bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multimodal Climbing-Swimming Soft Robotic Lamprey
Authors: Gallentine James , Barth Eric J. , Galloway Kevin , Van Stratum Brian , Clark Jonathan , Shoele Kourosh
Published: November 2022

Here, we present a multimodal, lamprey-inspired, 3D printed soft fluidic robot/actuator based on an antagonistic pneunet architecture. The Pacific Lamprey is a unique fish which is able to climb wetted vertical surfaces using its suction-cup mouth and snake-like morphology. The continuum structure of these fish lends itself to soft robots, given their ability to form continuous bends. Additionally, the high gravimetric and volumetric power density attainable by soft actuators make them good candidates for climbing robots. Fluidic soft robots are often limited in the forces they can exert due to limitations on their actuation pressure. This actuator is able to operate at relatively high pressures (for soft robots) of 756 kPa (95 psig) with a −3 dB bandwidth of 2.23 Hz to climb at rates exceeding 18 cm/s. The robot is capable of progression on a vertical surface using a compliant microspine attachment as the functional equivalent of the lamprey’s more complex suction-cup mouth. The paper also presents the details of the 3D-printed manufacturing of this actuator/robot.
Hydrogen permeation barriers and preparation techniques: A review
Authors: Xiao Shu , Meng Xinyu , Shi Kejun , Liu Liangliang , Wu Hao , Lian Weiqi , Zhou Chilou , Lyu Yunrong , Chu Paul K.
Published: November 2022

In the hydrogen energy industry, penetration of hydrogen into storage and transportation materials is a big problem because the process causes cracks, equipment damage, hydrogen leakage, failure, and even explosion. Hydrogen permeation barriers are, thus, necessary to improve the hydrogen resistance of materials and new coating materials and fabrication techniques are being explored. In this review, recent progress in the research of hydrogen permeation barriers is reviewed in terms of both the materials and preparation technology. The current research progress is first discussed based on traditional barriers such as metals and ceramics. Recent development of two-dimensional materials and composite coatings is described and the hydrogen resistance mechanism is discussed. The advantages and limitations of six common preparation methods: physical vapor deposition, chemical vapor deposition, solgel method, plasma spraying, electrochemical deposition, and plasma electrolytic oxidation are compared. Novel composite coatings with “hydrogen storage and barrier” structures are attractive and constitute one of the future research directions.
Soundiation: A software in evaluation of acoustophoresis driven by radiation force and torque on axisymmetric objects
Authors: Tang Tianquan , Huang Lixi
Published: November 2022

Acoustic radiation force and torque arising from wave scattering are commonly used to manipulate micro-objects without contact. We applied the partial wave expansion series and the conformal transformation approach to estimate the acoustic radiation force and torque exerted on the axisymmetric particles. Meanwhile, the translational and rotational transformations are employed to perform the prediction of the acoustophoresis. Although these theoretical derivations are well-developed [Tang and Huang, J. Sound Vibr. 532, 117012 (2022), Tang and Huang, Phys. Rev. E 105, 055110 (2022)], coding the required systems, including generation of the wave function, implementation of the transformations, calculations between modules, etc., is non-trivial and time-consuming. Here, we present a new open-source, matlab-based software, called Soundiation [GitHub Repository: https://github.com/Tountain/SoundiationAcoustophoresis, GPL-3.0 license], to address the acoustic radiation force and torque while supporting the dynamic prediction of non-spherical particles. The implementation is basically generic, and its applicability is demonstrated through the validation of numerical methods. A graphical user interface is provided so that it can be used and extended easily.
Gluconacetobacter diazotrophicus Gene Fitness during Diazotrophic Growth
Authors: Schwister Erin M. , Dietz Benjamin R. , Knutson Carolann M. , Olszewski Neil E. , Barney Brett M.
Published: November 2022

Our results demonstrate a succinct set of genes involved in diazotrophic growth for
G. diazotrophicus
, with a lower degree of redundancy than what is found in other model diazotrophs. The results will serve as a valuable resource for those interested in biological nitrogen fixation and will establish a baseline data set for plant free growth, which could complement future studies related to the endophyte relationship.
Complete Genome Sequences of Four Pseudomonas aeruginosa Bacteriophages: Kara-mokiny 8, Kara-mokiny 13, Kara-mokiny 16, and Boorn-mokiny 1
Authors: Vaitekenas Andrew , Tai Anna S. , Ramsay Joshua P. , Stick Stephen M. , Agudelo-Romero Patricia , Kicic Anthony ,   WAERP,   AREST CF
Published: November 2022

Pseudomonas aeruginosa
is an opportunistic pathogen. Here, we report the isolation of four bacteriophages from wastewater. All four bacteriophages belong to the
Myoviridae
family. Kara-mokiny 8, 13, and 16 are of the
Pbunavirus
genus and have genomes between 65,527 and 66,420-bp. Boorn-mokiny 1 is of the
Phikzvirus
genus and has a 278,796-bp genome.
Biochemical Identification of a Nuclear Coactivator Protein Required for AtrR-Dependent Gene Regulation in Aspergillus fumigatus
Authors: Paul Sanjoy , Ror Shivani , McDonald W. Hayes , Moye-Rowley W. Scott
Published: November 2022

Aspergillus fumigatus
is a major filamentous fungal pathogen in humans and is susceptible to the azole antifungal class of drugs. However, loss of azole susceptibility has been detected with increasing frequency in the clinic, and infections associated with these azole-resistant isolates have been linked to treatment failure and worse outcomes.
Selection for Translational Efficiency in Genes Associated with Alphaproteobacterial Gene Transfer Agents
Authors: Kogay Roman , Zhaxybayeva Olga
Published: November 2022

Horizontal gene transfer (HGT) is a fundamental process that drives evolution of microorganisms. HGT can result in a rapid dissemination of beneficial genes within and among microbial communities and can be achieved via multiple mechanisms.
Hepatitis B Virus X Protein Stimulates Hepatitis C Virus (HCV) Replication by Protecting HCV Core Protein from E6AP-Mediated Proteasomal Degradation
Authors: Yoon Hyunyoung , Han Jiwoo , Jang Kyung Lib
Published: November 2022

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major human pathogens that cause a substantial proportion of liver diseases worldwide. As the two hepatotropic viruses have the same modes of transmission, coinfection is often observed, especially in areas and populations where HBV is endemic.
Sequencing and Variant Detection of Eight Abundant Plant-Infecting Tobamoviruses across Southern California Wastewater
Authors: Rothman Jason A. , Whiteson Katrine L.
Published: November 2022

Diseases caused by viruses in the genus Tobamovirus cause crop losses around the world. As with other viruses, mutation occurring in the virus’s genomes can have functional consequences and may alter viral infectivity.
High-Fidelity Cytosine Base Editing in a GC-Rich Corynebacterium glutamicum with Reduced DNA Off-Target Editing Effects
Authors: Heo Yu Been , Hwang Gue-Ho , Kang Seok Won , Bae Sangsu , Woo Han Min
Published: November 2022

Rat APOBEC1-derived cytosine base editor (CBE) that converts C•G to T•A at target genes induced DNA off-targets, regardless of single-guide RNA (sgRNA) sequences. Although the high efficiencies of bacterial CBEs have been developed, a risk of unidentified off-targets impeded genome editing for microbial cell factories.
Supplemental Material: “Excess Ar” by laboratory alteration of biotite
Authors: Villa Igor M. , Bosio Giulia
Published: November 2022

Table S1 (complete Ar isotope data), Table S2 (electron microprobe data), and Figure S1. 
Supplemental Material: Magmatic-hydrothermal evolution of long-lived Nb-Ta-(Sn) mineralization in Lianyunshan, NE Hunan, South China
Authors: Madayipu Nuerkanati , Li Huan , al. et
Published: November 2022

Analytical methods and Tables S1–S12.
Syndromes associated with Robin sequence: a national prospective cohort study
Authors: Davies Alex , Davies Amy , Wren Yvonne , Deacon Scott , Cobb Alistair , McLean Neil , David David , Chummun Shaheel
Published: November 2022

Objectives

To determine the prevalence of syndromic Robin sequence (RS) in the UK and if this group of patients had an increased need for airway and feeding management compared with a non-syndromic RS cohort.

Design

A prospective national multicentre study of cases submitted to the Cleft Collective cohort studies.

Setting

Specialist cleft services in the UK.

Patients

259 participants who fulfilled the diagnosis of RS. This group was compared with 548 participants with cleft palate only (CPO).

Main outcome measures

The primary outcome measure was the presence of a syndrome in patients with RS and CPO. Secondary outcome measures included the use of airway and feeding adjuncts.

Results

An associated syndrome was seen in 28% of patients with RS and 14% of patients with CPO. The most common syndrome for the RS group was Stickler syndrome (27%). Syndromic status was significantly higher among patients with RS compared with those with CPO (OR 2.36, 95% CI 1.65 to 3.39; p<0.001). Patients with syndromic RS have an increased reliance on airway adjuncts compared with the patients without syndromic RS (OR 2.02, 95% CI 1.13 to 3.64; p=0.018). There was no evidence of a difference in the use of feeding adjuncts between syndromic and non-syndromic RS groups (OR 2.43, 95% CI 0.78 to 7.58; p=0.126).

Conclusion

The presence of a syndrome has implications for management of patients with RS. Early identification of a syndrome may help prevent the consequences of a missed syndromic diagnosis. Routine ophthalmological and genetic screening for Stickler syndrome should be mandatory for all patients with RS.
Ionised hypocalcaemia in emergency and acute medicine
Authors: Yates Gregory P , Barrett Alice , Ogedengbe Onesi
Published: November 2022

Acute hypocalcaemia can be life-threatening and must be diagnosed promptly. The gold-standard investigation is ionised calcium, which is measured on most blood gas analysers. Total calcium measurements are inaccurate in severe depletion even if ‘corrected’ or ‘adjusted’ for albumin. We present an illustrative case of a woman in her 30s with symptomatic hypocalcaemia and a very low ionised calcium on VBG analysis. Emergency calcium replacement was delayed due to a falsely reassuring corrected calcium result. Our discussion includes a systematic literature review on the use of ionised calcium in emergency and acute medical settings. We suggest cognitive biases that may explain clinical over-reliance on corrected calcium, and call for the inclusion of ionised calcium values in major treatment guidelines for acute hypocalcaemia.
A unique presentation of IgG4 disease with ocular, neurologic and mastoid involvement
Authors: Narotam Jeena Heena , Afrogheh Amir , West Joshua , van der Colff Freddie , Brey Naeem
Published: November 2022

A man in his 20s presented with headache and acute deterioration in visual acuity. He was found to have panuveitis and raised intracranial pressure with papilloedema. MRI and F-fluorodeoxyglucose positron emission tomography confirmed a subclinical, but active, inflammatory mastoid process. Histology of the mastoid showed immunoglobulin G4 (IgG4) cells, plasma cells and storiform fibrosis.

This presentation of IgG4 disease has not been previously described.

Treatment with high-dose steroids was initiated, followed by long-term immunosuppressive therapy. The patient’s symptoms improved, although he remains dependent on azathioprine and low dose oral steroids for symptom control. To date, there has been no progression of the disease.
INvesTigating the Abnormality of detrusor ConTractility by uroflowmetry in diabetic children (INTACT Trial): protocol of a prospective, observational study
Authors: Martonosi Ágnes Rita , Pázmány Piroska , Kiss Szabolcs , Zsákai Annamária , Szabó László
Published: November 2022

Introduction

Bladder emptying abnormalities and cardiovascular autonomic dysfunction are manifestations of autonomic dysfunction in people with diabetes mellitus (DM), which are major causes of morbidity and mortality. Since they can reduce the quality of life, they are urgent to be addressed before resulting in complications. As uroflowmetry might determine autonomic neuropathy earlier than cardiovascular autonomic dysfunction symptoms occur, our aim is to detect early abnormalities in bladder muscle function in children with DM. We investigate the diagnostic accuracy of uroflowmetry. As a secondary aim, we compare the prevalence of uroflowmetry abnormalities to the appearance of measures of cardiovascular autonomic neuropathy. Finally, as an ancillary study, we examine the association of uroflowmetry with the appearance of peripheral neuropathy. These three aims, we feel, will put our results regarding uroflowmetry into an overall context of nerve disease early in the course of type 1 DM. To our knowledge, such an approach has heretofore not been performed.

Methods and analysis

This will be a prospective, observational, single-centre clinical study. Patients with DM fulfilling the inclusion criteria and healthy controls will have uroflowmetry examination, cardiovascular autonomic dysfunction tests (heart rate response to deep breathing, to Valsalva manoeuvre, blood pressure and heart rate response to standing up, and to sustained handgrip) and nerve conduction test. The autonomic nervous system function will be examined by the reproducible and standardised cardiovascular reflex tests described by Ewinget al. During the examination, electrocardiogram (ECG) and blood pressure values will be recorded continuously. Heart rate response to deep inspiration will be executed to investigate the parasympathetic nervous system. Peripheral neuropathy will be evaluated by nerve conduction test. After a pilot period, when the first 50 diabetic and 50 healthy children will be assessed, sample size calculation will be carried out. The primary objective of this trial is to evaluate the diagnostic accuracy (sensitivity, specificity, positive and negative predictive value) of uroflowmetry. To do so, we compare uroflowmetry to the gold standard neuropathy tests, which are cardiovascular autonomic dysfunction tests (heart rate response to deep breathing, to Valsalva manoeuvre, blood pressure and heart rate response to standing up and to sustained handgrip).

Ethics and dissemination

Ethics approval was obtained from the Scientific and Research Ethics Committee of the Heim Pál National Paediatric Institute in Budapest, Hungary (registration number KUT-37/2021). Results will be submitted for publication in a peer-reviewed journal.

Trial registration number

NCT05247840.
Risky business: a single-centre cross-sectional analysis of calculated cardiovascular risk in patients with primary aldosteronism and essential hypertension
Authors: Solanki Pravik , Gwini Stella May , Libianto Renata , Gabb Genevieve , Shen Jimmy , Young Morag J , Fuller Peter J , Yang Jun
Published: November 2022

Objectives

Primary aldosteronism (PA), the most common endocrine cause of hypertension, is associated with a higher risk of cardiovascular disease (CVD) than blood pressure (BP)-matched essential hypertension (EH). We aimed to compare the calculated risks of CVD in patients who had hypertension with PA or EH using CVD risk calculators, hypothesising that they will fail to recognise the increased CVD risk in PA.

Design

Cross-sectional analysis.

Setting

An endocrine hypertension service in Victoria, Australia.

Participants

Patients who had hypertension without CVD referred for the investigation of hypertension.

Outcome measures

Calculated 5-year or 10-year CVD risk as predicted by the National Vascular Disease Prevention Alliance (NVDPA) algorithm, Framingham Risk Score, Pooled Cohort Equations and QRISK3.

Results

Those with PA (n=128) and EH (n=133), did not differ significantly in their calculated CVD risks with the NVDPA algorithm (moderate-to-high 5-year risk 36/100 vs 45/99, p=0.17); the Framingham Risk Score (median 10-year risk 7.72% (4.43%–12.95%) vs 6.84% (3.85%–10.50%), p=0.14); the Pooled Cohort Equations (median 10-year risk 9.45% (4.36%–15.37%) vs 7.90% (2.09%–14.73%), p=0.07); and QRISK3 (median 10-year risk 11.31% (7.22%–20.29%) vs 12.47% (5.10%–19.93%), p=0.51). Similarities persisted on regression analyses accounting for systolic BP.

Conclusions

CVD risk algorithms do not reflect the increased risk of CVD in patients with PA, and likely underestimate the true risk of CVD among those with PA. Screening for PA, in addition to using the CVD risk algorithm in patients who had hypertension, may facilitate the targeted treatment of PA and minimisation of cardiovascular risk in affected individuals.
Benefit finding in first-ever young and middle-aged patients who had a stroke and their spousal caregivers in China: a longitudinal mixed-methods study protocol
Authors: Li Hui , Zhang Leyun , Wang Wenna , Xiang Dandan , Zhang Zhenxiang , Mei Yongxia
Published: November 2022

Introduction

The global burden caused by stroke is shifting to young and middle-aged people. Researchers have emphasised the significance of benefit finding (BF) in psychological health. However, current research has paid little attention to stroke and has discussed BF from only a single perspective, that is, that of either patients or caregivers. Our study aims to understand the changing trajectory, predictors and dyadic interaction of BF in dyads of patient who had a stroke and caregiver.

Methods and analysis

This study is a longitudinal mixed-methods, multicentre study. A total of 142 patients who had a stroke and 142 spousal caregivers will be investigated. Participants will be recruited from four large public hospitals in northern China. Quantitative and qualitative data will be collected at five time points (near discharge and 1, 3, 6 and 12 months following discharge). Validated and reliable questionnaires will be used in quantitative studies. Information on sociodemographic data, BF, functional status, perceived stress, coping styles and mutuality will be collected from the dyads. Qualitative data will be collected via semistructured interviews and observations. The growth mixture model will be used to analyse quantitative data, and Colaizzi’s seven-step analysis method will be used to analyse qualitative data. We plan to conduct parallel but separate quantitative and qualitative data analyses and ultimately integrate the data sets to determine confirmation, expansion or discordance.

Ethics and dissemination

All participants will be provided with an informed consent form. This study will encode all identifiable data and store all recorded data on a secure research server. This study has been approved by the Ethics Review Committee of the College of Nursing and Health, Zhengzhou University (ZZUIRB2020-53). The results of the longitudinal study will be published in peer-reviewed journals and presented at national conferences.

Trial registration number

ChiCTR2000039509.
Patient and physiotherapist perceptions of the Getting Recovery Right After Neck Dissection (GRRAND) rehabilitation intervention: a qualitative interview study embedded within a feasibility trial
Authors: Fordham Beth , Smith Toby O , Lamb Sarah , Morris Alana , Winter Stuart C
Published: November 2022

Objective

The Getting Recovery Right After Neck Dissection (GRRAND) intervention is a physiotherapy programme for patients with head and neck cancer who have undergone neck dissection. The aim of this qualitative study was to understand if the intervention was useful, acceptable and whether it was feasible to conduct a randomised controlled trial (RCT).

Design

This qualitative study was embedded within the GRRAND-Feasibility (GRRAND-F) Study.

Setting

Participants were recruited from four acute National Health Service hospitals in England between 2020 and 2021.

Participants

We interviewed four usual care and four intervention patient-participants from a single study site (Oxford). Six were male, two were female. All were white British ethnicity. We interviewed two physiotherapists from Oxford who delivered the GRRAND-F intervention, and physiotherapists from Birmingham, Poole and Norwich who were trained to deliver the intervention but were not able to deliver it within the study time frame.

Results

The analysis identified five themes: (1) Acceptability, (2) Adherence, (3) Outcomes, (4) Feasibility and (5) Stand-alone themes (prehabilitation, video consultations, healthcare use).

Patient-participants and physiotherapist-participants agreed that usual care was not meeting patients’ rehabilitation needs. The GRRAND intervention provided biopsychosocial support. In comparison to the usual care group, patient-participants who received the intervention were more confident that they could perform rehabilitation exercises and were more motivated to engage in long-term adaptive behaviour change. Physiotherapists felt they needed more administrative support to participate in an RCT.

Conclusion

Participants felt that usual care was insufficient. GRRAND provided much needed, biopsychosocial support to patients. Participants were supportive that it would be feasible to test GRRAND in an RCT.

Trial registration number

ISRCTN11979997.
Chimeric antigen receptor T-cell therapy targeting a MAGE A4 peptide and HLA-A*02:01 complex for unresectable advanced or recurrent solid cancer: protocol for a multi-institutional phase 1 clinical trial
Authors: Okumura Satoshi , Ishihara Mikiya , Kiyota Naomi , Yakushijin Kimikazu , Takada Kohichi , Kobayashi Shinichiro , Ikeda Hiroaki , Endo Makoto , Kato Koji , Kitano Shigehisa , Matsumine Akihiko , Nagata Yasuhiro , Kageyama Shinichi , Shiraishi Taizo , Yamada Tomomi , Horibe Keizo , Takesako Kazuto , Miwa Hiroshi , Watanabe Takashi , Miyahara Yoshihiro , Shiku Hiroshi
Published: November 2022

Introduction

Adoptive cell transfer of genetically engineered T cells is a promising treatment for malignancies; however, there are few ideal cancer antigens expressed on the cell surface, and the development of chimeric antigen receptor T cells (CAR-T cells) for solid tumour treatment has been slow. CAR-T cells, which recognise major histocompatibility complex and peptide complexes presented on the cell surface, can be used to target not only cell surface antigens but also intracellular antigens. We have developed a CAR-T-cell product that recognises the complex of HLA-A*02:01 and an epitope of the MAGE-A4 antigen equipped with a novel signalling domain of human GITR (investigational product code: MU-MA402C) based on preclinical studies.

Methods and analysis

This is a dose-escalation, multi-institutional, phase 1 study to evaluate the tolerability and safety of MU-MA402C for patients with MAGE A4-positive and HLA-A*02:01-positive unresectable advanced or recurrent solid cancer. Two dose cohorts are planned: cohort 1, MU-MA402C 2×108/person; cohort 2, MU-MA402C 2×109/person. Prior to CAR-T-cell infusion, cyclophosphamide (CPA) and fludarabine (FLU) will be administered as preconditioning chemotherapy. Three evaluable subjects per cohort, for a total of 6 subjects (maximum of 12 subjects), will be recruited for this clinical trial. The primary endpoints are safety and tolerability. The severity of each adverse event will be evaluated in accordance with Common Terminology Criteria for Adverse Events V.5.0. The secondary endpoint is efficacy. Antitumour response will be evaluated according to Response Evaluation Criteria in Solid Tumours V.1.1.

Ethics and dissemination

This clinical trial will be conducted in accordance with the current version of Good Clinical Practice. The protocol was approved by the Clinical Research Ethics Review Committee of Mie University Hospital (approval number F-2021-017). The trial results will be published in peer-reviewed journals and/or disseminated through international conferences.

Trial registration number

jRCT2043210077.
Study on Hamstring Re-injury Prevention (SHARP): protocol for an international multicentre, randomised controlled trial
Authors: Zein Muhammad Ikhwan , Reurink Gustaaf , Verhagen Evert , Kerkhoffs Gino M M J , van der Horst Nick , Goedhart Edwin , Anggunadi Angelica , Knapstad Anders , Andersen Thor Einar , Ishøi Lasse , Hølmich Per , Tol Johannes L
Published: November 2022

Introduction

Previous studies showed that the Nordic hamstring exercise (NHE) effectively prevents primary hamstring injury. However, no study investigated the secondary preventing effect of the NHE on hamstring reinjury. The primary purpose of this study is to investigate the effectiveness of the NHE for preventing hamstring reinjury after return to play (RTP) following a hamstring injury in football players. The secondary purpose is to determine the effect of the NHE on sprint and jump performance.

Methods and analysis

This is an international multicentre, prospective, parallel-group randomised controlled trial study. Subjects include male or female football players aged 18–40 years and within 1 week of RTP following a hamstring injury will be randomised into Nordics or a control group. Subjects in both groups continue their regular football training, but the Nordics group will perform an additional NHE programme. An online questionnaire will be sent to the subjects in both groups once per week within the first 10 weeks, then continued at months 6, 9 and 12. In a (performance) substudy, we will evaluate the effect of the NHE on sprint and vertical jump performance at three time points (at the beginning of the study, after 10 weeks and 12 months of follow-up).

The primary outcomes are the incidence of hamstring reinjury within 2 and 12 months. The secondary outcomes are sprint and jump performance, adherence to the programme, duration of reinjury and reinjury burden.

Ethics and dissemination

This study is approved by the medical ethics committee of Amsterdam University Medical Center (UMC) in the Netherlands (METC 2021_117), Faculty of Medicine Universitas Gadjah Mada in Indonesia (KE/FK/1248/EC/2021), Norwegian School of Sport Sciences in Norway (number 216–2 70 122) and Denmark (ethical submission in process). The study’s findings will be disseminated in scientific peer-reviewed journals and presented at international conferences.

Trial registration number

NL9711.
Learning from stakeholders to inform good practice guidance on consent to research in intensive care units: a mixed-methods study
Authors: Paddock Katie , Woolfall Kerry , Kearney Anna , Pattison Natalie , Frith Lucy , Gamble Carrol , Welters Ingeborg , Trinder John , Young Bridget
Published: November 2022

Objectives

Obtaining informed consent from patients in intensive care units (ICUs) prior to enrolment in a study is practically and ethically complex. Decisions about the participation of critically ill patients in research often involve substitute decision makers (SDMs), such as a patient’s relatives or doctors. We explored the perspectives of different stakeholder groups towards these consent procedures.

Design and methods

Mixed-methods study comprising surveys completed by ICU patients, their relatives and healthcare practitioners in 14 English ICUs, followed by qualitative interviews with a subset of survey participants. Empirical bioethics informed the analysis and synthesis of the data. Survey data were analysed using descriptive statistics of Likert responses, and analysis of interview data was informed by thematic reflective approaches.

Results

Analysis included 1409 survey responses (ICU patients n=333, relatives n=488, healthcare practitioners n=588) and 60 interviews (ICU patients n=13, relatives n=30, healthcare practitioners n=17). Most agreed with relatives acting as SDMs based on the perception that relatives often know the patient well enough to reflect their views. While the practice of doctors serving as SDMs was supported by most survey respondents, a quarter (25%) disagreed. Views were more positive at interview and shifted markedly depending on particularities of the study. Participants also wanted reassurance that patient care was prioritised over research recruitment. Findings lend support for adaptations to consent procedures, including collaborative decision-making to correct misunderstandings of the implications of research for that patient. This empirical evidence is used to develop good practice guidance that is to be published separately.

Conclusions

Participants largely supported existing consent procedures, but their perspectives on these consent procedures depended on their perceptions of what the research involved and the safeguards in place. Findings point to the importance of explaining clearly what safeguards are in place to protect the patient.
Colombian ocular inflammatory diseases epidemiology study (COIDES): prevalence, incidence and sociodemographic characterisation of Scleritis in Colombia, 2015–2020
Authors: Cifuentes-González Carlos , Rojas-Carabali William , Mejia-Salgado Germán , Pineda-Sierra Juan Sebastián , Muñoz-Vargas Paula Tatiana , Boada-Robayo Laura , Cruz Danna Lesley , de-la-Torre Alejandra
Published: November 2022

Objective

To describe the epidemiological and demographic characteristics of scleritis in Colombia.

Methods and analysis

Population-based study using the national database from the Colombian Ministry of Health, using the International Classification of Diseases-10 code for Scleritis (H150) to estimate the prevalence and incidence from 2015 to 2019. Additionally, we evaluated the impact of the COVID-19 pandemic lockdown on the epidemiology of the disease during 2020, using the Gaussian Random Markov Field model (conditional autoregressive; CAR model). Finally, a standardised morbidity rate map was made to assess the geographic distribution of scleritis in the country.

Results

The 5-year average prevalence and incidence of scleritis in Colombia were 0.6 (95% CI 0.59 to 0.6) and 0.65 (95% CI 0.64 to 0.64) cases per 100 000 inhabitants, respectively. We found 1429 registers of scleritis throughout the country between 2015 and 2019. Women represented 64.3%. The age groups with most cases were between 40 and 69 years in both sexes. However, women between 30 and 39 years and men between 20 and 29 years presented the highest number of new cases. In 2020, the pandemic reduced approximately 0.23 points the incidence of scleritis. Bogotá, Valle del Cauca and Antioquia had most of the cases, the latter two with an increased risk over time.

Conclusion

Colombia has a lower incidence of scleritis than the reported in other latitudes, with a pattern of presentation at younger ages. Furthermore, the lockdown derived from the CODIV-19 pandemic affected the follow-up and diagnosis of patients with scleritis. This is the first epidemiological description of scleritis in a developing country and South America.
Scaling and spreading the electronic capture of patient-reported outcomes using a national surgical quality improvement programme: a feasibility study protocol
Authors: Melucci Alexa D , Liu Jason B , Brajcich Brian C , Collins Courtney E , Kazaure Hadiza S , Ko Clifford Y , Pusic Andrea L , Temple Larissa K
Published: November 2022

Introduction

Patient-reported outcomes (PROs) are important for research, patient care and quality assessment; however, large-scale collection among the US surgical patient population has been limited. A structured implementation and dissemination programme focused on electronic PRO collection could improve the use of PROs data to improve surgical care. This study aims to (1) evaluate the feasibility of PRO collection among a larger volume of surgical patients through the stepwise implementation of PRO collection processes in a sample of American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals; (2) identify best practices and barriers to PRO collection through qualitative study of participating hospitals and patients; and (3) evaluate the utility of PROs at detecting differences in the quality of care among surgical patients.

Methods and analysis

ACS NSQIP-participating hospitals are being recruited, and patients at participating hospitals who undergo elective surgical procedures receive invitations via e-mail or short message service ‘text’message to complete PROs after surgery. Validated PRO measures which evaluate physical and mental health-related quality of life, pain, fatigue, physical function and shared decision-making were selected. The scalability of PRO collection will be assessed by site enrolment, patient accrual and response rates. Qualitative interviews and focus groups will be performed with patients and hospital personnel to identify best practices and barriers to successful enrolment and PRO collection. Multivariable hierarchical regression models will be used to evaluate the distinctness of PROs from clinical outcomes captured in ACS NSQIP and the ability of PROs to detect differences in hospital performance.

Ethics and dissemination

This study was reviewed by the Advarra Institutional Review Board (IRB) and deemed to be exempt from IRB oversight. Findings will be disseminated through peer-reviewed manuscripts, reports and presentations.
Vascular Reactivity Index and PELOD-2 as a mortality predictor in paediatric septic shock: a single-centre retrospective study
Authors: Yuniar Irene , Setianingsih Utami Kurniawati , Pardede Sudung O , Kadim Muzal , Iskandar Adhi Teguh Perma , Prawira Yogi
Published: November 2022

Background

The mortality rate for children with septic shock is stil quite high in low-income and middle-income countries (31.7%). One of the most widely used scoring systems to assess mortality in sepsis or septic shock is Paediatric Logistic Organ Dysfunction 2 (PELOD-2). However, it requires various laboratory evaluations. A non-invasive, fast and easy method is needed to assess the mortality of children with septic shock at an early stage. Therefore, this study aims to evaluate the ability of Vascular Reactivity Index (VRI) compared with PELOD-2 score as a predictor of mortality in children with septic shock based on vascular response to vasoactive agents.

Methods

A retrospective cohort study was conducted using data from children aged 1 month to 18 years with septic shock treated in the ER and paediatric intensive care unit (PICU) of the tertiary hospital from 2017 to 2021. The serial haemodynamic data were analysed including Systemic Vascular Resistant Index (SVRI) and the cardiac index from ultrasound cardiac output monitoring device was recorded in the first and sixth hours after the diagnosis of septic shock. The VRI was determined by dividing SVRI/Vasoactive Inotropic Score (ie, accumulated doses of dopamine, dobutamine, epinephrine, milrinone, vasopressin and norepinephrine). The receiver operating curve was used to calculate the area under the curve (AUC), sensitivity and specificity of each cut-off point.

Results

A total of 68 subjects fulfilled the inclusion and exclusion criteria, the median age was 54 months with a range of 2–204 months and the mortality rate was 47%. The majority of the patients who died were found in the high cardiac index and low SVRI group (17.6%). Moreover, the optimum cut-off point of VRI was obtained to predict mortality in septic shock of 32.1, with 87.5% sensitivity and 88.9% specificity. The AUC for predicting death using VRI was 95% (95% CI 90% to 100%, p<0.001) and PELOD-2 92.6% (95% CI 96.4% to 98.8%, p<0.001).

Conclusion

The VRI <32.1 may potentially be used to predict mortality in children with septic shock and its predictive ability is as good as PELOD-2. The assessment of VRI is faster and easier than PELOD-2.
Building Blocks for the Long-acting and Permanent Contraceptives Coordinated Registry Network
Authors: Baird Courtney E , Guiahi Maryam , Chudnoff Scott , Loyo-Berrios Nilsa , Garcia Stephanie , Jung Mary , Gressler Laura Elisabeth , Mao Jialin , Hodshon Beth , Sedrakyan Art , Andrews Sharon , Colden Kelly , Roberts Jason , Anderson Abby , Sewell Catherine , Marinac-Dabic Danica
Published: November 2022

Objectives

A multistakeholder expert group under the Women’s Health Technology Coordinated Registry Network (WHT-CRN) was organized to develop the foundation for national infrastructure capturing the performance of long-acting and permanent contraceptives. The group, consisting of representatives from professional societies, the US Food and Drug Administration, academia, industry and the patient community, was assembled to discuss the role and feasibility of the CRN and to identify the core data elements needed to assess contraceptive medical product technologies.

Design

We applied a Delphi survey method approach to achieve consensus on a core minimum data set for the future CRN. A series of surveys were sent to the panel and answered by each expert anonymously and individually. Results from the surveys were collected, collated and analyzed by a study design team from Weill Cornell Medicine. After the first survey, questions for subsequent surveys were based on the analysis process and conference call discussions with group members. This process was repeated two times over a 6-month time period until consensus was achieved.

Results

Twenty-three experts participated in the Delphi process. Participation rates in the first and second round of the Delphi survey were 83% and 100%, respectively. The working group reached final consensus on 121 core data elements capturing reproductive/gynecological history, surgical history, general medical history, encounter information, long-acting/permanent contraceptive index procedures and follow-up, procedures performed in conjunction with the index procedure, product removal, medications, complications related to the long-acting and/or permanent contraceptive procedure, pregnancy and evaluation of safety and effectiveness outcomes.

Conclusions

The WHT-CRN expert group produced a consensus-based core set of data elements that allow the study of current and future contraceptives. These data elements influence patient and provider decisions about treatments and include important outcomes related to safety and effectiveness of these medical devices, which may benefit other women’s health stakeholders.
Health-related quality of life, patient-centred communication and self-efficacy in ovarian cancer: a mediation analysis
Authors: Pozzar Rachel A , Xiong Niya , Mazzola Emanuele , Wright Alexi A , Goff Barbara A , Tulsky James A , Hammer Marilyn J , Berry Donna L
Published: November 2022

Objective

To assess the role of self-efficacy as a mediator of the association between patient-centred communication (PCC) and health-related quality of life (HRQoL) in a sample of participants with ovarian cancer.

Methods

English-speaking adults with ovarian cancer completed a cross-sectional survey. We assessed self-efficacy with the Self-Efficacy for Managing Chronic Disease scale, PCC with the Patient-Centred Communication in Cancer Care-36, and HRQoL with the Functional Assessment of Cancer Therapy-General. We used the PROCESS macro to calculate regression coefficients for the total effect of PCC on HRQoL and direct effect of PCC on HRQoL. We calculated a 95% CI for the indirect effect of PCC on HRQoL using 10 000 bootstrapped samples.

Results

The total effect of PCC on HRQoL (9.47, 95% CI 6.21 to 12.74) was greater than the direct effect of PCC on HRQoL (3.47, 95% CI 0.73 to 6.21). The indirect effect of PCC on HRQoL was 6.00 (95% CI 3.56 to 8.95). Self-efficacy explained approximately 63.4% of the association between PCC and HRQoL.

Conclusions

Self-efficacy partially mediated the association between PCC and HRQoL. Self-efficacy is a potential target for communication interventions that aim to improve HRQoL. Research to validate this finding in the setting of a randomised trial is warranted.
Illegal Experimental Tobacco Marketplace II: effects of vaping product bans — findings from the 2020 International Tobacco Control Project
Authors: Freitas-Lemos Roberta , Stein Jeffrey S , Tegge Allison N , Kaplan Brent A , Heckman Bryan W , McNeill Ann , Cummings K Michael , Fong Geoffrey T , Bickel Warren K
Published: November 2022

Significance

Restrictive e-cigarette policies may increase purchases from illegal sources. The Illegal Experimental Tobacco Marketplace (IETM) allows examination of how restrictions impact illegal purchases. We investigated (1) the effect of a vaping ban, total flavour vaping ban and partial flavour vaping ban on the probability of purchasing illegal vaping products among different regulatory environments (USA, Canada and England) and tobacco user types (cigarette smokers, dual users and e-cigarette users); and (2) the relation between ban endorsement and illegal purchases.

Methods

Participants (N=459) from the International Tobacco Control Survey rated their support of bans and chose to purchase from a hypothetical legal experimental tobacco marketplace or IETM under control and the three ban conditions.

Results

In total, 25% of cigarette smokers, 67% of dual users and 79% of e-cigarette users made IETM purchases. Cross-country comparisons depicted dual users from Canada (OR: 19.8), and e-cigarette users from the USA (OR: 12.9) exhibited higher illegal purchases odds than the same user type in England. Within-country comparisons showed e-cigarette and dual users are more likely to purchase from the IETM than cigarette smokers in the most restrictive condition, with the largest effects in e-cigarette users (England—OR: 1722.6, USA—OR: 22725.3, Canada—OR: 6125.0). Increased opposition towards partial or total flavour ban was associated with increased IETM purchasing in the corresponding condition.

Conclusions

Vaping restrictions may shift users’ preference to the illegal marketplace in a regulatory environment. Evidence of the IETM generalisability in a geographically dispersed sample enhances its utility in tobacco regulatory science.
A Novel Actuation Dynamics Adaptive Compensation Strategy for Real-Time Hybrid Simulation Based on Unscented Kalman Filter
Authors: Huang Wei , Ning Xizhan , Ding Yong , Wang Zhen
Published: November 2022

To address the varying time-delay problem in real-time hybrid simulation (RTHS), an unscented Kalman filter (UKF)-based adaptive time-delay compensator (UKF-ADC) is proposed in this study. UKF-ADC comprises of two main parts: a feedforward controller with adjustable parameters and a parameter estimator of UKF. The former is constructed with the inverse model of the control plant, which is represented by a first-order transfer function, whereas the latter is used to estimate and update the parameters online in the feedforward controller using displacement commands and measurements. To fully explore the performance of UKF-ADC, the effects of the initial parameters in UKF and factor [Formula: see text] in the compensator are investigated through a prescribed displacement command adopting a nonlinear actuator model. As a result, the performance of UKF-ADC is mainly affected by factor [Formula: see text] and robust to the initial parameters of UKF. In addition, a series of virtual and actual RHTSs are performed, employing the validated compensator. The results reveal that UKF-ADC can effectively improve the accuracy of RTHS and exhibit strong robustness.
Discarded Cigarette Butts Regenerated Superhydrophilic/ Underwater Superoleophobic Chitosan–Cellulose Membrane for Oil/ Water Emulsion Separation
Authors: Sun Qian , Yang Jin , Da Zulin , Yan Yongsheng
Published: November 2022

With the rapid development of the chemical industry, oil/ water emulsion separation is receiving global attention. It is particularly important to find a low-cost, convenient, economical and environmentally friendly method to prepare superhydrophilic/ underwater superoleophobic membranes for oil/ water emulsion separation. In this paper, discarded cigarette butts were used as raw materials, combined with chitosan to form a superhydrophilic/ underwater superoleophobic membrane through a phase inversion method. The performance of CA/CS membrane is controlled by adjusting the ratio of cellulose acetate and chitosan. The cigarette butts are washed in ethanol solution to remove impurities to obtain cellulose acetate, and then chitosan and polyvinylpyrrolidone (PVP) are added to build the micro–nano structure on the surface of the membrane. The prepared CA/CS composite membrane was superhydrophilic/ underwater superoleophobic. For the oil-in-water emulsion, the filtrate of the CA/CS membrane can hardly see the oil droplets through electron microscope. CA/CS membrane has a higher emulsion permeation flux (more than 340 L m[Formula: see text] h[Formula: see text] and a higher separation efficiency (more than 97.1%). In addition, the membrane has good reusability within 10 cycles. This method can reduce the harm of cigarette butts to nature and can also be used for oil–water separation. The method of turning discarded cigarette butts into treasure is worthy of social advocacy.
The Wear and Electrical Performance of Cu-CNTs Composites with Network Structure CNTs Fabricated by Multi-Directional Forging
Authors: Liu Endian , Li Zaijiu , Xia Chenping
Published: November 2022

Cu-[Formula: see text] CNTs composites ([Formula: see text], 1, 2[Formula: see text]vol.%) were successfully prepared through a combination of pre-treatment, powder metallurgy and multi-directional forging (MDF) processes. It provided a solution for the industrial production of structural composites with reticulated CNTs. The effect of CNTs contents on wear and electrical performance of the composites was investigated. The addition of CNTs results in a significant increase in the wear resistance of the composites. During the wear process, reticulated CNTs will carry the load barrier to high temperature softening and plastic deformation of the Cu-matrix, which protects the matrix eventually. In general, the addition of CNTs will reduce the conductivity of the composites. Under MDF process, the CNTs were organically linked together and formed a network structure as the volume fraction increased from 1% to 2%, resulting in a significant promotion of conductivity by providing paths for electron transfer. The contact resistance increased slightly when 2[Formula: see text]vol.% CNTs were added, with an average value of 5.87[Formula: see text]m[Formula: see text]. The contact resistance volatility of the Cu-2[Formula: see text]vol.% CNTs was the most stable (variance of 1.485). Reticulated CNTs can effectively attenuate the erosive effect of molten pools and welding bridges on the anode material, and are ideal reinforcers for Cu-based electrical contact materials.