bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of cannabis use among tobacco smokers: a systematic review protocol
Authors: Skelton Eliza , Rich Jane , Handley Tonelle , Bonevski Billie
Published: May 2022

Introduction

Understanding the prevalence of cannabis use among tobacco smokers has important implications for research in terms of intervention effectiveness and measurement in smoking cessation trials. The co-use of these substances also has important implications for health service planning, specifically ensuring appropriate and adequate clinical treatment. To date, there have been no synthesis of the literature on the prevalence of tobacco and cannabis co-use in adult clinical populations. Improved understanding of the current prevalence, route of administration and specific subpopulations with the highest rates of tobacco and cannabis co-use will support future intervention development. We aim to provide a pooled estimate of the percentage of smokers who report using cannabis and to examine the prevalence of co-use by sociodemographic characteristics.

Methods and analysis

We will conduct a systematic review using six scientific databases with published articles from 2000 to 2022 inclusive (CENTRAL, CINAHL, EMBASE, Medline, PsycINFO, Psychology and Behavioural Sciences Collection, Scopus). Peer-reviewed journal articles published in English that report on tobacco and cannabis use will be included. Rates of co-use (simultaneous or sequentially) and routes of administration will be assessed. Use in populations groups will be described. Quality assessments will be conducted for all included studies. Data will be synthesised using a narrative approach. This study will be conducted from June 2022 to the end of August 2022.

Ethics and dissemination

This review is based on previously published data and, therefore, ethical approval or written informed consent will not be required. It is the intention of the research team to disseminate the results of the systematic review as a peer-reviewed publication and conference presentations.

PROSPERO registration number

CRD42020194051.
Associations between socioeconomic position and young people’s physical activity and sedentary behaviour in the UK: a scoping review
Authors: Pearson Natalie , Griffiths Paula , van Sluijs Esther , Atkin Andrew J , Khunti Kamlesh , Sherar Lauren B
Published: May 2022

Objective

To examine the evidence on the associations between socioeconomic position and young people’s physical activity and sedentary behaviours in the UK.

Design

Scoping review.

Data sources

PubMed, SCOPUS and Web of Science databases were searched for articles published up to and including January 2021.

Eligibility criteria for selecting studies

Observational studies in children and adolescents (aged 5–18 years) from the UK that had assessed associations between at least one indicator of socioeconomic position and at least one outcome of physical activity and/or sedentary behaviour.

Data extraction and synthesis

Data were extracted by one reviewer and 20% were double checked. Indicators of socioeconomic position were tabulated with domains of physical activity and sedentary behaviour.

Results

Fifty-seven publications were included in the review; 37 publications from 19 studies (k=23) of children and 21 publications from 15 studies (k=23) of adolescents. Most studies were cross-sectional. 63% of studies of children, and 40% of studies of adolescents assessed Index of Multiple Deprivation. Eighteen studies measured physical activity in children, 13 measured sedentary behaviour. Eleven studies of adolescents included a measure of physical activity, 10 included a measure of sedentary behaviour. Among children and adolescents, the association between socioeconomic position and measures of either physical activity or sedentary behaviour was highly variable depending on the measure of both socioeconomic position used and the behavioural outcome, with the exception of higher family affluence which was consistently associated with higher reported physical activity among adolescents.

Conclusion

Physical activity and sedentary behaviours of children and adolescents in the UK are complex and influenced by multiple indicators of socioeconomic position that are, in most cases, different across age stages, outcomes examined and measurement tools. Greater consistency in the use and measures of socioeconomic position as well as outcomes of behaviour are required for robust country-specific meta-analyses.
Association between vaccine preventable diseases in children and improved sanitation following a nationwide sanitation campaign in India: an ecological analysis
Authors: Singh Parvati , Forthal Donald N , Shah Manisha , Bruckner Tim-Allen
Published: May 2022

Objective

Persistent exposure to faecal pathogens due to open defecation may cause environmental enteropathy that, in turn, may lead to undernutrition and vaccine failure in under 5-year-old (u5) children. The Swachh Bharat Mission (SBM) programme in India, launched in 2014, aimed to construct toilets for every household nationwide and reduce open defecation. This programme, if successful, had the potential to reduce the burden of four vaccine preventable diseases (VPDs): diphtheria, pertussis, tetanus and measles. We examine whether increased household toilet availability in Indian districts following SBM corresponds with a reduction in diphtheria, pertussis, tetanus and measles in u5 children.

Design

Observational, ecological study.

Setting

532 districts in 28 Indian states, from 2013 to 2016.

Primary outcome and exposure

We retrieved data on district-level change in the annual incidence (per 1000 u5 children) of four VPDs, from 2013 (pre-SBM) to 2016 (post-SBM). We obtained data on our exposure, the change in the percentage of households with toilets (per district), from three large national surveys conducted in 2013 and 2016. We used linear regression analysis, which controlled for change over time in socioeconomic factors, health system-related covariates and pre-SBM annual incidence of VPDs.

Results

A one percentage point increase in households with toilets corresponds with 0.33 fewer measle cases per 1000 u5 children in a district (coefficient: −0.33, 95% CI −0.0641 to –0.014; p<0.05). About 12% of this association is mediated by a reduction in u5 stunting. We observe no relation of the exposure with diphtheria, pertussis or tetanus. Findings remain robust to sensitivity analyses.

Conclusion

Rapid improvements in ambient sanitation through increased toilet availability correspond with a reduction in the annual incidence of measles in u5 children. We encourage replication of findings and further research to identify potential pathways by which SBM may reduce measle burden in u5 children.
Imaging features for the prediction of clinical endpoints in chronic liver disease: a scoping review protocol
Authors: Chouhan Manil D , Taylor Stuart Andrew , Bhagwanani Anisha , Munday Charlotte , Pinnock Mark A , Parry Tom , Hu Yipeng , Barratt Dean , Yu Dominic , Mookerjee Rajeshwar P , Halligan Steve , Mallett Sue
Published: May 2022

Introduction

Chronic liver disease is a growing cause of morbidity and mortality in the UK. Acute presentation with advanced disease is common and prioritisation of resources to those at highest risk at earlier disease stages is essential to improving patient outcomes. Existing prognostic tools are of limited accuracy and to date no imaging-based tools are used in clinical practice, despite multiple anatomical imaging features that worsen with disease severity.

In this paper, we outline our scoping review protocol that aims to provide an overview of existing prognostic factors and models that link anatomical imaging features with clinical endpoints in chronic liver disease. This will provide a summary of the number, type and methods used by existing imaging feature-based prognostic studies and indicate if there are sufficient studies to justify future systematic reviews.

Methods and analysis

The protocol was developed in accordance with existing scoping review guidelines. Searches of MEDLINE and Embase will be conducted using titles, abstracts and Medical Subject Headings restricted to publications after 1980 to ensure imaging method relevance on OvidSP. Initial screening will be undertaken by two independent reviewers. Full-text data extraction will be undertaken by three pretrained reviewers who have participated in a group data extraction session to ensure reviewer consensus and reduce inter-rater variability. Where needed, data extraction queries will be resolved by reviewer team discussion. Reporting of results will be based on grouping of related factors and their cumulative frequencies. Prognostic anatomical imaging features and clinical endpoints will be reported using descriptive statistics to summarise the number of studies, study characteristics and the statistical methods used.

Ethics and dissemination

Ethical approval is not required as this study is based on previously published work. Findings will be disseminated by peer-reviewed publication and/or conference presentations.
Image guidance for endoscopic sinus surgery in patients with chronic rhinosinusitis: a systematic review and meta-analysis protocol
Authors: Nobre Maria Luisa , Sarmento Ayane Cristine Alves , Nobre Maria Gabriela , Bedaque Henrique de Paula , Medeiros Kleyton Santos , Cobucci Ricardo Ney , Gonçalves Ana Katherine
Published: May 2022

Introduction

Endoscopic sinus surgery (ESS) is a current procedure for treating patients with chronic rhinosinusitis (CRS). Image-guided surgery (IGS) for ESS may help reduce complications and improve precision. However, it is uncertain in which cases IGS is beneficial. This work aims to compare ESS with and without IGS in patients with CRS.

Methods and analysis

PubMed, Embase, Scopus, Web of Science, Scielo, Cochrane Central Register of Controlled Trials, CINAHL, LILACS and Clinicaltrials.gov will be searched for reported clinical trials comparing the quality of life and perioperative outcomes of ESS with and without navigation. The search is planned for 20 April 2022. Three independent authors will select eligible articles and extract their data. The risk of bias will be assessed using the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendation Assessment, Development and Evaluation method will evaluate the strength of the evidence. Data synthesis will be performed using the Review Manager software V.5.4.1. To assess heterogeneity, I2statistics will be computed. Additionally, meta-analysis will be performed if the included studies are sufficiently homogenous.

Ethics and dissemination

This study reviews published data, and thus it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42020214791.
From direct attendance to telephone triage in an emergency primary healthcare service: an observational study
Authors: Midtbø Vivian , Fotland Siri-Linn Schmidt , Johansen Ingrid Hjulstad , Hunskaar Steinar
Published: May 2022

Objectives

To describe how an intervention to limit direct attendance in an emergency primary healthcare service affected the contacts to the clinic and the level of care given, and which factors were associated with a change from direct attendance to telephone contact.

Design

Observational study.

Setting

Seven Norwegian emergency primary healthcare services. The telephone triage operators are primarily registered nurses.

Participants

Registered patient contacts to the services during 2007–2019.

Interventions

In 2013, one of the seven services made an intervention to limit direct attendances to the emergency primary healthcare clinic. Through an advertisement in a local newspaper, the public was encouraged to call in advance. Patients who still attended directly, were encouraged to call in advance next time.

Measures

We compared the proportions of direct attendance and telephone contact, and of consultation by a general practitioner and telephone consultation by an operator, before and after the intervention. We also compared the proportions of direct attendance regarding gender, age group, time of day and urgency level. Descriptive analyses and log binomial regression analyses were applied.

Results

There were 1 105 019 contacts to the seven services during the study period. The average proportion of direct attendance decreased from 68.7% (95% CI 68.4% to 68.9%) to 23.4% (95% CI 23.2% to 23.6%) in the service that carried out the intervention. Telephone consultation by an operator increased from 11.7% (95% CI 11.5% to 11.8%) to 29.2% (95% CI 28.9% to 29.5%) and medical consultation by a general practitioner decreased from 78.3% (95% CI 78.1% to 78.5%) to 57.0% (95% CI 56.7% to 57.3%). The youngest and the oldest age group and women had the largest decrease in direct attendance, by −81%, −74% and −71%, respectively.

Conclusion

The intervention influenced how the public contacted the service. Information campaigns on how to contact healthcare services should be implemented on a regular basis.
Efficacy of convalescent plasma therapy in the patient with COVID-19: a randomised control trial (COPLA-II trial)
Authors: Bajpai Meenu , Maheshwari Ashish , Dogra Vikas , Kumar Suresh , Gupta Ekta , kale Pratibha , Saluja Vandana , Thomas Sherin S , Trehanpati Nirupama , Bihari Chhagan , Agarwal Reshu , Bharti Praveen , Shankar Prabha , Hussain Javid , Chhabra Karan , Gupta Amita , Narayanan Ashad , Agarwal Sarika , Jain Shruti , Bhardwaj Ankit , Kumar Guresh , Yadav Birendra Kumar , Sarin Shiv Kumar
Published: May 2022

Importance

No proven treatment is available for severely ill COVID-19. Therapeutic use of COVID-19 convalescent plasma (COPLA) is under investigation.

Objective

To compare the efficacy of COPLA with standard medical therapy (SMT) alone in severe COVID-19 patients.

Design, setting and participants

A multicentric, open-labelled, phase-III randomised controlled trial conducted at two treatment centres with COPLA collected at the third dedicated centre in North-India, the coordinating centre during trial from June 2020 to December 2020. The study population comprised 400 participants in the ratio of 1:1 in each treatment group.

Intervention

One group received COPLA with SMT (n=200), and another group received SMT only (n=200).

Main outcome measures

Primary outcome was time to clinical improvement measured by a two-point reduction in the ordinal scale. Secondary outcomes included duration of O2therapy, the proportion of patients on mechanical ventilation at day-7, mortality, SARS-CoV-2 antibody levels, cytokine levels and incidence of adverse events.

Results

The median time to a two-point reduction in the ordinal scale in both groups was 9 days (IQR=7–13) (p=0.328). The median duration of O2therapy was 8 days (IQR=6–12) in COPLA and 10 days (IQR=6–12) in SMT group (p=0.64). The PaO2/FiO2ratio showed significant improvement at 7 days in COPLA group(p=0.036). There was no difference in mortality till 28 days in both groups (p=0.62). However, if COPLA was given within 3 days of hospital admission, a significant reduction in ordinal scale was observed (p=0.04). Neutralising antibody titres in COPLA group (80 (IQR 80–80)) were higher than SMT group (0 (IQR 0–80)) at 48 hours (p=0.001). COPLA therapy led to a significant reduction in TNF-α levels at 48 hours (p=0.048) and D-dimer at 7 days (p=0.02). Mild allergic reactions were observed in 3 (1.5%) patients in COPLA group.

Conclusion and relevance

Convalescent plasma with adequate antibody titres should be transfused in COVID-19 patients along with SMT in the initial 3 days of hospitalisation for better clinical outcomes.

Trial registration number

NCT04425915.
Effect of partial preservation versus complete preservation of Denonvilliers’ fascia on postoperative urogenital function in male patients with low rectal cancer (PREDICTION): protocol of a multicentre, prospective, randomised controlled clinical trial
Authors: Zheng Zhifang , Ye Daoxiong , Wang Xiaojie , Lu Xingrong , Huang Ying , Chi Pan
Published: May 2022

Introduction

Total mesorectal excision (TME) has been the gold standard for the surgical treatment of mid-low rectal cancer, but traditional TME removal of Denonvilliers’ fascia (DVF) is too low and is prone to damage the connecting branches of the bilateral neurovascular bundles, which can lead to posturogenital dysfunction. A recently published multicenter randomised controlled trial revealed that TME with complete preservation of DVF (CP-DVF) has protective effects on postoperative urogenital function for male patients with rectal cancer with specific staging and location (preoperative staging T1-4N0-2M0, but T1-2 for anterior rectal wall). Our previous studies have confirmed that TME with partial preservation of DVF (PP-DVF) could also achieve satisfactory results regardless of the circumferential location of the tumour. However, there is a lack of randomised controlled trials to prove that the efficacy of TME with PP-DVF is equivalent to that with CP-DVF with respect to postoperative urogenital function.

Methods and analysis

This study is a prospective, multicentre, equivalent design, open-label randomised clinical trial in which 278 male patients with low rectal cancer will be recruited from 11 large-scale gastrointestinal medical centres in China. Patients will be randomly assigned to undergo PP-DVF or CP-DVF. We will test the hypothesis that PP-DVF is similar to CP-DVF with respect to sexual function at postoperative month 12 (5-item version of the International Erectile Function Index Questionnaire and ejaculation function classification). The secondary outcomes include the assessment of urinary function, surgical safety and oncological outcomes.

Ethics and dissemination

This trial has been approved by the Institutional Review Board of Fujian Medical University Union Hospital (2020YF016-01) and is filed on record by all other centres. Written informed consent will be obtained from all eligible participants before enrolment. The trial’s results will be disseminated via peer-reviewed scientific journals and conference presentations.

Trial registration number

ChiCTR2000034892.
Causal explanations for patient engagement with primary care services in Saudi Arabia: a realist review protocol
Authors: Alghamdi Alaa , Abrams Ruth , Bailey Julia V , Alves Paula , Park Sophie
Published: May 2022

Introduction

Saudi Arabia (SA) has a rapidly developing universal healthcare system which is maturing from its hospital focused origins. However, health service usage suggests that up to 65% of the cases seen in emergency departments were classified as non-urgent and could have been appropriately managed in primary healthcare (PHC) settings. Primary care development in SA has lagged behind secondary care, and evidence suggests that Saudi citizens are currently ambivalent or dissatisfied with their PHC services. Previous research has focused on the quality and patient satisfaction of PHC services in SA. Yet, uncertainty still exists about causal explanations for patient engagement with PHC services and what refinements are needed for PHC. Less attention has been paid to how patient engagement strategies might work differently, which is increasingly recognised as important in PHC services. The aim of this review is to understand the causal explanations for patient engagement with PHC and to generate theory of how the intended outcome of patient engagement with PHC in SA might be achieved through identified contexts and mechanisms.

Methods and analysis

A realist review approach will be used to synthesise the evidence. Databases including Medline, EMBASE and CINAHL will be searched. Literature will be included if it has relevance to the research question, and is trustworthy in nature. All document types will be screened including peer reviewed articles, relevant grey literature and related media items. All study types will be included. Stakeholders’ feedback will also inform our review. A realist approach is suitable for this review because patient engagement with PHC services is a complex phenomenon. A range of different relevant data will be included in the following stages: developing an initial programme theory, searching the evidence, selecting data, extracting data, synthesising data and refining the programme theory.

Ethics and dissemination

This study will use secondary data, and stakeholders are involved only to shape our understanding of the important contexts in patient engagement; hence, a formal ethics review is not required. Findings will be disseminated in a peer-reviewed journal and at relevant conferences.

PROSPERO registration number

CRD42020175955.
Patient experience of symptoms and impacts of COVID-19: a qualitative investigation with symptomatic outpatients
Authors: Rofail Diana , McGale Nadine , Podolanczuk Anna J , Rams Alissa , Przydzial Krystian , Sivapalasingam Sumathi , Mastey Vera , Marquis Patrick
Published: May 2022

Objectives

There is little in-depth qualitative evidence of how symptoms manifest themselves in outpatients with COVID-19 and how these in turn impact outpatients’ daily lives. The objective of the study was therefore to explore the experience of outpatients with COVID-19 qualitatively, concerning the symptomatic experience and its subsequent impact on daily life.

Setting

Qualitative research study comprising virtual in-depth, open-ended interviews with outpatients and clinicians.

Participants

Thirty US adult patients with COVID-19 were interviewed within 21 days of diagnosis. Patients were 60% female and 87% white, who had to self-report one of the following: fever, cough, shortness of breath/difficulty breathing, change/loss of taste/smell, vomiting/diarrhoea or body/muscle aches. Five independent clinicians were also interviewed about their experience treating outpatients.

Primary and secondary outcome measures

Transcripts were analysed thematically to organise symptoms and impacts of daily life into higher-order overarching categories, and subsequently propose a conceptual model. The adequacy of the sample size was assessed by conceptual saturation analysis.

Results

Patient-reported concepts were organised into six symptom themes (upper respiratory, lower respiratory, systemic, gastrointestinal, smell and taste, and other) and seven impact themes (activities of daily living, broad daily activities, leisure/social activities, and physical, emotional, professional and quarantine-specific impacts). Symptom type, severity, duration and time of onset varied by patient. Clinicians endorsed all patient-reported symptoms.

Conclusions

The manifestation of symptoms in outpatients is heterogeneous and affects all aspects of daily life. Outpatients offered new detailed insights into their symptomatic experiences, including heterogeneous experiences of smell and taste, and the impacts that symptoms had on their daily lives. Findings of this research may be used to supplement existing knowledge of the outpatient experience of mild-to-moderate COVID-19, to further inform treatment guidelines and to provide an evidence base for evaluating potential treatment benefits.
Dutch injection versus surgery trial in patients with carpal tunnel syndrome (DISTRICTS): protocol of a randomised controlled trial comparing two treatment strategies
Authors: Palmbergen Wijnand A C , de Bie Rob M A , Alleman Tim W H , Verstraete Esther , Jellema Korne , Verhagen Wim I M , Brekelmans Geert J F , de Ruiter Godard C W , van de Beek Diederik , de Borgie Corianne A J M , de Haan Rob , Beekman Roy , Verhamme Camiel
Published: May 2022

Introduction

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. The optimal treatment strategy is still unknown. The objective of the Dutch Injection versus Surgery TRIal in patients with CTS (DISTRICTS) is to investigate if initial surgery of CTS results in a better clinical outcome and is more cost-effective when compared with initial treatment with corticosteroid injection.

Methods and analysis

The DISTRICTS is an ongoing multicenter, open-label randomised controlled trial. Participants with CTS are randomised to treatment with surgery or with a corticosteroid injection. If needed, any additional treatments after this first treatment are allowed and these are not dictated by the study protocol. The primary outcome is the difference between the groups in the proportion of participants recovered at 18 months. Recovery is defined as having no or mild symptoms as measured with the 6-item carpal tunnel symptoms scale. Secondary outcome measurements are among others: time to recovery, hand function, patient satisfaction, quality of life, additional treatments, adverse events, and use of care and health-related costs.

Ethics and dissemination

The study was approved by the Medical Ethical Committee of the Amsterdam University Medical Centers (study number 2017-171). Study results will be disseminated in peer-reviewed journals and conferences.

Trial registration number

ISRCTN Registry: 13164336.
COVID-19 pandemic in shelters for asylum seekers: a scoping review of preventive measures
Authors: Führer Amand , Özer Erdogdu Ilknur , Kompa Paula , Yilmaz-Aslan Yüce , Brzoska Patrick
Published: May 2022

Objective

To investigate which measures are recommended by guidelines on prevention and management of infectious disease outbreaks in refugee shelters, how outbreaks have been dealt with in these facilities in the past and how measures taken compare with the recommendations identified in the literature.

Design, data sources and eligibility criteria

The review comprised German and English language literature on refugees residing in shelters located in high-income countries, published between 1990 and 2021. We searched PubMed, CINAHL and Web of Science.

Data extraction and synthesis

We extracted information concerning the characteristics of the setting and the study population, measures for outbreak prevention and reported difficulties with implementing these measures. The findings were evaluated using descriptive statistics and were narratively summarised.

Results

Of a total of 1162 publications, 36 were included in the review, of which 19 were original research articles and 17 were guidelines/commentaries. In the guidelines, 37 different measures of infection control were mentioned. Among those, social distancing and isolation or quarantine were mentioned most frequently. In the outbreak reports, 27 different measures were reported, of which testing was reported most often. Different reasons why recommendations are difficult to implement in shelters were described, which are related to space, equipment, staff and financial constraints. Discrepancies between recommendations and actual practice mostly relate to the lack of preparation for outbreaks and the lack of appropriate measures to ensure intersectoral cooperation.

Conclusions

Recommendations on infection control and outbreak management and the measures actually taken in refugee shelters differ considerably. Among others, this results from a lack of intersectoral cooperation between state ministries, municipal health offices and the administration of the facilities as well as from guidelines not sufficiently tailored to the characteristics of refugee shelters.
Pulse oximetry and oxygen services for the care of children with pneumonia attending frontline health facilities in Lagos, Nigeria (INSPIRING-Lagos): study protocol for a mixed-methods evaluation
Authors: Graham Hamish R , Olojede Omotayo E , Bakare Ayobami Adebayo A , McCollum Eric D , Iuliano Agnese , Isah Adamu , Osebi Adams , Seriki Ibrahim , Ahmed Tahlil , Ahmar Samy , Cassar Christine , Valentine Paula , Olowookere Temitayo Folorunso , MacCalla Matt , Uchendu Obioma , Burgess Rochelle Ann , Colbourn Timothy , King Carina , Falade Adegoke G
Published: May 2022

Introduction

The aim of this evaluation is to understand whether introducing stabilisation rooms equipped with pulse oximetry and oxygen systems to frontline health facilities in Ikorodu, Lagos State, alongside healthcare worker (HCW) training improves the quality of care for children with pneumonia aged 0–59 months. We will explore to what extent, how, for whom and in what contexts the intervention works.

Methods and analysis

Quasi-experimental time-series impact evaluation with embedded mixed-methods process and economic evaluation. Setting: seven government primary care facilities, seven private health facilities, two government secondary care facilities. Target population: children aged 0–59 months with clinically diagnosed pneumonia and/or suspected or confirmed COVID-19. Intervention: ‘stabilisation rooms’ within participating primary care facilities in Ikorodu local government area, designed to allow for short-term oxygen delivery for children with hypoxaemia prior to transfer to hospital, alongside HCW training on integrated management of childhood illness, pulse oximetry and oxygen therapy, immunisation and nutrition. Secondary facilities will also receive training and equipment for oxygen and pulse oximetry to ensure minimum standard of care is available for referred children. Primary outcome: correct management of hypoxaemic pneumonia including administration of oxygen therapy, referral and presentation to hospital. Secondary outcome: 14-day pneumonia case fatality rate. Evaluation period: August 2020 to September 2022.

Ethics and dissemination

Ethical approval from University of Ibadan, Lagos State and University College London. Ongoing engagement with government and other key stakeholders during the project. Local dissemination events will be held with the State Ministry of Health at the end of the project (December 2022). We will publish the main impact results, process evaluation and economic evaluation results as open-access academic publications in international journals.

Trial registration number

ACTRN12621001071819; Registered on the Australian and New Zealand Clinical Trials Registry.
Decision-making autonomy in maternal health service use and associated factors among women in Mettu District, Southwest Ethiopia: a community-based cross-sectional study
Authors: Kassahun Asmamaw , Zewdie Asrat
Published: May 2022

Objectives

Women’s autonomy is valued in a range of healthcare settings, from seeking and receiving care to deciding between treatment options. This study aimed to assess the level of decision-making autonomy women have and associated factors when it comes to using maternal healthcare services.

Design

A community-based cross-sectional study was conducted.

Setting

The study was conducted in Mettu Rural District, Iluababor Zone, Southwest Ethiopia.

Methods

Data were collected using a pretested interviewer-administered questionnaire from 541 women selected by a multistage sampling technique. The collected data were entered into EpiData V.3.1 and exported to SPSS V.22 for analysis. Bivariable and multivariable binary logistic regression were used to identify factors associated with women’s decision-making autonomy on maternal health service use. Variables with a p value less than 0.05 at 95% CI were declared significant, and the strength of the association was measured by an adjusted OR (AOR).

Primary outcome

Level of women’s decision-making autonomy on maternal health service use.

Results

It was found that 60.5% of women were autonomous in maternal health service use (95% CI 56.2% to 64.7%). The older age group (AOR=4.27, 95% CI 1.6 to 11.4, p=0.034), higher educational level (AOR=3.8, 95% CI 2.2 to 6.7, p=0.042), small family size (AOR=2.5, 95% CI 1.5 to 4.1, p=0.01) and proximity to health facilities (AOR=5.3, 95% CI 2.5 to 11.3, p=0.004) were all associated factors with healthcare decision-making autonomy.

Conclusion

Two-fifths of women have diminished autonomy in decision making on healthcare service use. Age, level of education, family size and accessibility of health services were found to influence women’s autonomy. Special attention should be given to education and access to health services to improve women’s autonomy.
Effects of a video intervention on physicians’ acceptance of pain apps: a randomised controlled trial
Authors: Hein Hauke Jeldrik , Glombiewski Julia Anna , Rief Winfried , Riecke Jenny
Published: May 2022

Objectives

The aim of our study was to determine and enhance physicians’ acceptance, performance expectancy and credibility of health apps for chronic pain patients. We further investigated predictors of acceptance.

Design

Randomised experimental trial with a parallel-group repeated measures design.

Setting and participants

248 physicians working in various, mainly outpatient settings in Germany.

Intervention and outcome

Physicians were randomly assigned to either an experimental group (short video about health apps) or a control group (short video about chronic pain). Primary outcome measure was acceptance. Performance expectancy and credibility of health apps were secondary outcomes. In addition, we assessed 101 medical students to evaluate the effectiveness of the video intervention in young professionals.

Results

In general, physicians’ acceptance of health apps for chronic pain patients was moderate (M=9.51, SD=3.53, scale ranges from 3 to 15). All primary and secondary outcomes were enhanced by the video intervention: A repeated-measures analysis of variance yielded a significant interaction effect for acceptance (F(1, 246)=15.28, p=0.01), performance expectancy (F(1, 246)=6.10, p=0.01) and credibility (F(1, 246)=25.61, p<0.001). The same pattern of results was evident among medical students. Linear regression analysis revealed credibility (β=0.34, p<0.001) and performance expectancy (β=0.30, p<0.001) as the two strongest factors influencing acceptance, followed by scepticism (β=−0.18, p<0.001) and intuitive appeal (β=0.11, p=0.03).

Conclusions and recommendations

Physicians’ acceptance of health apps was moderate, and was strengthened by a 3 min video. Besides performance expectancy, credibility seems to be a promising factor associated with acceptance. Future research should focus on ways to implement acceptability-increasing interventions into routine care.
Novel genetic variants associated with inhaled corticosteroid treatment response in older adults with asthma
Authors: Wang Alberta L , Lahousse Lies , Dahlin Amber , Edris Ahmed , McGeachie Michael , Lutz Sharon M , Sordillo Joanne E , Brusselle Guy , Lasky-Su Jessica , Weiss Scott T , Iribarren Carlos , Lu Meng X , Tantisira Kelan G , Wu Ann C
Published: May 2022

Introduction

Older adults have the greatest burden of asthma and poorest outcomes. The pharmacogenetics of inhaled corticosteroid (ICS) treatment response is not well studied in older adults.

Methods

A genome-wide association study of ICS response was performed in asthmatics of European ancestry in Genetic Epidemiology Research on Adult Health and Aging (GERA) by fitting Cox proportional hazards regression models, followed by validation in the Mass General Brigham (MGB) Biobank and Rotterdam Study. ICS response was measured using two definitions in asthmatics on ICS treatment: (1) absence of oral corticosteroid (OCS) bursts using prescription records and (2) absence of asthma-related exacerbations using diagnosis codes. A fixed-effect meta-analysis was performed for each outcome. The validated single-nucleotide polymorphisms (SNPs) were functionally annotated to standard databases.

Results

In 5710 subjects in GERA, 676 subjects in MGB Biobank, and 465 subjects in the Rotterdam Study, four novel SNPs on chromosome six nearPTCHD4validated across all cohorts and met genome-wide significance on meta-analysis for the OCS burst outcome. In 4541 subjects in GERA and 505 subjects in MGB Biobank, 152 SNPs with p<5 × 10−5were validated across these two cohorts for the asthma-related exacerbation outcome. The validated SNPs included methylation and expression quantitative trait loci forCPED1,CRADDandDSTfor the OCS burst outcome andGM2A,SNW1,CACNA1C,DPH1, andRPS10for the asthma-related exacerbation outcome.

Conclusions

Multiple novel SNPs associated with ICS response were identified in older adult asthmatics. Several SNPs annotated to genes previously associated with asthma and other airway or allergic diseases, includingPTCHD4.
High-performance Reconfigurable DNN Accelerator on a Bandwidth-limited Embedded System
Authors: Hu Xianghong , Huang Hongmin , Li Xueming , Zheng Xin , Ren Qinyuan , He Jingyu , Xiong Xiaoming
Published: May 2022

Deep convolutional neural networks (DNNs) have been widely used in many applications, particularly in machine vision. It is challenging to accelerate DNNs on embedded systems because real-world machine vision applications should reserve a lot of external memory bandwidth for other tasks, such as video capture and display, while leaving little bandwidth for accelerating DNNs. In order to solve this issue, in this study, we propose a high-throughput accelerator, called reconfigurable tiny neural network accelerator (ReTiNNA), for the bandwidth-limited system and present a real-time object detection system for the high-resolution video image. We first present a dedicated computation engine that takes different data mapping methods for various filter types to improve data reuse and reduce hardware resources. We then propose an adaptive layer-wise tiling strategy that tiles the feature maps into strips to reduce the control complexity of data transmission dramatically and to improve the efficiency of data transmission. Finally, a design space exploration (DSE) approach is presented to explore design space more accurately in the case of insufficient bandwidth to improve the performance of the low-bandwidth accelerator. With a low bandwidth of 2.23 GB/s and a low hardware consumption of 90.261K LUTs and 448 DSPs, ReTiNNA can still achieve a high performance of 155.86 GOPS on VGG16 and 68.20 GOPS on ResNet50, which is better than other state-of-the-art designs implemented on FPGA devices. Furthermore, the real-time object detection system can achieve a high object detection speed of 19 fps for high-resolution video.
Experimental and Numerical Study of the Drying Process of a Consolidated Clay Soil
Authors: Cheng Wen-Qing , Bian Han-B ing , Gao Qian-Feng , Hattab Mahdia
Published: May 2022

The clay soil is composed of solid skeleton and porous and can be studied in the framework of porous media. During the drying process, the initial saturated clay soil deforms mainly due to the changes of water content and capillary pressure. With the further increase in capillary pressure, the soil cracks. In fact, the deformation and the stress in clay soil are tightly related with the water content and capillary pressure. Therefore, it is of great interest to understand the changes in capillary pressure and water content within the clay soil during the drying process. However, it is difficult to obtain these field variables by experiments alone. Therefore, the numerical simulation could be good choice for deeper understanding of the dry process in clay soil. In current research, the combined numerical simulation and laboratory experiments research are conducted; the numerical results are compared with the laboratory observation. This research is the basis for the further study of the cracking process of clay soil due to drying.
Molecular Dynamics Simulation and Essential Dynamics of Deleterious Proline 12 Alanine Single-Nucleotide Polymorphism in PPARγ2 Associated with Type 2 Diabetes, Cardiovascular Disease, and Nonalcoholic Fatty Liver Disease
Authors: Taghvaei Somayye , Saremi Leila
Published: May 2022

Background. Peroxisome proliferator-activated receptor-γ (PPARγ) gene is located at 3p25 position. PPARγ functions as the master regulator of glucose homeostasis and lipoprotein metabolism, and recent studies have reported that it is involved in various metabolic diseases such as diabetes mellitus, hyperlipidemia, coronary artery disease (CAD), and nonalcoholic fatty liver disease (NAFLD). PPARγ1 and PPARγ2 are necessary for the development of adipose tissue and insulin sensitivity regulation. But PPARγ2 is the isoform that was controlled in response to nutrient intake and obesity. Methodology. In this study, we used computational techniques to show the impact of Pro12Ala polymorphism on PPARγ2. The 3-D structure of PPARγ2 was modeled using I-TASSER server. The modeled structure was validated with the ZLab server, and the mutation was created with SPDB viewer. Stability prediction tools were used. Molecular dynamics simulation (MDS) was used to understand the structural and functional behavior of the wild type and mutant. Essential dynamics was also applied. Results and Conclusions. Stability prediction tools were showed that this mutation has a destabilizing effect on the PPARγ2 structure. The RMSD, RMSF, Rg, SASA, and DSSP were in line with H-bond results that showed less flexibility in the mutant structure. Essential dynamics was used to verify MDS results. Pro12Ala polymorphism leads to rigidity of the PPARγ2 protein and might disturb the conformational changes and interactions of PPARγ2 and results in type 2 diabetes mellitus (T2DM), CAD, and NAFLD. This study can help scientists to develop a drug therapy against these diseases.
Ideological and Political Teaching Resource Sharing Method Based on Edge Computing
Authors: He Lanyun
Published: May 2022

In the process of ideological and political teaching resource sharing, the sharing time is long due to the interference of redundant data. Therefore, an ideological and political teaching resource sharing method based on edge computing is proposed. Based on the sharing model of ideological and political teaching resources of edge computing, the information entropy suppression method is used to eliminate the redundant data in the ideological and political teaching resources, calculate the sinking of the edge node of the resource after removing the redundancy, assign the task to the edge node, and finally build a location index for the ideological and political teaching resources to realize the sharing of ideological and political teaching resources. The results show that when using the research method to share ideological and political teaching resources, the completion time, average waiting delay, and resource download time of resource sharing are shorter.
Multiagent Reinforcement Learning for Task Offloading of Space/Aerial-Assisted Edge Computing
Authors: Li Yanlong , Liang Lei , Fu Jielin , Wang Junyi
Published: May 2022

The task offloading in space-aerial-ground integrated network (SAGIN) has been envisioned as a challenging issue. In this paper, we investigate a space/aerial-assisted edge computing network architecture considering whether to take advantage of edge server mounted on the unmanned aerial vehicle and satellite for task offloading or not. By optimizing the energy consumption and completion delay, we formulate a NP-hard and non-convex optimization problem to minimize the computation cost, limited by the computation capacity and energy availability constraints. By formulating the problem as a Markov decision process (MDP), we propose a multiagent deep reinforcement learning (MADRL)-based scheme to obtain the optimal task offloading policies considering dynamic computation request and stochastic time-varying channel conditions, while ensuring the quality-of-service requirements. Finally, simulation results demonstrate the task offloading scheme learned from our proposed algorithm that can substantially reduce the average cost as compared to the other three single agent deep reinforcement learning schemes.
Sex-Related Differences in Outcomes for Oropharyngeal Squamous Cell Carcinoma by HPV Status
Authors: Kao Derek D. , Ferrandino Rocco M. , Marshall Deborah C. , Mutetwa Tinaye , Miles Brett , Bauml Joshua M. , Sigel Keith M.
Published: May 2022

Background. Overall survival for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) has differed by sex, but little is known regarding cancer-specific outcomes. We assessed the independent association of sex with cancer-specific survival in patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Methods. We identified 14,183 patients from the Surveillance, Epidemiology, and End Results (SEER) program with OPSCC and tumor HPV status. We used Kaplan–Meier methods to compare overall survival (OS) and OPSCC-specific survival (HNCSS) by patient sex and by tumor HPV status. We then separately fit multivariable survival and competing risk models evaluating the association of sex on these outcomes by tumor HPV status and stratified by the use of guideline-concordant OPSCC treatment. Results. A total of 10,210 persons with HPV-positive tumors (72.0%) and 3,973 with HPV-negative tumors (28.0%) were identified. A larger proportion of women had HPV-negative tumors (24.0%) versus HPV-positive tumors (13.2%;

p
<
0.001

). Women with HPV-positive tumors were less likely to receive guideline-concordant treatment compared to men. In unadjusted survival analyses, women did not differ in OS or HNCSS compared to men for HPV-positive tumors but had worse OS and HNCSS for HPV-negative tumors. After adjustment, men and women with HPV-positive OPSCC did not differ in OS or HNCSS. However, women with HPV-negative tumors faced worse overall survival (hazard ratio (HR) 1.15, 95% CI 1.02–1.29) that persisted even after stratifying for stage-appropriate treatment (HR 1.28, 95% CI 1.11–1.47). Conclusions. Women with HPV-positive OPSCC had similar survival outcomes compared to men, but those with HPV-negative tumors have worse overall and cancer-specific survival.
A Methodical Review on Carbon-Based Nanomaterials in Energy-Related Applications
Authors: Onyancha Robert Birundu , Ukhurebor Kingsley Eghonghon , Aigbe Uyiosa Osagie , Osibote Otolorin Adelaja , Kusuma Heri Septya , Darmokoesoemo Handoko
Published: May 2022

Carbon nanomaterials are endowed with novel and magnificent optical, electrical, chemical, mechanical, and thermal properties, with a promising prospect in different advanced applications such as electronics, batteries, capacitors, wastewater treatment, membranes, heterogeneous catalysis, and medical sciences. However, macroscopic synthesis of carbon materials for industrial use has been a great challenge. Furthermore, structural nonhomogeneity and indefinite fabrication have hindered vigorous and consistent implementation of these materials in extensive technologies. Nevertheless, they offer exotic physics, and as a result, they have continued to attract great interest from the scientific community in an effort aimed to optimize their properties through innovative synthesis techniques, ensuring macroscopic production and discovering new applications. Hence, this study endeavours to provide a conscious review of these materials via the comprehensive discussion of the various allotropes of carbon (fullerenes, carbon nanotubes, and graphene), synthesis techniques (arc discharge, laser ablation, and chemical vapor deposition), and their applications in energy-related fields (batteries, capacitors, photocells, hydrogen storage, sensors, etc.) and their impending prospects.