bluuebunny/crossref_metadata_2025 huggingface dataset:
Photocatalytic production of ethylene and propionic acid from plastic waste by titania-supported atomically dispersed Pd species
Authors: Zhang Shuai , Xia Bingquan , Qu Yang , Jing Liqiang , Jaroniec Mietek , Ran Jingrun , Qiao Shi-Zhang
Published: December 2023

Current chemical recycling of bulk synthetic plastic, polyethylene (PE), operates at high temperature/pressure and yields a complex mixture of products. PE conversion under mild conditions and with good selectivity toward value-added chemicals remains a practical challenge. Here, we demonstrate an atomic engineering strategy to modify a TiO
2
photocatalyst with reversible Pd species for the selective conversion of PE to ethylene (C
2
H
4
) and propionic acid via dicarboxylic acid intermediates under moderate conditions. TiO
2
-supported atomically dispersed Pd species exhibits C
2
H
4
evolution of 531.2 μmol g
cat
−1
hour
−1
, 408 times that of pristine TiO
2
. The liquid product is a valuable chemical propanoic acid with 98.8% selectivity. Plastic conversion with a C
2
hydrocarbon yield of 0.9% and a propionic acid yield of 6.3% was achieved in oxidation coupled with 3 hours of photoreaction. In situ spectroscopic studies confirm a dual role of atomic Pd species: an electron acceptor to boost charge separation/transfer for efficient photoredox, and a mediator to stabilize reaction intermediates for selective decarboxylation.
Biocrusts protect the Great Wall of China from erosion
Authors: Cao Yousong , Bowker Matthew A. , Delgado-Baquerizo Manuel , Xiao Bo
Published: December 2023

The Great Wall of China, one of the most emblematic and historical structures built by humankind throughout all of history, is suffering from rain and wind erosion and is largely colonized by biocrusts. However, how biocrusts influence the conservation and longevity of this structure is virtually unknown. Here, we conducted an extensive biocrust survey across the Great Wall and found that biocrusts cover 67% of the studied sections. Biocrusts enhance the mechanical stability and reduce the erodibility of the Great Wall. Compared with bare rammed earth, the biocrust-covered sections exhibited reduced porosity, water-holding capacity, erodibility, and salinity by 2 to 48%, while increasing compressive strength, penetration resistance, shear strength, and aggregate stability by 37 to 321%. We further found that the protective function of biocrusts mainly depended on biocrust features, climatic conditions, and structure types. Our work highlights the fundamental importance of biocrusts as a nature-based intervention to the conservation of the Great Wall, protecting this monumental heritage from erosion.
Pan-antiviral effects of a PIKfyve inhibitor on respiratory virus infection in human nasal epithelium and mice
Authors: Baker Jonathan , Ombredane Hugo , Daly Leah , Knowles Ian , Rapeport Garth , Ito Kazuhiro
Published: December 2023

Endocytosis, or internalization through endosomes, is a major cell entry mechanism used by respiratory viruses. Phosphoinositide 5-kinase (PIKfyve) is a critical enzyme for the synthesis of phosphatidylinositol (3, 5)biphosphate (PtdIns (3, 5)P2) and has been implicated in virus trafficking
via
the endocytic pathway. In fact, antiviral effects of PIKfyve inhibitors against SARS-CoV-2 and Ebola have been reported, but there is little evidence regarding other respiratory viruses. In this study, we demonstrated the antiviral effects of PIKfyve inhibitors on influenza virus and respiratory syncytial virus
in vitro
and
in vivo
. PIKfyve inhibitors Apilimod mesylate (AM) and YM201636 concentration-dependently inhibited several influenza strains in an MDCK cell-cytopathic assay. AM also reduced the viral load and cytokine release, while improving the cell integrity of human nasal air-liquid interface cultured epithelium infected with influenza PR8. In PR8-infected mice, AM (2 mg/mL), when intranasally treated, exhibited a significant reduction of viral load and inflammation and inhibited weight loss caused by influenza infection, with effects being similar to oral oseltamivir (10 mg/kg). In addition, AM demonstrated antiviral effects in RSV A2-infected human nasal epithelium
in vitro
and mouse
in vivo
, with an equivalent effect to that of ribavirin. AM also showed antiviral effects against human rhinovirus and seasonal coronavirus
in vitro
. Thus, PIKfyve is found to be involved in influenza and RSV infection, and PIKfyve inhibitor is a promising molecule for a pan-viral approach against respiratory viruses.
Draft genome sequence of an
Atlantibacter hermannii
clinical strain isolated from human muscle tissue
Authors: Feng Yan , Feng Yu , Zong Zhiyong
Published: December 2023

Atlantibacter hermannii
is a species of the family
Enterobacteriaceae
and a rare opportunistic pathogen. The draft genome sequence of an
Atlantibacter hermannii
clinical strain that had been isolated from infected muscle tissue was obtained. The genome contains about 4.4 million bases and has no known plasmid replicons.
The draft genome sequence of
bla
IMP-4
-carrying
Enterobacter soli
isolated from human blood
Authors: Feng Yu , Zong Zhiyong
Published: December 2023

Enterobacter soli
is a Gram-negative rod characterized by its motile, non-spore-forming, and facultatively anaerobic nature. In this study, strain 140044, identified as
Enterobacter soli
, was isolated from human blood. The strain was sequenced, revealing a 5.37-Mb draft genome harboring the carbapenemase gene
bla
IMP-4
.
Draft genome sequence of
Acidiplasma cupricumulans
strain BH2
T
, isolated from a pregnant leachate solution of heap bioleaching
Authors: Bulaev Aleksandr G. , Kanygina Aleksandra V. , Mardanov Andrey V.
Published: December 2023

We report the draft genome sequence of a type strain
Acidiplasma cupricumulans
Strain BH2
T
, isolated from a pregnant leachate solution of industrial-scale chalcocite bioleach heap (Monywa, Myanmar). The genome is 1.7 Mbp long with a GC content of 34.2%.
Whole genome sequences of
Lactococcus lactis
KCKM 0851 isolated from green onion kimchi
Authors: Ko Hye In , Kim So-Rim , Jeong Chae-Rim , Lee Mo Eun , Eun Jong-Bang , Kim Tae-Woon
Published: December 2023

Lactococcus lactis
KCKM 0851 isolated from green onion kimchi is a probiotic candidate and can be used as a starter culture for kimchi and dairy products. The whole-genome data of this strain will help us understand its genetics and metabolic characteristics.
Mass spectrometry imaging of natural carbonyl products directly from agar-based microbial interactions using 4-APEBA derivatization
Authors: Veličković Dušan , Zemaitis Kevin J. , Bhattacharjee Arunima , Anderton Christopher R.
Published: December 2023

Aliphatic carboxylic acids, aldehydes, and ketones play diverse roles in microbial adaptation to their microenvironment, from excretion as toxins to adaptive metabolites for membrane fluidity. However, the spatial distribution of these molecules throughout biofilms and how microbes in these environments exchange these molecules remain elusive for many of these bioactive species due to inefficient molecular imaging strategies. Herein, we apply on-tissue chemical derivatization (OTCD) using 4-(2-((4-bromophenethyl)dimethylammonio)ethoxy)benzenaminium dibromide (4-APEBA) on a co-culture of a soil bacterium (
Bacillus subtilis
NCIB 3610) and fungus (
Fusarium
sp. DS 682) grown on agar as our model system. Using matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI), we spatially resolved more than 300 different metabolites containing carbonyl groups within this model system. Various spatial patterns are observable in these species, which indicate possible extracellular or intercellular processes of the metabolites and their up- or downregulation during microbial interaction. The unique chemistry of our approach allowed us to bring additional confidence in accurate carbonyl identification, especially when multiple isomeric candidates were possible, and this provided the ability to generate hypotheses about the potential role of some aliphatic carbonyls in this
B. subtilis
/
Fusarium
sp. interaction. The results shown here demonstrate the utility of 4-ABEBA-based OTCD MALDI-MSI in probing interkingdom interactions directly from microbial co-cultures, and these methods will enable future microbial interaction studies with expanded metabolic coverage.

IMPORTANCE

The metabolic profiles within microbial biofilms and interkingdom interactions are extremely complex and serve a variety of functions, which include promoting colonization, growth, and survival within competitive and symbiotic environments. However, measuring and differentiating many of these molecules, especially in an
in situ
fashion, remains a significant analytical challenge. We demonstrate a chemical derivatization strategy that enabled highly sensitive, multiplexed mass spectrometry imaging of over 300 metabolites from a model microbial co-culture. Notably, this approach afforded us to visualize over two dozen classes of ketone-, aldehyde-, and carboxyl-containing molecules, which were previously undetectable from colonies grown on agar. We also demonstrate that this chemical derivatization strategy can enable the discrimination of isobaric and isomeric metabolites without the need for orthogonal separation (e.g., online chromatography or ion mobility). We anticipate that this approach will further enhance our knowledge of metabolic regulation within microbiomes and microbial systems used in bioengineering applications.
Progression of the FIB-4 index among patients with chronic HCV infection and early liver disease
Authors: Krassenburg Lisette A P , Maan Raoel , Puenpatom Amy , Erler Nicole S , Welsch Christoph , van Hees Stijn , Cerrhoci Orlando , Vermehren Johannes , de Knegt Robert J , Hansen Bettina E , Zeuzem Stefan , Vanwolleghem Thomas , Janssen Harry L A , de Man Robert A , Feld Jordan J , van der Meer Adriaan J
Published: December 2023

Background and aims

Historical paired liver biopsy studies are likely to underestimate current progression of disease in patients with chronic hepatitis C virus (HCV) infection. We aimed to assess liver disease progression according to the non-invasive Fibrosis-4 (FIB-4) index in patients with chronic HCV and early disease.

Methods and results

Patients diagnosed with chronic HCV and FIB-4 <3.25 from four international liver clinics were included in a retrospective cohort study. Follow-up ended at start of antiviral therapy resulting in sustained virological response, at time of liver transplantation or death. Primary outcome of advanced liver disease was defined as FIB-4 >3.25 during follow-up. Survival analyses were used to assess time to FIB-4 >3.25.

In total, 4286 patients were followed for a median of 5.0 (IQR 1.7–9.4) years, during which 41 071 FIB-4 measurements were collected. At baseline, median age was 47 (IQR 39–55) years, 2529 (59.0%) were male, and 2787 (65.0%) patients had a FIB-4 <1.45. Advanced liver disease developed in 821 patients. Overall, 10-year cumulative incidence of advanced disease was 32.1% (95% CI 29.9% to 34.3%). Patients who developed advanced disease showed an exponential FIB-4 increase. Among patients with a presumed date of HCV infection, cumulative incidence of advanced disease increased 7.7-fold from 20 to 40 years as opposed to the first 20 years after HCV infection.

Conclusions

The rate of advanced liver disease is high among chronic HCV-infected patients with early disease at time of diagnosis, among whom liver disease progression accelerated over time. These results emphasise the need to overcome any limitations with respect to diagnosing and treating all patients with chronic HCV across the globe.
How does the pandemic shape the future of allergies?
Authors: Papadopoulos Nikolaos G , Miligkos Michael
Published: December 2023

The COVID-19 pandemic posed an extraordinary challenge to societies and healthcare systems. Allergic individuals could not be an exception, being both directly and indirectly affected by the rapid and exponential spread of SARS-CoV-2. Although asthma was initially considered a risk factor for severe disease, evidence suggests that only poorly controlled asthmatics may constitute a high-risk group. A complex interplay between various factors involved in type 2 inflammation appears to determine an individual’s susceptibility to the virus and control of the infection. The impact of the pandemic on allergic patients’ mental health and trust in vaccines was also substantial, but through proper public health measures these effects are anticipated to abate. The implementation of innovative telemedical services was extensive and their use in everyday clinical practice will hopefully improve outcomes in various allergic diseases in the near future. Mitigation measures resulted in several changes in the exposome, including air quality and circulation of respiratory viruses, but also in human microbiome. The repercussions of these measures on the incidence and severity of allergic diseases are currently under study. Notwithstanding the detrimental consequences of SARS-CoV-2, the evolving pandemic offers the opportunity to investigate the long-term implications of various exposome changes; furthermore, it has provided opportunities towards improved care and public health measures to support the allergic individual.
Dietary strategies for early immune modulation in primary food allergy prevention
Authors: Heine Ralf G
Published: December 2023

As the global incidence of food allergies continues to rise, effective primary prevention strategies remain a public health priority. Eczema in early infancy is a major risk factor for IgE-mediated food allergies. Exposure to food allergens via inflamed skin promotes a cascade of allergic immune responses and increases the risk of IgE-mediated food allergies. By contrast, early exposure to food allergens via the gut is likely to induce oral tolerance. Landmark studies have demonstrated a significant reduction in the incidence of egg and peanut allergy in response to the early dietary introduction of food allergens. As a result, early feeding guidelines in countries with a high incidence of food allergies have shifted from recommending prolonged allergen avoidance to a policy of early introduction from around 6 months of age, as part of a diverse complementary diet. Uncertainties remain regarding the optimum timing for the introduction of specific food allergens, as well as the minimum effective frequency and dose. Exclusive breast feeding for around 6 months, and continuation to 2 years, is generally recommended but does not appear to consistently prevent food allergies. Perinatal and intermittent supplementary feeding with cow’s milk-based formula may increase the risk of cow’s milk protein allergy. Maternal food allergen avoidance during pregnancy and lactation is not effective. However, maternal consumption of food allergens during breast feeding appears to increase their preventive effect for the infant in conjunction with the early introduction of allergens into the complementary diet. Data on the dietary supplementation of pregnant women, breastfeeding mothers and infants with vitamin D, omega-3 polyunsaturated fatty acids, prebiotics or probiotics for the purpose of food allergy prevention are insufficient to make firm clinical recommendations. In infants with eczema, a combination of early allergen introduction with regular emollient treatment may have additive preventive effects, but clinical trials have so far had mixed outcomes. Further clinical trials combining dietary strategies with interventions aiming to restore the disrupted skin barrier in infants with eczema may provide new insights into effective food allergy prevention in at-risk populations.
Healthcare professionals’ intention to adopt mobile phone-based SMS and its predictors for adherence support and care of TB patients in a resource-limited setting: a structural equation modelling analysis
Authors: Walle Agmasie Damtew , Hunde Mekonnen Kenate , Demsash Addisalem Workie
Published: December 2023

Objective

To assess healthcare providers’ intentions and the associated factors to use mobile phone-based short message service (SMS) to support adherence and care of tuberculosis (TB) patients in the Oromia region of southwest Ethiopia.

Study design

An institutional-based cross-sectional study was conducted from October to November 2022.

Study setting

The study was conducted in public hospitals which include Mettu Karl referral hospital, Dembi Hospital, Bedelle Hospital, Darimu Hospital and Chora Hospital in Ilu Aba Bor and Buno Bedelle zones.

Participants

A total of 625 (54.9% male and 45.1% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All health professionals permanently working in Ilu Aba Bor and Buno Bedelle zone hospitals were included in this study. However, health professionals with less than 6 months of experience and those who were not present during the data collection period were excluded from this study.

Outcome measure

The intention to use mobile phone-based SMS to support TB patients.

Results

Healthcare professionals’ intention to use mobile SMS was 54.4%. Effort expectancy had a significant direct effect on attitude (β=0.162, p<0.01) and intention towards using mobile phone SMS (β=0.329, p<0.001). The intention to use mobile phone SMS was directly influenced by facilitating conditions (β=0.104, p<0.01) and attitude (β=0.26, p<0.001). The relationship between effort expectancy and intention to use SMS was mediated by attitude (β=0.043, p<0.01).

Conclusions

Overall, intention to use of mobile-based SMS was high. Effort expectancy, attitude and facilitating conditions were significant factors that determined healthcare professionals’ behavioural intention to use mobile phone SMS. Effort expectancy had a more significant prediction power than others. As a result, system forms that are easily interactive and applicable should be implemented to improve capacity building and support the adherence and care of TB patients.
Randomised controlled trial of the effects of kefir on behaviour, sleep and the microbiome in children with ADHD: a study protocol
Authors: Lawrence Kate , Fibert Philippa , Hobbs Jemima , Myrissa Kyriaki , Toribio-Mateas Miguel A , Quadt Frits , Cotter Paul D , Gregory Alice M
Published: December 2023

Introduction

Current interventions for children with attention-deficit/hyperactivity disorder (ADHD) are primarily medication, behavioural therapy and parent training. However, research suggests dietary manipulations may provide therapeutic benefit for some. There is accumulating evidence that the gut microbiome may be atypical in ADHD, and therefore, manipulating gut bacteria in such individuals may help alleviate some of the symptoms of this condition. The aim of this study is to explore the effects of supplementation with kefir (a fermented dairy drink) on ADHD symptomatology, sleep, attention and the gut microbiome in children diagnosed with ADHD.

Methods and analysis

A 6-week randomised, double-blind, placebo-controlled trial in 70 children aged 8–13 years diagnosed with ADHD. Participants will be recruited throughout the UK, through support groups, community groups, schools, social media and word of mouth. Children will be randomised to consume daily either dairy kefir or a placebo dairy drink for 6 weeks. The primary outcome, ADHD symptomatology, will be measured by The Strengths and Weakness of ADHD-symptoms and Normal-behaviour scale. Secondary outcomes will include gut microbiota composition (using shotgun metagenomic microbiome sequencing), gut symptomatology (The Gastrointestinal Severity Index questionnaire), sleep (using 7-day actigraphy recordings, The Child’s Sleep Habits Questionnaire and Sleep Self Report questionnaire), inattention and impulsivity (with a computerised Go/NoGo test). Assessments will be conducted prior to the intervention and at the end of the intervention. Interaction between time (preintervention/postintervention) and group (probiotic/placebo) is to be analysed using a Mixed Model Analysis of Variances.

Ethics and dissemination

Ethical approval for the study was granted by St Mary’s University Ethics Committee. Results will be disseminated through peer-reviewed publications, presentations to the scientific community and support groups.

Trial registration number

NCT05155696.
Experiences and management needs of endocrine therapy-related symptoms in patients with breast cancer: a systematic review and qualitative evidence synthesis protocol
Authors: Wang Lijie , Wei Tao , Liu Jiahui , Peng Siyi , Chen Jiejun , Hu Meihong , Li Xuying
Published: December 2023

Introduction

Patients with breast cancer and endocrine therapy-related symptoms often experience pain, self-denial, anxiety, fear of recurrence and despair, which can be extremely physically and psychologically traumatising for the patients. Failure to receive effective support and management reduces adherence to medications, leading to a higher risk of relapse and mortality. Clearly, it is paramount to identify what support these patients may need and how to meet their symptom management needs. This paper outlines a protocol to synthesise qualitative evidence on endocrine therapy symptom experiences, management expectations and preferences of patients with breast cancer.

Methods and analysis

The following databases were searched in November 2023 with no date restriction applied: The Cochrane Library, PubMed, Embase, Web of Science, Scopus, CINAHL and OpenGrey. Published studies on qualitative or mixed-method on symptom experiences and management needs during endocrine therapy in patients with breast cancer will be retrieved. We will also search for reference lists and perform a forward citation search. Before inclusion in this review, two reviewers will independently apply the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to ensure methodological validity. Any disagreements regarding the evaluation of the articles will be resolved through discussion with or by a third reviewer. Data will be extracted using the standardised data extraction tool EndNote20 for unified management, assessment, and review of information. The common sense model of self-regulation will guide data extraction and synthesis. The final synthesised findings will be graded according to the GRADE-CERQual approach to establish confidence.

Ethics and dissemination

This systematic review addressed previously published studies without personally identifiable participant information. Ethical approval from the research committee was not required. The findings of this systematic review will be disseminated to various key stakeholders and published in peer-reviewed journals.

PROSPERO registration number

CRD42023406987
Factors guiding gastrostomy tube decision-making for caregivers of children with cystic fibrosis: a scoping review protocol
Authors: Zientek Emily , Rane Sanika , Godfrey Chelsea , Sisson Amy , Dickinson Kimberly M.
Published: December 2023

Introduction

While ensuring appropriate growth is essential for all children, optimising nutritional status in children with cystic fibrosis (CF) is critical for improving health outcomes. Nutritional challenges in CF are multifactorial and malnutrition is common. While gastrostomy tubes (G-tubes) can improve weight status in individuals with CF, they also have common and chronic complications resulting in clinical equipoise. To date, factors influencing G-tube decision-making among caregivers of children with CF have not been systematically explored. This review aims to chart existing knowledge about caregivers’ decisional needs related to G-tube placement, with a focus on caregivers of children with CF, as well as known medical and psychosocial benefits and risks of G-tube feedings in paediatric care.

Methods and analysis

This scoping review will follow the JBI methodological framework. We will include articles published between 1 January 1985 and 1 November 2023 in English and Spanish from MEDLINE (Ovid), Embase, CINAHL, PsycInfo, Cochrane Database of Systematic Reviews and Web of Science related to G-tube decision-making. Articles published in languages besides English and Spanish will be excluded. Articles will be screened for final eligibility and inclusion according to title and abstract, followed by full texts. Articles will be independently reviewed by two reviewers and any disagreements discussed with a third reviewer for consensus. We will map themes and concepts, and data extracted will be presented in tabular, diagrams and descriptive summaries.

Ethics and dissemination

As a form of secondary analysis, scoping reviews do not require ethics approval. This review will inform future research with caregivers involved in G-tube decision-making for children with CF. The final review will be submitted to a peer-reviewed scientific journal, disseminated at relevant academic conferences and will be shared with patients and clinicians.

Trial registration number

Center for Open Science.https://osf.io/g4pdb.
ARCHERY: a prospective observational study of artificial intelligence-based radiotherapy treatment planning for cervical, head and neck and prostate cancer – study protocol
Authors: Aggarwal Ajay , Court Laurence Edward , Hoskin Peter , Jacques Isabella , Kroiss Mariana , Laskar Sarbani , Lievens Yolande , Mallick Indranil , Abdul Malik Rozita , Miles Elizabeth , Mohamad Issa , Murphy Claire , Nankivell Matthew , Parkes Jeannette , Parmar Mahesh , Roach Carol , Simonds Hannah , Torode Julie , Vanderstraeten Barbara , Langley Ruth
Published: December 2023

Introduction

Fifty per cent of patients with cancer require radiotherapy during their disease course, however, only 10%–40% of patients in low-income and middle-income countries (LMICs) have access to it. A shortfall in specialised workforce has been identified as the most significant barrier to expanding radiotherapy capacity. Artificial intelligence (AI)-based software has been developed to automate both the delineation of anatomical target structures and the definition of the position, size and shape of the radiation beams. Proposed advantages include improved treatment accuracy, as well as a reduction in the time (from weeks to minutes) and human resources needed to deliver radiotherapy.

Methods

ARCHERY is a non-randomised prospective study to evaluate the quality and economic impact of AI-based automated radiotherapy treatment planning for cervical, head and neck, and prostate cancers, which are endemic in LMICs, and for which radiotherapy is the primary curative treatment modality. The sample size of 990 patients (330 for each cancer type) has been calculated based on an estimated 95% treatment plan acceptability rate. Time and cost savings will be analysed as secondary outcome measures using the time-driven activity-based costing model. The 48-month study will take place in six public sector cancer hospitals in India (n=2), Jordan (n=1), Malaysia (n=1) and South Africa (n=2) to support implementation of the software in LMICs.

Ethics and dissemination

The study has received ethical approval from University College London (UCL) and each of the six study sites. If the study objectives are met, the AI-based software will be offered as a not-for-profit web service to public sector state hospitals in LMICs to support expansion of high quality radiotherapy capacity, improving access to and affordability of this key modality of cancer cure and control. Public and policy engagement plans will involve patients as key partners.
Economic evaluation of serplulimab plus chemotherapy as the first-line treatment of oesophageal squamous cell carcinoma in China
Authors: Chen Fang , Long Yunchun , Yang Jiayong , Zhong Kailong , Liu Bili
Published: December 2023

Objective

The ASTRUM-007 study confirmed the significant efficacy and safety of serplulimab plus chemotherapy for patients with locally advanced/metastatic, programmed cell death-ligand 1 positive oesophageal squamous cell carcinoma (OSCC). The economics of this regimen, however, is unclear. Therefore, this study aimed to evaluate the cost-effectiveness of adding serplulimab to chemotherapy for the treatment of advanced OSCC from the perspective of the Chinese healthcare system.

Design

A partitioned survival model was established to simulate the costs and outcomes of chemotherapy versus serplulimab plus chemotherapy. The survival data came from the ASTRUM-007 study. Only direct medical costs were considered, and utility values were referred to the literature. Sensitivity analysis was performed to assess the effect of parameter uncertainty on the model.

Outcome measures

Total costs, incremental costs, life years, quality-adjusted life years (QALYs), incremental QALYs and incremental cost-effectiveness ratio (ICER).

Results

The base case analysis showed that the cost of serplulimab plus chemotherapy (US$69 356) was US$41 607 higher than that of chemotherapy (US$27 749), but it also gained 0.38 QALYs more (1.38 vs 1 QALYs), with an ICER of US$110 744.36/QALY, which was higher than the willingness to pay. The factors that most influenced the ICER were the price of serplulimab, weight and utility value of the progression-free survival stage. The subgroup analysis and scenario analysis also demonstrated that serplulimab plus chemotherapy was not economical.

Conclusions

Compared with chemotherapy, serplulimab coupled with chemotherapy was not cost-effective for the treatment of advanced OSCC in China.
Willingness to vaccinate against herpes zoster in Chinese urban population: a mixed-methods study
Authors: Wang Ming , Hu Mingzheng , Wang Yanshang , Long Chao , Xia Yiqi , Zhu Dawei , Zhao Weiying , Yuan Beibei , He Ping
Published: December 2023

Objective

Although the herpes zoster vaccine has been available in mainland China since June 2020, residents’ knowledge of herpes zoster and the herpes zoster vaccine is poor, and vaccination rates are low, especially among the elderly, who are at high risk for herpes zoster. This study assessed willingness to be vaccinated against herpes zoster and factors associated with vaccination among urban residents in China.

Methods

A mixed-methods study was conducted in community health centres from August 2022 to September 2022. We used convenience sampling to select 2864 residents from 9 Chinese cities for the quantitative study and 67 adults for the qualitative study. A structured questionnaire was used for the quantitative study, and data were collected through face-to-face interviews. Multinomial logistic regression was used to analyse factors associated with willingness to vaccinate. Qualitative data were analysed using thematic analysis of barriers to herpes zoster vaccination.

Results

A total of 2864 eligible respondents were included in the study. Of these, 42.67% intended to receive the herpes zoster vaccine, 21.44% refused and 35.89% were hesitant. The results of the quantitative and qualitative analyses showed that the factors associated with respondents’ willingness to be vaccinated against herpes zoster included: personal characteristics such as gender, age and income; knowledge and attitudes about herpes zoster and the vaccine; vaccine characteristics such as efficacy, safety and price; and other factors such as pain tolerance and accessibility to vaccination.

Conclusion

The low willingness to vaccinate, especially among the elderly, is mainly related to their poor knowledge and negative attitude towards the infection and vaccination. Therefore, health education about herpes zoster, immunisation promotion, and improvement of accessibility and affordability would be valuable in China.
Access, Relationships, Quality and Safety (ARQS): a qualitative study to cocreate an Indigenous patient experience tool for virtual primary care
Authors: Roach Pamela , Campbell Paige , Ody Meagan , Scott Melissa , Barnabe Cheryl , Montesanti Stephanie , Kennedy Andrea , Murry Adam , Tailfeathers Esther , Crowshoe Lynden
Published: December 2023

Background

Perspectives from Indigenous peoples and their primary care providers about the quality and impacts of virtual primary care for Indigenous patients are currently limited. This study engaged Indigenous patients and their primary care providers, resulting in four domains being established for an Indigenous patient experience tool for use in virtual primary care. In this paper, we explore the development and finalisation of the Access, Relationships, Quality and Safety (ARQS) tool.

Methods

We re-engaged five Indigenous patient participants who had been involved in the semistructured interviews that established the ARQS tool domains. Through cognitive interviews, we tested the tool statements, leading to modifications. To finalise the tool statements, an Indigenous advisory group was consulted.

Results

The ARQS tool statements were revised and finalised with twelve statements that reflect the experiences and perspectives of Indigenous patients.

Discussion

The ARQS tool statements assess the four domains that reflect high-quality virtual care for Indigenous patients. By centring Indigenous peoples and their lived experience with primary care at every stage in the tool’s development, it captures Indigenous-centred understandings of high-quality virtual primary care and has validity for use in virtual primary care settings.

Conclusion

The ARQS tool offers a promising way for Indigenous patients to provide feedback and for clinics to measure the quality and safety of virtual primary care practice on the provider and/or clinic level. This is important, as such feedback may help to promote improvements in virtual primary care delivery for Indigenous patients and more widely, may help advance Indigenous health equity.
A realist review of medication optimisation of community dwelling service users with serious mental illness
Authors: Howe Jo , MacPhee Maura , Duddy Claire , Habib Hafsah , Wong Geoff , Jacklin Simon , Oduola Sheri , Upthegrove Rachel , Carlish Max , Allen Katherine , Patterson Emma , Maidment Ian
Published: December 2023

Background

Severe mental illness (SMI) incorporates schizophrenia, bipolar disorder, non-organic psychosis, personality disorder or any other severe and enduring mental health illness. Medication, particularly antipsychotics and mood stabilisers are the main treatment options. Medication optimisation is a hallmark of medication safety, characterised by the use of collaborative, person-centred approaches. There is very little published research describing medication optimisation with people living with SMI.

Objective

Published literature and two stakeholder groups were employed to answer: What works for whom and in what circumstances to optimise medication use with people living with SMI in the community?

Methods

A five-stage realist review was co-conducted with a lived experience group of individuals living with SMI and a practitioner group caring for individuals with SMI. An initial programme theory was developed. A formal literature search was conducted across eight bibliographic databases, and literature were screened for relevance to programme theory refinement. In total 60 papers contributed to the review. 42 papers were from the original database search with 18 papers identified from additional database searches and citation searches conducted based on stakeholder recommendations.

Results

Our programme theory represents a continuum from a service user’s initial diagnosis of SMI to therapeutic alliance development with practitioners, followed by mutual exchange of information, shared decision-making and medication optimisation. Accompanying the programme theory are 11 context-mechanism-outcome configurations that propose evidence-informed contextual factors and mechanisms that either facilitate or impede medication optimisation. Two mid-range theories highlighted in this review are supported decision-making and trust formation.

Conclusions

Supported decision-making and trust are foundational to overcoming stigma and establishing ‘safety’ and comfort between service users and practitioners. Avenues for future research include the influence of stigma and equity across cultural and ethnic groups with individuals with SMI; and use of trained supports, such as peer support workers.

PROSPERO registration number

CRD42021280980.
Risk factors for injury complaints leading to restricted participation in Athletics (Track and Field): a secondary analysis of data from 320 athletes over one season
Authors: Edouard Pascal , Tondut Jeanne , Hollander Karsten , Dandrieux Pierre-Eddy , Navarro Laurent , Bruneau Antoine , Junge Astrid , Blanco David
Published: December 2023

Objective

To investigate if several potential risk factors were associated with time to injury complaints leading to participation restriction in Athletics (ICPR).

Methods

We performed a secondary analysis of data collected during 39 weeks of the 2017–2018 Athletics season in a cluster-randomised controlled trial (‘PREVATHLE’). Univariate and multivariable analyses using Cox regression models were performed to analyse the association between the time to first ICPR and potential risk factors collected (1) at baseline: sex, age, height, body mass, discipline, the usual duration of Athletics training and non-specific sports training, ICPR in the preceding season (yes/no), ICPR at baseline (yes/no); (2) weekly during the season: duration and intensity of Athletics training and competition, and non-specific sports training, fitness subjective state, sleep duration and illness (yes/no); and (3) combined.

Results

Data from 320 athletes were included; 138 (43.1%) athletes reported at least one ICPR during the study follow-up. The combined multivariable analyses revealed that the risk of ICPR at any given time was significantly higher in athletes with a pre-existing ICPR (hazard rate ratio, HRR 1.90, 95% CI 1.15 to 3.15; p=0.012) and lower in athletes with a higher fitness subjective state (HRR 0.63, 95% CI 0.55 to 0.73; p<0.001) and who had had at least one illness during the season (HRR 0.42, 95% CI 0.29 to 0.62; p<0.001).

Conclusions

Our results provide new insights into injury risk factors in Athletics that could help with potential injury risk reduction strategies. These could be to explore the pre-existing injury presence at the season’s beginning and to monitor the fitness subjective state and illnesses occurrence during the season.

Trial registration

ClinicalTrials.gov Identifier:NCT03307434
Facility-based approach for the management of acute ST segment elevation myocardial infarction with cardiogenic shock in a rural medical centre: the Durango model
Authors: Carter Andrew Joseph , Raffoul Jad , Lane Linden , LeSage Leah , Langenhorst Shelley , Smolin Matthew , Dempsey Michael , Hughes David , Gleason Michael , Weiss Steven , Anderson William D
Published: December 2023

Introduction

Cardiogenic shock (CS) complicates 5%–15% of cases of acute myocardial infarction (AMI) with inpatient mortality greater than 40%. The implementation of standardised protocols may improve clinical outcomes in patients with AMI-CS.

Methods and analysis

The Durango model is a prospective single-centre registry designed to enable early identification of patients with STEMI-CS to facilitate primary reperfusion therapy with a shock team management algorithm in a rural level II heart attack centre. This prospective registry includes all patients >18 years of age presenting with STEMI with or without CS beginning on 1 February 2023. The primary outcome measures are adherence to model-based documentation of SCAI shock Classification prehospital and in the ED with appropriate STEMI shock alert for AMI and stages C, D, E shock; use of mechanical circulatory support Pre-PCI and door to support time <90 min.

Ethics and dissemination

This study was approved by the Institutional Review Board with a waiver of informed consent. The findings will be submitted for publication in a peer-review open access journal on completion of the study.

Conclusions

The Durango model will demonstrate that the implementation of a STEMI shock team can be feasible in a rural medical centre through comprehensive education of a diverse group providers with different levels of experience, continuous model/device proficiency training and performance feedback.
Safety and efficacy of e-cigarettes in those with atherosclerotic disease: a review
Authors: McCaughey Conor James , Murphy Greg , Jones Jennifer , Mirza Kaumal Baig , Hensey Mark
Published: December 2023

Smoking cessation is the most effective intervention to reduce mortality in patients with established atherosclerotic cardiovascular disease (ASCVD), with ‘e-cigarettes’ becoming an increasingly used intervention to achieve smoking cessation. The current review aims to summarise the current evidence base for their efficacy and safety in the ASCVD cohort. A search of the PUBMED and MEDLINE databases using the terms ‘e-cigarette’, ‘cessation’, ‘safety’ and ‘efficacy’ since 2012 yielded 706 results. Both observational and experimental studies were included, while those with an unavailable full text, non-English or duplicates were excluded, yielding 78 relevant articles, with 13 subsequent additional articles included from a search of reference lists, for a total of 91 included papers. E-cigarette vapour contains many known pro-atherosclerotic substances and has been demonstrated to potentiate traditional atherosclerotic mechanisms. While e-cigarettes may be more effective in promoting smoking cessation in the general population over a medium term (>6 months), when compared with nicotine replacement therapy (NRT), few studies specifically examined those with ASCVD, despite the latter having a higher baseline quit rate (52% vs 2%). Most studies compare e-cigarettes with NRT alone and do not include pharmacotherapy, which may be more effective in the ASCVD cohort. The single randomised controlled trial addressing the research question favoured traditional methods. Those that successfully quit smoking using e-cigarettes are more likely to continue to use the intervention at 1 year (90% vs 9%). Conflicting advice exists regarding the utilisation of e-cigarettes for smoking cessation. E-cigarettes may be inferior to standard care for smoking cessation in those with ASCVD, and their use is likely to promote the key drivers of the atherosclerotic process already active in this cohort.
Diffusing capacity of lungs for carbon monoxide associated with subclinical myocardial impairment in systemic sclerosis: A cardiac MR study
Authors: He Huilin , Tong Xinyu , Ning Zihan , Zhou Jiaxin , Du Chenlin , Wang Yuhua , Wang Qian , Xu Dong , Zeng Xiaofeng , He Zuo-Xiang , Zhao Xihai
Published: December 2023

Background

Systemic sclerosis (SSc) is characterised by microvascular and fibrotic lesions, which are located not only in skin but also in lungs and heart.

Objective

This study aimed to investigate the association between lung function and myocardial T1 values using cardiac MR (CMR) imaging in patients with SSc without cardiovascular symptoms.

Methods

The SSc patients and age- and sex-matched healthy subjects underwent CMR. The cardiac function and native T1 values of myocardium and lung function were measured. Spearman’s rank correlations and linear regression analyses were performed to determine the association between lung function and myocardial T1.

Results

Forty-five SSc patients (aged 47.7±13.2 years, 40 females) and 23 (aged 46.0±14.4 years, 20 females) healthy subjects were enrolled. SSc patients exhibited considerably higher native T1 values compared with healthy subjects (1305.9±49.8 ms vs 1272.6±37.6 ms, p=0.006). Linear regression analysis revealed that decrease of diffusing capacity of lungs for carbon monoxide (DLCO) in SSc patients was notably associated with myocardial native T1 value before (β –1.017; 95% CI –1.883 to –0.151; p=0.022) and after adjusting for confounding factors (β –1.108; 95% CI −2.053 to –0.164; p=0.023). Moderate-to-severe decrease of DLCO was found to be significantly associated with myocardial native T1 value (β 48.006; 95% CI 17.822 to 78.190; p=0.003) after adjusting for confounding factors.

Conclusion

DLCO inversely correlates with myocardial native T1 values in SSc patients, particularly moderate-to-severely decreased DLCO, suggesting that DLCO might be a potential indicator for subclinical myocardial impairment in SSc patients.
Rituximab to treat prolidase deficiency due to a novel pathogenic copy number variation inPEPD
Authors: Atschekzei Faranaz , Fedchenko Mykola , Elsayed Abdulwahab , Dubrowinskaja Natalia , Graalmann Theresa , Ringshausen Felix C , Witte Torsten , Sogkas Georgios
Published: December 2023

Prolidase deficiency (PD) is a rare autosomal recessive inborn error of immunity caused by biallelic homozygous or compound heterozygous loss-of-function mutations inPEPD, the gene that encodes prolidase. PD typically manifests with variable dysmorphic features, chronic cutaneous ulcers, recurrent infections and autoimmune features, including systemic lupus erythematosus. So far, there is no consensus regarding treatment of PD and its autoimmune manifestations. Here, we present a 28-year-old female patient with PD due to a novel homozygous intragenic deletion inPEPD, diagnosed at the age of 6 years and 7 months with an undifferentiated connective tissue disease that, apart from its very early onset, would be consistent with the diagnosis of Sjögren’s syndrome. Steroids and diverse conventional synthetic disease-modifying antirheumatic drugs failed to control PD-associated vasculitis and mucocutaneous ulcerations and led to infectious complications, including cytomegalovirus colitis. Introduction of rituximab (RTX) treatment in this patient led to sustained recession of mucocutaneous ulceration, enabling tapering of steroids. High interleukin-1β (IL-1β) production by this patient’s monocytes, together with the detection of both IL-1β and interleukin-18 (IL-18) in her serum, suggest enhanced inflammasome activation in PD, whereas the therapeutic efficacy of RTX implies a role for CD20 positive B cells in the complex immunopathogenesis of PD.