: Hume-Nixon Maeve , Ratu Tupou , Clark Stephanie , Nguyen Cattram Duong , Neal Eleanor F G , Pell Casey L , Bright Kathryn , Watts Emma , Hart John , Mulholland Kim , Fong James , Rafai Eric , Sakumeni Kelera , Tuibeqa Ilisapeci , Satzke Catherine , Steer Andrew , Russell Fiona M
Published: December 2022

Introduction

Infections are a leading cause of neonatal mortality globally and can be transmitted from mother-to-child vertically or horizontally. Fiji has higher rates of serious neonatal infections and infant skin and soft tissue infections (SSTIs) than high-income countries. Research from the Gambia found that a single dose of oral azithromycin in labour decreased bacterial carriage and infections in mothers and infants, particularly infant skin infections. The Bulabula MaPei clinical trial evaluates the safety and efficacy of a single dose of azithromycin in labour in reducing the incidence of maternal and infant SSTIs and other infections and the impact on bacterial carriage. It will also describe the effect of azithromycin on antimicrobial (AMR) resistance, the maternal and infant microbiome, and infant dysbiosis.

Methods and analysis

We are conducting a blinded, placebo-controlled randomised clinical trial administering 2 g of oral azithromycin, or placebo, given to healthy, pregnant women (≥18 years) in labour in Suva, Fiji. The primary outcome is the cumulative incidence of SSTIs in infants by 3 months of age. Secondary outcomes include the incidence of other infant and maternal infections, and safety and tolerability of azithromycin in mother and infant. Following informed consent, 2110 pregnant women will be randomised in a 1:1 ratio, with all study staff and participants masked to group allocation. Mother/infant pairs will be followed up for 12 months over six visits collecting clinical data on infections, antimicrobial use, safety and anthropometrics, in addition to nasopharyngeal, oropharyngeal, rectovaginal and vaginal swabs, maternal breastmilk and infant stool samples, in order to compare bacterial carriage, AMR rates and microbiome. Recruitment for Bulabula MaPei started in June 2019.

Ethics and dissemination

This trial was approved and is being conducted according to the protocol approved by The Royal Children’s Hospital Human Research Ethics Committee, Australia, and the Fiji National Health Research and Ethics Review Committee. The findings of this study will be disseminated in peer-reviewed journals and presented at conferences.

Trial registration number

NCT03925480.
Extent and nature of duplication in PROSPERO using COVID-19-related registrations: a retrospective investigation and survey
Authors: Beresford Lucy , Walker Ruth , Stewart Lesley
Published: December 2022

Objectives

During COVID-19, the International Prospective Register of Systematic Reviews (PROSPERO) experienced a surge in registrations for COVID-19-related systematic reviews, and duplication of research questions became apparent. Duplication can waste funding, time and research effort and make policy making more difficult.

This project explored the extent of and reasons for duplication of COVID-19-related systematic review registrations in PROSPERO during the pandemic.

Design

Retrospective analysis of COVID-19-related registrations in PROSPERO, and a qualitative survey.

Setting

PROSPERO was searched for registrations related to four COVID-19 research areas: epidemiology, rehabilitation, transmission and treatments.

Methods

Records identified were compared using Population, Intervention/Exposure, Comparator, Outcome, Study Design (PICOS) elements of PROSPERO registration forms. Registrations with similar or identical PICOS were evaluated further as ‘duplicates’.

Authors of ‘duplicate’ registrations were invited to complete a survey asking whether they searched PROSPERO prior to registration, identified similar reviews and, if so, why they continued with their review.

Results

1054 COVID-19 reviews were registered between March 2020 and January 2021, of which 138 were submitted when at least one similar protocol was already registered in PROSPERO. Duplication was greatest in reviews of COVID-19 treatments; for example, there were 14 similar reviews evaluating the efficacy of hydroxychloroquine.

From 138 authors invited to take part in the survey, we received 41 responses. Most respondents said that they identified similar reviews when they searched PROSPERO prior to registration. Main reasons given for ‘duplication’ were differences in PICOS or planned analyses (n=13), poor quality of previous registrations (n=2) and the need to update evidence (n=3).

Conclusions

This research highlights that registration of similar and duplicate systematic reviews related to COVID-19 in PROSPERO occurred frequently. Awareness of research waste is required, and initial checking for similar reviews should be embedded within good review practice.
Rapamycin and inulin for third-dose vaccine response stimulation (RIVASTIM): Inulin – study protocol for a pilot, multicentre, randomised, double-blinded, controlled trial of dietary inulin to improve SARS-CoV-2 vaccine response in kidney transplant recipients
Authors: Singer Julian , Tunbridge Matthew , Perkins Griffith B , Salehi Tania , Ying Tracey , Wu Huiling , Coates P Toby , Chadban Steven J
Published: December 2022

Introduction

Kidney transplant recipients (KTRs) are at an increased risk of hospitalisation and death from COVID-19. Vaccination against SARS-CoV-2 is our primary risk mitigation strategy, yet vaccine effectiveness in KTRs is suboptimal. Strategies to enhance vaccine efficacy are therefore required. Current evidence supports the role of the gut microbiota in shaping the immune response to vaccination. Gut dysbiosis is common in KTRs and is a potential contributor to impaired COVID-19 vaccine responses. We hypothesise that dietary fibre supplementation will attenuate gut dysbiosis and promote vaccine responsiveness in KTRs.

Methods and analysis

Rapamycin and inulin for third-dose vaccine response stimulation-inulin is a multicentre, randomised, prospective, double-blinded, placebo-controlled pilot trial examining the effect of dietary inulin supplementation prior to a third dose of COVID-19 vaccine in KTRs who have failed to develop protective immunity following a 2-dose COVID-19 vaccine schedule. Participants will be randomised 1:1 to inulin (active) or maltodextrin (placebo control), administered as 20 g/day of powdered supplement dissolved in water, for 4 weeks prior to and following vaccination. The primary outcome is the proportion of participants in each trial arm that achieve in vitro neutralisation of live SARS-CoV-2 virus at 4 weeks following a third dose of COVID-19 vaccine. Secondary outcomes include the safety and tolerability of dietary inulin, the diversity and differential abundance of gut microbiota, and vaccine-specific immune cell populations and responses.

Ethics and dissemination

Ethics approval was obtained from the Central Adelaide Local Health Network (CALHN) Human Research Ethics Committee (HREC) (approval number: 2021/HRE00354) and the Sydney Local Health District (SHLD) HREC (approval numbers: X21-0411 and 2021/STE04280). Results of this trial will be published following peer-review and presented at scientific meetings and congresses.

Trial registration number

ACTRN12621001465842.
Prognostic factors for streptococcal toxic shock syndrome: systematic review and meta-analysis
Authors: Bartoszko Jessica J , Elias Zeyad , Rudziak Paulina , Lo Carson K L , Thabane Lehana , Mertz Dominik , Loeb Mark
Published: December 2022

Objectives

To quantify the prognostic effects of demographic and modifiable factors in streptococcal toxic shock syndrome (STSS).

Design

Systematic review and meta-analysis.

Data sources

MEDLINE, EMBASE and CINAHL from inception to 19 September 2022, along with citations of included studies.

Eligibility criteria

Pairs of reviewers independently screened potentially eligible studies of patients with Group AStreptococcus-induced STSS that quantified the association between at least one prognostic factor and outcome of interest.

Data extraction and synthesis

We performed random-effects meta-analysis after duplicate data extraction and risk of bias assessments. We rated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results

One randomised trial and 40 observational studies were eligible (n=1918 patients). We found a statistically significant association between clindamycin treatment and mortality (n=144; OR 0.14, 95% CI 0.06 to 0.37), but the certainty of evidence was low. Within clindamycin-treated STSS patients, we found a statistically significant association between intravenous Ig treatment and mortality (n=188; OR 0.34, 95% CI 0.15 to 0.75), but the certainty of evidence was also low. The odds of mortality may increase in patients ≥65 years when compared with patients 18–64 years (n=396; OR 2.37, 95% CI 1.47 to 3.84), but the certainty of evidence was low. We are uncertain whether non-steroidal anti-inflammatory drugs increase the odds of mortality (n=50; OR 4.14, 95% CI 1.13 to 15.14; very low certainty). Results failed to show a significant association between any other prognostic factor and outcome combination (very low to low certainty evidence) and no studies quantified the association between a prognostic factor and morbidity post-infection in STSS survivors.

Conclusions

Treatment with clindamycin and within clindamycin-treated patients, IVIG, was each significantly associated with mortality, but the certainty of evidence was low. Future research should focus on morbidity post-infection in STSS survivors.

PROSPERO registration number

CRD42020166961.
Safety and efficacy of acupuncture for varicocele-induced male infertility: a systematic review protocol
Authors: Wang Sijia , Lu Rongchen , Shi Hongshuo , Chen Jiangnan , Sun Miaomiao , Ding Jing , Lv Qiang , Wang Chenyao , Ren Jianjun , Zhou Guangming , Tang Zhian
Published: December 2022

Introduction

Varicocele (VC) is a common clinical disease in andrology. Among a number of ways for VC treatment, surgery is the most common one, but the measurable benefit of surgical repair was slight. A growing exploration of complementary therapies has been conducted in clinical research on acupuncture for VC, but there is no relevant systematic review and meta-analysis to assess the efficacy and safety of acupuncture for VC.

Methods and analysis

All relevant publications published from database inception through August 2022 will be searched in three English-language databases (Embase, CENTRAL, MEDLINE) and four Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese Biomedical Literature Database and Wanfang Data). Randomised controlled trials in English and Chinese concerned with acupuncture for patients with VC will be included. The input clinical data will be processed by the Review Manager software (RevMan). The literature will be appraised with the Cochrane Collaboration risk of bias tool. The Grading of Recommendations Assessment, Development and Evaluation system (GRADE system) will be used to evaluate the quality of evidence.

Ethics and dissemination

This study is a secondary study based on clinical studies so it does not relate to any individual patient information or infringe the rights of participants. Hence no ethical approval is required. The results will be reported in peer-reviewed journals or disseminated at relevant conferences.

PROSPERO registration number

CRD42022316005.
Revisiting systematic geographical variations in tonsils surgery in children in the Spanish National Health System: spatiotemporal ecological study on hospital administrative data
Authors: Castaño-Riera Eusebio , Ridao Manuel , Librero Julian , Martínez-Lizaga Natalia , Comendeiro-Maaløe Micaela , Angulo-Pueyo Ester , Peiro Salvador , Bernal-Delgado Enrique
Published: December 2022

Objective

To provide new evidence on how tonsils surgery in children has geographically varied over time in the context of the Spanish National Health System.

Design

Observational ecological spatiotemporal study on geographical variations in medical practice, using linked administrative datasets, including virtually all surgeries performed from 2003 to 2015.

Setting

The Spanish National Health System, a quasi-federal structure with 17 autonomous communities (ACs), and 203 healthcare areas (HCAs).

Participants

Patients aged 19 and younger residing in the HCAs and ACs.

Interventions

Tonsillectomy with adenoidectomy (T&A); and tonsillectomies alone (T).

Main endpoints

(1) Evolution of T&A and T rates; (2) spatiotemporal variation in the risk of receiving T&A or T surgery at regional level (ACs) and HCAs; and (3) the fraction of the variation (FV) attributed to each of the components of variation—ACs, HCAs, year and interaction ACs year.

Results

T&A age-sex standardised rates increased over the period of analysis from 15.2 to 20.9 (5.7 points per 10 000 inhabitants). T alone remained relatively lower than T&A rates, evolving from 3.6 in 2003 to 3.9 in 2015 (0.3 points per 10 000 inhabitants). Most of the risk variation was captured at the HCAs level in both procedures (FV: 55.3% in T&A and 72.5% in T). The ACs level explained 27.6% of the FV in the risk in T&A versus 8% in T. The interaction ACs year was similar in both procedures (FV: 15.5% in T&A and 17.5% in T). The average trend hardly explained 1.46% and 1.83% of the variation, respectively.

Conclusion

Our study showed wide persistent variations with a steady increase in rates and risk of T&A and a stagnation of T alone, where most of the variation risk was explained at HCA level.
ULTrasound-guided TRAnsfemoral puncture in COmplex Large bORe PCI: study protocol of the UltraCOLOR trial
Authors: Meijers Thomas A , Nap Alexander , Aminian Adel , Dens Joseph , Teeuwen Koen , van Kuijk Jan-Peter , van Wely Marleen , Schmitz Thomas , Bataille Yoann , Kraaijeveld Adriaan O , Roolvink Vincent , Hermanides Renicus S , Braber Thijs L , van Royen Niels , van Leeuwen Maarten A H
Published: December 2022

Introduction

Although recently published evidence favours transradial access (TRA) when using large-bore guiding catheters for percutaneous coronary intervention (PCI) of complex coronary lesions, the femoral artery will still be used in a considerate proportion of patients undergoing complex PCI, especially in PCI of chronic total occlusions (CTO). Ultrasound-guided puncture of the femoral artery may reduce clinically relevant access site complications, but robust evidence is lacking up to date.

Methods and analysis

A total of 542 patients undergoing complex PCI, defined as PCI of CTO, complex bifurcation, heavy calcified lesion or left main, in which the 7-F or 8-F transfemoral access is required, will be randomised to ultrasound-guided puncture or fluoroscopy-guided puncture. The primary outcome is the incidence of the composite end-point of clinically relevant access site related bleeding and/or vascular complications requiring intervention. Access site complications and major adverse cardiovascular events up to 1 month will also be compared between both groups.

Ethics and dissemination

Ethical approval for the study was granted by the local Ethics Committee (‘Medisch Ethische Toetsing Commissie Isala Zwolle’) for all Dutch sites, ‘Comité Medische Ethiek Ziekenhuis Oost-Limburg’ for Hospital Oost-Limburg, ‘Comité d’éthique CHU-Charleroi—ISPPC’ for Centre Hospilatier Universitaire de Charleroi and ‘Ethik Kommission de Ärztekammer Nordrhein’ for Elisabeth-Krankenhaus). The trial outcomes will be published in peer-reviewed journals of the concerned literature. Theultrasound guidedtransfemoral access incomplexlarge bore PCI trial has been administered in the ClinicalTrials.gov database, reference number:NCT03846752.

Registration details

ClinicalTrials.gov identifier:NCT03846752.