bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study
Authors: Swaminathan Sumathi , Dehghan Mahshid , Raj John Michael , Thomas Tinku , Rangarajan Sumathy , Jenkins David , Mony Prem , Mohan Viswanathan , Lear Scott A , Avezum Alvaro , Lopez-Jaramillo Patricio , Rosengren Annika , Lanas Fernando , AlHabib Khalid F , Dans Antonio , Keskinler Mirac Vural , Puoane Thandi , Soman Biju , Wei Li , Zatonska Katarzyna , Diaz Rafael , Ismail Noorhassim , Chifamba Jephat , Kelishadi Roya , Yusufali Afzalhussein , Khatib Rasha , Xiaoyun Liu , Bo Hu , Iqbal Romaina , Yusuf Rita , Yeates Karen , Teo Koon , Yusuf Salim
Published: February 2021

Objective

To evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study.

Design

Prospective cohort study.

Setting

PURE study in 21 countries.

Participants

148 858 participants with median follow-up of 9.5 years.

Exposures

Country specific validated food frequency questionnaires were used to assess intakes of refined grains, whole grains, and white rice.

Main outcome measure

Composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure). Hazard ratios were estimated for associations of grain intakes with mortality, major cardiovascular events, and their composite by using multivariable Cox frailty models with random intercepts to account for clustering by centre.

Results

Analyses were based on 137 130 participants after exclusion of those with baseline cardiovascular disease. During follow-up, 9.2% (n=12 668) of these participants had a composite outcome event. The highest category of intake of refined grains (≥350 g/day or about 7 servings/day) was associated with higher risk of total mortality (hazard ratio 1.27, 95% confidence interval 1.11 to 1.46; P for trend=0.004), major cardiovascular disease events (1.33, 1.16 to 1.52; P for trend<0.001), and their composite (1.28, 1.15 to 1.42; P for trend<0.001) compared with the lowest category of intake (<50 g/day). Higher intakes of refined grains were associated with higher systolic blood pressure. No significant associations were found between intakes of whole grains or white rice and health outcomes.

Conclusion

High intake of refined grains was associated with higher risk of mortality and major cardiovascular disease events. Globally, lower consumption of refined grains should be considered.
Use of high dose cyproterone acetate and risk of intracranial meningioma in women: cohort study
Authors: Weill Alain , Nguyen Pierre , Labidi Moujahed , Cadier Benjamin , Passeri Thibault , Duranteau Lise , Bernat Anne-Laure , Yoldjian Isabelle , Fontanel Sylvie , Froelich Sébastien , Coste Joël
Published: February 2021

Objective

To assess the risk of meningioma associated with use of high dose cyproterone acetate, a progestogen indicated for clinical hyperandrogenism.

Design

Observational cohort study.

Setting

Data from SNDS, the French administrative healthcare database, between 2007 and 2015.

Participants

253 777 girls and women aged 7-70 years living in France who started cyproterone acetate between 2007 and 2014. Participants had at least one reimbursement for high dose cyproterone acetate and no history of meningioma or benign brain tumour, or long term disease status. Participants were considered to be exposed when they had received a cumulative dose of at least 3 g during the first six months (139 222 participants) and very slightly exposed (control group) when they had received a cumulative dose of less than 3 g (114 555 participants). 10 876 transgender participants (male to female) were included in an additional analysis.

Main outcome measure

Surgery (resection or decompression) or radiotherapy for one or more intracranial meningiomas.

Results

Overall, 69 meningiomas in the exposed group (during 289 544 person years of follow-up) and 20 meningiomas in the control group (during 439 949 person years of follow-up) were treated by surgery or radiotherapy. The incidence of meningioma in the two groups was 23.8 and 4.5 per 100 000 person years, respectively (crude relative risk 5.2, 95% confidence interval 3.2 to 8.6; adjusted hazard ratio 6.6, 95% confidence interval 4.0 to 11.1). The adjusted hazard ratio for a cumulative dose of cyproterone acetate of more than 60 g was 21.7 (10.8 to 43.5). After discontinuation of cyproterone acetate for one year, the risk of meningioma in the exposed group was 1.8-fold higher (1.0 to 3.2) than in the control group. In a complementary analysis, 463 women with meningioma were observed among 123 997 already using cyproterone acetate in 2006 (risk of 383 per 100 000 person years in the group with the highest exposure in terms of cumulative dose). Meningiomas located in the anterior skull base and middle skull base, particularly the medial third of the middle skull base, involving the spheno-orbital region, appeared to be specific to cyproterone acetate. An additional analysis of transgender participants showed a high risk of meningioma (three per 14 460 person years; 20.7 per 100 000 person years).

Conclusions

A strong dose-effect relation was observed between use of cyproterone acetate and risk of intracranial meningiomas. A noticeable reduction in risk was observed after discontinuation of treatment.
Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
Authors: Atuhairwe Susan , Gemzell-Danielsson Kristina , Byamugisha Josaphat , Kaharuza Frank , Tumwesigye Nazarius Mbona , Hanson Claudia
Published: February 2021

Introduction

With a view to inform policy for improved postabortion care, we describe abortion-related near-miss and mortality by sociodemographic risk factors and management options by pregnancy trimester in Uganda.

Methods

This secondary data analysis used an adapted WHO near-miss methodology to collect cross-sectional maternal near-miss and abortion complications data at 43 health facilities in Central and Eastern Uganda in 2016–2017. We computed abortion severe morbidity, near-miss and mortality ratios per 100 000 live births, and described the proportion of cases that worsened to an abortion near-miss or death, stratified by geographical region and trimester. We tested for association between independent variables and abortion near-miss, and obtained prevalence ratios for association between second trimester near-miss and independent demographic and management indicators. We assessed health facility readiness for postabortion care provision in Central and Eastern regions.

Results

Of 3315 recorded severe abortion morbidity cases, 1507 were near-misses. Severe abortion morbidity, near-miss and mortality ratios were 2063, 938 and 23 per 100 000 live births, respectively. Abortion-related mortality ratios were 11 and 57 per 100 000 in Central and Eastern regions, respectively. Abortion near-miss cases were significantly associated with referral (p<0.001). Second trimester had greater abortion mortality than first trimester. Eastern region had greater abortion-related morbidity and mortality than Central region with facilities in the former characterised by inferior readiness to provide postabortion care.

Conclusions

Uganda has a major abortion near-miss morbidity and mortality; with mortality higher in the second trimester. Life-saving commodities are lacking especially in Eastern region compromising facility readiness for postabortion care provision.
Equity considerations in outcome measures of the HIV pre-exposure prophylaxis care continuum in high-income countries: a systematic review protocol
Authors: Cabecinha Melissa , Solomon Danielle , Rait Greta , Saunders John , Mohammed Hamish , McDonagh Lorraine Katherine
Published: February 2021

Introduction

HIV pre-exposure prophylaxis (PrEP) is an effective intervention to reduce acquisition of HIV. PrEP provision has increased in recent years, however, it is not known whether PrEP implementation has been equitably implemented across all risk groups, particularly groups experiencing high levels of health inequity. A PrEP care continuum (PCC) has been proposed to evaluate the success of PrEP implementation programmes, but the extent to which health equity characteristics are currently taken into account in the PCC has not been described. The objectives of this proposed systematic review are to (i) identify and collate outcome measure definitions for the main stages of the PCC (awareness, acceptability, uptake, adherence and retention), (ii) describe how equity characteristics are considered in outcome definitions of the PCC and (iii) describe data sources for capturing equity characteristics.

Methods and analysis

Quantitative studies published between 1 January 2012 and 3 March 2020 will be included. Five databases (MEDLINE, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts) will be searched to identify English language publications that include an outcome measure definition of at least one of the five main stages of the PCC. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Data on outcome measure definitions and equity characteristics will be extracted. Results will be presented in a narrative synthesis and all findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Ethics and dissemination

Ethical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete. The review findings will have relevance to healthcare professionals, policymakers and commissioners in informing how to best evaluate PrEP implementation programmes and inform new implementation strategies for vulnerable and less advantaged populations.

PROSPERO registration number

CRD42020169779.
Experiences with traumatic events, consequences and care among people with visual impairment and post-traumatic stress disorder: a qualitative study from The Netherlands
Authors: van der Ham Alida J , van der Aa Hilde P A , Verstraten Peter , van Rens Ger H M B , van Nispen Ruth M A
Published: February 2021

Objective

Having a visual impairment is known to be associated with an increased vulnerability to (potentially) traumatic events. Little is known about how people with visual impairment experience and process such events. This qualitative study aimed to provide more insight into experiences with traumatic events, consequences of traumatic events and post-traumatic stress disorder (PTSD)-related care among people with visual impairment and PTSD.

Methods

Eighteen persons with visual impairment and (a history of) PTSD were interviewed. Among them were 14 women and 4 men aged between 23 and 66 years. Recruitment of participants was done through health professionals from two low-vision service centres and a patient association for people with eye diseases and visual impairment in The Netherlands. Interviews focused on experiences with (1) traumatic events, (2) consequences of traumatic events and (3) PTSD-related care. Thematic content analysis of interview data was performed using ATLAS.ti. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used to check for completeness and transparency of the study. Data were collected between 2018 and 2020.

Results

The most commonly reported traumatic events were sexual and physical abuse. Many participants experienced that their impairment had negatively affected their acceptance by others, independence and self-esteem, increasing their vulnerability for traumatic events. Additionally, having a visual impairment negatively impacted participants’ ability to respond to situations and aggravated post-traumatic stress reactions. Existing treatments seem suitable for people with visual impairment when accommodated to the impairment.

Conclusions

Having a visual impairment may affect traumatic events and post-traumatic stress reactions, particularly by contributing to low self-esteem, problems in social interactions and a lack of visual information. Insights from this study provide starting points for adapting pretraumatic and post-traumatic care to the needs of people with visual impairment.
Prevalence and risk factors of anxiety and depression among patients with breast cancer: a protocol for systematic review and meta-analysis
Authors: Li Jie , Zhang Feng , Wang Wenchun , Pang Rizhao , Liu Jiancheng , Man Qiuhong , Zhang Anren
Published: February 2021

Background

Patients with breast cancer often experience severe psychological distress, especially anxiety and depression, leading to poorer quality of life, shortened survival time and increased mortality.

The objective of the review will be to summarise data on the prevalence and risk factors of anxiety and depression in patients with breast cancer.

Methods and analysis

Two reviewers will be applied in seven databases, including Web of Science, PubMed, EMBASE, Wan Fang Data Knowledge Service Platform, Chinese Biomedical Literature Database, Chinese Scientific Journal Database (VIP database), China National Knowledge Infrastructure and for studies on the prevalence and risk factors of depression in patients with breast cancer, which should be published from inception to Feb 2020 in English, Chinese, French and Spanish. The selection of studies, data extraction and risk of bias assessment will be done independently by two reviewers. Data synthesis will be carried out using RevMan V.5.3 software. The heterogeneity will be determined by the I² test. Publication bias will be evaluated by generating a funnel plot and performing the Begg and Egger test. The quality of the systematic review will be assessed using the Grading of Recommendations Assessment, Development and Evaluation Tool criteria.

Ethics and dissemination

No ethical approval is required. This protocol will not involve individual patient information and endangering participant rights. The results will be reported in a peer-reviewed journal or disseminated in relevant conferences.

OSF registration number

DOI 10.17605/OSF.IO/D6A4P.
Patient and informal carer experience of hip fracture: a qualitative study using interviews and observation in acute orthopaedic trauma
Authors: Tutton Elizabeth , Saletti-Cuesta Lorena , Langstaff Debbie , Wright Julie , Grant Richard , Willett Keith
Published: February 2021

Objectives

The time taken for older people to recover from hip fracture can be extensive. The aim of this study was to gain an understanding of patient and informal carer experience of recovery in the early stage, while in acute care.

Design

A phenomenological (lived experience) approach was used to guide the design of the study. Interviews and observation took place between March 2016 and December 2016 in acute care.

Setting

Trauma wards in a National Health Service Foundation Trust in the South West of England.

Participants

A purposive sample of 25 patients were interviewed and observation taking 52 hours was undertaken with 13 patients and 12 staff. 11 patients had memory loss, 2 patients chose to take part in an interview and observation. The age range was 63–91 years (median 83), 10 were men. A purposive sample of 25 informal carers were also interviewed, the age range was 42–95 years (mean 64), 11 were men.

Results

The results identified how participants moved forward together after injury by sharing the journey. This was conveyed through three themes: (1) sustaining relationships while experiencing strong emotions and actively helping, (2) becoming aware of uncertainty about the future and working through possible outcomes, (3) being changed, visibly looking different, not being able to walk, and enduring indignity and pain.

Conclusion

This study identified the experience of patients and informal carers as they shared the journey during a challenging life transition. Strategies that support well-being and enable successful negotiation of the emotional and practical challenges of acute care may help with longer term recovery. Research should focus on developing interventions that promote well-being during this transition to help provide the foundation for patients and carers to live fulfilled lives.
Programme theory and realist evaluation of the ‘Smoke-Free Vocational Schools’ research and intervention project: a study protocol
Authors: Hjort Anneke Vang , Christiansen Tenna Børsting , Stage Maria , Rasmussen Kathrine Højlund , Pisinger Charlotta , Tjørnhøj-Thomsen Tine , Klinker Charlotte Demant
Published: February 2021

Introduction

Smoke-free school hours (SFSHs) entails a smoking ban during school hours and might be an effective intervention to reduce the high smoking prevalence in vocational schools. For SFSH to be effective, the policy must be adequately implemented and enforced; this challenge for schools constitutes a research gap. The ‘Smoke-Free Vocational Schools’ research and intervention project has been developed to facilitate schools’ implementation of SFSH. It is scheduled to run from 2018 to 2022, with SFSH being implemented in 11 Danish vocational schools. This study protocol describes the intervention project and evaluation design of the research and intervention project.

Methods and analysis

The intervention project aims to develop an evidence-based model for implementing SFSH in vocational schools and similar settings. The project is developed in a collaboration between research and practice. Two public health NGOs are responsible for delivering the intervention activities in schools, while the research partner evaluates what works, for whom, and under what circumstances. The intervention lasts one year per school, targeting different socioecological levels. During the first 6 months, activities are delivered to stimulate organisational readiness to implement SFSH. Then, SFSH is established, and during the next 6 months, activities are delivered to stimulate implementation of SFSH into routine practice. The epistemological foundation is realistic evaluation. The evaluation focuses on both implementation and outcomes. Process evaluation will determine the level of implementation and explore what hinders or enables SFSH becoming part of routine practice using qualitative and quantitative methods. Outcomes evaluation will quantitively assess the intervention’s effectiveness, with the primary outcome measure being changes in smoking during school hours.

Ethics and dissemination

Informed consent will be obtained from study participants according to the General Data Protection Regulation (GDPR) and Danish data protection law. The study adheres to Danish ethics procedures. Study findings will be disseminated at conferences and further published in open-access peer-reviewed journals.
Seroprevalence of SARS-CoV-2 in the West Bank region of Palestine: a cross-sectional seroepidemiological study
Authors: Qutob Nouar , Awartani Faisal , Salah Zaidoun , Asia Mohammad , Abu Khader Imad , Herzallah Khaled , Balqis Nadeen , Sallam Husam
Published: February 2021

Objectives

Seroprevalence rates are important indicators to the epidemiology of COVID-19 and the extent of the pandemic given the existence of asymptomatic cases. The purpose of this study is to assess the seroprevalence rate in the Palestinian population residing in the West Bank.

Setting

The study involved 1355 participants from 11 governorates, including 112 localities in the West Bank and 1136 individuals visiting Palestinian medical laboratories.

Participants

Blood samples were collected between 15th June 2020 and 30th June 2020 from 1355 individuals from randomly selected households in the West Bank, in addition to 1136 individuals visiting Palestinian medical laboratories between the 1st May 2020 and 9th July 2020 for a routine check-up.

Primary and secondary outcome measures

Out of the 2491 blood samples collected, serological tests for 2455 adequate serum samples were done using an immunoassay for qualitative detection of antibodies against SARS-CoV-2. Seroprevalence was estimated as the proportion of individuals who had a positive result in the total SARS-CoV-2 antibodies in the immunoassay.

Results

The random sample of Palestinians living in the West Bank yielded 0% seroprevalence with 95% and an adjusted CI (0% to 0.0043%), while the lab referral samples yielded an estimated seroprevalence of 0.354% with 95% and an adjusted CI (0.001325% to 0.011566%).

Conclusions

Our results indicate that as of mid-June 2020, seroprevalence in Palestine persists low and is inadequate to provide herd immunity, emphasising the need to maintain health measures to keep the outbreak under control. Population-based seroprevalence studies are to be conducted periodically to monitor the SARS-CoV-2 seroprevalence in Palestine and inform policymakers about the efficacy of their surveillance system.
Are do-not-resuscitate orders associated with limitations of care beyond their intended purpose in patients with acute intracerebral haemorrhage? Analysis of the ABC-ICH study
Authors: Minhas Jatinder S , Sammut-Powell Camilla , Birleson Emily , Patel Hiren C , Parry-Jones Adrian R
Published: February 2021

Implementation of an acute bundle of care for intracerebral haemorrhage (ICH) was associated with a marked improvement in survival at our centre, mediated by a reduction in early (<24 hours) do-not-resuscitate (DNR) orders. The aim of this study was to identify possible mechanisms for this mediation. We retrospectively extracted additional data on resuscitation attempts and supportive care. This observational study utilised existing data collected for the Acute Bundle of Care for ICH (ABC-ICH) quality improvement project between from 2013 to 2017. The primary outcome was whether a patient received an early (<24 hours) DNR order. We used multivariable logistic regression to estimate the adjusted association between clinically meaningful factors, including an indicator for a change in treatment on the introduction of the ABC care bundle. Early DNR orders were associated with a reduced odds of escalation to critical care (OR: 0.07, 95% CI: 0.03 to 0.17, p<0.001). Commencement of palliative care within 72 hours was far more likely (OR: 8.76, 95% CI: 4.74 to 16.61, p<0.001) if an early DNR was in place. The cardiac arrest team were not called for an ICH patient before implementation but were called on five occasions overall during and after implementation. Further qualitative evaluation revealed that on only one occasion was there a cardiac or respiratory arrest with cardiopulmonary resuscitation performed. We found no significant increase in resuscitation attempts after bundle implementation but early DNR orders were associated with less admission to critical care and more early palliation. Early DNR orders are associated with less aggressive supportive care and should be judiciously used in acute ICH.
Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): a narrative review and the viewpoint of the Latin American Society of Pediatric Intensive Care (SLACIP) Sepsis Committee
Authors: Fernández-Sarmiento Jaime , De Souza Daniela , Jabornisky Roberto , Gonzalez Gustavo Ariel , Arias López Maria del Pilar , Palacio Gladys
Published: February 2021

Background

In this review, we discuss some important aspects of paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS), a new syndrome that is temporally related to previous exposure to SARS-CoV-2 infection. This virus has a broad spectrum of presentation that may overlap with Kawasaki disease in terms of presenting symptoms and laboratory and cardiac findings. Our objective was to review and summarise published evidence regarding the most important aspects of PIMS-TS, with special emphasis on the treatment strategies suggested for middle-income and low-income countries.

Methods

A systematic review of the literature was performed in the principal medical databases including PubMed, Embase (OVID) and Google Scholar between December 2019 and August 2020.

Results

A total of 69 articles were identified in the described databases. Altogether, 13 articles met the inclusion criteria and were eligible. The most frequently described symptoms of PIMS-TS include fever (82%), shock (67%) and gastrointestinal (87%), skin (71%) and cardiac disorders (75%). In most series, it has been observed between 4 and 6 weeks after the pandemic appears in the general population. Multisystem inflammatory syndrome in children is presented as a great systemic inflammatory response syndrome, which sometimes presents as shock requiring fluid resuscitation and vasoactive drug support (26%). Several treatment strategies have been used, including immunoglobulin, steroids, aspirin, anakinra and anticoagulation among others. These general and specific interventions should be guided by an interdisciplinary and multidisciplinary team, especially in settings with limited resources.

Conclusions

PIMS-TS COVID-19 is a new type of presentation of SARS-CoV-2 infection, with an exaggerated inflammatory response and frequent—but not exclusive—digestive and myocardial involvement. It is important to describe the clinical course and outcomes in countries with limited resources as well as establish the role of biomarkers for early diagnosis, effective therapeutic strategies and outpatient follow-up schemes.
Be still, my beating heart: reading pulselessness from Shakespeare to the artificial heart
Authors: Hansen Claire , Stevens Michael Charles
Published: February 2021

Today, patients with heart failure can be kept alive by an artificial heart while they await a heart transplant. These modern artificial hearts, or left ventricular assist devices (LVADs), remove the patient’s discernible pulse while still maintaining life. This technology contradicts physiological, historical and sociocultural understandings of the pulse as central to human life. In this essay, we consider the ramifications of this contrast between the historical and cultural importance placed on the pulse (especially in relation to our sense of self) and living with a pulseless LVAD. We argue that the pulse’s relationship to individual identity can be rescripted by examining its representation in formative cultural texts like the works of William Shakespeare. Through an integration of historical, literary and biomedical engineering perspectives on the pulse, this paper expands interpretations of pulselessness and advocates for the importance of cultural—as well as biomedical—knowledge to support patients with LVADs and those around them. In reconsidering figurative and literal representations of the heartbeat in the context of technology which removes the need for a pulse, this essay argues that narrative and metaphor can be used to reconceptualise the relationship between the heartbeat and identity.
Cosmetic surgeries and procedures among youth in Saudi Arabia: a cross-sectional study of undergraduate university students in the Eastern Province
Authors: AlShamlan Nouf A , AlOmar Reem S , Al-Sahow Abdullah Zuhair , AlShamlan Abeer A , Almir Bayan Mohammed , Al-johani Wejdan M , Althunyan Abdullatif K , Motabgani Sameerah
Published: February 2021

Purpose of the study

To assess the attitudes and acceptance of cosmetic surgeries and procedures among undergraduate university students in the Eastern Province, Saudi Arabia, as well as the barriers against having cosmetic surgeries and procedures.

Study design

A cross-sectional study of undergraduate university students in the Eastern Province, Saudi Arabia, during October 2020. The research instrument included the Attitudes towards Cosmetic Surgery Scale (ACSS), sociodemographic data and perceived barriers towards cosmetic surgeries and procedures. A bivariate analysis was performed followed by a linear regression to account for confounders.

Results

A total of 1240 students participated in the study. The mean ACSS for cosmetic surgeries was 3.14 (±1.37 SD), and 3.25 (±1.49 SD) for cosmetic procedures. Older students, students with a history of previous cosmetic surgeries/procedures, and students with engineering specialties had more acceptance scores in both cosmetic surgeries and procedures. On the other hand, men, students belonging to a middle family income and students who perceived themselves to be aware of the risk associated with cosmetic surgeries/procedures had less acceptance scores. The most reported barrier to have cosmetic surgeries and procedures among students was feeling that they do not need it.

Conclusion

The findings from the current study could help dermatologists, plastic surgeons and adolescent specialists wishing to recognise the rising interest in cosmetic surgeries and procedures in Arabic youth populations, the possible associated factors, as well as the barriers to have these surgeries and procedures. A further qualitative in-depth study to explore the acceptance is suggested.
Methodological aspects of design, analysis and reporting of studies with work participation as an outcome domain in patients with inflammatory arthritis: results of two systematic literature reviews informing EULAR points to consider
Authors: Marques Mary Lucy , Alunno Alessia , Boonen Annelies , ter Wee Marieke M , Falzon Louise , Ramiro Sofia , Putrik Polina
Published: February 2021

Objective

To summarise the methodological aspects in studies with work participation (WP) as outcome domain in inflammatory arthritis (IA) and other chronic diseases.

Methods

Two systematic literature reviews (SLRs) were conducted in key electronic databases (2014–2019): search 1 focused on longitudinal prospective studies in IA and search 2 on SLRs in other chronic diseases. Two reviewers independently identified eligible studies and extracted data covering pre-defined methodological areas.

Results

In total, 58 studies in IA (22 randomised controlled trials, 36 longitudinal observational studies) and 24 SLRs in other chronic diseases were included. WP was the primary outcome in 26/58 (45%) studies. The methodological aspects least accounted for in IA studies were as follows (proportions of studies positively adhering to the topic are shown): aligning the studied population (16/58 (28%)) and sample size calculation (8/58 (14%)) with the work-related study objective; attribution of WP to overall health (28/58 (48%)); accounting for skewness of presenteeism/sick leave (10/52 (19%)); accounting for work-related contextual factors (25/58 (43%)); reporting attrition and its reasons (1/58 (2%)); reporting both aggregated results and proportions of individuals reaching predefined meaningful change or state (11/58 (16%)). SLRs in other chronic diseases confirmed heterogeneity and methodological flaws identified in IA studies without identifying new issues.

Conclusion

High methodological heterogeneity was observed in studies with WP as outcome domain. Consensus around various methodological aspects specific to WP studies is needed to improve quality of future studies. This review informs the EULAR Points to Consider for conducting and reporting studies with WP as an outcome in IA.
Cilostazol for secondary stroke prevention: systematic review and meta-analysis
Authors: Tan Choon Han , Wu Andrew GR , Sia Ching-Hui , Leow Aloysius ST , Chan Bernard PL , Sharma Vijay Kumar , Yeo Leonard LL , Tan Benjamin YQ
Published: February 2021

Background

Stroke is one of the leading causes of death worldwide. Cilostazol, an antiplatelet and phosphodiesterase 3 inhibitor, has not been clearly established for ischaemic stroke use. We aim to determine the efficacy and safety of cilostazol for secondary stroke prevention.

Methods

MEDLINE, EMBASE, Cochrane Library, Web of Science and ClinicalTrials.gov were searched from inception to 25 September 2020, for randomised trials comparing the efficacy and safety of cilostazol monotherapy or dual therapy with another antiplatelet regimen or placebo, in patients with ischaemic stroke. Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess study quality. This meta-analysis was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results

Eighteen randomised trials comprising 11 429 participants were included in this meta-analysis. Most trials possessed low risk of bias and were of low heterogeneity. Cilostazol significantly reduced the rate of ischaemic stroke recurrence (risk ratio, RR=0.69, 95% CI 0.58 to 0.81), any stroke recurrence (RR=0.64, 95% CI 0.54 to 0.74) and major adverse cardiovascular events (RR=0.67, 95% CI 0.56 to 0.81). Cilostazol did not significantly decrease mortality (RR=0.90, 95% CI 0.64 to 1.25) or increase the rate of good functional outcome (Modified Rankin Scale score of 0–1; RR=1.07, 95% CI 0.95 to 1.19). Cilostazol demonstrated favourable safety profile, significantly reducing the risk of intracranial haemorrhage (RR=0.46, 95% CI 0.31 to 0.68) and major haemorrhagic events (RR=0.49, 95% CI 0.34 to 0.70).

Conclusions

Cilostazol demonstrated superior efficacy and safety profiles compared with traditional antiplatelet regimens such as aspirin and clopidogrel for secondary stroke prevention but does not appear to affect functional outcomes. Future randomised trials can be conducted outside East Asia, or compare cilostazol with a wider range of antiplatelet agents.
Early adoption of heated tobacco products resembles that of e-cigarettes
Authors: Zhu Shu-Hong , Ong Julian , Wong Shiushing , Cole Adam , Zhuang Yue-Lin , Shi Yuyan
Published: February 2021

Background

Heated tobacco products (HTP) generate nicotine-containing aerosol by heating tobacco rather than burning it. The US Food and Drug Administration (FDA) has recently authorised the sale of one HTP brand, iQOS, in the USA. This study examined the awareness, use and risk perceptions of HTP in the USA following FDA authorisation.

Methods

A national probability sample of 20 449 US adults completed an online survey between November 2019 and February 2020. In addition to assessing awareness and use of HTP, two ratios were calculated: the ratio of those who experimented with HTP given that they had heard about it (E/H) and the ratio of those who currently used HTP given experimentation (C/E). These ratios for HTP were compared against those for e-cigarettes from a similar national survey in 2012.

Results

Overall, 8.1% of respondents had heard of HTP. Only 0.55% had tried and 0.10% were current users. The rate of experimentation among those who heard about HTP and the rate of current use among experimenters were, however, similar to those for e-cigarettes in 2012: E/H and C/E for HTP were 6.8% and 18.2%, respectively; and 10.7% and 17.8%, respectively for e-cigarettes. The majority of respondents considered HTP either less harmful than (11.6%), or equally harmful as e-cigarettes (42.7%).

Conclusions

Only a small fraction of US population in 2020 have tried any HTP. However, the similarity in early adoption rates following awareness, suggests that future adoption for HTP may be similar to that for e-cigarettes, if HTP are marketed more aggressively.
Heated debates on regulations of heated tobacco products in South Korea: the news valence, source and framing of relative risk/benefit
Authors: Jun Jungmi , Kim Sei-Hill , Thrasher James , Cho Yoo Jin , Heo Yu-Jin
Published: February 2021

Background

We analyse news representations of the regulation of heated tobacco products (HTPs) in South Korea, the country where HTP use is among the highest in the world despite conflicts between the government and the HTP manufacturers.

Methods

We analysed a total of 571 print and TV news covering HTP regulations, published between 2017 and 2018, the time period when HTPs were introduced to the country and various regulations of HTPs were proposed and implemented. We assessed the prevalence and associations among specific types of HTP regulations that were discussed, valence towards regulation, sources, framing of the relative health risks/benefits of HTPs compared with conventional cigarettes.

Results

Taxation (55.2%) and warning labels (25.7%) were two regulation topics covered the most. Almost equal proportions of pro-regulation (2.5%) and anti-regulation valence (2.2%) were found in taxation-related news, while pro-regulation valence appeared more frequently for other restrictions, including warning labels (pro=9.5% vs anti=1.4%), marketing restrictions (pro=6.9% vs anti=0%) and integration of HTPs into smoke-free policies for cigarettes (pro=8.7% vs anti=0%). The government (59%), followed by the tobacco industry (39.4%), was the source cited most often across news stories while the presence of tobacco control advocates was low (4.9%). As for framing, there was no significant difference in the prevalence of stories mentioning reduced harm (31.7%) and equal or more harm (33.6%) of HTPs compared with cigarettes.

Conclusions

We provide implications for governments and tobacco control advocates on building consensus for applying cigarette equivalent taxes and pictorial warning labels to HTPs.
Study on Resource-Dependent No-Wait Flow Shop Scheduling with Different Due-Window Assignment and Learning Effects
Authors: Lv Dan-Yang , Wang Ji-Bo
Published: February 2021

In this paper, different due-window assignment flow shop scheduling problem with learning effect and resource allocation is considered. Under two machine no-wait flow shop setting, the goal is to determine the due-window starting time, due-window size, optimal resource allocation and the optimal sequence of all jobs. A bicriteria analysis of the problem is provided where the first criterion is to minimize the scheduling cost (including earliness-tardiness penalty, due-window starting time and due-window size of all jobs) and the second criterion is to minimize the resource consumption cost. It is shown that four versions about scheduling cost and resource consumption cost can be solved in polynomial time.
Multi-stream Network for Human-object Interaction Detection
Authors: Wang Chang , Sun Jinyu , Ma Shiwei , Lu Yuqiu , Liu Wang
Published: February 2021

Detecting the interaction between humans and objects in images is a critical problem for obtaining a deeper understanding of the visual relationship in a scene and also a critical technology in many practical applications, such as augmented reality, video surveillance and information retrieval. Be that as it may, due to the fine-grained actions and objects in the real scene and the coexistence of multiple interactions in one scene, the problem is far from being solved. This paper differs from prior approaches, which focused only on the features of instances, by proposing a method that utilizes a four-stream CNNs network for human-object interaction (HOI) detection. More detailed visual features, spatial features and pose features from human-object pairs are extracted to solve the challenging task of detection in images. Specially, the core idea is that the region where people interact with objects contains important identifying cues for specific action classes, and the detailed cues can be fused to facilitate HOI recognition. Experiments on two large-scale HOI public benchmarks, V-COCO and HICO-DET, are carried out and the results show the effectiveness of the proposed method.
Finding Suitable Membership Functions for Mining Fuzzy Association Rules in Web Data Using Learning Automata
Authors: Anari Zohreh , Hatamlou Abdolreza , Anari Babak
Published: February 2021

Transactions in web data are huge amounts of data, often consisting of fuzzy and quantitative values. Mining fuzzy association rules can help discover interesting relationships between web data. The quality of these rules depends on membership functions, and thus, it is essential to find the suitable number and position of membership functions. The time spent by users on each web page, which shows their level of interest in those web pages, can be considered as a trapezoidal membership function (TMF). In this paper, the optimization problem was finding the appropriate number and position of TMFs for each web page. To solve this optimization problem, a learning automata-based algorithm was proposed to optimize the number and position of TMFs (LA-ONPTMF). Experiments conducted on two real datasets confirmed that the proposed algorithm enhances the efficiency of mining fuzzy association rules by extracting the optimized TMFs.
Wind Speed Prediction based on Spatio-Temporal Covariance Model Using Autoregressive Integrated Moving Average Regression Smoothing
Authors: Wang Yu , Zhu Changan , Ye Xiaodong , Zhao Jianghai , Wang Deji
Published: February 2021

It is essential to enhance the ability of wind speeds forecasting for wind energy and wind resource planning. For this purpose, a hybrid strategy has been proposed based on spatio-temporal covariance model which combined the spatio-temporal ordinary kriging (STOK) technology with autoregressive integrated moving average (ARIMA) regression smoothing method. This is because wind speed time series exhibits a long-term dependency. In the case study, both STOK method and ARIMA method are employed and their performances are compared. The ARIMA model can obtain a necessary and sufficient smoothing condition for them to be smoothed. Meanwhile, further theoretical analysis is provided to discuss why the STOK method is potentially more accurate than the ARIMA method for wind speed time series prediction. Results show that the proposed method outperforms the Non-Sep-Gneiting model by 9% and 7.2% in terms of mean absolute error (MAE) and root-mean-square error (RMSE).
A Global Sensitivity Analysis Method for Multi-Input Multi-Output System and its Application in Structural Design
Authors: Liu Qiming , Tong Nichen , Han Xu
Published: February 2021

Commonly, variance-based global sensitivity analysis methods are popular and applicable to quantify the impact of a set of input variables on output response. However, for many engineering practical problems, the output response is not single but multiple, which makes some traditional sensitivity analysis methods difficult or unsuitable. Therefore, a novel global sensitivity analysis method is presented to evaluate the importance of multi-input variables to multi-output responses. First, assume that a multi-input multi-output system (MIMOS) includes [Formula: see text] variables and [Formula: see text] responses. A set of summatory functions [Formula: see text] and [Formula: see text] are constructed by the addition and subtraction of any two response functions. Naturally, each response function is represented using a set of summatory function. Subsequently, the summatory functions [Formula: see text] and [Formula: see text] are further decomposed based on the high dimensional model representation (HDMR), respectively. Due to the orthogonality of all the decomposed function sub-terms, the variance and covariance of each response function can be represented using the partial variances of all the decomposed function sub-terms on the corresponding summatory functions, respectively. The total fluctuation of MIMOS is calculated by the sum of the variances and covariances on all the response functions. Further, the fluctuation is represented as the sum of the total partial variances for all the [Formula: see text]-order function sub-terms, and the total partial variance is the sum of [Formula: see text] partial variances for the corresponding [Formula: see text]-order function sub-terms. Then, the function sensitivity index (FSI) [Formula: see text] for s-order function sub-terms is defined by the ratio of the total partial variance and total fluctuation, which includes first-order, second-order, and high-order FSI. The variable sensitivity index [Formula: see text] of variable [Formula: see text] is calculated by the sum of all the FSIs including the contribution of variable [Formula: see text]. Finally, numerical example and engineering application are employed to demonstrate the accuracy and practicality of the presented global sensitivity analysis method for MIMOS.
A geometric interpretation of maximal Lyapunov exponent based on deviation curvature
Authors: Yajima Takahiro , Nakase Shintaro
Published: February 2021

In this study, we discuss a relationship between the behavior of nonlinear dynamical systems and geometry of a system of second-order differential equations based on the Jacobi stability analysis. We consider how a maximal Lyapunov exponent is related to the geometric quantities. As a result of a theoretical investigation, the maximal Lyapunov exponent can be represented by a nonlinear connection and a deviation curvature. Thus, this means that the Jacobi stability given by the sign of the deviation curvature affects the change of the maximal Lyapunov exponent. Additionally, for an equation of nonlinear pendulum, we numerically confirm the theoretical results. We observe that a change of the maximal Lyapunov exponent is related to a change of an average deviation curvature. These results indicate that the deviation curvature and Jacobi stability are essential for considering the change of maximal Lyapunov exponent.
Experimental Investigation on Seismic Compression of Sand Subjected to Multidirectional Cyclic Loads
Authors: Chen Qingsheng , Gao Guangyun , Nie Chunxiao , Yang Jun , Bi Junwei , Gu Xiaoqiang
Published: February 2021

The ground is simultaneously subjected to both horizontal and vertical motions during earthquakes; however, the majority of existing studies on seismic compression are still limited to the horizontal earthquake motions only. In this work, the objective is therefore to experimentally investigate the effects of multidirectional nature of load application on seismic compression of sand. Multiple series of hollow cylindrical torsional shear tests were conducted on dry sand specimens with different relative densities, where different scenarios of stress conditions induced by earthquakes were simulated by applying various combinations of vertical and horizontal cyclic loads. Test results revealed that coupling with horizontal motions, the vertical component of seismic loads would significantly contribute to the development of both shear and vertical strains in the sand specimen. The increment in vertical strain under coupled motions could be up to over 70% compared to its counterpart for the sand specimen under horizontal cyclic stress alone. Nevertheless, it is also interestingly found that the contribution of superimposed vertical motion alone to the growth of vertical strain is limited. Besides, the effect of relative density on the change of vertical strain is nonlinear, and the decreasing rate of vertical strain diminishes with the increase of relative density.
Ni-doped, urchin-like Bi2S3 particles for electrocatalytic oxidation of glucose
Authors: Wang Biao , Liu Ya , Huai Xu , Miao Yuqing
Published: February 2021

In order to develop non-noble metal-based electrocatalysts for glucose oxidation, the Ni-doped, urchin-like Bi2S3 particles were prepared by a solvothermal method using the solvent of ethylene glycol/H2O. The obtained products were characterized by scanning electron microscopy, transmission electron microscopy, X-ray photoelectron spectroscopy and X-ray diffraction. The background signal from capacitance current is relatively low and the electrocatalytic oxidation current of glucose relatively high due to the urchin-like nanostructure of Bi2S3 particles and high surface area where the presence of Bi also improves the electrocatalytic performance of Ni[Formula: see text]/Ni[Formula: see text] shift.