bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive repair of acetabular fractures in dogs: Ex vivo feasibility study and case report
Authors: Dalton Cambrie L. , Kim Stanley E. , Biedrzycki Adam H. , Mullen Kaitlyn M.
Published: February 2023

Objective

To describe and evaluate minimally invasive repair of acetabular fractures in dogs using plates contoured to 3D‐printed hemipelvic models.

Study design

Ex vivo feasibility study and case report.

Sample population

Adult canine cadavers (n = 5); 8 year old male neutered Chihuahua.

Methods

Bone plates were contoured to 3D printed hemipelvic models derived from computed tomographic scans of each dog. In cadavers, acetabular, ischial, and pubic osteotomies were performed. A small craniolateral approach to the ilial body and a caudal approach to the ischium were made and connected through epiperiosteal tunnels. Under fluoroscopic guidance, fractures were reduced, and precontoured bone plates were applied with locking screws. Postoperative computed tomographic images were used to assess fracture gaps, step defects, and pelvic angulation. Cadavers were dissected for subjective assessment of sciatic nerve injury. Radiographic and clinical follow up was acquired for the clinical case.

Results

Small fracture gaps (<2 mm) and step defects (<1 mm), low pelvic angulation (<5°), and minimal (none n = 4 and mild n = 1) sciatic nerve injuries were observed in cadaver testing. There was slight (~1 mm) medial displacement of the pubic segment and good functional outcome for the clinical case, with radiographic healing documented at 3 months postoperatively.

Conclusion

Minimally invasive acetabular fracture repair in dogs with the aid of 3D printing was feasible and accurate.

Clinical significance

Minimally invasive repair techniques assisted by 3D printing may be applicable for acetabular fractures in dogs. The technique should be evaluated further before routine use can be recommended.
A North–Western Habitat: the Paleoethology and Colonisation of a European Peninsula, based upon the first comprehensive analysis of the excavation in Pin Hole Cave, Creswell Crags
Authors: Jenkinson Rogan
Published: February 2023

Pin Hole Cave is located within the Creswell Crags limestone gorge in the East Midlands of the United Kingdom. The locality became well known when Quaternary fossil and archaeological remains were discovered within the interior during the 1870s. The cave under went a small excavation in 1875 and then a much larger exploration from 1924 onwards. Despite many publications dealing with the Creswell Caves, Pin Hole Cave has not previously been comprehensively published. The publication includes individual descriptions and associated records for over 70,000 finds from the site, reported in the related digital archive as part of CAPI (Creswell Archaeological and Palaeontological Inventory). The evidence is assessed within the framework of known concepts of modern ecological behaviour to provide a context that might explain such intense activity within this particular Quaternary ecotone.
Prospectiva de la gestión del riesgo de origen sísmico. Vulnerabilidad en las unidades patrimoniales urbanísticas de Popayán – Colombia
Authors: Villaquirán Lis Fabián Andrés , Polanco Puerta Manuel Francisco
Published: February 2023

En la búsqueda de los componentes de sostenibilidad asociados a los procesos de desarrollo urbano de Popayán se contribuyó en la discusión sobre escenarios de vulnerabilidad sísmica y valores arquitectónicos patrimoniales de la ciudad, y sobre las diversas amenazas, conceptos y evidencias para necesidades insatisfechas ante el incumplimiento de normas. De esta manera, se tuvo un panorama organizado crítico y justificado, con lineamientos generales acordes a la gestión prospectiva del riesgo de origen sísmico, definiendo unos criterios con el fin de formular recomendaciones relacionadas con conceptualizaciones y temáticas emergentes que aminoren la vulnerabilidad del patrimonio integral de la ciudad de Popayán. La amenaza sísmica en la ciudad está incorporada al proceso de desarrollo y los valores simbólicos unidos a los edificios del centro histórico que refuerzan el sentimiento de identidad en la ciudad patrimonial; así pues, tomando la vulnerabilidad como factor preponderante en la gestión de riesgo de desastres, se debe hacer una integración del municipio a escenarios prospectivos, incorporando la gestión del riesgo, ya no como un concepto de atención de emergencias, sino como gestión del desarrollo.
Achieving high tribological and corrosion performances via a new approach: Al2O3/CrN duplex coatings
Authors: Guan Xiaoyan , Shi Haorong , Zhao Meiyan , Zhang Guangan , Cao Yiwei
Published: February 2023

Owing to growth defects, the CrN coating–substrate system may suffer from severe corrosion and wear attack in a marine environment, which limits the coating protection against the 316L substrate. To improve the efficiency, a new approach of fabricating Al2O3/CrN duplex coatings to achieve excellent corrosion and wear performances was provided by sealing the growth defects and extending the deposition time of the CrN layer. The Al2O3/CrN duplex coatings were obtained by multi-arc ion plating system sputter CrN layers combined with sequential atomic layer deposition Al2O3 layers. The morphology and structure of the as-deposited coating were investigated by scanning electron microscopy and x-ray photoelectron spectroscopy. The corrosion performances and tribological properties of the Al2O3/CrN duplex coatings in a seawater environment were investigated. The results showed that the density of the duplex coating decreases as the CrN layer thickness increases. The Al2O3/CrN duplex coatings with a suitable CrN layer thickness exhibited superior corrosion resistance in a seawater environment, which may be ascribed to the Al2O3 layer filling or sealing the partial growth defects of the CrN layer and playing a good barrier role to prevent the infiltration and penetration of corrosive media. Furthermore, the wear rate of the Al2O3/CrN duplex coating was reduced more than 30% compared to the single CrN coating of the same thickness. The good wear resistance of Al2O3/CrN duplex coatings was attributed to the synergistic effect of the dense structure, high wear resistance of the Al2O3 layer, and the supporting effect of the CrN layer as well as the formation of the lubricating component of CaCO3 and Mg(OH)2 during wear progress.
Gaborheometry: Applications of the discrete Gabor transform for time resolved oscillatory rheometry
Authors: John Rathinaraj Joshua David , McKinley Gareth H.
Published: February 2023

Oscillatory rheometric techniques such as small amplitude oscillatory shear (SAOS) and, more recently, medium amplitude oscillatory shear and large amplitude oscillatory shear (LAOS) are widely used for rheological characterization of the viscoelastic properties of complex fluids. However, in a time-evolving or mutating material, the build-up or breakdown of microstructure is commonly both time- and shear-rate (or shear-stress) dependent, and thixotropic phenomena are observed in many complex fluids including drilling fluids, biopolymer gels, and many food products. Conventional applications of Fourier transforms for analyzing oscillatory data assume the signals are time-translation invariant, which constrains the mutation number of the material to be extremely small. This constraint makes it difficult to accurately study shear-induced microstructural changes in thixotropic and gelling materials, and it is becoming increasingly important to develop more advanced signal processing techniques capable of robustly extracting time-resolved frequency information from oscillatory data. In this work, we explore applications of the Gabor transform (a short-time Fourier transform combined with a Gaussian window), for providing optimal joint time-frequency resolution of a mutating material’s viscoelastic properties. First, we show using simple analytic models and measurements on a bentonite clay that the Gabor transform enables us to accurately measure rapid changes in both the storage and/or loss modulus with time as well as extract a characteristic thixotropic/aging time scale for the material. Second, using the Gabor transform we demonstrate the extraction of useful viscoelastic data from the initial transient response following the inception of oscillatory flow. Finally, we consider extension of the Gabor transform to nonlinear oscillatory deformations using an amplitude-modulated input strain signal, in order to track the evolution of the Fourier–Tschebyshev coefficients of thixotropic fluids at a specified deformation frequency. We refer to the resulting test protocol as Gaborheometry (Gabor-transformed oscillatory shear rheometry). This unconventional, but easily implemented, rheometric approach facilitates both SAOS and LAOS studies of time-evolving materials, reducing the number of required experiments and the data postprocessing time significantly.
3D imaging of a nuclear reactor using muography measurements
Authors: Procureur Sébastien , Attié David , Gallego Laurent , Gomez Hector , Gonzales Philippe , Lefèvre Baptiste , Lehuraux Marion , Lesage Bertrand , Mandjavidze Irakli , Mas Philippe , Pomarède Daniel
Published: February 2023

The inspection of very large or thick structures represents one of the biggest challenges for nondestructive techniques. For such objects, a particularly powerful technique is muography, which makes use of free, natural cosmic-ray muons. Among other applications, this technique has been applied to provide two-dimensional (2D) images of nuclear reactors, pyramids, or volcanos. Recently, 3D algorithms developed for medical applications were adapted to the special case of muon imaging to derive density maps. The main difficulties relate to the size of the object and to the limited number of available projections. Here, we report on the first 3D imaging of a whole nuclear reactor, obtained without any prior information on its structure and using the largest set of muographic projections ever made in this field.
Epistasis between promoter activity and coding mutations shapes gene evolvability
Authors: Cisneros Angel F. , Gagnon-Arsenault Isabelle , Dubé Alexandre K. , Després Philippe C. , Kumar Pradum , Lafontaine Kiana , Pelletier Joelle N. , Landry Christian R.
Published: February 2023

The evolution of protein-coding genes proceeds as mutations act on two main dimensions: regulation of transcription level and the coding sequence. The extent and impact of the connection between these two dimensions are largely unknown because they have generally been studied independently. By measuring the fitness effects of all possible mutations on a protein complex at various levels of promoter activity, we show that promoter activity at the optimal level for the wild-type protein masks the effects of both deleterious and beneficial coding mutations. Mutations that are deleterious at low activity but masked at optimal activity are slightly destabilizing for individual subunits and binding interfaces. Coding mutations that increase protein abundance are beneficial at low expression but could potentially incur a cost at high promoter activity. We thereby demonstrate that promoter activity in interaction with protein properties can dictate which coding mutations are beneficial, neutral, or deleterious.
CTCF, BEAF-32, and CP190 are not required for the establishment of TADs in early
Drosophila
embryos but have locus-specific roles
Authors: Cavalheiro Gabriel R. , Girardot Charles , Viales Rebecca R. , Pollex Tim , Cao T. B. Ngoc , Lacour Perrine , Feng Songjie , Rabinowitz Adam , Furlong Eileen E. M.
Published: February 2023

The boundaries of topologically associating domains (TADs) are delimited by insulators and/or active promoters; however, how they are initially established during embryogenesis remains unclear. Here, we examined this during the first hours of
Drosophila
embryogenesis. DNA-FISH confirms that intra-TAD pairwise proximity is established during zygotic genome activation (ZGA) but with extensive cell-to-cell heterogeneity. Most newly formed boundaries are occupied by combinations of CTCF, BEAF-32, and/or CP190. Depleting each insulator individually from chromatin revealed that TADs can still establish, although with lower insulation, with a subset of boundaries (~10%) being more dependent on specific insulators. Some weakened boundaries have aberrant gene expression due to unconstrained enhancer activity. However, the majority of misexpressed genes have no obvious direct relationship to changes in domain-boundary insulation. Deletion of an active promoter (thereby blocking transcription) at one boundary had a greater impact than deleting the insulator-bound region itself. This suggests that cross-talk between insulators and active promoters and/or transcription might reinforce domain boundary insulation during embryogenesis.
Long-term insect censuses capture progressive loss of ecosystem functioning in East Asia
Authors: Zhou Yan , Zhang Haowen , Liu Dazhong , Khashaveh Adel , Li Qian , Wyckhuys Kris A. G. , Wu Kongming
Published: February 2023

Insects provide critical ecosystem services such as biological pest control, in which natural enemies (NE) regulate the populations of crop-feeding herbivores (H). While H-NE dynamics are routinely studied at small spatiotemporal scales, multiyear assessments over entire agrolandscapes are rare. Here, we draw on 18-year radar and searchlight trapping datasets (2003–2020) from eastern Asia to (i) assess temporal population trends of 98 airborne insect species and (ii) characterize the associated H-NE interplay. Although NE consistently constrain interseasonal H population growth, their summer abundance declined by 19.3% over time and prominent agricultural pests abandoned their equilibrium state. Within food webs composed of 124 bitrophic couplets, NE abundance annually fell by 0.7% and network connectance dropped markedly. Our research unveils how a progressive decline in insect numbers debilitates H trophic regulation and ecosystem stability at a macroscale, carrying implications for food security and (agro)ecological resilience during times of global environmental change.
Noncanonical splicing junctions between exons and transposable elements represent a source of immunogenic recurrent neo-antigens in patients with lung cancer
Authors: Merlotti Antonela , Sadacca Benjamin , Arribas Yago A. , Ngoma Mercia , Burbage Marianne , Goudot Christel , Houy Alexandre , Rocañín-Arjó Ares , Lalanne Ana , Seguin-Givelet Agathe , Lefevre Marine , Heurtebise-Chrétien Sandrine , Baudon Blandine , Oliveira Giacomo , Loew Damarys , Carrascal Montserrat , Wu Catherine J. , Lantz Olivier , Stern Marc-Henri , Girard Nicolas , Waterfall Joshua J. , Amigorena Sebastian
Published: February 2023

Although most characterized tumor antigens are encoded by canonical transcripts (such as differentiation or tumor-testis antigens) or mutations (both driver and passenger mutations), recent results have shown that noncanonical transcripts including long noncoding RNAs and transposable elements (TEs) can also encode tumor-specific neo-antigens. Here, we investigate the presentation and immunogenicity of tumor antigens derived from noncanonical mRNA splicing events between coding exons and TEs. Comparing human non–small cell lung cancer (NSCLC) and diverse healthy tissues, we identified a subset of splicing junctions that is both tumor specific and shared across patients. We used HLA-I peptidomics to identify peptides encoded by tumor-specific junctions in primary NSCLC samples and lung tumor cell lines. Recurrent junction-encoded peptides were immunogenic in vitro, and CD8+T cells specific for junction-encoded epitopes were present in tumors and tumor-draining lymph nodes from patients with NSCLC. We conclude that noncanonical splicing junctions between exons and TEs represent a source of recurrent, immunogenic tumor-specific antigens in patients with NSCLC.
CD8 T cells are forever
Authors: Maltzman Jonathan S.
Published: February 2023

Iterative acute stimulations can maintain CD8 T cells for longer than their organismal lifespan.
Finding TB vaccine antigens: follow the TCRs
Authors: Lichtman Andrew
Published: February 2023

TCR sequencing and analysis of predicted CDR3 structures were used to identify TCR similarity groups and the
M. tuberculosis
antigens they recognize that associate with infection control or progression.
CrAssphage May Be Viable Markers of Contamination in Pristine and Contaminated River Water
Authors: Mafumo Nyasha , Bezuidt Oliver K. I. , le Roux Wouter , Makhalanyane Thulani P.
Published: February 2023

Rivers support substantial populations and provide important ecosystem services. Despite the application of fecal coliform tests and other markers, we lack rapid and reproducible approaches for determining fecal contamination in rivers.
Accretion of an early Paleozoic Alaska-type arc onto northern North China: Implications for continental growth of the Central Asian orogenic belt
Authors: Zeng Hao , Song Dongfang , Xiao Wenjiao , Li Puqing
Published: February 2023

The accretionary orogenesis of the Central Asian orogenic belt is essential for understanding the reconstruction and growth of the Asian continent. The origin and accretion of the Bainaimiao arc along the northern margin of North China remain controversial. Here, a comprehensive study of field geology, geochemistry, and geochronology was performed on plutons and an ophiolite-bearing accretionary complex in the Ganqimaodu region, Inner Mongolia. Geochemical data indicate that ca. 445−431 Ma plutons were generated in an intra-oceanic arc and represent the western extent of the Bainaimiao arc. Field mapping and zircon U-Pb dating revealed that the ophiolitic mélange contains ca. 470−435 Ma tectonic blocks of ultramafic rocks, gabbros, plagiogranites, and metavolcanic and siliceous rocks in a matrix of intensely foliated quartz schist. The pillow basalt−limestone sequence might have originated from a seamount and then been incorporated into the accretionary complex. Northward subduction of the South Bainaimiao Ocean was responsible for the early Paleozoic tectonic evolution of the Bainaimiao arc, based on the spatial-temporal configuration of arc magmatism and accretionary complexes. Integration of new data with previous studies indicates that the Bainaimiao arc was an Alaska-type arc with various components of intra-oceanic and continental arcs. We suggest that a scissor-like arc-continent collision led to the accretion of the Bainaimiao arc onto the northern margin of North China, which played a fundamental role in the continental growth of the southern Central Asian orogenic belt.
Supplemental Material: Tectono-magmatic response to the geometric evolution of slab breakoff in hte Paleo-Tethys Ocean: Contraints from Late Triassic granites in the Qiangtang block, northern Tibet
Authors: Wu Hao , et al.
Published: February 2023

Table S1: Zircon isotopic LA-ICP-MS analyses for the granitoid samples.Table S2: Major- (wt%) and trace-element (ppm) compositions of the granitoid samples. Table S3: Hf isotopes of zircons from the granitoid samples. Table S4: Summary of age data for the Late Triassic granitic rocks and metamorphic rocks in the Qiangtang block. Table S5: Summary of major- (wt%) and trace-element (ppm) compositions for the Late Triassic granitic rocks in the Qiangtang block.
Cerebral artery conditional blood velocity in sickle cell disease: a multicentre study and evidence for active treatment
Authors: Modebe Emmanuel , Nonyelu Charles , Duru Augustine , Ezenwosu Osita , Chukwu Barth , Madu Anazoeze , Ezekekwu Chinedu , Aneke John , Izuka Mildred , Nri-Ezedi Chisom , Nnachi Oluomachi , Eze Alozie , Ajuba Ifeoma , Okwummuo Emeka , Chilaka Jane , Onodugo Chinenye , Fidelis-Ewa Uwaoma , Agwu Obineche , Anigbogu Ikechukwu , Muoghalu Ebele , Okoye Helen , Efobi Chilota , Ejiofor Obiora , Ugwu Ngozi , Maduka Collins , Iloanusi Nneka , Ugwu Angela , Okocha Chide , Ulasi Thomas , Okpala Iheanyi
Published: February 2023

Objective

To obtain multicentre data on the prevalence of normal, high or conditional (intermediate) blood velocity in the cerebral arteries among children with sickle cell disease (SCD) in Nigeria.

Design

A prospective observational study in five tertiary healthcare institutions. By transcranial Doppler (TCD) ultrasonography, cerebral artery peak systolic blood velocity (PSV) was determined in 193 children with SCD and time averaged mean of the maximum blood velocity (TAMMV) in a different cohort of 115 children. This design was to make the findings relevant to hospitals with TCD equipment that measure either PSV or TAMMV.

Setting

Nigeria.

Participants

308 children (126 girls, 182 boys; age 2–16 years).

Main outcome measures

Percentage of children with SCD who have normal, high or intermediate (often termed conditional) PSV or TAMMV.

Results

In the cohort of 193 children, PSV was normal in 150 (77.7%), high in 7 (3.6%) and conditional in 36 (18.7%). In the cohort of 115 children, TAMMV was normal in 96 (84%), high in 7 (6%) and conditional in 12 (10%). There were no significant differences in gender or age distribution between the PSV and TAMMV cohorts. Altogether, cerebral artery blood velocity was normal in 246/308 children (80%), high in 14 (4.5%) and conditional in 48 (15.5%).

Conclusion

Since conditional blood velocity in cerebral arteries can progress to high values and predispose to stroke, the proportion of children with SCD who are affected (15.5%) raises the question of whether regular monitoring and proactive intervention ought to be the standard of care.
Monkeypox presenting as supraglottitis in an immunocompromised patient
Authors: Amos Dora , Collins Jennifer , Walker David T
Published: February 2023

We describe a young man with AIDS who presented to the ear, nose and throat team with a severe sore throat mimicking supraglottitis. He had a 3-day history of sore throat, hoarse voice, fevers and myalgia. On examination, he had cervical lymphadenopathy and profuse pus overlying his right tonsil. On flexible nasoendoscopy, this pus was seen to track down to the supraglottis, with associated mucosal ulceration. The patient was treated for supraglottitis and he improved. 24 hours postadmission, a pustule suspicious for monkeypox developed on the patient’s hand. The diagnosis was confirmed by PCR testing. The patient was isolated and treated supportively and recovered fully. This case highlights that monkeypox may present with a severe sore throat without cutaneous lesions. Monkeypox is a growing public health concern . Its early symptoms are non-specific and healthcare professionals should be alert to it.
Role of individual characteristics and national distancing policies for COVID-19 protective behaviour among older adults: a cross-sectional study of 27 European countries
Authors: Mikucka Malgorzata , Antczak Radoslaw
Published: February 2023

Objective

Evidence on how individual characteristics and distancing policies during the first wave of COVID-19 together influenced health behaviours is scarce. The objective of this study is to fill in this gap by studying how the propensity to engage in protective behaviours in Europe was shaped by the interplay of individual characteristics and national policies.

Design

Data on individual behaviour in 27 countries came from the ‘Corona Survey’ module of the Survey of Health, Ageing and Retirement in Europe, collected in summer 2020. As outcomes, we considered avoidant behaviours (never leaving home, reducing frequency of walks and reducing frequency of social meetings) and preventive behaviour (wearing a face mask). Among relevant policies, we considered stay-at-home restrictions, mask wearing policies and gathering restrictions. Individual characteristics comprised gender, health risk of COVID-19 (older age and poor health) and activity (employment and providing help to other households).

Participants

Nationally representative samples of older adults (50 years and over), n=51 540 respondents (58% of women).

Results

Active people (employed and helping other households) were more likely to wear face masks but less likely to use avoidant behaviours. People at health risk (older people and those in poor health) were more likely to use all types of protective behaviours. Protective behaviours were also more frequent among women than among men. Longer duration of distancing polices correlated with more frequent protective behaviours. Distancing policies reduced social differences in the rate of protective behaviours only in case of social meetings and mask wearing.

Conclusions

Protective behaviours responded to distancing policies, but our results suggest that people used them voluntarily, especially if they were at health risk.
Multimorbidity combinations and their association with functional disabilities among Indian older adults: evidence from Longitudinal Ageing Study in India (LASI)
Authors: Kumar Manish , Kumari Neha , Chanda Srei , Dwivedi Laxmi Kant
Published: February 2023

Objective

This study aims to identify the unique multimorbidity combinations (MMCs) and their associations with the functional disability of Indian older adults. Moreover, the population attributable fractions (PAFs) were calculated to assess the potential impact of additional diseases in the nested groups on disability.

Design

A cross-sectional data were analysed in this study.

Setting and participants

The present study uses data from the first wave of the Longitudinal Ageing Study in India (2017–2018). The sample for the study consists of 27 753 aged 60 years and over.

Primary and secondary outcome measures

The primary outcome variable was functional disability, measured by the combined activities of daily living (ADL)-instrumental activities of daily living (IADL) index.

Results

Out of 197 uniquely identified MMCs, the combination of hypertension and high depressive symptoms (HDS) was the most prevalent (10.3%). Overall, all MMCs were associated with increased functional limitation. Specifically, the combination of hypertension, arthritis and HDS was associated with greater ADL-IADL disability than any other MMC. The addition of HDS in group 3 (hypertension and arthritis) (incidence rate ratios (IRR)=1.44; 95% CI 1.26 to 1.64) and the addition of arthritis in group 1 (hypertension, HDS) (IRR=1.48; 95% CI 1.28 to 1.71) and group 2 (hypertension, diabetes) (IRR=1.49; 95% CI 1.22 to 1.82) significantly increases the rates of ADL-IADL disability. The estimated PAFs of the group 1 (hypertension and HDS), group 3 (hypertension and arthritis) and group 4 (arthritis and HDS) for ADL-IADL disability were 22.5% (19.2–25.5), 21.6% (18.7–24.4) and 23.5% (20.6–26.3), respectively.

Conclusion

The findings from this study underscore the importance of addressing the morbidity combinations which are more disabling than the others in older adults. Understanding the somatic and psychological relevance of the morbidities in functional health is necessary and can help reduce disabilities among older adults.
Protocol for a scoping review on ‘surgical sabermetrics:’ technology-enhanced measurement of operative non-technical skills
Authors: Howie Emma , Wigmore Stephen J , Daglius Dias Roger , Skipworth Richard , Yule Steven
Published: February 2023

Introduction

Surgeons need high fidelity, high quality, objective, non-judgemental and quantitative feedback to measure their performance in order to optimise their performance and improve patient safety. This can be provided through surgical sabermetrics, defined as ‘advanced analytics of digitally recorded surgical training and operative procedures to enhance insight, support professional development and optimise clinical and safety outcomes’. The aim of this scoping review is to investigate the assessment of surgeon’s non-technical skills using sabermetrics principles, focusing on digital, automated measurements that do not require a human observer.

Methods and analysis

To investigate the current methods of digital, automated measurements of surgeons’ non-technical skills, a systematic scoping review will be conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, using databases from medicine and other fields. Covidence software is used for screening of potential studies. A data extraction tool will be developed specifically for this study to evaluate the methods of measurement. Quality assurance will be assessed using Quality Assessment Tool for Diverse Designs. Multiple reviewers will be responsible for screening of studies and data extraction.

Ethics and dissemination

This is a review study, not using primary data, and therefore, ethical approval is not required. A range of methods will be employed for dissemination of the results of this study, including publication in journals and conference presentations.
Self-report and device-based physical activity measures and adherence to physical activity recommendations: a cross-sectional survey among people with inflammatory joint disease in four European countries
Authors: Brodin N , Conradsson David Moulaee , Swinnen Thijs Willem , Esbensen Bente Appel , Kennedy Norelee , Hammer Nanna Maria , McKenna Sean , Henriksson Peter , Nordgren Birgitta
Published: February 2023

Objectives

Self-monitoring of physical activity (PA) has the potential to contribute to successful behaviour change in PA interventions in different populations, including people with inflammatory joint diseases (IJDs). The objectives of this study were to describe the use and knowledge of self-report-based and device-based PA measures in people with IJDs in four European countries, and to explore if the use of such devices, sociodemographic or disease-related variables were associated with adherence to the recommendations of at least 150 min of moderate to vigorous PA per week.

Setting

Cross-sectional survey, performed in 2015–2016.

Participants

People with IJDs in Belgium, Denmark, Ireland and Sweden.

Primary and secondary outcome measures

Use of self-report and device-based PA measures, receipt of instructions how to use PA measures, confidence in using them, adherence to PA recommendations and associated factors for adherence to PA recommendations.

Results

Of the 1305 respondents answering questions on PA measures, 600 (46%) reported use of any kind of self-report or device-based measures to self-monitor PA. Between country differences of 34%–58% was observed. Six per cent and four per cent received instructions from health professionals on how to use simple and complex devices, respectively. Independent associated factors of fulfilment of recommendations of PA were living in Ireland (OR=84.89, p<0.001) and Sweden (OR=1.68, p=0.017) compared with living in Denmark, not perceiving activity limitations in moderate activities (OR=1.92, p<0.001) and using a device to measure PA (OR=1.56, p<0.001). Those living in Belgium (OR=0.21, p<0.001) were less likely to fulfil recommendations of PA.

Conclusions

Almost half of the participants with IJDs used self-report-based or deviced-based PA measures, although few used wearable devices regularly. The results indicate that participants meeting public PA health guidelines were engaged in self-monitoring of PA.
Implementing an intervention to enhance care delivery and consistency for people with hip fracture and cognitive impairment in acute hospital wards: a mixed methods process evaluation of a randomised controlled feasibility trial (PERFECTED)
Authors: Backhouse Tamara , Fox Chris , Hammond Simon P , Poland Fiona , McDermott-Thompson Vicki , Penhale Bridget , Cross Jane L
Published: February 2023

Objectives

To determine how, and under what circumstances, the PERFECT-ER intervention was implemented in five acute hospital wards and impacted on staff practices and perceptions.

Design

Mixed methods process evaluation (undertaken between 2016 and 2018).

Setting

Five acute hospital wards across three different UK regions.

Participants

Patients (n=3) admitted to acute wards with hip fracture and cognitive impairment, their relatives (n=29) and hospital staff (n=63).

Interventions

PERFECT-ER, a multicomponent intervention designed to enhance the recovery of patients with hip fracture and cognitive impairment was implemented for 18 months. PERFECT-ER was implemented at ward level ensuring that multiple new and existing practices were undertaken consistently, on the assumption that collectively, small individual advances would improve care delivery for patients.

Primary and secondary outcome measures

Implementation of the PERFECT-ER intervention examined through regular intervention scores, service improvement staff reports and action plans, and semi-structured interviews and focus groups.

Results

The process evaluation identified points of implementation vulnerability and strength. All wards implemented some elements of PERFECT-ER. Implementation was fragile when ward pressures were high and when ward staff perceived the relative priority of intervention practices to be low. Adaptations to the implementation process may have reduced whole-ward staff engagement with implementation. However, strategical enlistment of senior ward influencers (such as ward managers, orthogeriatricians) combined with service improvement lead in-ward peer pressure tactics facilitated implementation processes.

Conclusions

Our study suggests that implementation was expediated when senior staff were on board as opinion leaders and formally appointed internal implementation leaders exerted their power. Within hierarchical settings such as acute wards, key individuals appeared to influence implementation through endorsement and sometimes enforcement. This indicates that whole-ward interventions may not always require cognitive engagement from all ward staff to implement changes. Future ward-level implementation studies could consider how best to engage staff and most importantly, which staff to best target.

Trial registration number

ISRCTN99336264.
Impact of minimum unit pricing on alcohol-related hospital outcomes: systematic review
Authors: Maharaj Tobias , Angus Colin , Fitzgerald Niamh , Allen Kathryn , Stewart Stephen , MacHale Siobhan , Ryan John D
Published: February 2023

Objective

To determine the impact of minimum unit pricing (MUP) on the primary outcome of alcohol-related hospitalisation, and secondary outcomes of length of stay, hospital mortality and alcohol-related liver disease in hospital.

Design

Databases MEDLINE, Embase, Scopus, APA Psycinfo, CINAHL Plus and Cochrane Reviews were searched from 1 January 2011 to 11 November 2022. Inclusion criteria were studies evaluating the impact of minimum pricing policies, and we excluded non-minimum pricing policies or studies without alcohol-related hospital outcomes. The Effective Public Health Practice Project tool was used to assess risk of bias, and the Bradford Hill Criteria were used to infer causality for outcome measures.

Setting

MUP sets a legally required floor price per unit of alcohol and is estimated to reduce alcohol-attributable healthcare burden.

Participant

All studies meeting inclusion criteria from any country

Intervention

Minimum pricing policy of alcohol

Primary and secondary outcome measures

Results

22 studies met inclusion criteria; 6 natural experiments and 16 modelling studies. Countries included Australia, Canada, England, Northern Ireland, Ireland, Scotland, South Africa and Wales. Modelling studies estimated that MUP could reduce alcohol-related admissions by 3%–10% annually and the majority of real-world studies demonstrated that acute alcohol-related admissions responded immediately and reduced by 2%–9%, and chronic alcohol-related admissions lagged by 2–3 years and reduced by 4%–9% annually. Minimum pricing could target the heaviest consumers from the most deprived groups who tend to be at greatest risk of alcohol harms, and in so doing has the potential to reduce health inequalities. Using the Bradford Hill Criteria, we inferred a ‘moderate-to-strong’ causal link that MUP could reduce alcohol-related hospitalisation.

Conclusions

Natural studies were consistent with minimum pricing modelling studies and showed that this policy could reduce alcohol-related hospitalisation and health inequalities.

PROSPERO registration number

CRD42021274023.
Association of sarcopenia with liver fibrosis and steatohepatitis in non-alcoholic fatty liver disease: protocol for a systematic review and meta-analysis
Authors: Wang Zheng , Li Saixin , Wang Kenan , Zhang Min , Wu Jie , Liu Dongbin , Liang Kuo
Published: February 2023

Introduction

Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disorder over the last four decades, more evidence shows a high prevalence of sarcopenia in NAFLD that may influence disease severity. This meta-analysis aims to determine the association of sarcopenia with liver fibrosis and steatohepatitis in NAFLD.

Methods and analysis

We will conduct the literature search using Medline (via PubMed), Web of Science databases, EMBASE, Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews (from the date of inception to 1 May 2022). There will be no restriction to the publication year. Two reviewers will independently screen the articles and abstract key study characteristics. The outcome of this meta-analysis is the strength of association of sarcopenia with liver fibrosis and steatohepatitis in NAFLD. The STATA (V.14, StataCorp, 2015) will be used to carry out the statistical analysis. Comprehensive evaluation of bias risk and heterogeneity will be performed before data synthesis. Also, consistency and evidence quality will be assessed.

Ethics and dissemination

There will be no need of ethics approval as this systematic review is summary and analysis of existing literature. Final results may be presented in international conferences or a peer-reviewed journal.

PROSPERO registration number

CRD42022322685.
Mortality and associated risk factors between young and elderly maintenance haemodialysis patients: a multicentre retrospective cohort study in China
Authors: Chen Jilin , Wang Jinling , Liu Ying , Zhao Guangben , Gao Fengdi , Hu Menghong , Wang Weidong , Lin Hong-li
Published: February 2023

Objectives

Mortality and associated risk factors in young and elderly haemodialysis patients with end-stage kidney disease (ESKD) have not been well examined in China. Therefore, we aimed to assess the all-cause mortality and risk factors associated with all-cause mortality between young and elderly haemodialysis patients in China.

Design

A population-based multicentre retrospective cohort study.

Setting

Using the Dialysis Initiation based on Fuzzy mathematics Equation study data, patients with ESKD undergoing maintenance haemodialysis from 24 centres in China from 1 January 2008 to 30 September 2015.

Participants

1601 enrolled patients with ESKD were categorised into young group (18–44 years old) and elderly (≥60 years old) group.

Outcome measures

The primary outcome was all-cause mortality. We estimated overall survival using a log-rank test. Cox proportional hazard regression analysis was implemented to identify risk factors and HR associated all-cause mortality.

Results

During a mean follow-up of 48.17±25.59 months, of the 1601 subjects, 319 (19.92%) patients death, including 64 (9.97%) in young group and 255 (26.59%) in elderly group, respectively. The cumulative survival in elderly group was lower than young group (Log Rank tests=63.31, p<0.001). Multivariate Cox proportional hazards analysis showed the cardiovascular disease (HR, 2.393; 95% CI 1.532 to 3.735; p<0.001), cerebrovascular disease (HR, 2.542; 95% CI 1.364 to 4.739; p=0.003) and serum albumin<3.5 g/dL (HR, 1.725; 95% CI 1.091 to 2.726; p=0.020) at the haemodialysis initiation were associated with increased risk of all-cause mortality in elderly groups; however, the cardiovascular disease only was associated with increased risk of all-cause mortality in young groups.

Conclusions

The all-cause mortality of elderly haemodialysis patients were higher than young haemodialysis patients in China. Identified risk factors associated all-cause mortality may inform development of age-appropriate treatment, intervention strategies and improve survival prognosis of this unique population.
Health literacy levels in patients with type 2 diabetes in an affluent Gulf country: a cross-sectional study
Authors: Nair Satish Chandrasekhar , Al Saraj Yasir , Sreedharan Jayadevan , Vijayan Karthik , Ibrahim Halah
Published: February 2023

Objectives

To identify health literacy levels in patients with type 2 diabetes mellitus in the United Arab Emirates (UAE).

Intervention

Nationwide cross-sectional survey.

Setting and participants

Individuals with type 2 diabetes mellitus attending outpatient diabetes clinics in all emirates of the UAE were surveyed between January 2019 and May 2020. Out of 832 patients approached, 640 met the inclusion criteria and agreed to participate.

Outcome variables

The outcome variable of interest was the health literacy level, which was measured using the Eastern-Middle Eastern Adult Health Literacy 13 Questionnaire. The association of health literacy level with age, gender and education was conducted using the Χ2test.

Results

Only 11% of respondents had adequate health literacy levels. Age and education were directly correlated with health literacy levels. Patients under age 50 years had statistically significant higher rates of marginal (106 of 238, 44.5%) and adequate literacy (67 of 238, 28.2%, p<0.001) than the older population. Participants with bachelor’s or postgraduate degrees also had significantly higher adequate health literacy levels (24 of 79, 30.4%, p<0.001).

Conclusions

The low health literacy levels found in outpatients with diabetes may be a major challenge to optimising diabetes care in the UAE. In addition to health services strategies, targeted educational and behavioural interventions for the older population and those with less formal education are necessary.
Critical appraisal and comparison of recommendations of clinical practice guidelines for the treatment of schizophrenia in children and adolescents: a methodological survey
Authors: Ramos Alves Maíra , Bergamaschi Cristiane de Cássia , Barberato-Filho Silvio , de Melo Daniela Oliveira , Mayer Rejane Coan Ferretti , de Oliveira Jardel Corrêa , Gabriel Franciele Cordeiro , Sekercioglu Nigar , Abdala Carmen Verônica Mendes , Lopes Luciane Cruz
Published: February 2023

Introduction

The production of clinical practice guidelines (CPGs) has grown in the past years. Notwithstanding, the quality of these documents and their recommendations for the treatment of schizophrenia in children and adolescents is still unknown.

Objective

To assess the quality of the guidelines and recommendations for the treatment of schizophrenia in this population.

Methods

CPGs from 2004 to December 2020 were identified through a systematic search on EMBASE, MEDLINE, PsycINFO, PubMed, Epistemonikos, VHL, Global Index Medicus and specific CPG databases. The CPGs’ quality was independently assessed by three reviewers using AGREE II and they were considered of high quality if they scored ≥60% in domains 3 and 6. The evidence classification systems were described, the quality of recommendations was assessed in pairs using AGREE-REX and the recommendations were compared.

Results

The database search retrieved 3182 results; 2030 were screened and 29 were selected for full-text reading. Four guidelines were selected for extraction. Two CPGs were considered of high quality in the AGREE II assessment. We described the commonly agreed recommendations for each treatment phase. The pharmacological recommendations were described in all treatment phases. Scores of AGREE-REX were lower for psychosocial recommendations.

Conclusion

There are still few clinical studies and CPGs regarding schizophrenia in children and adolescents. The quality of the documents was overall low, and the quality of the recommendations report has much to improve. There is also a lack of transparency about the quality of the evidence and the strength of the recommendations.

Protocol registration number

CRD42020164899.
Automatic medication refills to improve glycaemic control among patients with diabetes and low medication adherence
Authors: Golob Anna L , Geyer John , O'Keeffe Chatty , Nelson Kaylen , Song Cassandra , Vanderwarker Christopher , Britton Jacqueline , Reddy Ashok , Wong Edwin , Schuttner Linnaea
Published: February 2023

Background

Medication adherence impacts health outcomes. Healthcare organisations implementing system-level interventions have potential for greater spread and sustainability than individual-level interventions. Within the integrated US Veterans Health Administration, a multidisciplinary team developed and evaluated a pilot quality improvement programme to assess the feasibility of automatic mailed prescription refills for patients with diabetes and low medication adherence (assessed by medication possession ratio <80%).

Methods

Patients were randomised to usual care with self-initiated refills versus automatic mailed refills for 6 months. Process outcomes included glycaemic control measures (HgbA1C), medication possession ratios for both automatic and self-initiated (reference) refills of medications, patient satisfaction and workforce effort (pharmacist time).

Results

Overall, 199 patients were randomised to automatic refills (n=99; 40 of whom participated) versus usual care (n=100). In multivariable analysis adjusting for baseline differences, after 6 months there was no difference in the proportion of patients with follow-up HgbA1C <8% (60.8% automatic refills vs 60.5% usual care, p=0.96). In the automatic refill group, the medication possession ratio for reference medicines was significantly higher than usual care (63.9% vs 54.5%, 95% CI (for difference) 3.1% to 15.9%, p<0.01).

Conclusions

Implications and lessons from this pilot programme include potential beneficial indirect effects from automatic medication refills on patient self-initiated refills of other medications; the importance of tailoring solutions to patient subgroups and specific adherence barriers; and recognition that the rapid deployment, iteration and evaluation of the project was facilitated by a multidisciplinary team embedded within an organisational learning health system.
Childhood adversity is associated with hospitalisations and survival following external causes and non-communicable diseases: a 46-year follow-up of a Stockholm birth cohort
Authors: Jackisch Josephine , Almquist Ylva B
Published: February 2023

Background

Childhood adversity indicated by involvement with child welfare services (ICWS) is associated with increased risks of disease and injuries in young adulthood. It is yet unknown whether such risks are limited to external causes and mental and behavioural disorders or whether they extend beyond early adulthood and to non-communicable diseases (NCDs) with later onset. Moreover, it has not been explored whether ICWS associates with decreased survival prospects following hospitalisation.

Methods

Based on prospective data for a 1953 Stockholm birth cohort (n=14 134), ICWS was operationalised distinguishing two levels in administrative child welfare records (ages 0–19; ‘investigated’ and ‘placed’ in out-of-home care (OHC)). Hospitalisations and all-cause mortality (ages 20–66) were derived from national registers. Hospitalisation records were categorised into external causes and NCDs, and nine subcategories. Negative binomial regression models were used to estimate differences in hospitalisation risks between those with and without experiences of ICWS and Cox survival models to estimate mortality after hospitalisation.

Results

Placement in OHC was associated with higher risks of hospitalisation due to external causes and NCDs and all investigated subcategories except cancers. Risks were generally also elevated among those investigated but not placed. ICWS was further linked to higher mortality risks following hospitalisation.

Conclusion

Differential risk of morbidity and differential survival may explain inequalities in mortality following childhood adversity. We conclude that the healthcare sector might play an important role in preventing and mitigating the elevated risks of externally caused morbidity, disease and premature mortality observed among those with a history of ICWS.