bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators for implementation of a national recommended specialty core-curriculum across UK medical schools: a cross-sectional study using an online questionnaire
Authors: Sharma Maulina , Murphy Ruth , Doody Gillian A
Published: March 2022

Objectives

The National Health Service (NHS) Long-Term plan published in 2019 set out healthcare reforms to meet the healthcare demands of UK. Undergraduate specialty core-curricula like dermatology aligns well to the training needs of the future workforce but lacks representation, consistency and implementation. This study explores the barriers and facilitators influencing the implementation of a specialty-specific (dermatology) national core-curriculum across UK medical schools.

Design

A constructivist approach was used to develop an online questionnaire and data collected using mixed methodology.

Participants

Undergraduate dermatology teaching leads across all UK medical schools.

Results

30 out of 42 UK medical schools responded to the survey (71%). 16 out of 30 (53%) responders were unaware of the planned Medical Licensing Assessments (MLA) for all UK graduates in 2024–2025; 43% were unaware if dermatology was mapped to national standards; 50% were unsure if the dermatology was blueprinted on school curricula. Barriers to implementation included competing NHS service commitments, the specialty not seen as a priority and difficulty influencing curricula changes at school level. Facilitators included workforce planning and transparency in funding to support leadership in undergraduate education. Domains identified for curriculum implementation were: (1) awareness of the role of General Medical Council and the MLA, (2) medical education training for teaching leads, (3) lack of recognition and resources for leadership, (4) skills development to map, blueprint and assess specialty core-components, (5) medical school and specialty engagement.

Conclusions

This study identifies the potential barriers and facilitators to specialty specific core-curricular implementation across UK medical schools. Lack of standardised training in medical education, time and resources undermine the role of specialty teaching leads as medical educators. Medical school engagement with specialties with mutual support would aid the forthcoming educational reforms.
Mapping evidence of community health workers delivering physical rehabilitation services in sub-Saharan Africa: a scoping review protocol
Authors: Mapulanga Miriam , Dlungwane Thembelihle
Published: March 2022

Introduction

Sub-Saharan Africa (SSA) is one of the low-income regions in the world which is affected by the critical shortage of human resources for health amid a high disease burden, including physical disability. Community health workers are viewed as the possible solution to increase population access to health services, including rehabilitation at the community level. The purpose of this scoping review is to map the evidence and scope of physical rehabilitation services delivered by community health workers in SSA.

Methods and analysis

The framework by Arksey and O’Malley will be used to guide the scoping review protocol. Database searching will be conducted using PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. Other sources of literature will include reference lists, conference presentations and publications on organisational websites such as WHO, Ministries of Health, and Non-governmental Organisations in SSA. The screening will be guided by the inclusion and exclusion criteria. Thematic content analysis aided by NVivo V.12 will be done to present the narrative account of the review. The Mixed Methods Appraisal Tool version 2018 will be used to evaluate the methodological quality of the studies.

Ethics and dissemination

The review is part of a larger study that has received ethical clearance. The result will be disseminated using print and electronic media.
Individual goal-based plan based on nursing theory for adults with type 2 diabetes and self-care deficits: a study protocol of a randomised controlled trial
Authors: Rosman Jessica , Eriksson Jan W , Martinell Mats , Lindholm Olinder Anna , Leksell Janeth
Published: March 2022

Introduction

The prevalence and costs of type 2 diabetes are increasing worldwide. A cornerstone in the treatment and care of diabetes is supporting each patient in self-management. In Sweden, most patients with type 2 diabetes are cared for in the primary care setting, which is heavily burdened. Because of implementation difficulties regarding evidenced-based diabetes self-management education and support in this setting, there is a need for an instrument that is easy to use and implement. We developed an individual care plan based on the self-care deficit nursing theory of Dorothea Orem as an instrument to facilitate more individualised self-care support for patients with type 2 diabetes. In this study, we aim to determine whether a written, theory-based, individual goal-based plan for patients with type 2 diabetes and self-management deficits can affect their glycaemic control and health-related quality of life, as well as their experiences of living with diabetes and of support from diabetes care.

Methods and analysis

The study design is a randomised controlled trial using a quantitative approach. A total of 110 patients will be included. Additionally, a qualitative interview study will be conducted 12 months after the intervention. The primary outcome will be glycosylated haemoglobin levels. Secondary outcomes will be health-related quality of life measured using the RAND-36, and the patient’s experience of living with diabetes and of the support from diabetes care measured using the Diabetes Questionnaire. Quantitative data will be analysed using the paired t-test, unpaired t-test, and Mann–Whitney U test with IBM SPSS V.26.0 software. Qualitative content analysis will be used for qualitative data.

Ethics and dissemination

This study has been approved by the Ethical Review Authority in Uppsala, Sweden (Etikprövningsmyndigheten, Uppsala, Sverige) (Dnr: 2020-03421). The results will be disseminated in peer-reviewed publications.

Trial registration number

ISRCTN10030245.
Prevalence of lateral violence in nurse workplace: a systematic review and meta-analysis
Authors: Zhang Yue , Cai Jianzheng , Yin Rulan , Qin Shuwen , Wang Haifang , Shi Xiaoqing , Mao Lifen
Published: March 2022

Background

The prevalence of inter-nurse lateral violence (LV) reported in current studies is inconsistent, ranging from 7% to 83%. The purpose of this study is to quantify the prevalence of LV in nurses’ workplaces.

Methods

Systematic review and meta-analysis. Cochrane, PubMed, Embase, CINAHL, CNKI and Wanfang databases were searched for relevant studies (up to 27 January 2021). We included cross-sectional, case–control or cohort studies in which both abusers and victims were nurses. Studies that did not provide specific data on abusers were excluded. Stata V.16.0 was used for statistical analysis. Fixed-effect or random-effect model was adopted according to heterogeneity, which was evaluated by Cochran’s Q and I2 values. The main indicator was LV prevalence. Sensitivity analysis, subgroup analysis and meta-regression were performed to investigate the sources of heterogeneity.

Results

A total of 14 studies with 6124 nurses were included. Further, 13 articles with 5745 nurses were included in the meta-analysis, and the pooled prevalence of LV among nurses was 33.08% (95% CI: 23.41% to 42.75%, p<0.05; I2=99.0%). The remaining one study containing 370 samples reported that the prevalence of inter-nurse LV was 7.92%. Subgroup analysis showed that region, sample size, sampling, study’s quality, response rate and publication time might not be the sources of heterogeneity. Meta-regression indicated that sample size had the main influence on model heterogeneity. Egger’s test showed the existence of publication bias (p=0.03).

Discussion

The prevalence of inter-nurse LV is high in nurse workplace. It is suggested that scholars pay more attention to the cultural differences of inter-nurse LV between regions in the future. This study has the following limitations: there is a lack of studies on LV prevalence in many countries; lack of standard assessment tools; no grey literature was searched.
Association of serum cardiac troponin I and severity of coronary stenosis in patients with varied renal functions: a retrospective cohort study
Authors: Zhang Qian , Wang Yong-Fei , Hu Xiao , Tan Ya-Jun , Gao Cui , Chen Jianxiao , Han Fei , Chen Jianghua , Yang Yi
Published: March 2022

Background and objective

Recent studies showed cardiac troponin I (cTnI) might be a non-invasive biomarker to estimate the severity of coronary stenosis. However, serum cTnI is also found associated with renal function. The study objective is to analyse the association of serum cTnI and severity of coronary stenosis in patients with varied renal functions.

Design

A retrospective cohort study.

Setting

The First Affiliated Hospital, College of Medicine, Zhejiang University in Hangzhou, China.

Population

A total of 6487 subjects who underwent elective coronary angiography between January 2017 to June 2020 were involved in this study.

Primary outcomes

Severity of coronary stenosis was divided into three degrees based on Gensini score, mild coronary stenosis, moderate coronary stenosis and severe coronary stenosis.

Results

By using ordinal logistic regression, serum cTnI was associated with severity of coronary stenosis (OR=1.14, p<0.05). By construction and comparison of two models for predicting severity of coronary stenosis, the addition of cTnI significantly improved the predictive ability of the model. Differences between areas under the curves were 0.03, 0.03, 0.03, 0.12 (all p<0.05). Net reclassification improvements were 0.08, 0.05, 0.05, 0.35, respectively, in varied renal functions. Compared with the participants with normal renal function and without hypertroponinaemia, groups of participants with hypertroponinaemia showed higher ORs. ORs were 3.52, 4.20, 4.45, 6.00, respectively, as renal function decreased (all p<0.05).

Conclusions

In this cohort of patients with stable coronary artery disease and varied renal functions, cTnI was intensely associated with severity of coronary stenosis which based on Gensini score. The presentation of hypertroponinaemia in patients with impaired renal function always indicates a higher risk of severe coronary stenosis.
Examining family planning and adverse pregnancy outcomes for women with active tuberculosis disease: a systematic review
Authors: Nguyen Yen , McNabb Katherine C , Farley Jason E , Warren Nicole
Published: March 2022

Objectives

(1) Summarise and evaluate the current evidence of tuberculosis (TB)-associated pregnancy outcomes, (2) evaluate the state of the science of family planning during TB treatment and (3) provide recommendations to move forward to improve care and outcomes during TB disease.

Design

Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Data sources

PubMed, Embase, CINAHL, Cochrane, Web of Science and Scopus were searched from September 2009 to November 2021.

Eligibility criteria

Studies were included if they assessed pregnant women with active TB, drug-resistant TB (DR-TB) or TB/HIV coinfection and examined pregnancy, maternal, fetal/birth and TB or TB/HIV coinfection outcomes. Studies were also included if they examined family planning services among women initiating TB treatment.

Data extraction and synthesis

Two independent reviewers extracted data using PRISMA guidelines and conducted quality assessment using the Joanna-Briggs Institute Critical Appraisal Tools. The level of evidence was reported using the Johns Hopkins Evidence-Based Practice guidelines.

Results

69 studies were included in this review. Case reports, case series, case controls, cohort studies, secondary data analyses and a service delivery improvement project conducted in 26 countries made up the totality of the evidence. Most studies reported pregnancy complications for mothers (anaemia, postpartum haemorrhage, deaths) and fetuses or newborns (low birth weight, premature birth, and spontaneous or induced abortions). Few studies discussed the value of offering family planning to prevent adverse pregnancy outcomes. One study examined the effect of a provider training on contraceptive use with reported increased contraceptive use.

Conclusions

Integrating family planning services within a TB treatment programme is essential to reduce adverse TB-associated maternal-child outcomes. Despite well-established adverse pregnancy outcomes, little attention has been paid to family planning to prevent poor pregnancy outcomes for women with TB/DR-TB. Recommendations for clinicians, TB programmes and researchers are provided and reflect evidence presented in this review.
Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia
Authors: Hodges Jacqueline , Waldman Ava Lena , Koshkina Olga , Suzdalnitsky Alexey , Schwendinger Jason , Vitko Serhiy , Plenskey Alexey , Plotnikova Yulia , Moiseeva Elena , Koshcheyev Mikhail , Sebekin Sergey , Zhdanova Svetlana , Ogarkov Oleg , Heysell Scott , Dillingham Rebecca
Published: March 2022

Objectives

We developed and tested a mobile health-based programme to enhance integration of HIV and tuberculosis (TB) care and to promote a patient-centred approach in a region of high coinfection burden. Phases of programme development included planning, stakeholder interviews and platform re-build, testing and iteration.

Setting

In Irkutsk, Siberia, HIV/TB coinfection prevalence is high relative to the rest of the Russian Federation.

Participants

Pilot testing occurred for a cohort of 60 people with HIV and TB.

Results

Key steps emerged to ensure the mobile health-based programme could be operational and adequately adapted for the context, including platform language adaptation, optimisation of server management, iteration of platform features, and organisational practice integration. Pilot testing of the platform rebuild yielded favourable patient perceptions of usability and acceptability at 6 months (n=47 surveyed), with 18 of 20 items showing scores above 4 (on a scale from 1 to 5) on average. Development of this mobile health-based programme for integrated care of infections highlighted the importance of several considerations for tailoring these interventions contextually, including language adaptation and technological capacity, but also, importantly, contextualised patient preferences related to privacy and communication with peers and/or providers, existing regional capacity for care coordination of different comorbidities, and infection severity and treatment requirements.

Conclusions

Our experience demonstrated that integration of care for TB and HIV can be well served by using multimodal mobile health-based programmes, which can enhance communication and streamline workflow between providers across multiple collaborating institutions and improve continuity between inpatient and outpatient care settings. Further study of programme impact on contextual disease-related stigma and social isolation as well as evaluation of implementation on a broader scale for HIV care is currently under way.

Trial registration number

NCT03819374.
Record linkage studies of drug-related deaths among former adult prisoners who have been released to the community: a scoping review protocol
Authors: Cooper Janine A , Onyeka Ifeoma , O'Reilly Dermot , Kirk Richard , Donnelly Michael
Published: March 2022

Introduction

Prisoners often have a complex mix of health and care needs including needs relating to mental and physical ill-health conditions. In addition, substance use disorders are common in prisoners. The transition between prison and community poses risks in terms of a disruption to treatment and care and a deterioration in health. Studies have demonstrated an increased risk of drug-related deaths among former prisoners during the first weeks following release from custody. The aim of this scoping review is to provide an up-to-date account of evidence from record linkage studies about drug-related deaths among former adult prisoners.

Methods and analysis

This is a protocol for a scoping review. The framework for conducting scoping reviews by Arksey and O’Malley, in addition to the methodology and guidance developed by the Joanna Briggs Institute (JBI) and the JBI Collaboration will be followed. MEDLINE, EMBASE, PsychINFO and Web of Science will be searched for studies from 2011 to 2021 using search terms relating to ‘mortality’, ‘drugs’ and ‘ex-prisoner’. A preliminary search in MEDLINE identified at least 473 potentially eligible papers. Two authors will independently screen all titles and abstracts for eligibility using the inclusion and exclusion criteria. There will be no geographical restrictions but non-English language papers will be excluded. Data will be extracted using a piloted customised charting form and the findings will be mapped (guided by the population, concept and context inclusion criteria) and grouped by main conceptual categories (including methodology, key findings and gaps in the research).

Discussion, ethics and dissemination

This scoping review will identify, map and summarise publicly available sources of research and therefore does not require ethical approval. The results will inform our empirical investigation of ex-prisoner mortality as well as being shared with key stakeholders, disseminated in a peer-reviewed journal and presented at relevant conferences.
Warmer summer nocturnal surface air temperatures and cardiovascular disease death risk: a population-based study
Authors: Majeed Haris , Floras John S.
Published: March 2022

Background

In recent summers, some populous mid-latitude to high-latitude regions have experienced greater heat intensity, more at night than by day. Such warming has been associated with increased cause-specific adult mortality. Sex-specific and age-specific associations between summer nocturnal surface air temperatures (SAT) and cardiovascular disease (CVD) deaths have yet to be established.

Methods

A monthly time series analysis (June–July, 2001–2015) was performed on sex-specific CVD deaths in England and Wales of adults aged 60–64 and 65–69 years. Using negative binomial regression with autocorrelative residuals, associations between summer (June–July) nocturnal SAT anomalies (primary exposure) and CVD death rates (outcome) were computed, controlling for key covariates. To explore external validity, similar associations with respect to CVD death in King County, Washington, USA, also were calculated, but only for men aged 60–64 and 65–69 years. Results are reported as incidence rate ratios.

Results

From 2001 to 2015, within these specific cohorts, 39 912 CVD deaths (68.9% men) were recorded in England and Wales and 488 deaths in King County. In England and Wales, after controlling for covariates, a 1°C rise in anomalous summer nocturnal SAT associated significantly with a 3.1% (95% CI 0.3% to 5.9%) increased risk of CVD mortality among men aged 60–64, but not older men or either women age groups. In King County, after controlling for covariates, a 1°C rise associated significantly with a 4.8% (95% CI 1.7% to 8.1%) increased risk of CVD mortality among those <65 years but not older men.

Conclusion

In two mid-latitude regions, warmer summer nights are accompanied by an increased risk of death from CVD among men aged 60–64 years.
Rural–urban correlates of skilled birth attendance utilisation in Sierra Leone: evidence from the 2019 Sierra Leone Demographic Health Survey
Authors: Sserwanja Quraish , Mufumba Ivan , Kamara Kassim , Musaba Milton W
Published: March 2022

Objectives

Understanding the rural–urban context-specific correlates of skilled birth attendance (SBA) is important to designing relevant strategies and programmes. This analysis aimed to assess for the rural-urban correlates of SBA in Sierra Leone.

Setting

The latest nationally representative Sierra Leone Demographic and Health Survey of 2019.

Participants

The study included a weighted sample of 7326 women aged 15–49 years. Each of them had a live birth within 5 years prior to the survey (4531 in rural areas and 2795 women in urban areas).

Primary and secondary outcome measure

SBA (primary) and predictors of SBA (secondary).

Results

SBA was higher in urban areas at 94.9% (95% CI 94.1% to 95.7%) compared with 84.2% (95% CI 83.8% to 85.9%) in rural areas. Rural women resident in the Southern, Northern and Eastern regions, with postprimary education (adjusted OR (aOR) 1.8; 95% CI 1.3 to 2.5), exposure to mass media (aOR 1.5; 95% CI 1.1 to 1.9), not having difficulties with distance to the nearest health facility (aOR 2.3; 95% CI 1.7 to 3.0) were associated with higher odds of SBA. Urban women resident in the Southern, Eastern region, with households having less than seven members (aOR 1.5; 95% CI 1.1 to 2.3), exposure to mass media (aOR 1.8; 95% CI 1.1 to 2.9) and not having difficulties with distance to the nearest health facility (aOR 1.6; 95% CI 1.1 to 2.5) were associated with higher odds of SBA.

Conclusion

Given the observed differences, improving SBA requires programmes and strategies that are context-specific.
Personalising activity to target peak hyperglycaemia and improve cardiometabolic health in people with type 2 diabetes: protocol for a randomised controlled trial
Authors: Chang Courtney R , Astell-Burt Thomas , Russell Brooke M , Francois Monique E
Published: March 2022

Introduction

The benefits of physical activity for glycaemic control in type 2 diabetes (T2D) are well-known. However, whether established glycaemic and cardiovascular benefits can be maximised by exercising at a certain time of day is unknown. Given postprandial glucose peaks contribute to worsening glycated haemoglobin (HbA1c) and cardiovascular risk factors, and that exercise immediately lowers blood glucose, prescribing exercise at a specific time of day to attenuate peak hyperglycaemia may improve glycaemic control and reduce the burden of cardiovascular disease in people with T2D.

Methods and analysis

A single-centre randomised controlled trial will be conducted by the University of Wollongong, Australia. Individuals with T2D (n=70, aged 40–75 years, body mass index (BMI): 27–40 kg/m2) will be recruited and randomly allocated (1:1), stratified for sex and insulin, to one of three groups: (1) exercise at time of peak hyperglycaemia (ExPeak, personalised), (2) exercise not at time of peak hyperglycaemia (NonPeak) or (3) waitlist control (WLC, standard care). The trial will be 5 months, comprising an 8-week intervention and 3-month follow-up. Primary outcome is the change in HbA1c preintervention to postintervention. Secondary outcomes include vascular function (endothelial function and arterial stiffness), metabolic control (blood lipids and inflammation) and body composition (anthropometrics and dual-energy X-ray absorptiometry (DEXA)). Tertiary outcomes will examine adherence.

Ethics and dissemination

The joint UOW and ISLHD Ethics Committee approved protocol (2019/ETH09856) prospectively registered at the Australian New Zealand Clinical Trials Registry. Written informed consent will be obtained from all eligible individuals prior to commencement of the trial. Study results will be published as peer-reviewed articles, presented at national/international conferences and media reports.

Trial registration number

ACTRN12619001049167.
Using storytelling methodology to identify barriers and facilitators of sustained physical activity in patients with a chronic disease: a qualitative study
Authors: de Boer Johanna Jacoba , Feleus Anita , Hesselink Arlette , Siemonsma Petra , Verhoef John , Schmitt Maarten
Published: March 2022

Objectives

To identify implicit and more profound barriers and facilitators and involving context elements to accomplish sustained physical activity (PA) in patients with a chronic disease. Understanding these barriers and facilitators may help develop future strategies to be used by healthcare professionals in primary care to support patients with a chronic disease to reach sustained PA.

Design and methods

The qualitative, narrative research method storytelling was applied. Perspectives of both patients with a chronic disease (n=12) and involved healthcare professionals (n=11) were collected. Stories were audiotaped and retrieved from the transcriptions. Analysis involved a cyclic process of constant comparison. Main themes were arranged in the theoretical framework of the Capability, Opportunity, Motivation and Behaviour (COM-B) model.

Participants

Patients were adults with a chronic disease or at high risk of developing a chronic disease who participated in a PA promoting programme. Eligible healthcare professionals were those involved in these PA promoting programmes in primary care, such as physiotherapists, nurse practitioners or sports consultants.

Results

From 176 stories, 62 relevant and unique stories were selected for further analysis. Eleven main themes were identified and afterwards linked to the COM-B model. Trust in one’s own capabilities and in the healthcare professional were relevant themes. Also, health literacy and coping with temporary interruption were important capabilities. Important motivators were customised PA, increasing awareness, meaningful activities, exercising in a group and success experiences. Aversion to sports was seen as a barrier. Interprofessional collaboration and prerequisites can be a facilitator or a barrier.

Conclusions

This study provides insight into deeper motivations, barriers and facilitators of sustained PA from both the patients’ and healthcare professionals’ perspective. Comparing these perspectives revealed different views and beliefs on some themes. Attention for temporary interruptions, aversion to sports and health literacy were identified to be important for sustained PA.
Protocol for the Let’s Grow randomised controlled trial: examining efficacy, cost-effectiveness and scalability of a m-Health intervention for movement behaviours in toddlers
Authors: Hesketh Kylie D , Downing Katherine L , Galland Barbara C , Nicholson Jan M , Taylor Rachael , Orellana Liliana , Abdelrazek Mohamed , Koorts Harriet , Brown Victoria , Haines Jess , Campbell Karen J , Barnett Lisa M , Löf Marie , Moodie Marj , Carson Valerie , Salmon Jo
Published: March 2022

Introduction

Despite being an important period for the development of movement behaviours (physical activity, sedentary behaviour and sleep), few interventions commencing prior to preschool have been trialled. The primary aim of this trial is to assess the 12-month efficacy of the Let’s Grow mHealth intervention, designed to improve the composition of movement behaviours in children from 2 years of age. Let’s Grow is novel in considering composition of movement behaviours as the primary outcome, using non-linear dynamical approaches for intervention delivery, and incorporating planning for real-world implementation and scale-up from its inception.

Methods and analysis

A randomised controlled trial will test the effects of the 12-month parental support mHealth intervention, Let’s Grow, compared with a control group that will receive usual care plus electronic newsletters on unrelated topics for cohort retention. Let’s Grow will be delivered via a purpose-designed mobile web application with linked SMS notifications. Intervention content includes general and movement-behaviour specific parenting advice and incorporates established behaviour change techniques. Intervention adherence will be monitored by app usage data. Data will be collected from participants using 24-hour monitoring of movement behaviours and parent report at baseline (T0), mid-intervention (T1; 6 months post baseline), at intervention conclusion (T2; 12 months post baseline) and 1-year post intervention (T3; 2 years post baseline). The trial aims to recruit 1100 families from across Australia during 2021. In addition to assessment of efficacy, an economic evaluation and prospective scalability evaluation will be conducted.

Ethics and dissemination

The study was approved by the Deakin University Human Ethics Committee (2020-077). Study findings will be disseminated through publication in peer-reviewed journals, presentation at scientific and professional conferences, and via social and traditional media.

Trial registration number

ACTRN12620001280998; U1111-1252-0599.
Explaining population trends in cardiovascular risk: protocol for a comparative analysis of health transitions in South Africa and England using nationally representative survey data
Authors: Adjaye-Gbewonyo Kafui , Cois Annibale
Published: March 2022

Introduction

Cardiovascular diseases (CVD) are the leading cause of death globally and share determinants with other major non-communicable diseases. Risk factors for CVD are routinely measured in population surveys and thus provide an opportunity to study health transitions. Understanding the drivers of health transitions in countries that have not followed expected paths compared with those that exemplified models of ‘epidemiologic transition’, such as England, can generate knowledge on where resources may best be directed to reduce the burden of disease. This study aims to examine the notions of epidemiological transition by identifying and quantifying the drivers of change in CVD risk in a middle-income African setting compared with a high-income European setting.

Methods and analysis

This is a secondary joint analysis of data collected within the scope of multiple population surveys conducted in South Africa and England between 1998 and 2017 on nationally representative samples of the adult population. The study will use a validated, non-laboratory risk score to estimate and compare the distribution of and trends in total CVD risk in the population. Statistical modelling techniques (fixed-effects and random-effects multilevel regression models and structural equation models) will be used to examine how various factors explain the variation in CVD risk over time in the two countries.

Ethics and dissemination

This study has obtained approval from the University of Greenwich (20.5.6.8) and Stellenbosch University (X21/09/027) Research Ethics Committees. It uses anonymised microdata originating from population surveys which received ethical approval from the relevant bodies, with no additional primary data collection. Results of the study will be disseminated through (1) peer-reviewed articles in open access journals; (2) policy briefs; (3) conferences and meetings; and (4) public engagement activities designed to reach health professionals, governmental bodies, civil society and the lay public. A harmonised data set will be made publicly available through online repositories.
Real-world outcomes of a clinical decision support system for diabetic retinopathy in Spain
Authors: Romero-Aroca Pedro , Verges Raquel , Maarof Najlaa , Vallas-Mateu Aida , Latorre Alex , Moreno-Ribas Antonio , Sagarra-Alamo Ramon , Basora-Gallisa Josep , Cristiano Julian , Baget-Bernaldiz Marc
Published: March 2022

Objective

The aim of present study was to evaluate our clinical decision support system (CDSS) for predicting risk of diabetic retinopathy (DR). We selected randomly a real population of patients with type 2 diabetes (T2DM) who were attending our screening programme.

Methods and analysis

The sample size was 602 patients with T2DM randomly selected from those who attended the DR screening programme. The algorithm developed uses nine risk factors: current age, sex, body mass index (BMI), duration and treatment of diabetes mellitus (DM), arterial hypertension, Glicated hemoglobine (HbA1c), urine–albumin ratio and glomerular filtration.

Results

The mean current age of 67.03±10.91, and 272 were male (53.2%), and DM duration was 10.12±6.4 years, 222 had DR (35.8%). The CDSS was employed for 1 year. The prediction algorithm that the CDSS uses included nine risk factors: current age, sex, BMI, DM duration and treatment, arterial hypertension, HbA1c, urine–albumin ratio and glomerular filtration. The area under the curve (AUC) for predicting the presence of any DR achieved a value of 0.9884, the sensitivity of 98.21%, specificity of 99.21%, positive predictive value of 98.65%, negative predictive value of 98.95%, α error of 0.0079 and β error of 0.0179.

Conclusion

Our CDSS for predicting DR was successful when applied to a real population.
COVID-19 Oximetry @home: evaluation of patient outcomes
Authors: Boniface Michael , Burns Daniel , Duckworth Christopher , Ahmed Mazen , Duruiheoma Franklin , Armitage Htwe , Ratcliffe Naomi , Duffy John , O’Keeffe Caroline , Inada-Kim Matt
Published: March 2022

Background

COVID-19 has placed unprecedented demands on hospitals. A clinical service, COVID-19 Oximetry @home (CO@h) was launched in November 2020 to support remote monitoring of COVID-19 patients in the community. Remote monitoring through CO@h aims to identify early patient deterioration and provide timely escalation for cases of silent hypoxia, while reducing the burden on secondary care.

Methods

We conducted a retrospective service evaluation of COVID-19 patients onboarded to CO@h from November 2020 to March 2021 in the North Hampshire (UK) community led service (a collaboration of 15 General Practitioner (GP) practices covering 230 000 people). We have compared outcomes for patients admitted to Basingstoke and North Hampshire Hospital who were CO@h patients (COVID-19 patients with home monitoring of oxygen saturation (SpO2; n=115), with non-CO@h patients (those directly admitted without being monitored by CO@h (n=633)). Crude and adjusted OR analysis was performed to evaluate the effects of CO@h on patient outcomes of 30-day mortality, Intensive care unit (ICU) admission and hospital length of stay greater than 3, 7, 14 and 28 days.

Results

Adjusted ORs for CO@h show an association with a reduction for several adverse patient outcome: 30-day hospital mortality (p<0.001, OR 0.21, 95% CI 0.08 to 0.47), hospital length of stay larger than 3 days (p<0.05, OR 0.62, 95% CI 0.39 to 1.00), 7 days (p<0.001, OR 0.35, 95% CI 0.22 to 0.54), 14 days (p<0.001, OR 0.22 95% CI, 0.11 to 0.41), and 28 days (p<0.05, OR 0.21, 95% CI 0.05 to 0.59). No significant reduction ICU admission was observed (p>0.05, OR 0.43, 95% CI 0.15 to 1.04). Within 30 days of hospital admission, there were no hospital readmissions for those on the CO@h service as opposed to 8.7% readmissions for those not on the service.

Conclusions

We have demonstrated a significant association between CO@h and better patient outcomes; most notably a reduction in the odds of hospital lengths of stays longer than 7, 14 and 28 days and 30-day hospital mortality.
Improving participation and engagement with a COVID-19 surveillance programme in an outpatient setting
Authors: Wemyss Callum , Hobson Simon , Sweeney Jill , Chua Pei Rong , Binti Mohd Khairi Siti Aishah , Edwards Maura , Burns Jacqueline , McGoldrick Niall , Braid Raymond , Gorman Megan , Redmond Suzanne , Clark Claire , Brown Clare , Watling Chris , Conway David I , Culshaw Shauna
Published: March 2022

Background

On 3 August 2020, Public Health Scotland commenced a prospective surveillance study to monitor the prevalence of COVID-19 among asymptomatic outpatients attending dental clinics across 14 health boards in Scotland.

Objectives

The primary aim of this quality improvement project was to increase the number of COVID-19 tests carried out in one of the participating sites, Glasgow Dental Hospital and School. The secondary aim was to identify barriers to patient participation and staff engagement when implementing a public health initiative in an outpatient setting.

Method

A quality improvement working group met weekly to discuss hospital findings, identify drivers and change ideas. Details on reasons for patient non-participation were recorded and questionnaires on project barriers were distributed to staff. In response to findings, rapid interventions were implemented to fast-track increases in the numbers of tests being carried out.

Results

Over 16 weeks, 972 tests were carried out by Glasgow Dental Hospital and School Secondary Care Services. The number of tests per week increased from 19 (week 1) to 129 (week 16). This compares to a similar ‘control’ site, where the number of tests carried out remained unchanged; 38 (week 1) to 36 (week 16). The most frequent reason given for non-participation was fear that the swab would hurt. For staff, lack of time and forgetting to ask patients were identified as the most significant barriers.

Conclusion

Public health surveillance programmes can be integrated rapidly into outpatient settings. This project has shown that a quality improvement approach can be successful in integrating such programmes. The key interventions used were staff engagement initiatives and front-line data collection. Implementation barriers were also identified using staff questionnaires.
Role of mass spectrometry-based serum proteomics signatures in predicting clinical outcomes and toxicity in patients with cancer treated with immunotherapy
Authors: Park Yeonggyeong , Kim Min Jeong , Choi Yoonhee , Kim Na Hyun , Kim Leeseul , Hong Seung Pyo Daniel , Cho Hyung-Gyo , Yu Emma , Chae Young Kwang
Published: March 2022

Immunotherapy has fundamentally changed the landscape of cancer treatment. However, only a subset of patients respond to immunotherapy, and a significant portion experience immune-related adverse events (irAEs). In addition, the predictive ability of current biomarkers such as programmed death-ligand 1 (PD-L1) remains unreliable and establishing better potential candidate markers is of great importance in selecting patients who would benefit from immunotherapy. Here, we focus on the role of serum-based proteomic tests in predicting the response and toxicity of immunotherapy. Serum proteomic signatures refer to unique patterns of proteins which are associated with immune response in patients with cancer. These protein signatures are derived from patient serum samples based on mass spectrometry and act as biomarkers to predict response to immunotherapy. Using machine learning algorithms, serum proteomic tests were developed through training data sets from advanced non-small cell lung cancer (Host Immune Classifier, Primary Immune Response) and malignant melanoma patients (PerspectIV test). The tests effectively stratified patients into groups with good and poor treatment outcomes independent of PD-L1 expression. Here, we review current evidence in the published literature on three liquid biopsy tests that use biomarkers derived from proteomics and machine learning for use in immuno-oncology. We discuss how these tests may inform patient prognosis as well as guide treatment decisions and predict irAE of immunotherapy. Thus, mass spectrometry-based serum proteomics signatures play an important role in predicting clinical outcomes and toxicity.
Severe flares are associated with a poorer health-related quality of life (HRQoL) in patients with SLE: data from the Almenara Lupus Cohort
Authors: Ugarte-Gil Manuel Francisco , Gamboa-Cardenas Rocio Violeta , Reátegui-Sokolova Cristina , Pimentel-Quiroz Victor Román , Medina Mariela , Elera-Fitzcarrald Claudia , Zevallos Francisco , Pastor-Asurza Cesar Augusto , Zazzetti Federico , Karyekar Chetan S , Alarcón Graciela S , Perich-Campos Risto Alfredo
Published: March 2022

Background

Flares in patients with SLE, regardless of their severity, have been associated with damage accrual. However, their impact on health-related quality of life (HRQoL) has not been fully evaluated. In fact, disease activity is only minimally associated with HRQoL.

Objective

To determine the association between flares and HRQoL.

Methods

Patients from the Almenara Lupus Cohort were included. Visits occurring between December 2015 and February 2020 were evaluated. Flares were defined as an increase on the SLE Disease Activity Index 2000 (SLEDAI-2K) of at least 4 points; severe flares were those with a final SLEDAI-2K ≥12 and mild-moderate flares all the others. HRQoL was measured using the LupusQoL. Univariable and multivariable generalised estimating regression equations were performed, adjusting for possible confounders. Confounders were determined at one visit, whereas the outcome was determined on the subsequent visit; flares were determined based on the variation of the SLEDAI-2K between these visits.

Results

Two hundred and seventy-seven patients were included; 256 (92.4%) were female, mean age at diagnosis was 36.0 (SD: 13.3) years and mean disease duration at baseline was 9.1 (SD: 7.1) years. Patients had mean of 4.8 (SD: 1.9) visits and a mean follow-up of 2.7 (1.1) years. Out of 1098 visits, 115 (10.5%) flares were defined, 17 were severe and 98 mild-moderate. After adjustment for possible confounders, only severe flares were associated with a poorer HRQoL in planning, pain, emotional health and fatigue.

Conclusions

Severe flares, but not mild-moderate, flares are associated with poorer HRQoL.
Synthesis and characterization of mesoporous-HZSM-5 as a catalyst for ethanol dehydration to ethylene
Authors: Cao Kesheng , Wu Yibo , Song Guoqiang , Li Qingbin , Ma Wei , Sheng Pengtao , Tian Gang , Cao Yunli , Feng Yunxiao , Gao Xinghe , Liu Mengxin , Peng Qinlong
Published: March 2022

In this work, mesoporous HZSM-5 (M-HZSM-5) was synthesized with γ-(2,3-epoxypropoxy) propyltrimethoxysilane as pore-expanding agent through one-pot method and was studied for its catalytic activity and stability in ethanol dehydration. The resultant samples were characterized by various techniques, including Brunauer-Emmett-Teller, Scanning electron microscopy, Fourier transform infrared spectroscopy, the temperature-programmed desorption of NH3, and Thermogravimetric. Based on the analysis of the results, M-HZSM-5 with the typical MFI structure displays a specific surface area of 450 m2 g−1. Furthermore, the improvement of the activity and anti-coking ability of the catalyst for ethanol dehydration to ethylene is attributed to the existence of mesopores in HZSM-5, which can provide the reaction space and acid sites.
Characterisation of the dip-bump structure observed in proton–proton elastic scattering at $$\sqrt{s}$$ = 8 TeV
Authors: Antchev G. , Aspell P. , Atanassov I. , Avati V. , Baechler J. , Barrera C. Baldenegro , Berardi V. , Berretti M. , Borchsh V. , Bossini E. , Bottigli U. , Bozzo M. , Burkhardt H. , Cafagna F. S. , Catanesi M. G. , Csanád M. , Csörgő T. , Deile M. , De Leonardis F. , Doubek M. , Druzhkin D. , Eggert K. , Eremin V. , Ferro F. , Fiergolski A. , Forthomme L. , Garcia F. , Georgiev V. , Giani S. , Grzanka L. , Hammerbauer J. , Isidori T. , Ivanchenko V. , Janda M. , Karev A. , Kašpar J. , Kaynak B. , Kopal J. , Kundrát V. , Lami S. , Latino G. , Linhart R. , Lindsey C. , Lokajíček M. V. , Losurdo L. , Rodríguez F. Lucas , Macrí M. , Malawski M. , Minafra N. , Minutoli S. , Naaranoja T. , Nemes F. , Niewiadomski H. , Novák T. , Oliveri E. , Oljemark F. , Oriunno M. , Österberg K. , Palazzi P. , Passaro V. , Peroutka Z. , Procházka J. , Quinto M. , Radermacher E. , Radicioni E. , Ravotti F. , Robutti E. , Royon C. , Ruggiero G. , Saarikko H. , Samoylenko V. D. , Scribano A. , Siroky J. , Smajek J. , Snoeys W. , Stefanovitch R. , Sziklai J. , Taylor C. , Tcherniaev E. , Turini N. , Urban O. , Vacek V. , Vavroch O. , Welti J. , Williams J. , Zich J. , Zielinski K. ,   TOTEM Collaboration
Published: March 2022

The TOTEM collaboration at the CERN LHC has measured the differential cross-section of elastic proton–proton scattering at $$\sqrt{s} = 8\,\mathrm{TeV}$$

s

=
8

TeV

in the squared four-momentum transfer range $$0.2\,\mathrm{GeV^{2}}< |t| < 1.9\,\mathrm{GeV^{2}}$$

0.2

GeV
2

<

|
t
|

<
1.9

GeV
2

. This interval includes the structure with a diffractive minimum (“dip”) and a secondary maximum (“bump”) that has also been observed at all other LHC energies, where measurements were made. A detailed characterisation of this structure for $$\sqrt{s} = 8\,\mathrm{TeV}$$

s

=
8

TeV

yields the positions, $$|t|_{\mathrm{dip}} = (0.521 \pm 0.007)\,\mathrm{GeV^2}$$

|
t
|

dip

=

(
0.521
±
0.007
)

GeV
2

and $$|t|_{\mathrm{bump}} = (0.695 \pm 0.026)\,\mathrm{GeV^2}$$

|
t
|

bump

=

(
0.695
±
0.026
)

GeV
2

, as well as the cross-section values, $$\left. {\mathrm{d}\sigma /\mathrm{d}t}\right| _{\mathrm{dip}} = (15.1 \pm 2.5)\,\mathrm{{\mu b/GeV^2}}$$

d
σ
/
d
t

dip

=

(
15.1
±
2.5
)

μ
b
/

GeV
2

and $$\left. {\mathrm{d}\sigma /\mathrm{d}t}\right| _{\mathrm{bump}} = (29.7 \pm 1.8)\,\mathrm{{\mu b/GeV^2}}$$

d
σ
/
d
t

bump

=

(
29.7
±
1.8
)

μ
b
/

GeV
2

, for the dip and the bump, respectively.
Proton-PDF uncertainties in extracting nuclear PDFs from $$W^\pm $$ production in p+Pb collisions
Authors: Eskola Kari J. , Paakkinen Petja , Paukkunen Hannu , Salgado Carlos A.
Published: March 2022

We discuss the recent CMS Collaboration measurement of$$W^\pm $$W±boson production in p+Pb collisions at 8.16 TeV in terms of the constraining power on nuclear parton distribution functions (PDFs). The impact of the free-proton PDF uncertainties on the nuclear PDF extraction is quantified by using a theoretical covariance-matrix method and Hessian PDF reweighting. We discuss different ways to mitigate these theoretical uncertainties, including self-normalization, forward-to-backward ratios and nuclear-modification ratios. It is found that none of these methods offer perfect cancellation of the free-proton PDFs but, with the present data uncertainties, the residual free-proton-PDF dependence has, conveniently for the global analyses, little effect on the extraction of the nuclear modifications. Based on a simple estimate of obtainable statistics at the LHC Run 3, we argue that this will change in the near future and it becomes more important to propagate the proton-PDF uncertainties accordingly. Using the obtained information on the correlations of the free-proton uncertainties, we also identify a new charge asymmetry ratio, where the cancellation of the proton-PDF uncertainties is found to be extremely good.
Method of Short-Circuit Fault Diagnosis in Transmission Line Based on Deep Learning
Authors: Li Tong , Zhao Hai , Zhou Xiaoming , Zhu Shidong , Yang Zheng , Yang Hongping , Liu Wei , Zhou Zhenliu
Published: March 2022

It is important to locate the fault distance and identify the fault types quickly, take effective measures to maintain line stability, and minimize the losses timely when there are short-circuit faults in transmission lines. For this purpose, a method based on deep learning is proposed for short-circuit faults identification in the transmission line. According to the similarity of samples in the reconstruction phase, a minimum neighborhood sample set is selected from the massive samples firstly, and then, the samples are trained using the back propagation algorithm along time in a recurrent neural network (RNN) with long-short term memory (LSTM) units. Compared with existing algorithms, the experimental results show that this algorithm meets the requirements of rapid fault diagnosis in the case of variable parameters, and higher fault type recognition accuracy and lower fault distance error can be obtained.
On the families of polynomials forming a part of the Askey–Wilson scheme and their probabilistic applications
Authors: Szabłowski Paweł J.
Published: March 2022

In this paper, we review the properties of six families of orthogonal polynomials that form the main bulk of the collection called the Askey–Wilson scheme of polynomials. We give connection coefficients between them as well as the so-called linearization formulae and other useful important finite and infinite expansions and identities. An important part of the paper is the presentation of probabilistic models where most of these families of polynomials appear. These results were scattered within the literature in recent 15 years. We put them together to enable an overall outlook on these families and understand their crucial rôle in the attempts to generalize Gaussian distributions and find their bounded support generalizations. This paper is based on 65 items in the predominantly recent literature.