bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning Tools for Flow-Related Defects Detection in Friction Stir Welding
Authors: Ambrosio Danilo , Wagner Vincent , Dessein Gilles , Vivas Javier , Cahuc Olivier
Published: May 2023

Flow-related defects in friction stir welding are critical for the joints affecting their mechanical properties and functionality. One way to identify them, avoiding long and sometimes expensive destructive and nondestructive testing, is using machine learning tools with monitored physical quantities as input data. In this work, artificial neural network and decision tree models are trained, validated, and tested on a large dataset consisting of forces, torque, and temperature in the stirred zone measured when friction stir welding three aluminum alloys such as 5083-H111, 6082-T6, and 7075-T6. The built models successfully classified welds between sound and defective with accuracies over 95%, proving their usefulness in identifying defects on new datasets. Independently from the models, the temperature in the stirred zone is found to be the most influential parameter for the assessment of friction stir weld quality.
HYPAD-UQ: A Derivative-Based Uncertainty Quantification Method Using a Hypercomplex Finite Element Method
Authors: Balcer Matthew , Aristizabal Mauricio , Rincon-Tabares Juan-Sebastian , Montoya Arturo , Restrepo David , Millwater Harry
Published: May 2023

A derivative-based uncertainty quantification (UQ) method called HYPAD-UQ that utilizes sensitivities from a computational model was developed to approximate the statistical moments and Sobol' indices of the model output. Hypercomplex automatic differentiation (HYPAD) was used as a means to obtain accurate high-order partial derivatives from computational models such as finite element analyses. These sensitivities are used to construct a surrogate model of the output using a Taylor series expansion and subsequently used to estimate statistical moments (mean, variance, skewness, and kurtosis) and Sobol' indices using algebraic expansions. The uncertainty in a transient linear heat transfer analysis was quantified with HYPAD-UQ using first-order through seventh-order partial derivatives with respect to seven random variables encompassing material properties, geometry, and boundary conditions. Random sampling of the analytical solution and the regression-based stochastic perturbation finite element method were also conducted to compare accuracy and computational cost. The results indicate that HYPAD-UQ has superior accuracy for the same computational effort compared to the regression-based stochastic perturbation finite element method. Sensitivities calculated with HYPAD can allow higher-order Taylor series expansions to be an effective and practical UQ method.
Wigner–Smith time delay matrix for acoustic scattering: Theory and phenomenology
Authors: Patel Utkarsh R. , Mao Yiqian , Michielssen Eric
Published: May 2023

The Wigner–Smith (WS) time delay matrix relates a lossless system's scattering matrix to its frequency derivative. First proposed in the realm of quantum mechanics to characterize time delays experienced by particles during a collision, this article extends the use of WS time delay techniques to acoustic scattering problems governed by the Helmholtz equation. Expression for the entries of the WS time delay matrix involving renormalized volume integrals of energy densities are derived, and shown to hold true, independent of the scatterer's geometry, boundary condition (sound-soft or sound-hard), and excitation. Numerical examples show that the eigenmodes of the WS time delay matrix describe distinct scattering phenomena characterized by well-defined time delays.
Suprathreshold auditory processes in listeners with normal audiograms but extended high-frequency hearing loss
Authors: Mishra Srikanta K. , Fu Qian-jie , Galvin John J. , Galindo Andrea
Published: May 2023

Hearing loss in the extended high-frequency (EHF) range (>8 kHz) is widespread among young normal-hearing adults and could have perceptual consequences such as difficulty understanding speech in noise. However, it is unclear how EHF hearing loss might affect basic psychoacoustic processes. The hypothesis that EHF hearing loss is associated with poorer auditory resolution in the standard frequencies was tested. Temporal resolution was characterized by amplitude modulation detection thresholds (AMDTs), and spectral resolution was characterized by frequency change detection thresholds (FCDTs). AMDTs and FCDTs were measured in adults with or without EHF loss but with normal clinical audiograms. AMDTs were measured with 0.5- and 4-kHz carrier frequencies; similarly, FCDTs were measured for 0.5- and 4-kHz base frequencies. AMDTs were significantly higher with the 4 kHz than the 0.5 kHz carrier, but there was no significant effect of EHF loss. There was no significant effect of EHF loss on FCDTs at 0.5 kHz; however, FCDTs were significantly higher at 4 kHz for listeners with than without EHF loss. This suggests that some aspects of auditory resolution in the standard audiometric frequency range may be compromised in listeners with EHF hearing loss despite having a normal audiogram.
An atlas of regulatory elements in chicken: A resource for chicken genetics and genomics
Authors: Pan Zhangyuan , Wang Ying , Wang Mingshan , Wang Yuzhe , Zhu Xiaoning , Gu Shenwen , Zhong Conghao , An Liqi , Shan Mingzhu , Damas Joana , Halstead Michelle M. , Guan Dailu , Trakooljul Nares , Wimmers Klaus , Bi Ye , Wu Shang , Delany Mary E. , Bai Xuechen , Cheng Hans H. , Sun Congjiao , Yang Ning , Hu Xiaoxiang , Lewin Harris A. , Fang Lingzhao , Zhou Huaijun
Published: May 2023

A comprehensive characterization of regulatory elements in the chicken genome across tissues will have substantial impacts on both fundamental and applied research. Here, we systematically identified and characterized regulatory elements in the chicken genome by integrating 377 genome-wide sequencing datasets from 23 adult tissues. In total, we annotated 1.57 million regulatory elements, representing 15 distinct chromatin states, and predicted about 1.2 million enhancer-gene pairs and 7662 super-enhancers. This functional annotation of the chicken genome should have wide utility on identifying regulatory elements accounting for gene regulation underlying domestication, selection, and complex trait regulation, which we explored. In short, this comprehensive atlas of regulatory elements provides the scientific community with a valuable resource for chicken genetics and genomics.
Hominin fossils from Kromdraai and Drimolen inform
Paranthropus robustus
craniofacial ontogeny
Authors: Braga José , Wood Bernard A. , Zimmer Veronika A. , Moreno Benjamin , Miller Catherine , Thackeray John F. , Zipfel Bernhard , Grine Frederick E.
Published: May 2023

Ontogeny provides critical information about the evolutionary history of early hominin adult morphology. We describe fossils from the southern African sites of Kromdraai and Drimolen that provide insights into early craniofacial development in the Pleistocene robust australopith
Paranthropus robustus
. We show that while most distinctive robust craniofacial features appear relatively late in ontogeny, a few do not. We also find unexpected evidence of independence in the growth of the premaxillary and maxillary regions. Differential growth results in a proportionately larger and more postero-inferiorly rotated cerebral fossa in
P. robustus
infants than in the developmentally older
Australopithecus africanus
juvenile from Taung. The accumulated evidence from these fossils suggests that the iconic SK 54 juvenile calvaria is more likely early
Homo
than
Paranthropus.
It is also consistent with the hypothesis that
P. robustus
is more closely related to
Homo
than to
A. africanus
.
γδ-Enriched CAR-T cell therapy for bone metastatic castrate-resistant prostate cancer
Authors: Frieling Jeremy S. , Tordesillas Leticia , Bustos Xiomar E. , Ramello Maria Cecilia , Bishop Ryan T. , Cianne Junior E. , Snedal Sebastian A. , Li Tao , Lo Chen Hao , de la Iglesia Janis , Roselli Emiliano , Benzaïd Ismahène , Wang Xuefeng , Kim Youngchul , Lynch Conor C. , Abate-Daga Daniel
Published: May 2023

Immune checkpoint blockade has been largely unsuccessful for the treatment of bone metastatic castrate-resistant prostate cancer (mCRPC). Here, we report a combinatorial strategy to treat mCRPC using γδ-enriched chimeric antigen receptor (CAR) T cells and zoledronate (ZOL). In a preclinical murine model of bone mCRPC, γδ CAR-T cells targeting prostate stem cell antigen (PSCA) induced a rapid and significant regression of established tumors, combined with increased survival and reduced cancer-associated bone disease. Pretreatment with ZOL, a U.S. Food and Drug Administration–approved bisphosphonate prescribed to mitigate pathological fracture in mCRPC patients, resulted in CAR-independent activation of γδ CAR-T cells, increased cytokine secretion, and enhanced antitumor efficacy. These data show that the activity of the endogenous Vγ9Vδ2 T cell receptor is preserved in CAR-T cells, allowing for dual-receptor recognition of tumor cells. Collectively, our findings support the use of γδ CAR-T cell therapy for mCRPC treatment.
Genomic evidence for homoploid hybrid speciation in a marine mammal apex predator
Authors: Lopes Fernando , Oliveira Larissa R. , Beux Yago , Kessler Amanda , Cárdenas-Alayza Susana , Majluf Patricia , Páez-Rosas Diego , Chaves Jaime , Crespo Enrique , Brownell Robert L. , Baylis Alastair M. M. , Sepúlveda Maritza , Franco-Trecu Valentina , Loch Carolina , Robertson Bruce C. , Peart Claire R. , Wolf Jochen B. W. , Bonatto Sandro L.
Published: May 2023

Hybridization is widespread and constitutes an important source of genetic variability and evolution. In animals, its role in generating novel and independent lineages (hybrid speciation) has been strongly debated, with only a few cases supported by genomic data. The South American fur seal (SAfs)
Arctocephalus australis
is a marine apex predator of Pacific and Atlantic waters, with a disjunct set of populations in Peru and Northern Chile [Peruvian fur seal (Pfs)] with controversial taxonomic status. We demonstrate, using complete genome and reduced representation sequencing, that the Pfs is a genetically distinct species with an admixed genome that originated from hybridization between the SAfs and the Galapagos fur seal (
Arctocephalus galapagoensis
) ~400,000 years ago. Our results strongly support the origin of Pfs by homoploid hybrid speciation over alternative introgression scenarios. This study highlights the role of hybridization in promoting species-level biodiversity in large vertebrates.
Write a Researcher: a Pen Pal Outreach Program for Middle and High School Students
Authors: Steingard Caroline H. , Wollmuth Emily M. , Murtha Andrew N. , Correa Alberto
Published: May 2023

The decision to pursue a science, technology, engineering, and/or math (STEM) career is often made in middle and high school, yet many students do not have access to resources or opportunities to navigate this career path. Without guidance, obtaining a job in STEM may seem like a daunting or impossible task.
Complete Genome Sequence of Bacillus licheniformis Strain GN02, Isolated from the Root Surface of Brassica chinensis
Authors: He Yan , Xu Jinzhi , Qin Lijun , Yang Xingyong
Published: May 2023

Bacillus licheniformis
GN02 was isolated from the root surface of Pak Choi Cabbage (
Brassica chinensis
). Here, we report the whole-genome sequence of strain GN02, which includes only a circular chromosome (4,252,022 bp; GC content, 46.08%).
Complete Genome Sequence of a Bovine Coronavirus Isolated from a Goat in Pennsylvania, USA
Authors: Chothe Shubhada K. , Byukusenge Maurice , Sekhwal Manoj K. , Li Lingling , LaBella Lindsey Cecelia , Jakka Padmaja , Palchak Kay , Barry Rhiannon , Yon Michele , Nissly Ruth H. , Kelly Kathleen M. , Jayarao Bhushan M. , Surendran Nair Meera , Kuchipudi Suresh V.
Published: May 2023

We report a complete genome sequence of bovine coronavirus (BCoV) isolated from a goat in the state of Pennsylvania in 2022. BCoV often causes calf scours and winter dysentery in cattle.
Whole-Genome Sequence of Mucilaginibacter jinjuensis Strain KACC 16571
T
Authors: Choi Hyorim , Kim Seunghwan , Kim Yiseul , Lee Daseul , Han Byeong-Hak , Hong Seung-Beom , Kwon Soon-Wo , Lee Yong Hoon , Heo Jun
Published: May 2023

We report the whole-genome sequence of
Mucilaginibacter jinjuensis
type strain KACC 16571, which was isolated from rotten wood in South Korea. The genome of
Mucilaginibacter jinjuensis
KACC 16571
T
consists of a 6.16-Mb circular chromosome, with a G+C content of 42.1% and 5,262 total predicted coding genes.
Drivers of stability and transience in composition-functioning links during serial propagation of litter-decomposing microbial communities
Authors: Moore Eric R. , Suazo Dennis , Babilonia Joany , Montoya Kyana N. , Gallegos-Graves La Verne , Sevanto Sanna , Dunbar John , Albright Michaeline B. N.
Published: May 2023

Biotic factors that influence the temporal stability of microbial community functioning are an emerging research focus for the control of natural and engineered systems. The discovery of common features within community ensembles that differ in functional stability over time is a starting point to explore biotic factors. We serially propagated a suite of soil microbial communities through five generations of 28-day microcosm incubations to examine microbial community compositional and functional stability during plant litter decomposition. Using dissolved organic carbon (DOC) abundance as a target function, we hypothesized that microbial diversity, compositional stability, and associated changes in interactions would explain the
relative
stability of the ecosystem function between generations. Communities with initially high DOC abundance tended to converge towards a “low DOC” phenotype within two generations, but across all microcosms, functional stability between generations was highly variable. By splitting communities into two cohorts based on their relative DOC functional stability, we found that compositional shifts, diversity, and interaction network complexity were associated with the stability of DOC abundance between generations. Further, our results showed that legacy effects were important in determining compositional and functional outcomes, and we identified taxa associated with high DOC abundance. In the context of litter decomposition, achieving functionally stable communities is required to utilize soil microbiomes to increase DOC abundance and long-term terrestrial DOC sequestration as one solution to reduce atmospheric carbon dioxide concentrations. Identifying factors that stabilize function for a community of interest may improve the success of microbiome engineering applications.

IMPORTANCE

Microbial community functioning can be highly dynamic over time. Identifying and understanding biotic factors that control functional stability is of significant interest for natural and engineered communities alike. Using plant litter–decomposing communities as a model system, this study examined the stability of ecosystem function over time following repeated community transfers. By identifying microbial community features that are associated with stable ecosystem functions, microbial communities can be manipulated in ways that promote the consistency and reliability of the desired function, improving outcomes and increasing the utility of microorganisms.
Supplemental Material: Breaking plates: Creation of the East Anatolian fault, the Anatolian plate, and a tectonic escape system
Authors: Whitney Donna L , al. et
Published: May 2023

S1: Description of thermochronology methods and associated references. Tables S2–S5. S6-8: Maximum Mode thermal history. S6-9: Summary of graphical QTQt inverse thermal modeling plots. Figures S6–S10.  
Study design and baseline profile for adults with type 2 diabetes in the once-weekly subcutaneous SEmaglutide randomized PRAgmatic (SEPRA) trial
Authors: Buse John B , Nordahl Christensen Helene , Harty Brian J , Mitchell Julie , Soule Benjamin P , Zacherle Emily , Cziraky Mark , Willey Vincent J
Published: May 2023

Introduction

Once-weekly subcutaneous semaglutide, a glucagon-like peptide-1 analog, is approved in the USA as an adjunct to diet and exercise for adults with inadequately controlled type 2 diabetes (T2D) to improve glycemic control and reduce the risk of major adverse cardiovascular events in people with T2D and established cardiovascular disease. The Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN) phase III clinical trial program demonstrated the efficacy and safety of once-weekly subcutaneous semaglutide; however, determining its effectiveness in a real-world setting could support decision-making by clinicians, payers and policy makers in routine clinical practice.

Research design and methods

SEmaglutide PRAgmatic (SEPRA) is an ongoing open-label, randomized, pragmatic clinical trial designed to compare the effects of once-weekly subcutaneous semaglutide versus standard of care in US health-insured adults with T2D and physician-determined inadequate glycemic control. The primary end point is the proportion of participants achieving glycated hemoglobin (HbA1c) <7.0% at year 1; other key outcomes include glycemic control, weight loss, healthcare utilization, and patient-reported outcomes. Individual-level data will be collected from routine clinical practice and health insurance claims. The last patient last visit is expected by June 2023.

Results

Between July 2018 and March 2021, 1278 participants were enrolled from 138 study sites across the USA. At baseline, 54% were male with mean±SD age 57.4±11.1 years and body mass index 35.7±8.0 kg/m2. Mean diabetes duration was 7.4±6.0 years and mean HbA1c was 8.5±1.6%. At baseline, concomitant antidiabetes medications included metformin, sulfonylureas, sodium-glucose co-transporter-2 inhibitors, and dipeptidyl peptidase-4 inhibitors. The majority of participants had hypertension and dyslipidemia. The trial design was self-assessed using the PRagmatic Explanatory Continuum Indicator Summary-2 tool by the study steering group and was scored 4–5 in all domains suggesting a highly pragmatic study.

Conclusions

SEPRA, a highly pragmatic ongoing study, will provide data on the effects of once-weekly subcutaneous semaglutide in a real-world setting when used during routine management of T2D.

Trial registration number

NCT03596450.

Trial registration number
Factors that influence the uptake of postnatal care from the perspective of fathers, partners and other family members: a qualitative evidence synthesis
Authors: Finlayson Kenneth , Sacks Emma , Brizuela Vanessa , Crossland Nicola , Cordey Sarah , Ziegler Daniela , Langlois Etienne V , Javadi Dena , Comrie-Thomson Liz , Downe Soo , Bonet Mercedes
Published: May 2023

Background

Postnatal care (PNC) is a key component of maternity provision and presents opportunities for healthcare providers to optimise the health and well-being of women and newborns. However, PNC is often undervalued by parents, family members and healthcare providers. As part of a larger qualitative review exploring the factors that influence PNC uptake by relevant stakeholders, we examined a subset of studies highlighting the views of fathers, partners and family members of postpartum women.

Methods

We undertook a qualitative evidence synthesis using a framework synthesis approach. We searched multiple databases and included studies with extractable qualitative data focusing on PNC utilisation. We identified and labelled a subset of articles reflecting the views of fathers, partners and other family members. Data abstraction and quality assessment were carried out using a bespoke data extraction form and established quality assessment tools. The framework was developeda prioribased on previous research on the topic and adapted accordingly. Findings were assessed for confidence using the GRADE-CERQual approach and are presented by country income group.

Results

Of 12 678 papers identified from the original search, 109 were tagged as ‘family members views’ and, of these, 30 were eligible for this review. Twenty-nine incorporated fathers’ views, 7 included the views of grandmothers or mothers-in-law, 4 incorporated other family member views and 1 included comothers. Four themes emerged: access and availability; adapting to fatherhood; sociocultural influences and experiences of care. These findings highlight the significant role played by fathers and family members on the uptake of PNC by women as well as the distinct concerns and needs of fathers during the early postnatal period.

Conclusion

To optimise access to postnatal care, health providers should adopt a more inclusive approach incorporating flexible contact opportunities, the availability of more ‘family-friendly’ information and access to psychosocial support services for both parents.
Frontiers of household water insecurity metrics: severity, adaptation and resilience
Authors: Stoler Justin , Jepson Wendy E , Brewis Alexandra , Wutich Amber
Published: May 2023

The measurement of household-level and individual-level water insecurity has accelerated over the past 5 years through innovation and dissemination of new survey-based experiential psychometric scales modelled after food insecurity scales. These measures offer needed insight into the relative frequency of various dimensions of water problems experienced by households or individuals. But they currently tell us nothing about the severity of these experiences, mitigating behaviours (ie, adaptation) or the effectiveness of water-related behaviours (ie, resilience). Given the magnitude of the global challenge to provide water security for all, we propose a low-cost, theoretically grounded modification to common water insecurity metrics in order to capture information about severity, adaptation and resilience. We also discuss ongoing challenges in cost-effective measurement related to multidimensionality, water affordability and perception of water quality for maximising the impact and sustainability of water supply interventions. The next generation of water insecurity metrics promises better monitoring and evaluation tools—particularly in the context of rapid global environmental change—once scale reliability across diverse contexts is better characterised.
Descriptive assessment of COVID-19 responses and lessons learnt in Cambodia, January 2020 to June 2022
Authors: Chhim Srean , Ku Grace , Mao Sovathiro , Put Willem Van De , Van Damme Wim , Ir Por , Chhea Chhorvann , Or Vandine
Published: May 2023

As a member state of the International Health Regulations 2005, Cambodia is continuously strengthening its capacity to respond to health emergencies and prevent the international spread of diseases. Despite this, Cambodia’s capacity to prevent, detect and rapidly respond to public health threats remained limited at the onset of the pandemic, as was the case in most countries. This paper describes epidemiological phases, response phases, strategy and lessons learnt in Cambodia between 27 January 2020 and 30 June 2022. We classified epidemiological phases in Cambodia into three phases, in which Cambodia responded using eight measures: (1) detect, isolate/quarantine; (2) face coverings, hand hygiene and physical distancing measures; (3) risk communication and community engagement; (4) school closures; (5) border closures; (6) public event and gathering cancellation; (7) vaccination; and (8) lockdown. The measures corresponded to six strategies: (1) setting up and managing a new response system, (2) containing the spread with early response, (3) strengthening the identification of cases and contacts, (4) strengthening care for patients with COVID-19, (5) boosting vaccination coverage and (6) supporting disadvantaged groups. Thirteen lessons were learnt for future health emergency responses. Findings suggest that Cambodia successfully contained the spread of SARS-CoV-2 in the first year and quickly attained high vaccine coverage by the second year of the response. The core of this success was the strong political will and high level of cooperation from the public. However, Cambodia needs to further improve its infrastructure for quarantining and isolating cases and close contacts and laboratory capacity for future health emergencies.
Antidepressant Advisor (ADeSS): a decision support system for antidepressant treatment for depression in UK primary care – a feasibility study
Authors: Harrison Phillippa , Carr Ewan , Goldsmith Kimberley , Young Allan , Ashworth Mark , Fennema Diede , Duan Suqian , Barrett Barbara M , Zahn Roland
Published: May 2023

Objectives

To develop and probe the first computerised decision-support tool to provide antidepressant treatment guidance to general practitioners (GPs) in UK primary care.

Design

A parallel group, cluster-randomised controlled feasibility trial, where individual participants were blind to treatment allocation.

Setting

South London NHS GP practices.

Participants

Ten practices and eighteen patients with treatment-resistant current major depressive disorder.

Interventions

Practices were randomised to two treatment arms: (a) treatment-as-usual, (b) computerised decision support tool.

Results

Ten GP practices participated in the trial, which was within our target range (8–20). However, practice and patient recruitment were slower than anticipated and only 18 of 86 intended patients were recruited. This was due to fewer than expected patients being eligible for the study, as well as disruption resulting from the COVID-19 pandemic. Only one patient was lost to follow-up. There were no serious or medically important adverse events during the trial. GPs in the decision tool arm indicated moderate support for the tool. A minority of patients fully engaged with the mobile app-based tracking of symptoms, medication adherence and side effects.

Conclusions

Overall, feasibility was not shown in the current study and the following modifications would be needed to attempt to overcome the limitations found: (a) inclusion of patients who have only tried one Selective Serotonin Reuptake Inhibitor, rather than two, to improve recruitment and pragmatic relevance of the study; (b) approaching community pharmacists to implement tool recommendations rather than GPs; (c) further funding to directly interface between the decision support tool and self-reported symptom app; (d) increasing the geographic reach by not requiring detailed diagnostic assessments and replacing this with supported remote self-report.

Trial registration number

NCT03628027.
Institutional delivery and postnatal care utilisation among reproductive-aged women who had completed four or more antenatal care visits in Myanmar: a secondary analysis of 2015–2016 Demographic and Health Survey
Authors: Oo Htun Yadanar , Tun Thandar , Khaing Cho Thet , Mya Kyaw Swa
Published: May 2023

Objectives

To examine the prevalence of institutional delivery and postnatal care after home delivery and to identify their determinants in Myanmar mothers who received at least four antenatal care visits.

Design

The study used the Myanmar Demographic and Health Survey data (2015–2016), a nationally representative cross-sectional study.

Participants

The study included women aged 15–49 years who had at least one birth within the 5 years preceding the survey and completed four or more antenatal visits.

Outcome measures

Institutional delivery and postnatal care after home delivery were used as outcomes. We used two separate samples, that is, 2099 women for institutional delivery and 380 mothers whose most recent birth was within 2 years before the survey and delivered at home for postnatal care utilisation. We used multivariable binary logistic regression analyses.

Setting

Fourteen states/regions and Nay Pyi Taw Union Territory in Myanmar.

Results

The prevalence of institutional delivery was 54.7% (95% CI: 51.2%, 58.2%) and postnatal care utilisation was 76% (95% CI: 70.2%, 80.9%). Women who lived in urban areas, women who had higher education, women who had higher wealth status, women who had educated husbands and women having their first childbirth were more likely to have institutional delivery than their counterparts. The institutional delivery was lower among women who live in rural areas, poor women and women with husbands who worked in agriculture than their counterparts. Postnatal care utilisation was significantly higher among women living in central plains and coastal regions, women who received all seven components of antenatal care and women who had skilled assistance at birth than their counterparts.

Conclusions

Policymakers should address the identified determinants to improve the service continuum and reduce maternal mortality in Myanmar.
Protocol and statistical analysis plan for the Antibiotic Choice On ReNal outcomes (ACORN) randomised clinical trial
Authors: Qian Edward Tang , Casey Jonathan D , Wright Adam , Wang Li , Siemann Justin , Dear Mary Lynn , Stollings Joanna , Lloyd Bradley Daniel , Seitz Kevin , Nelson George , Wright Patty , Siew Edward D , Dennis Bradley , Wrenn Jesse , Andereck Jonathan , Self Wesley H , Semler Matthew W , Rice Todd W
Published: May 2023

Introduction

Antibiotics are time-critical in the management of sepsis. When infectious organisms are unknown, patients are treated with empiric antibiotics to include coverage for gram-negative organisms, such as antipseudomonal cephalosporins and penicillins. However, in observational studies, some antipseudomonal cephalosporins (eg, cefepime) are associated with neurologic dysfunction while the most common antipseudomonal penicillin (piperacillin–tazobactam) is associated with acute kidney injury (AKI). No randomised control trials have compared these regimens. This manuscript describes the protocol and analysis plan for a trial designed to compare the effects of antipseudomonal cephalosporins and antipseudomonal penicillins among acutely ill patients receiving empiric antibiotics.

Methods and analysis

The Antibiotic Choice On ReNal outcomes trial is a prospective, single-centre, non-blinded randomised trial being conducted at Vanderbilt University Medical Center. The trial will enrol 2500 acutely ill adults receiving gram-negative coverage for treatment of infection. Eligible patients are randomised 1:1 to receive cefepime or piperacillin–tazobactam on first order entry of a broad-spectrum antibiotic covering gram-negative organisms. The primary outcome is the highest stage of AKI and death occurring between enrolment and 14 days after enrolment. This will be compared between patients randomised to cefepime and randomised to piperacillin–tazobactam using an unadjusted proportional odds regression model. The secondary outcomes are major adverse kidney events through day 14 and number of days alive and free of delirium and coma in 14 days after enrolment. Enrolment began on 10 November 2021 and is expected to be completed in December 2022.

Ethics and dissemination

The trial was approved by the Vanderbilt University Medical Center institutional review board (IRB#210591) with a waiver of informed consent. Results will be submitted to a peer-reviewed journal and presented at scientific conferences.

Trial registration number

NCT05094154.
Piloting an online telecoaching community-based exercise intervention with adults living with HIV: protocol for a mixed-methods implementation science study
Authors: O'Brien Kelly K , Ibáñez-Carrasco Francisco , Carusone Soo Chan , Bayoumi Ahmed M , Tang Ada , McDuff Kiera , Jiancaro Tizneem , Da Silva George , Torres Brittany , Loutfy Mona R , Islam Shaz , Lindsay Joanne , Price Colleen , Zobeiry Mehdi , Pandovski Zoran , Illic Ivan , Ahluwalia Puja , Brown Darren A , Avery Lisa , Solomon Patricia
Published: May 2023

Introduction

Our aim is to evaluate the implementation of an online telecoaching community-based exercise (CBE) intervention with the goal of reducing disability and enhancing physical activity and health among adults living with HIV.

Methods and analysis

We will conduct a prospective longitudinal mixed-methods two-phased intervention study to pilot the implementation of an online CBE intervention with ~30 adults (≥18 years) living with HIV who consider themselves safe to participate in exercise. In the intervention phase (0–6 months), participants will take part in an online CBE intervention involving thrice weekly exercise (aerobic, resistance, balance and flexibility), with supervised biweekly personal training sessions with a fitness instructor, YMCA membership providing access to online exercise classes, wireless physical activity monitor to track physical activity and monthly online educational sessions on topics related to HIV, physical activity and health. In the follow-up phase (6–12 months), participants will be encouraged to continue independent exercise thrice weekly. Quantitative assessment: Bimonthly, we will assess cardiopulmonary fitness, strength, weight, body composition and flexibility, followed by administering self-reported questionnaires to assess disability, contextual factor outcomes (mastery, engagement in care, stigma, social support), implementation factors (cost, feasibility, technology), health status and self-reported physical activity. We will conduct a segmented regression analyses to describe the change in level and trend between the intervention and follow-up phases. Qualitative assessment: We will conduct online interviews with a subsample of ~10 participants and 5 CBE stakeholders at baseline (month 0), postintervention (month 6) and end of follow-up (month 12) to explore experiences, impact and implementation factors for online CBE. Interviews will be audiorecorded and analysed using content analytical techniques.

Ethics and dissemination

Protocol approved by the University of Toronto Research Ethics Board (Protocol # 40410). Knowledge translation will occur in the form of presentations and publications in open-access peer-reviewed journals.

Trial registration number

NCT05006391.
Non-invasive high-frequency oscillatory ventilation versus nasal continuous positive airway pressure in extremely preterm infants with respiratory distress syndrome: study protocol for a multicentre randomised controlled, superiority trial
Authors: Li Yang , Zhu Xingwang , Shi Yuan
Published: May 2023

Introduction

Tracheal intubation and invasive mechanical ventilation (IMV) significantly decreased mortality of respiratory distress syndrome (RDS) in extremely preterm infants (28 weeks’ gestational age) whereas bronchopulmonary dysplasia increased. Thus, consensus guidelines recommend the use of non-invasive ventilation (NIV), as the preferred first-line approach for these infants. This trial aims to compare the effect of nasal continuous positive airway pressure (NCPAP) and non-invasive high-frequency oscillatory ventilation (NHFOV) as the primary respiratory support in extremely preterm infants with RDS.

Methods and analysis

We designed a multicentre, randomised, controlled, superiority trial investigating the effect of NCPAP and NHFOV as the primary respiratory support in extremely preterm infants with RDS in neonatal intensive units in China. At least 340 extremely preterm infants with RDS will be randomised to NHFOV or NCPAP as a primary mode of NIV. The primary outcomes will be the respiratory support failure determined by the need for IMV within 72 hours from birth.

Ethics and dissemination

Our protocol has been approved by the Ethics Committee of Children’s Hospital of Chongqing Medical University. We will present our findings at national conferences and peer-reviewed paediatrics journals.

Trial registration number

NCT05141435.
Psychological treatments for the mental health symptoms among individuals infected with COVID-19: a scoping review protocol
Authors: Sugita So , Hata Kotone , Takamatsu Naoki , Kimura Kentaro , Gonzalez Lecsy , Kodaiarasu Krandhasi , Miller Christian , Umemoto Ikue , Murayama Keitaro , Nakao Tomohiro , Kito Shinsuke , Ito Masaya , Kuga Hironori
Published: May 2023

Introduction

Mental health symptoms such as depression, anxiety and sleep problems are commonly observed in individuals suffering from acute COVID-19 infection to post-COVID-19 syndrome. Studies have provided preliminary evidence for the efficacies of cognitive behavioural therapy, mindfulness-based interventions, acceptance and commitment therapy, and many other treatments for this population. Although there have been attempts to synthesise the literature on these psychological interventions, previous reviews have been limited in terms of the sources, symptoms and interventions that they included. Furthermore, most studies reviewed were conducted in early 2020, when COVID-19 had only recently been classified as a global pandemic. Since then, substantial research has been conducted. As such, we sought to provide an updated synthesis of the available evidence of treatments for the range of mental health symptoms associated with COVID-19.

Methods and analysis

This scoping review protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Systematic searches were carried out on scientific databases (PubMed, Web of Science, PsycINFO and Scopus) and clinical trial registries (ClinicalTrials.gov, WHO ICTRP, EU Clinical Trials Register and Cochrane Central Register of Controlled Trials) to identify studies that have or will assess the efficacy or any aspects of psychological treatment for acute to post-COVID-19 syndrome. The search was conducted on 14 October 2022 and identified 17 855 potentially eligible sources/studies published since 1 January 2020 (duplicates removed). Six investigators will independently carry out titles and abstract screening, full-text screening and data charting and the results will be summarised using descriptive statistics and narrative synthesis.

Ethics and dissemination

Ethical approval is not required for this review. The results will be disseminated through a peer-reviewed journal, conference presentations and/or academic newspapers. This scoping review has been registered with Open Science Framework (https://osf.io/wvr5t).
Analysis of the determinants of sleep quality in a Spanish population: a study protocol for a cross-sectional study
Authors: Jiménez-Vaquero César , Alonso-Dominguez Rosario , Garcia-Yu Irene A , Martín-Nogueras Ana M , Sánchez-Aguadero Natalia , Crespo-Sedano Andrea , Rihuete-Galve María I , García-Alonso María A , García-Prieto María L , González-Sánchez Jesús , Recio José-Ignacio
Published: May 2023

Introduction

Sleep problems are a growing public health concern being related, among others, to an increased risk of cardiovascular diseases or worse cognitive functioning. In addition, they can affect aspects related to personal motivation and quality of life. However, very few studies have analysed the possible determinants of sleep quality in the adult population as a whole, establishing patterns based on these determinants.

The objectives are to evaluate the determinants of sleep quality in a representative sample of the general adult population between 25 and 65 years old, and to establish patterns of sleep quality based on lifestyles, psychological factors, morbidities, sociodemographic variables, biological markers and other possible determinants.

Methods and analysis

Descriptive observational cross-sectional study. The study population will include a representative sample of 500 people between 25 and 65 years old from the cities of Salamanca and Ávila (Spain) selected by random sampling stratified by age groups and sex. A 90-minute visit will be performed, during which sleep quality will be assessed. The variables collected will be: morbidity, lifestyles (physical activity, diet, toxic habits), psychological factors (depression, stress, occupational stress and anxiety), socioeconomic and work-related variables, habitability conditions of the habitual residence and rest area, screen time, relaxation techniques and melatonin as a biological marker related to sleep quality.

Discussion

With the results of this work, improved interventions for behaviour modification could be designed, as well as intervention and education programmes or other research aimed at improving sleep quality.

Ethics and dissemination

This study has a favourable opinion from the Ethics Committee for Drug Research of the Health Areas of Salamanca and Ávila (CEim Code: PI 2021 07 815). The results of this study will be published in international impact journals of different specialties.

Trial registration number

NCT05324267.
Outcomes of discontinuing renin-angiotensin system inhibitors: a study protocol for conducting systematic review and meta-analysis
Authors: Suzuki Taihei , Nishiwaki Hiroki , Watanabe Yoshitaka , Abe Yoshifusa , Noma Hisashi , Ota Erika , Honda Hirokazu , Hasegawa Takeshi
Published: May 2023

Introduction

Renin-angiotensin system (RAS) plays a key role in various types of cardiovascular disease and many kinds of RAS inhibitors have been developed. The effect of discontinuation of RAS inhibitors on clinical outcomes is still controversial. This study aims to evaluate the effects of discontinuing RAS inhibitor medication on the clinical outcomes of patients continuously taking these agents.

Methods and analysis

This article presents a systematic review protocol described in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will include randomised controlled trials in which the effects of RAS inhibitor withdrawal were evaluated. Initially, four authors will search for eligible studies in MEDLINE, EMBASE, the Cochrane Database Trial Register, European trial registry and ClinicalTrials.gov. Abstracts and full-text screenings will be performed by the four authors with data extraction performed by each author independently. We will include patients taking RAS inhibitors—including ACE inhibitor, angiotensin receptor blocker and angiotensin receptor neprilysin inhibitor and exclude the patients undergoing renal replacement therapy (RRT), adolescents (under 18 years of age) and patients with acute infectious diseases. Our search will be performed on 1 May 2023. Studies in which the patients discontinued RAS inhibitors due to any reason will be included. Patients who continuously took RAS inhibitors under conditions in which the intervention group discontinued these agents will be considered eligible as the comparison group. Death (any cause), Death (cardiovascular disease (CVD)) and CVD events will be set as primary outcomes. Secondary outcomes will be set as RRT, acute kidney injury, renal function (analysis of the change in estimated glomerular filtration rate), hyperkalaemia, proteinuria and blood pressure.

Ethics and dissemination

Research ethics approval was not required in this study due to it being a systematic review, and any data belonging to individuals cannot be identified. The results of this study will be disseminated through peer-reviewed journals and conferences.

Trial registration number

PROSPERO CRD42022300777.
Evaluation of safety, effectiveness and treatment patterns of sodium zirconium cyclosilicate in management of hyperkalaemia in China: a real-world study protocol
Authors: Shen Nan , Meng Qingyang , Zhang Lihong , Xie Hua , Zhao Jianrong , Xing Changying , Zuo Li , Long Gang , Zhu Qiang , Shan Chunyan , Cai Xudong , Yang Jing , Luo Xun , Wang Jianmin , Ye Jianming , Wan Xin , Tian Shaojiang , Wu Yifan , Lin Yongqiang , Yu Xiaoyong , Li Qing , Liu Xinyu , Shi Zhenwei , Zhou Jingwei , Liu Chunyan , Cao Yanping , Wang Niansong , Jiang Xinxin , Wu Henglan , Hu Yao , Li Lu , Wang Zhaohua , He Jingdong , Cao Juan , Wu Fenglei , Ma Cong , Yin Xun , Li Zhongxin , Wang Huimin , Lin Hongli
Published: May 2023

Introduction

Hyperkalaemia (HK) is a potentially life-threatening electrolyte imbalance associated with several adverse clinical outcomes. The efficacy and negative effects of currently existing treatment options have made HK management questionable. Sodium zirconium cyclosilicate (SZC), a novel highly selective potassium binder, is approved for the treatment of HK. The present study will be aimed to assess the safety, effectiveness and treatment patterns of SZC in Chinese patients with HK in a real-world clinical setting as it is required by China’s drug review and approval process.

Methods and analysis

This is a multicentre, prospective cohort study which plans to enrol 1000 patients taking SZC or willing to take SZC from approximately 40 sites in China. Patients ≥18 years of age at the time of signing the written informed consent and with documented serum potassium levels ≥5.0 mmol/L within 1 year before study enrolment day will be included. Eligible patients will receive SZC treatment and will be followed up for 6 months from enrolment day. The primary objective will be to evaluate the safety of SZC for the management of HK in Chinese patients in terms of adverse events (AEs), serious AEs as well as discontinuation of SZC. The secondary objectives will include understanding the SZC dosage information in terms of its effectiveness and treatment patterns under real-world clinical practice and assessing effectiveness of SZC during the observational period.

Ethics and dissemination

This study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (approval number: YJ-JG-YW-2020). All the participating sites have received the ethics approval. Results will be disseminated through national and international presentations and peer-reviewed publications.

Trial registration number

NCT05271266.
Light chain only variant of proliferative glomerulonephritis with monoclonal immunoglobulin deposits: a clinicopathological study of three cases
Authors: Liang Shaoshan , Liang Dongmei , Zhu Xiaodong , Liang Dandan , Xu Feng , Tu Yuanmao , Zeng Caihong
Published: May 2023

Aims

To explore the clinical and pathological features of light chain only variant of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID-LC).

Methods

From January 2010 to December 2022, patients who were diagnosed with PGNMID-LC were selected, and their clinical and pathological features were retrospectively analysed.

Results

Three males aged 42–61 years old were enrolled. Hypertension was present in three patients, oedema in three patients, anaemia in two patients, proteinuria in three patients, nephrotic syndrome in one patient, microscopic haematuria in three patients, renal insufficiency in two patients and hypocomplementaemia of C3 in one patient. Elevated serum-free LC ratios and plasmacytosis on bone marrow smears were observed in three patients, and κ was identified by serum protein immunofixation electrophoresis in one patient. Renal biopsy showed membranoproliferative glomerulonephritis in two patients and endocapillary proliferative glomerulonephritis in one patient on light microscopy. Immunofluorescence indicated restricted κ LC and C3 distributed in glomeruli. By electron microscopy, electron-dense deposits without substructure were identified predominantly in the mesangial and subendothelial regions and were variable in the subepithelial region. Two patients were treated with plasma cell-directed chemotherapy and achieved haematological complete response or very good partial response, and one of them achieved a renal status of complete remission. One patient treated with immunosuppressive therapy only did not achieve haematological or renal remission.

Conclusions

PGNMID-LC is a rare and uniform disease with a high frequency of a detectable pathogenic plasma cell clone and is characterised by glomerular deposition of restricted LC and C3 in renal pathology. Plasma cell-directed chemotherapy may improve haematological and renal prognosis.