bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of a smoke‐evacuation unit on ultrafine particle concentrations in the operating room during approach to the proximal tibia for tibial plateau‐leveling osteotomy surgery in dogs
Authors: Geier Cindy M. , Barnes Katherine H. , Simon Bradley T. , Thieman Mankin Kelley M.
Published: February 2022

Objective

To evaluate the effectiveness of a smoke‐evacuation unit on reducing ultrafine particle concentration in the operating room (OR) during the approach to the proximal tibia for tibial plateau‐leveling osteotomy (TPLO).

Study design

Prospective, randomized, controlled clinical trial.

Sample population

Twenty‐nine client‐owned dogs undergoing unilateral TPLO at a single institution were assigned to either smoke‐evacuator groups (SE; n = 15) or non–smoke‐evacuator groups (NSE; n = 14).

Methods

Dogs were randomly assigned to the SE group or the NSE group. An airborne particle measuring device measured and recorded baseline and intraoperative particles per cm3 (ppc) during the approach to the proximal tibia during which electrosurgery was used to provide hemostasis, dissect subcutis, transect and elevate fascia. The mean ppc, maximum ppc, and baseline ppc were compared between groups. Mean ppc was also compared to the baseline ppc within each group.

Results

During surgery, mean ppc (1352) and maximum ppc (62 450) for the NSE group were higher in than mean ppc (763) and maximum ppc (10 100) for the SE group (P < .0001, P < .0001, respectively). Mean ppc was higher in both SE (mean ppc = 763; P < .0001) and NSE (mean ppc = 1352; P = .0001) than their respective baseline ppc (213 and 240).

Conclusion

The use of a smoke evacuator decreased particle concentrations 56.4% during the approach to the proximal tibia. Performing the approach to the proximal tibia resulted in higher particle concentrations than the baseline, regardless of smoke‐evacuator use.

Clinical significance

Surgeons should be aware of smoke produced by electrosurgery, potential health consequences, and methods of smoke mitigation (smoke evacuation).
The physiological and clinical importance of cardiorespiratory fitness in people with abdominal aortic aneurysm
Authors: Perissiou Maria , Bailey Tom G. , Saynor Zoe L. , Shepherd Anthony I. , Harwood Amy E. , Askew Christopher D.
Published: February 2022

New Findings

What is the topic of this review?

This review focuses on the physiological impact of abdominal aortic aneurysm (AAA) on cardiorespiratory fitness and the negative consequences of low fitness on clinical outcomes in AAA. We also discuss the efficacy of exercise training for improving cardiorespiratory fitness in AAA.

What advances does it highlight?

We demonstrate the negative impact of low fitness on disease progression and clinical outcomes in AAA. We highlight potential mechanistic determinants of low fitness in AAA and present evidence that exercise training can be an effective treatment strategy for improving cardiorespiratory fitness, postoperative mortality and disease progression.

An abdominal aortic aneurysm (AAA) is an abnormal enlargement of the aorta, below the level of the renal arteries, where the aorta diameter increases by >50%. As an aneurysm increases in size, there is a progressive increase in the risk of rupture, which ranges from 25 to 40% for aneurysms >5.5 cm in diameter. People with AAA are also at a heightened risk of cardiovascular events and associated mortality. Cardiorespiratory fitness is impaired in people with AAA and is associated with poor (postoperative) clinical outcomes, including increased length of hospital stay and postoperative mortality after open surgical or endovascular AAA repair. Although cardiorespiratory fitness is a well‐recognized prognostic marker of cardiovascular health and mortality, it is not assessed routinely, nor is it included in current clinical practice guidelines for the management of people with AAA. In this review, we discuss the physiological impact of AAA on cardiorespiratory fitness, in addition to the consequences of low cardiorespiratory fitness on clinical outcomes in people with AAA. Finally, we summarize current evidence for the effect of exercise training interventions on cardiorespiratory fitness in people with AAA, including the associated improvements in postoperative mortality, AAA growth and cardiovascular risk. Based on this review, we propose that cardiorespiratory fitness should be considered as part of the routine risk assessment and monitoring of people with AAA and that targeting improvements in cardiorespiratory fitness with exercise training might represent a viable adjunct treatment strategy for reducing postoperative mortality and disease progression.
Tránsitos nostálgicos: habitando las posibilidades de lo trans y su vinculación errática con lo monstruoso
Authors: Bermejo Camacho Catherine
Published: February 2022

La idea de lo humano ha dependido siempre de la construcción del mito de lo monstruoso. De esta manera, el mito del minotauro, a quien Teseo da muerte en el centro del laberinto, da cuenta de una monstruosidad problemática que se construye en la marginalización de una experiencia otra. Las disidencias sexuales y de género han encarnado este enfrentamiento, en el que los cuerpos que atraviesan una experiencia de vida trans conﬁguran la amenaza de un sistema de desigualdad que se reproduce en aquella lógica binaria. Debido a esto, ciertos cuerpos han sido condenados al ostracismo, al encierro y hasta a la muerte, tal como le ocurre a aquel “monstruo” del mito antiguo. Pero ¿quién ha visto al monstruo? ¿Quién puede reconocer a sus víctimas? Y, sobre todo, ¿quién enuncia su monstruosidad? Tránsitos nostálgicos recorre la trayectoria de aquel mito en Colombia, en el que lo humano y lo monstruoso solo tienen ciertas posibilidades. Así, enuncia el pecado como la apariencia discursiva que, en nuestro periodo colonial, tomaron las experiencias de travestimiento; explica los signiﬁcados de enfermedad y de criminalidad con los que la ciencia del siglo XIX resigniﬁcó la experiencia; y, ﬁnalmente, revela la manera en la que, contemporáneamente, el dispositivo de lo religioso, lo jurídico y lo cientíﬁco enfrenta la reescritura de un mito herido, cuya sutura está en la aﬁrmación colectiva y en el camino de regreso al cuerpo que nos pertenece.
Measuring the Magnetic Field Vector of Earth
Authors: Minkin Leonid , Sikes Daniel
Published: February 2022

The magnetic field of Earth, Be, is an intriguing topic in the introductory physics curriculum that engages students’ curiosity and inspires numerous speculations about the nature of this phenomenon. There are several methods for measuring Earth’s magnetic field. Probably, the most widespread and visual method of measuring the field in student lab experiments utilizes a tangent galvanometer. Recently, PASCO scientific suggested to use a magnetic field sensor for this goal, in a procedure where a magnetic field sensor combined with a rotary motion sensor is rotated in a 2-D plane containing the magnetic field vector of Earth. In this case, the magnetic field detected by the magnetic field sensor is a component of the magnetic field vector oriented relative to the direction of the magnetic field sensor probe (radial component of magnetic field). This means that the detected magnetic field considered as a function of the angle of rotation of the sensor will be a sinusoidal function. The amplitude of this function is the magnitude of Earth’s magnetic field. In conducting this experiment, initially the sensor is set to zero by placing it in a Zero Gauss Chamber (mu-metal). The equipment setup of the experiment is depicted in the figure shown in Ref. 9. The described experiment requires the use of a dip needle that is a compass pivoted to move in the plane containing the magnetic field vector of Earth. The dip needle shows the dip angle θ (inclination) that Earth’s magnetic field makes with the horizontal. Besides the previously mentioned devices, this experiment requires the use of an aluminum table clamp, adjustable angle clamp, and angle indicator to ensure proper alignment of the rotary motion sensor in a 2D plane containing the magnetic field vector.
Astronomy activities for promoting scientific evaluation
Authors: Bailey Janelle M. , Lombardi Doug
Published: February 2022

We have developed activities to engage students in evaluating competing scientific models. Ford identified evaluation as a critical aspect of doing science, and it sits at the crux of the K-12 Framework and NGSS’s Science and Engineering Practices. Scientific evaluation often involves both the evaluation of the connections between evidence and the explanation and the evaluation of competing explanations. But how do we get students to engage with this process?
The hand boiler and how it does not work
Authors: Lincoln James
Published: February 2022

The hand boiler is an intriguing physics demonstration that is perfectly suited to the high school classroom. The ubiquity of this device, and the many incorrect explanations of its workings, motivate this author to write and explain its physics correctly. In this article I explain how the hand boiler works and provide supporting experiments that refute the incorrect explanations. Also included are a few well-tested hands-on activities for students and teachers to enjoy. Examples of the hand boiler are shown in Fig. 1.
Passive acoustic monitoring reveals year-round marine mammal community composition off Tasiilaq, Southeast Greenland
Authors: Mattmüller Ramona M. , Thomisch Karolin , Van Opzeeland Ilse , Laidre Kristin L. , Simon Malene
Published: February 2022

Climate-driven changes are affecting sea ice conditions off Tasiilaq, Southeast Greenland, with implications for marine mammal distributions. Knowledge about marine mammal presence, biodiversity, and community composition is key to effective conservation and management but is lacking, especially during winter months. Seasonal patterns of acoustic marine mammal presence were investigated relative to sea ice concentration at two recording sites between 2014 and 2018, with one (65.6°N, 37.4°W) or three years (65.5°N, 38.0°W) of passive acoustic recordings. Seven marine mammal species were recorded. Bearded seals were acoustically dominant during winter and spring, whereas sperm, humpback, and fin whales dominated during the sea ice-free summer and autumn. Narwhals, bowhead, and killer whales were recorded only rarely. Song-fragments of humpback whales and acoustic presence of fin whales in winter suggest mating-associated behavior taking place in the area. Ambient noise levels in 1/3-octave level bands (20, 63, 125, 500, 1000, and 4000 Hz), ranged between 75.6 to 105 dB re 1 μPa. This study provides multi-year insights into the coastal marine mammal community composition off Southeast Greenland and suggests that the Tasiilaq area provides suitable habitat for various marine mammal species year-round.
Central retinal artery occlusion with cilioretinal sparing in a patient with Eisenmenger syndrome
Authors: Gupta Abhishek , Singh Prabhakar , Sanepalli Sravani Reddy , Raj Amit
Published: February 2022

A young boy in his 20s presented with sudden diminution of vision in right eye 2 days ago. Best-corrected visual acuity was hand movement in right eye and 20/20 in left eye. Funduscopy demonstrated diffuse retinal opacification and swelling at the posterior pole with a cherry red spot at the macula. There was sparing of the superonasal macula with a patent cilioretinal artery. OCT showed diffuse inner retinal thickening of the temporal macula. He was diagnosed as central retinal artery occlusion with cilioretinal sparing in right eye. He was a known case of Eisenmenger syndrome secondary to a large congenital ventricular septal defect. Medical history was notable for prominent pulmonary hypertension and shortness of breath on exertion. Physical examination revealed a harsh systolic murmur. Extremities showed digital erythema and severe clubbing. Chest X-ray demonstrated cardiomegaly. Laboratory examination revealed haemoglobin—220 g/L, haematocrit—60%, serum iron—20 µg/dL.
Dual duodenojejunostomies in the repair of megaduodenum, duodenal stenosis and prior missed diagnosis of annular pancreas
Authors: Chen Lily Ye , Cabrera-Bou Victor F , Casas-Melley Adela T
Published: February 2022

Duodenal stenosis and atresia are some of the most common forms of congenital bowel obstruction. The gold standard approach to treatment is duodenoduodenostomy, while rare, gastrojejunostomy and duodenojejunostomies may still be used. We report a case of a 7-year-old male presenting with annular pancreas with duodenal stenosis that was diagnosed at birth as primary duodenal atresia and repaired by gastrojejunostomy with a Braun enteroenterostomy. Through successful reoperation with dual duodenojejunostomy and subsequent management, we treated the sequelae of the initial repair, including megaduodenum. Regions of duodenal obstruction must have direct anastomotic repair to prevent subsequent issues related to dysmotility. Otherwise, further surgical intervention and long-term medical management, such as the novel strategy reported, may be necessary.
Challenges of remote consultations: a delayed diagnosis of aortic valve endocarditis complicated by recurrent intracranial events
Authors: Demetriades Polyvios , Ridley Paul , Yazdani Farah , Duckett Simon
Published: February 2022

Embolic events causing stroke and intracranial haemorrhage are among the most catastrophic complications of infective endocarditis (IE).

A female patient presented with acute unilateral weakness following a 3-month history of fever, for which she had multiple remote consultations with her general practitioner. A brain MRI confirmed a left sided infarct with haemorrhagic transformation. Blood cultures grewStreptococcus mitisand her cardiac imaging showed an aortic valve vegetation with severe aortic regurgitation. Following 2 weeks of antibiotics she developed a new cerebral haemorrhage associated with a mycotic aneurysm which was treated with two coils. After discussions within the multidisciplinary meeting, she underwent aortic valve replacement 3 weeks later. She made a remarkable recovery and was discharged.

Our case highlights the importance of face-to-face clinical review in the post-COVID era. It stresses that the management of patients with infective endocarditis and neurological complications is challenging and requires a multidisciplinary approach.
Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review
Authors: Cernota Monique , Kroeber Eric Sven , Demeke Tamiru , Frese Thomas , Getachew Sefonias , Kantelhardt Eva Johanna , Ngeh Etienne Ngeh , Unverzagt Susanne
Published: February 2022

Objectives

This systematic review aims to evaluate the evidence of non-pharmacological strategies to improve blood pressure (BP) control in patients with hypertension from African countries.

Design

We performed a systematic review and searched Medline, Central, CINAHL and study registers until June 2020 for randomised studies on interventions to decrease BP of patients with hypertension in African countries. We assessed the study quality using the Cochrane risk of bias tool and narratively synthesised studies on non-pharmacological hypertension interventions.

Setting

We included studies conducted in African countries.

Participants

Adult African patients with a hypertension diagnosis.

Interventions

Studies on non-pharmacological interventions aiming to improve BP control and treatment adherence.

Outcomes

Main outcomes were BP and treatment adherence.

Results

We identified 5564 references, included 23 with altogether 18 153 participants from six African countries. The studies investigated educational strategies to improve adherence (11 studies) and treatment by healthcare professionals (5 studies), individualised treatment strategies (2 studies), strategies on lifestyle including physical activity (4 studies) and modified nutrition (1 study). Nearly all studies on educational strategies stated improved adherence, but only three studies showed a clinically relevant improvement of BP control. All studies on individualised strategies and lifestyle changes resulted in clinically relevant effects on BP. Due to the type of interventions studied, risk of bias in domain blinding of staff/participants was frequent (83%). Though incomplete outcome data in 61% of the studies are critical, the general study quality was reasonable.

Conclusions

The identified studies offer diverse low-cost interventions including educative and task-shifting strategies, individualised treatment and lifestyle modifications to improve BP control. Especially trialled physical activity interventions show clinically relevant BP changes. All strategies were trialled in African countries and may be used for recommendations in evidence-based guidelines on hypertension in African settings.

PROSPERO registration number

CRD42018075062.
Mental health and mental well-being of Black students at UK universities: a review and thematic synthesis
Authors: Stoll Nkasi , Yalipende Yannick , Byrom Nicola C , Hatch Stephani L , Lempp Heidi
Published: February 2022

Background

There is a knowledge gap about the experiences that affect the mental health of Black university students in the UK. Current research is focused on understanding the continuation, attainment and progression gap between Black students and non-Black students. It is essential to know more about the interactions between personal and institutional factors on the mental health of Black students to explain the inequalities in their experiences and outcomes across the university lifecycle. The current study set out to thematically synthesise articles that explore the experiences that affect the mental health and mental well-being of Black university students in the UK.

Methods

This study is a qualitative thematic synthesis of a literature review. We developed search strategies for four online databases (PubMed, Social Science Premium Collection via ProQuest, Open Access Theses and Dissertations, and Open Grey) covering January 2010 to July 2020. This search was combined with a manual search of reference lists and related citations. All articles in English addressing mental health and mental well-being experiences among Black university students studying at a UK university were included. Critical Appraisal Skills Programme Checklist was used to assess bias. A thematic synthesis was conducted using Braun and Clarke (2006)’s six-step guide to develop descriptive themes and analytical constructs.

Results

Twelve articles were included. Several themes were identified as affecting the mental health of Black university students in the UK: academic pressure, learning environment, Black gendered experience, isolation and alienation, culture shock, racism and support.

Discussion

This review provides an appraisal of the factors affecting the mental health and mental well-being of Black students at UK universities, which need to be addressed by higher education policy-makers and key decision-makers. Further research is needed about the mental health experiences of Black university students in relation to Black identities, suicidality, mental health language, the physical environment, and racism and other institutional factors.
Participatory learning and action (PLA) to improve health outcomes in high-income settings: a systematic review protocol
Authors: Allaham Shereen , Kumar Ameeta , Morriss Felix , Lakhanpaul Monica , Wilson Emma , Sikorski Catherine , Martin Jennifer , Costello Anthony , Manikam Logan , Heys Michelle
Published: February 2022

Introduction

Participatory learning and action (PLA) is a form of group reflection and learning with documented efficacy in low-income countries to improve social and health outcomes. PLA represents both a learning philosophy and a practical framework that could be applied to a variety of contexts. To date, PLA has not been widely implemented within high-income countries (HICs) to improve health and health-related outcomes. We aim to synthesise the literature currently available by means of a systematic review to form a foundation for future applications of PLA methodology in HICs.

Methods and analysis

Two reviewers will independently search predefined terms in the following electronic bibliographic databases: MEDLINE, EMBASE, CINAHL and Cochrane Library. The search terms will encompass PLA and PDSA (Plan-Do-Study-Act) projects, as well as studies using the Triple/Quadruple Aim model. We will include randomised controlled trials that incorporate online or face-to-face components using the PLA/PDSA methodology. Our data will be extracted into a standardised prepiloted form with subsequent narrative review according to the SWiM (Synthesis Without Meta-Analysis) guidelines.

Ethics and dissemination

No ethics approval is required for this study. The results of this study will be submitted for publication in a leading peer-reviewed academic journal in this field. Additionally, a report will be produced for the funders of this review, which can be viewed for free on their website.

PROSPERO registration number

CRD42020187978.
Safety, feasibility, acceptability and preliminary effects of the Neurofenix platform for Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke (RHOMBUS): results of a feasibility intervention study
Authors: Kilbride Cherry , Scott Daniel J M , Butcher Tom , Norris Meriel , Warland Alyson , Anokye Nana , Cassidy Elizabeth , Baker Karen , Athanasiou Dimitrios A , Singla-Buxarrais Guillem , Nowicky Alexander , Ryan Jennifer
Published: February 2022

Objectives

To investigate the safety, feasibility and acceptability of the Neurofenix platform for home-based rehabilitation of the upper limb (UL).

Design

A non-randomised intervention design with a parallel process evaluation.

Setting

Participants’ homes, South-East England.

Participants

Thirty adults (≥18 years), minimum 12-week poststroke, not receiving UL rehabilitation, scoring 9–25 on the Motricity Index (elbow and shoulder), with sufficient cognitive and communicative abilities to participate.

Interventions

Participants were trained to use the platform, followed by 1 week of graded game-play exposure and 6-week training, aiming for a minimum 45 min, 5 days/week.

Outcomes

Safety was determined by assessing pain and poststroke fatigue at 8 and 12 weeks, and adverse events (AEs). Impairment, activity and participation outcomes were measured. Intervention feasibility was determined by the amount of specialist training and support required to complete the intervention, time and days spent training, and number of UL movements performed. Acceptability was assessed by a satisfaction questionnaire and semistructured interviews.

Results

Participants (14 women; mean (SD) age 60.0 (11.3) years) were a median of 4.9 years poststroke (minimum-maximum: 1–28 years). Twenty-seven participants completed the intervention. The odds of having shoulder pain were lower at 8 weeks (OR 0.45, 95% CI 0.24 to 0.83, p=0.010) and 12 weeks (OR 0.46, 95% CI 0.25 to 0.86, p=0.014) compared with baseline. Fugl-Meyer upper extremity, Motor Activity Log and passive range of movement improved. No other gains were recorded. Poststroke fatigue did not change. Thirty mild and short-term AEs and one serious (unrelated) AE were reported by 19 participants. Participants trained with the platform for a median of 17.4 hours over 7 weeks (minimum-maximum: 0.3–46.9 hours), equating to a median of 149 min per week. The median satisfaction score was 36 out of 40.

Conclusion

The Neurofenix platform is a safe, feasible and well accepted way to support UL training for people at least three months poststroke.

Trial registration number

ISRCTN60291412.
Patient and practitioner views on a combined face-to-face and digital intervention to support medication adherence in hypertension: a qualitative study within primary care
Authors: Van Emmenis Miranda , Jamison James , Kassavou Aikaterini , Hardeman Wendy , Naughton Felix , A'Court Charlotte , Sutton Stephen , Eborall Helen
Published: February 2022

Objectives

To explore patients’ and healthcare practitioners’ (HCPs) views about non-adherence to hypertension medication and potential content of a combined very brief face-to-face discussion (VBI) and digital intervention (DI).

Methods

A qualitative study (N=31): interviews with patients with hypertension (n=6) and HCPs (n=11) and four focus groups with patients with hypertension (n=14). Participants were recruited through general practices in Eastern England and London. Topic guides explored reasons for medication non-adherence and attitudes towards a potential intervention to support adherence. Stimuli to facilitate discussion included example SMS messages and smartphone app features, including mobile sensing. Analysis was informed methodologically by the constant comparative approach and theoretically by perceptions and practicalities approach.

Results

Participants’ overarching explanations for non-adherence were non-intentional (forgetting) and intentional (concerns about side effects, reluctance to medicate). These underpinned their views on intervention components: messages that targeted forgetting medication or obtaining prescriptions were considered more useful than messages providing information on consequences of non-adherence. Tailoring the DI to the individuals’ needs, regarding timing and number of messages, was considered important for user engagement. Patients wanted control over the DI and information about data use associated with any location sensing. While the DI was considered limited in its potential to address intentional non-adherence, HCPs saw the potential for a VBI in addressing this gap, if conducted in a non-judgemental manner. Incorporating a VBI into routine primary care was considered feasible, provided it complemented existing GP practice software and HCPs received sufficient training.

Conclusions

A combined VBI-DI can potentially address intentional and non-intentional reasons for non-adherence to hypertension medication. For optimal engagement, recommendations from this work include a VBI conducted in a non-judgmental manner and focusing on non-intentional factors, followed by a DI that is easy-to-use, highly tailored and with provision of data privacy details about any sensing technology used.
Prevalence and long-term prognostic implications of prolonged QRS duration in left ventricular hypertrophy: a population-based observational cohort study
Authors: Rankinen Jani , Haataja Petri , Lyytikäinen Leo-Pekka , Huhtala Heini , Lehtimäki Terho , Kähönen Mika , Eskola Markku , Tuohinen Suvi , Pérez-Riera Andrés Ricardo , Jula Antti , Rissanen Harri , Nikus Kjell , Hernesniemi Jussi
Published: February 2022

Objectives

ECG left ventricular hypertrophy (ECG-LVH) has been associated with left ventricular dysfunction and adverse prognosis, but little is known about the prevalence and prognostic significance of different levels of QRS duration in the presence of ECG-LVH in a general population.

Design

Population-based observational prospective cohort study.

Participants

Nationally representative random cluster of Finnish adult population.

Methods

We assessed the prevalence and long-term (median 15.9 years) prognostic significance of QRS duration in ECG-LVH, and compared the risk to individuals without ECG-LVH in a predominantly middle-aged random sample of 6033 Finnish subjects aged over 30 years (mean age 52.2, SD 14.6 years), who participated in a health examination including a 12-lead ECG.

Main outcome measures

Cardiovascular and all-cause mortality, incidence of heart failure (HF).

Results

ECG-LVH was present in 1337 (22.2%) subjects; 403 of these (30.1%) had QRS duration ≥100 ms and 100 (7.5%) had ≥110 ms. The increased risk of mortality in ECG-LVH became evident after a QRS threshold of ≥100 ms. After controlling for known clinical risk factors, QRS 100–109 ms was associated with increased cardiovascular (HR 1.38, 95% CI 1.01 to 1.88, p=0.045) and QRS≥110 ms with cardiovascular (1.74, 95% CI 1.07 to 2.82, p=0.025) and all-cause mortality (1.52, 95% CI 1.02 to 2.25, p=0.039) in ECG-LVH. The risk of new-onset HF was two-fold in subjects with QRS 100–109 ms and threefold in subjects with QRS ≥110 ms, even after adjustment for incident myocardial infarction within the follow-up. When the prognosis was compared with subjects without ECG-LVH, subjects with ECG-LVH but QRS duration <100 ms displayed similar mortality rates with or without ECG-LVH but higher rates of incident HF.

Conclusions

In ECG-LVH, the risk of excess mortality and new-onset HF markedly increases with longer QRS duration, but even QRS duration within normal limits in ECG-LVH carried a risk of HF compared with the risk in individuals without ECG-LVH.
Priority setting of vaccine introduction in Bangladesh: a multicriteria decision analysis study
Authors: Haider Mohammad Sabbir , Youngkong Sitaporn , Thavorncharoensap Montarat , Thokala Praveen
Published: February 2022

Objective

To prioritise vaccines for introduction in Bangladesh.

Methods

Multicriteria decision analysis (MCDA) process was used to prioritise potential vaccines for introduction in Bangladesh. A set of criteria were identified, weighted and assigned scores by relevant stakeholders (n=14) during workshop A. The performance matrix of the data of vaccines against the criteria set was constructed and validated with the experts (n=6) in workshop B. The vaccines were ranked and appraised by another group of stakeholders (n=10) in workshop C, and the final workshop D involved the dissemination of the findings to decision-makers (n=28).

Results

Five criteria including incidence rate, case fatality rate, vaccine efficacy, size of the population at risk and type of population at risk were used quantitatively to evaluate and to score the vaccines. Two other criteria, cost-effectiveness and outbreak potentiality, were considered qualitatively. On deliberation, the Japanese encephalitis (JE) vaccine was ranked top to be recommended for introduction in Bangladesh.

Conclusions

Based on the MCDA results, JE vaccine is planned to be recommended to the decision-makers for introduction into the national vaccine benefit package. The policymakers support the use of systematic evidence-based decision-making processes such as MCDA for vaccine introduction in Bangladesh, and to prioritise health interventions in the country.
Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study
Authors: Page John H , Londhe Ajit A , Brooks Corinne , Zhang Jie , Sprafka J Michael , Bennett Corina , Braunlin Megan , Brown Carolyn A , Charuworn Prista , Cheng Alvan , Gill Karminder , He Fang , Ma Junjie , Petersen Jeffrey , Ayodele Olulade , Bao Ying , Carlson Katherine B , Chang Shun-Chiao , Devercelli Giovanna , Jonsson-Funk Michele , Jiang Jenny , Keenan Hillary A , Ren Kaili , Roehl Kimberly A , Sanders Lynn , Wang Luyang , Wei Zhongyuan , Xia Qian , Yu Peter , Zhou Linyun , Zhu Julia , Gondek Kathleen , Critchlow Cathy W , Bradbury Brian D
Published: February 2022

Objectives

To examine the temporal patterns of patient characteristics, treatments used and outcomes associated with COVID-19 in patients who were hospitalised for the disease between January and 15 November 2020.

Design

Observational cohort study.

Setting

COVID-19 subset of the Optum deidentified electronic health records, including more than 1.8 million patients from across the USA.

Participants

There were 51 510 hospitalised patients who met the COVID-19 definition, with 37 617 in the laboratory positive cohort and 13 893 in the clinical cohort.

Primary and secondary outcome measures

Incident acute clinical outcomes, including in-hospital all-cause mortality.

Results

Respectively, 48% and 49% of the laboratory positive and clinical cohorts were women. The 50– 65 age group was the median age group for both cohorts. The use of antivirals and dexamethasone increased over time, fivefold and twofold, respectively, while the use of hydroxychloroquine declined by 98%. Among adult patients in the laboratory positive cohort, absolute age/sex standardised incidence proportion for in-hospital death changed by −0.036 per month (95% CI −0.042 to –0.031) from March to June 2020, but remained fairly flat from June to November, 2020 (0.001 (95% CI −0.001 to 0.003), 17.5% (660 deaths /3986 persons) in March and 10.2% (580/5137) in October); in the clinical cohort, the corresponding changes were −0.024 (95% CI −0.032 to –0.015) and 0.011 (95% CI 0.007 0.014), respectively (14.8% (175/1252) in March, 15.3% (189/1203) in October). Declines in the cumulative incidence of most acute clinical outcomes were observed in the laboratory positive cohort, but not for the clinical cohort.

Conclusion

The incidence of adverse clinical outcomes remains high among COVID-19 patients with clinical diagnosis only. Patients with COVID-19 entering the hospital are at elevated risk of adverse outcomes.
Attitudes and views on healthy lifestyle interventions for the prevention of dementia and cardiovascular disease among older people with low socioeconomic status: a qualitative study in the Netherlands
Authors: Eggink Esmé , Hafdi Melanie , Hoevenaar-Blom Marieke P , Richard Edo , Moll van Charante Eric P
Published: February 2022

Objectives

Individuals with a low socioeconomic status (SES) have an increased risk of cardiovascular disease (CVD) and dementia, partly due to the high prevalence of unhealthy behaviours in this population. Interventions targeting lifestyle-related risk factors can potentially delay or prevent CVD and dementia onset. In this study, we explore the attitudes, experiences and views of low SES older adults on healthy lifestyles for the prevention of CVD and dementia. We also aim to study the potential role for coach-supported mobile health (mHealth) use, facilitating the development of the Prevention of Dementia using Mobile Phone Applications intervention.

Design

We performed semi-structured interviews and used thematic analysis to analyse the data.

Setting

Recruitment through multiple general practices in the Netherlands.

Participants

Dutch non-demented adults aged ≥55, at increased risk of dementia, who possess a smartphone. Participants were purposively sampled on age, sex and history of CVD and diabetes.

Results

Between May 2018 and June 2019, we performed 19 interviews. Five main themes were: (1) participants perceived little influence on their future health, (2) the sacrifices of healthy lifestyles outweighed the potential benefits, (3) physical complaints or disease could prompt behaviour change, (4) participants perceived they had limited self-efficacy to change their behaviour and (5) the social network had an important role in behaviour change. Needs regarding mHealth support were an easy-to-use smartphone application with trustworthy health information, which is provided in a non-obligatory way.

Conclusions

Low SES older adults may benefit from lifestyle interventions that aim to improve self-efficacy levels by (remote) human support. Appropriateness and attractiveness of such interventions may increase when taking into account the participant’s own autonomy, and when emphasising the direct gains of lifestyle changes for daily life. Moreover, involving the social network may be a valuable approach when developing lifestyle interventions for low SES older adults.

Trial registration number

PRODEMOS trial, ISRCTN15986016; Pre-results.
Therapeutic or prophylactic anticoagulation in acute isolated distal deep vein thrombosis: protocol for a prospective, multicentre, single-blind, randomised controlled trial (TOP-IDDVT)
Authors: Zhou Min , Zhang Wan , Zhang Yucheng , Xie Tianchen , Mao Jieqi , Shi Zhenyu
Published: February 2022

Introduction

The efficacy and safety of anticoagulant treatment is not established for patients with acute symptomatic isolated distal deep vein thrombosis (IDDVT). In real-world clinical practice, both therapeutic and prophylactic anticoagulation are used for acute IDDVT. However, therapeutic anticoagulation is associated with higher risk of bleeding than prophylactic anticoagulation. Thus, this study aims to assess the efficacy and safety in patients with first acute symptomatic IDDVT treated with therapeutic or prophylactic anticoagulation using rivaroxaban.

Methods and analysis

This study is a prospective, multicentre, single-blind, randomised controlled trial. Outpatients with a first, acute, symptomatic, objectively confirmed IDDVT in four centres from 1 August 2021 are recruited. Eligible patients are randomised in a 1:1 ratio to receive prophylactic anticoagulation (rivaroxaban 10 mg once a day for 3 months) or therapeutic anticoagulation (rivaroxaban 20 mg once a day for 3 months). All patients are followed for 6 months. The primary efficacy outcome is radiographically confirmed recurrent venous thromboembolism. The primary safety outcome is the incidence of major or clinically relevant non-major bleeding events.

Ethics and dissemination

This study has been approved by the Ethics Committee of Zhongshan Hospital Fudan University (B2021-175R). Study results will be disseminated through peer-reviewed journals.

Trial registration number

NCT04967573
Barriers and opportunities of establishing an integrated prehospital emergency response system in North West Ethiopia: a qualitative study
Authors: Denu Zewditu Abdissa , Osman Mensur Yassin , Bisetegn Telake Azale , Biks Gashaw Andargie , Gelaye Kassahun Alemu
Published: February 2022

Background

Prehospital emergency care helps to reduce mortality and morbidity from time-sensitive conditions. In this study, we summarised the perspectives of various stakeholders on the establishment of a prehospital integrated emergency response system.

Methods

We conducted a qualitative study using a key informant interview. We used a purposive sampling technique to select participants from the sector offices based on their proximity to the problem under consideration. We took verbal informed consent from each participant before the interviews. We conducted a thematic content analysis.

Results

Twenty-three study participants, working at six sector offices (the zonal health office, University of Gondar, traffic office, fire extinguisher office, the Amhara regional health bureau and the Ethiopian red cross association), were included in this study. Five major themes have emerged. The themes that emerged include participants’ views on the importance of prehospital service, barriers and opportunities for establishing the system, and how to start and sustain the system.

Conclusion and recommendation

Lack of resources is not the main reason for the lack of prehospital emergency care in the study area rather; lack of commitment, ownership and high turnover of decision-makers were the main reasons for the absence of prehospital care, as viewed by respondents. On the other side, the availability of professionals, training institutions and the fact that emergency care is a shared agenda by different stakeholders were stated as an opportunity to establish the system. With the growing number of injuries and non-communicable diseases, emergency management should get due attention.
Tau-PET imaging predicts cognitive decline and brain atrophy progression in early Alzheimer’s disease
Authors: Lagarde Julien , Olivieri Pauline , Tonietto Matteo , Tissot Cecile , Rivals Isabelle , Gervais Philippe , Caillé Fabien , Moussion Martin , Bottlaender Michel , Sarazin Marie
Published: February 2022

Objectives

To explore whether regional tau binding measured at baseline is associated with the rapidity of Alzheimer’s disease (AD) progression over 2 years, as assessed by the decline in specified cognitive domains, and the progression of regional brain atrophy, in comparison with amyloid-positron emission tomography (PET), MRI and cerebrospinal fluid (CSF) biomarkers.

Methods

Thirty-six patients with AD (positive CSF biomarkers and amyloid-PET) and 15 controls underwent a complete neuropsychological assessment, 3T brain MRI, [11C]-PiB and [18F]-flortaucipir PET imaging, and were monitored annually over 2 years, with a second brain MRI after 2 years. We used mixed effects models to explore the relations between tau-PET, amyloid-PET, CSF biomarkers and MRI at baseline and cognitive decline and the progression of brain atrophy over 2 years in patients with AD.

Results

Baseline tau-PET was strongly associated with the subsequent cognitive decline in regions that are usually associated with each cognitive domain. No significant relationship was observed between the cognitive decline and initial amyloid load, regional cortical atrophy or CSF biomarkers. Baseline tau tracer binding in the superior temporal gyrus was associated with subsequent atrophy in an inferomedial temporal volume of interest, as was the voxelwise tau tracer binding with subsequent cortical atrophy in the superior temporal, parietal and frontal association cortices.

Conclusions

These results suggest that tau tracer binding is predictive of cognitive decline in AD in domain-specific brain areas, which provides important insights into the interaction between tau burden and neurodegeneration, and is of the utmost importance to develop new prognostic markers that will help improve the design of therapeutic trials.
Over 1 year later: smokers’ EVALI awareness, knowledge and perceived impact on e-cigarette interest
Authors: Wackowski Olivia A , Gratale Stefanie Kristen , Jeong Michelle , Delnevo Cristine D , Steinberg Michael B , O'Connor Richard J
Published: February 2022

Objectives

The e-cigarette or vaping product use-associated lung injury (EVALI) outbreak caused serious lung injuries in over 2800 people in the USA in 2019. By February 2020, most cases were determined as linked with vaping tetrahydrocannabinol (THC), including black market products using vitamin E acetate. This study examined smokers’ EVALI awareness, knowledge and perceived impact on their e-cigarette interest approximately 16 months after its peak.

Design

Between January and February 2021, we surveyed 1018 adult current smokers from a nationally representative US research panel. Participants were asked if they had heard about EVALI prior to COVID-19, knew its main cause, and if EVALI had impacted their interest in future e-cigarette use.

Results

Approximately 54% of smokers had heard of EVALI. Among those who had heard of EVALI (n=542), 37.3% believed itsmaincause was e-cigarettes used to vape nicotine, like JUUL. Fewer (16.6%) thought the main cause was products for vaping marijuana/THC, and 20.2% did not know. About 29% had heard vitamin E acetate was associated with EVALI, and 50.9% indicated EVALI made them less interested in using e-cigarettes in the future. EVALI awareness was significantly associated with e-cigarette risk perceptions (ie, that e-cigarettes are as harmful as smoking).

Conclusions

Despite the passage of time, considerable lack of knowledge and misperceptions about EVALI remain among those who smoke. Our findings suggest the need for continued efforts to promote better understanding of EVALI and appropriate behavioural and policy responses.
Protective effects of sildenafil administration on chemotherapeutic-induced ovarian damage in rats
Authors: Ergin Başak , Uluutku Gizem Berfin , Kale İbrahim , Topal Cumhur Selçuk , Toğrul Cihan , Muhcu Murat
Published: February 2022

Agents to reduce the gonadotoxic effects of chemotherapeutics are still under investigation. In this context, we aimed to investigate the protective effect of sildenafil against chemotherapeutic-induced gonadotoxicity in a rat model. A total of 62 female rats were divided into eight groups as control, sildenafil (1.4 mg/kg, orally), doxorubicin (3 mg/kg, i.p.), cisplatin (5 mg/kg, i.p.), cyclophosphamide (200 mg/kg, i.p.), doxorubicin+sildenafil, cisplatin+sildenafil, and cyclophosphamide+sildenafil (1.4 mg/kg orally sildenafil in addition to the same dose of chemotherapeutics). The groups were compared in terms of follicle count, ovarian size, and anti-müllerian hormone (AMH) levels. Use of sildenafil with cyclophosphamide was effective only in preserving primary follicle count (p = 0.026) and had no significant change in the secondary follicle count, ovarian size, or AMH level. Adding sildenafil to cisplatin had a significant protective effect on primary follicle count (p = 0.011), secondary follicle count (p = 0.009), and ovarian size (p = 0.001), but this effect could not be demonstrated at AMH level. Sildenafil was not effective on any parameter in the doxorubicin group. Sildenafil may be effective in reducing the gonadotoxicity associated with the use of cisplatin and cyclophosphamide.
Development of a small and transportable de-icing/anti-icing drone-mounted system. Part 1: System design
Authors: Villeneuve Eric , Karmouch Eric , Boulerice Xavier
Published: February 2022

The icing of aircraft on the ground is an important flight safety issue. Aircraft must be de-iced and anti-iced to remove and protect the aircraft from freezing and frozen contamination, respectively, before and during takeoff. Winter de-icing and anti-icing operations are nonetheless costly, require a significant amount of time, and rely on extensive infrastructures. The essential equipment is often not available at smaller airports and remote locations, thereby preventing departures under a range of winter conditions. For sites located in northern Canada, this limitation results in frequent takeoff delays or cancellations during a significant portion of the year. As part of Canada’s Department of National Defence Innovation for Defence Excellence and Security research program, this study aimed to develop a practical solution to mitigate these limitations. This solution involves mounting a ground de-icing/anti-icing system onto a drone for a system that can be readily acquired and stored at smaller airports and remote locations or even be transported within the aircraft itself to ensure the possibility of performing de-icing/anti-icing operations at sites lacking the standard infrastructure. This paper presents the conception and design of a drone-based system that should allow winter operations at small and remote airports where it is not yet available. To do so, a spraying system satisfying the industry requirements is designed and integrated to a selected drone. The calculations were theoretically confirmed as a concept, and a prototype was built to perform laboratory and flight test in the next part of the study.
Two photon exchange with nuclei from $$e^+/e^-$$ elastic cross section ratios
Authors: Kutz T. , Schmidt A.
Published: February 2022

Hadronic box diagrams pose a significant source of radiative corrections to lepton scattering and $$\beta $$
β
-decay measurements, yet their calculation remains highly model-dependent. Two-photon exchange is a box diagram generally relevant to most lepton scattering experiments, and is directly detectable via multiple observables. Single-spin asymmetries (SSA) are sensitive to the imaginary part of the TPE amplitude, while the ratio of $$e^+/e^-$$

e
+

/

e
-

elastic scattering cross sections is sensitive to the real part of the TPE amplitude. While SSA measurements have been reported for several complex nuclei, measurements of the $$e^+/e^-$$

e
+

/

e
-

ratio exist only for the proton. Proposed here is a measurement of the $$e^+/e^-$$

e
+

/

e
-

ratio on $$^4$$

4

He, a feasible nuclear target for which the ratio’s deviation from unity due to TPE is expected to be on order of 1–2%. Choosing a low Z nucleus minimizes Coulomb distortions, which could greatly overwhelm TPE for heavier nuclei. The proposed 19-day program, including measurements at three kinematic settings between $$0.3< Q^2 < 0.4$$

0.3
<

Q
2

<
0.4

GeV$$^2$$

2

, would be made possible by the addition of a positron source at Jefferson Lab.