bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical hydrography in the long nineteenth century
Authors: McAuley Kyle
Published: May 2022

This essay canvasses a variety of approaches to the cultural and literary study of water in recent historical eras. While various aqueously‐minded approaches have been presented in recent decades, they have not been fully integrated into the ecological mainstream of environmental humanist criticism, particularly in nineteenth‐century studies. This essay integrates discourses across geography, geology, cultural studies, and literary studies in order to theorize critical hydrography, an aqueous approach to cultural objects that apprehends water as an ecological domain influencing both method's design and its attentions. The essay shows how critical hydrography reflexively attaches itself to histories of race, empire, and capital in apprehending the scientific filiations of the environmental humanities. Critical hydrography conceptualizes water as method to raise its visibility in ecocritical discourse.
Cognitive biases and the predictable perils of the patient‐centric free‐market model of medicine
Authors: Shaffer Michael J.
Published: May 2022

This paper addresses the recent rise of the use of alternative medicine in Western countries, and it offers a novel explanation of that phenomenon in terms of cognitive and economic factors related to the free‐market and patient‐centric approach to medicine that is currently in place in those countries, in contrast to some alternative explanations of this phenomenon. Moreover, the paper addresses this troubling trend in terms of the serious harms associated with the use of alternative medical modalities. The explanatory theory defended here is then predicated on the idea that serious and avoidable harms predictably result from an extreme patient‐centric model of medical practice that treats largely ignorant patients as consumers of medical products and services, when they are endowed with an essentially unrestricted power of freedom to choose treatments. Some important moral and epistemological consequences of this model are then articulated, and corrective measures are suggested.
Engineering approaches to investigate the roles of lymphatics vessels in rheumatoid arthritis
Authors: Kraus Samantha E. , Lee Esak
Published: May 2022

Rheumatoid arthritis (RA) is one of the most common chronic inflammatory joint disorders. While our understanding of the autoimmune processes that lead to synovial degradation has improved, a majority of patients are still resistant to current treatments and require new therapeutics. An understudied and promising area for therapy involves the roles of lymphatic vessels (LVs) in RA progression, which has been observed to have a significant effect on mediating chronic inflammation. RA disease progression has been shown to correlate with dramatic changes in LV structure and interstitial fluid drainage, manifesting in the retention of distinct immune cell phenotypes within the synovium. Advances in dynamic imaging technologies have demonstrated that LVs in RA undergo an initial expansion phase of increased LVs and abnormal contractions followed by a collapsed phase of reduced lymphatic function and immune cell clearance in vivo. However, current animal models of RA fail to decouple biological and biophysical factors that might be responsible for this lymphatic dysfunction in RA, and a few attempted in vitro models of the synovium in RA have not yet included the contributions from the LVs. Various methods of replicating LVs in vitro have been developed to study lymphatic biology, but these have yet not been integrated into the RA context. This review discusses the roles of LVs in RA and the current engineering approaches to improve our understanding of lymphatic pathophysiology in RA.
Prevalence of Sjögren's syndrome in patients with dry mouth in the region of Central Hungary
Authors: Dézsi Anna Júlia , Erdei Csilla , Demeter Tamás , Kovács Alexandra , Nagy Gábor , Mensch Károly , Németh Orsolya , Hermann Péter , Tóth György , Füst Ágnes , Kiss Emese Virág , Kőhidai László , Zalatnai Attila , Márton Krisztina
Published: May 2022

Objective

One‐third of the Hungarian population suffers from xerostomia. Since there is no evidence of the actual prevalence of Sjögren's syndrome (SS) in Hungary, this study aimed to evaluate the same.

Materials and Methods

Data were collected from the Faculty of Dentistry, Semmelweis University from 2008 to 2015. A diagnosis of SS was established based on the American College of Rheumatology and European League Against Rheumatism criteria.

Results

Of the 1076 patients examined with sicca symptoms, 188 patients had confirmed SS. Primary SS (pSS) was diagnosed in 135 patients and secondary SS (sSS) was confirmed in 53 patients. According to the available statistical records of the public health service of Hungary, there were an average of 16 (0.0014%, 5–26) newly diagnosed SS cases in the entire population and 141 SS patient‐practitioner consultations (49–232) per 100,000 inhabitants in the country over the past 10 years (based on the past 10 years: 2011–2020).

Conclusion

Results revealed that approximately 1/5th–1/6th of patients with sicca symptoms have SS, among whom 72% and 285 have pSS and sSS, respectively. Global Hungarian records simultaneously revealed that the number of both new diagnoses and doctor‐SS patient encounters has significantly decreased (by 50%) yearly over the last decade.
Effect of Nellore (Bos indicus) donor age on in‐vitro embryo production and pregnancy rate
Authors: de Silva Marina Oliveira , Borges Marcelo Sant'Ana , Fernandes Luana Gomes , Rodrigues Naiara Nantes , Watanabe Yeda Fumie , Joaquim Daniel Carlino , Oliveira Clara Slade , da Feuchard Viviane Luzia Silva , dos Cyrillo Joslaine Noely Santos Gonçalves , Mercadante Maria Eugênia Zerlotti , Monteiro Fabio Morato
Published: May 2022

The aim of this study was to evaluate the effect of age of Nellore (Bos indicus) donors on the efficiency of in vitro embryo production (IVEP) and pregnancy rate. Thirty‐six donors, including 11 female calves (13 ± 0.61 months), 17 prepubertal heifers (25 ± 0.78 months) and 8 cows (83 ± 28 months), were submitted to 3 procedures of ovum pickup (OPU) on random days of the estrous cycle at intervals of 21 days. Caspase‐3 and IGFBP2 were quantified in oocytes and blastocysts for the evaluation of oocyte and embryo quality. The produced embryos were vitrified (n = 445) and transferred to synchronized recipients. Cows produced a larger number of follicles (cows: 54.5 ± 6.2; calves: 20.0 ± 0.57; prepubertal heifers: 20.8 ± 0.46), total oocytes (cows: 45.97 ± 7.22; calves: 28.93 ± 6.14; prepubertal heifers: 27.21 ± 4.94) and cleaved oocytes (cows: 21.14 ± 4.22; calves: 13.09 ± 3.72; prepubertal heifers: 12.4 ± 3.19). The cleavage rate was similar between age categories; however, cows tended (p < 0.07) to produce a larger number of blastocysts (9.74 ± 2.26) per OPU than calves (5.57 ± 1.99) and prepubertal heifers tended to have a higher blastocyst yield (35.4%) than calves (27.1%) (p < .07). The expression levels of IGFBP2 and caspase‐3 were higher in oocytes derived from calves compared to the other two categories. The pregnancy rate was higher in calves (43.1%) and cows (40.4%) than in prepubertal heifers (33.8%) (p = .03). Despite the larger numbers of follicles and viable oocytes in cows, the blastocyst production results and pregnancy rates obtained indicate that the use of young females as oocyte donors in IVEP is feasible and may contribute to reduce the generation interval.
Assessing Predictive Discrimination Performance of Biomarkers in The Presence of Treatment-Induced Dependent Censoring
Authors: Zhang Cuihong , Ning Jing , Belle Steven H. , Squires Robert H. , Cai Jianwen , Li Ruosha
Published: May 2022

In medical studies, some therapeutic decisions could lead to dependent censoring for the survival outcome of interest. This is exemplified by a study of paediatric acute liver failure, where death was subject to dependent censoring due to liver transplantation. Existing methods for assessing the predictive performance of biomarkers often pose the independent censoring assumption and are thus not applicable. In this work, we propose to tackle the dependence between the failure event and dependent censoring event using auxiliary information in multiple longitudinal risk factors. We propose estimators of sensitivity, specificity and area under curve, to discern the predictive power of biomarkers for the failure event by removing the disturbance of dependent censoring. Point estimation and inferential procedures were developed by adopting the joint modelling framework. The proposed methods performed satisfactorily in extensive simulation studies. We applied them to examine the predictive value of various biomarkers and risk scores for mortality in the motivating example.
Discovery of the novel HLA‐DRB1*08:113 allele in a Taiwanese bone marrow donor
Authors: Yang Kuo‐Liang , Li Chi‐Cheng , Lin Py‐Yu
Published: May 2022

Nucleotide substitutions in exon 2 of DRB1*08:34 result in the novel DRB1*08:113 allele.
Peritendinous effusion of the flexor hallucis longus tendon as a sign of ankle joint capsule injury
Authors: Hung Chen-Yu , Su Chiung-Jui , Wu Wei-Ting , Chang Ke-Vin
Published: May 2022

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Ultrasound imaging for congenital bilateral absence of extensor pollicis brevis tendons
Authors: Wu Wei-Ting , Chang Ke-Vin , Ozcakar Levent
Published: May 2022

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Pathology and ultrasound findings in diffuse sclerosing thyroid papillary carcinoma
Authors: Huang Jinchang , Sun Yanzhen , Fang Xiangnan
Published: May 2022

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Cardiac myxoma: benign, but deadly disease
Authors: Fabijanic Damir , Carević Vedran , Bečić Tina , Pešutić-Pisac Valdi
Published: May 2022

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Ultrasound imaging and treatment in a rare case with bilateral supinator syndrome
Authors: Hsueh Hsueh-Wen , Wei Kuo-Chang , Fan Sung-Pin , Wu Chueh-Hung
Published: May 2022

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Numerical modeling and observations of seismo-acoustic waves propagating as modes in a fluid-solid waveguide
Authors: Lecoulant Jean , Guennou Claude , Guillon Laurent , Royer Jean-Yves
Published: May 2022

This paper discusses the nature of the low-frequency seismo-acoustic waves generated by submarine earthquakes in the ocean. In a finite-depth homogeneous ocean over a semi-infinite solid crust, the derivation of the acoustic equations shows that waves propagate as modes. The waves propagating with the speed of sound in water (T waves) are preceded by waves with frequencies below the Airy phase. Furthermore, the group speeds of these modes are sensitive to the environmental setting. As a test, we applied the spectral finite-element code SPECFEM2D in a simplified configuration with an ocean layer overlaying a solid crust, and a seismic source below a Gaussian seamount surrounded by a flat seafloor. The simulations confirm that the generated T waves and their precursors follow the theoretical dispersion curves. A more realistic environment with a seismically-layered crust and a sound-speed profile in the ocean is then used to predict the expected acoustic modes. Although noisy, recordings by ocean bottom seismometers from the southwest Indian Ocean show T waves preceded by ultra-low frequency waves, which display two modes comparable to the theoretical ones. They are in good agreement for mode 1, whereas, for mode 0, a slight offset in frequency has yet to be explained.
Brain Stimulation Over the Motion-Sensitive Midtemporal Area Reduces Deleterious Effects of Mental Fatigue on Perceptual–Cognitive Skills in Basketball Players
Authors: Fortes Leonardo S. , Ferreira Maria E.C. , Faro Heloiana , Penna Eduardo M. , Almeida Sebastião S.
Published: May 2022

The objective of this study was to analyze the effect of anodal transcranial direct current stimulation (a-tDCS) over the motion-sensitive midtemporal area on perceptual–cognitive skills (visuomotor and basketball decision-making skills) in mentally fatigued basketball players. A total of 20 male basketball players were recruited. This was a randomized, double-blinded, and counterbalanced crossover study with two experimental conditions: a-tDCS and Sham. The participants completed the basketball decision-making task and visuomotor skill after performing a 60-min sport-based videogame task with anodal (i.e., a-tDCS) or placebo (Sham) stimulation over the motion-sensitive middle temporal area. Worse response time was observed in visuomotor skill for Sham than a-tDCS postexperiment (p < .05). There was no main condition effect for accuracy of visuomotor skill (p > .05). There was more impairment in accuracy and response time in basketball decision-making skills for the Sham condition than a-tDCS (p < .05). Notably, a-tDCS over the motion-sensitive middle temporal area removed the negative effects of mental fatigue on perceptual–cognitive skills.
Broadband and photovoltaic THz/IR response in the GaAs-based ratchet photodetector
Authors: Bai Peng , Li Xiaohong , Yang Ning , Chu Weidong , Bai Xueqi , Huang Siheng , Zhang Yueheng , Shen Wenzhong , Fu Zhanglong , Shao Dixiang , Tan Zhiyong , Li Hua , Cao Juncheng , Li Lianhe , Linfield Edmund Harold , Xie Yan , Zhao Ziran
Published: May 2022

High-performance broadband infrared (IR)/terahertz (THz) detection is crucial in many optoelectronic applications. However, the spectral response range of semiconductor-based photodetectors is limited by the bandgaps. This paper proposes a ratchet structure based on the GaAs/Al

x

Ga

1−
x

As heterojunction, where the quasi-stationary hot hole distribution and intravalence band absorption from light or heavy hole states to the split-off band overcome the bandgap limit, ensuring an ultrabroadband photoresponse from near-IR to THz region (4 to 300 THz). The peak responsivity of the proposed structure can reach 7.3 A/W, which is five orders of magnitude higher than that of the existing broadband photon-type detector. Because of the ratchet effect, the proposed photodetector has a bias-tunable photoresponse characteristic and can operate in the photovoltaic mode with a broad photocurrent spectrum (18 to 300 THz). This work not only demonstrates a broadband photon-type THz/IR photodetector but also provides a method to study the light-responsive ratchet.
MAIT and Vδ2 unconventional T cells are supported by a diverse intestinal microbiome and correlate with favorable patient outcome after allogeneic HCT
Authors: Andrlová Hana , Miltiadous Oriana , Kousa Anastasia I. , Dai Anqi , DeWolf Susan , Violante Sara , Park Hee-Yon , Janaki-Raman Sudha , Gardner Rui , El Daker Sary , Slingerland John , Giardina Paul , Clurman Annelie , Gomes Antonio L. C. , Nguyen Chi , da Silva Marina Burgos , Armijo Gabriel K. , Lee Nicole , Zappasodi Roberta , Chaligne Ronan , Masilionis Ignas , Fontana Emily , Ponce Doris , Cho Christina , Bush Amy , Hill Lauren , Chao Nelson , Sung Anthony D. , Giralt Sergio , Vidal Esther H. , Hosszu Kinga K. , Devlin Sean M. , Peled Jonathan U. , Cross Justin R. , Perales Miguel-Angel , Godfrey Dale I. , van den Brink Marcel R. M. , Markey Kate A.
Published: May 2022

Microbial diversity is associated with improved outcomes in recipients of allogeneic hematopoietic cell transplantation (allo-HCT), but the mechanism underlying this observation is unclear. In a cohort of 174 patients who underwent allo-HCT, we demonstrate that a diverse intestinal microbiome early after allo-HCT is associated with an increased number of innate-like mucosal-associated invariant T (MAIT) cells, which are in turn associated with improved overall survival and less acute graft-versus-host disease (aGVHD). Immune profiling of conventional and unconventional immune cell subsets revealed that the prevalence of Vδ2 cells, the major circulating subpopulation of γδ T cells, closely correlated with the frequency of MAIT cells and was associated with less aGVHD. Analysis of these populations using both single-cell transcriptomics and flow cytometry suggested a shift toward activated phenotypes and a gain of cytotoxic and effector functions after transplantation. A diverse intestinal microbiome with the capacity to produce activating ligands for MAIT and Vδ2 cells appeared to be necessary for the maintenance of these populations after allo-HCT. These data suggest an immunological link between intestinal microbial diversity, microbe-derived ligands, and maintenance of unconventional T cells.
The Tetraspanin CD81 Is a Host Factor for Chikungunya Virus Replication
Authors: Lasswitz Lisa , Zapatero-Belinchón Francisco J. , Moeller Rebecca , Hülskötter Kirsten , Laurent Timothée , Carlson Lars-Anders , Goffinet Christine , Simmons Graham , Baumgärtner Wolfgang , Gerold Gisa
Published: May 2022

In this study, we discover the tetraspanin CD81 as a host factor for the globally emerging chikungunya virus and related alphaviruses. We show that CD81 promotes replication of viral genomes in human and mouse cells, while virus entry into cells is independent of CD81.
Landmark Discoveries and Recent Advances in Type IV Pilus Research
Authors: Singh Pradip Kumar , Little Janay , Donnenberg Michael S.
Published: May 2022

Type IV pili (T4P) are retractable multifunctional nanofibers present on the surface of numerous bacterial and archaeal species. Their importance to microbiology is difficult to overstate.
Rapid Hypothesis Testing in Candida albicans Clinical Isolates Using a Cloning-Free, Modular, and Recyclable System for CRISPR-Cas9 Mediated Mutant and Revertant Construction
Authors: Liu Junyan , Vogel Amanda K. , Miao Jian , Carnahan Jennifer A. , Lowes David J. , Rybak Jeffrey M. , Peters Brian M.
Published: May 2022

Recently, phenotypic heterogeneity in
Candida albicans
isolates has been recognized as an underappreciated factor contributing to gene diversification and broadly impacts strain-to-strain antifungal resistance, fitness, and pathogenicity. We have designed a cloning-free genetic system for rapid gene deletion and reversion in
C. albicans
clinical isolates that interlaces established recyclable genetic systems with CRISPR-Cas9 technology.
Supplemental Material: Mid-loaf crisis: Internal breadcrust surfaces in rhyolitic pyroclasts reveal dehydration quenching
Authors: Tuffen Hugh , Farquharson Jamie , al. et
Published: May 2022

The corrections applied to the as-measured diffusion data, accounting for the post-diffusion volumetric expansion of the clast. 
Supplemental Material: Natural levees increase in prevalence in the backwater zone: Coastal Trinity River, Texas, USA
Authors: Hassenruck-Gudipati Hima J. , al. et
Published: May 2022

River, natural levee, floodplain x-y-z coordinates, and centerline distances for transects, as well as statistics of gauge data for flood events. 
Metastatic melanoma to the heart causing ventricular tachycardia: looking beyond the troponin
Authors: Goodall Jack , Beveridge Natalie E R , Rasoul Debar , Bhamidipati Kalyan Ram
Published: May 2022

A man in his mid-50s presented with palpitations, chest pain and syncope. After initial workup for a non-ST elevation myocardial infarction, a CT scan revealed metastatic melanoma. The malignancy was infiltrating his right ventricle, resulting in recurrent ventricular tachycardia. Although initially hard to manage, his arrhythmias were eventually controlled with medication. Unfortunately, despite an initial response to immunotherapy, he died six months after diagnosis.

Cardiac metastases are rare, but melanoma has a high predication for metastasising to the heart and a small number of cases of such metastases causing ventricular arrhythmias have previously been reported. This case shows the importance of concurrent investigations when patients report multiple, seemingly unrelated symptoms as a unifying diagnosis may be uncovered.
Automatic vein measurement by ultrasonography to prevent peripheral intravenous catheter failure for clinical practice using artificial intelligence: development and evaluation study of an automatic detection method based on deep learning
Authors: Takahashi Toshiaki , Nakagami Gojiro , Murayama Ryoko , Abe-Doi Mari , Matsumoto Masaru , Sanada Hiromi
Published: May 2022

Objectives

Complications due to peripheral intravenous catheters (PIVC) can be assessed using ultrasound imaging; however, it is not routinely conducted due to the need for training in image reading techniques. This study aimed to develop and validate a system that automatically measures blood vessel diameters on ultrasound images using artificial intelligence (AI) and provide recommendations for selecting an implantation site.

Design

Pilot study.

Setting

The University of Tokyo Hospital, Japan.

Primary and secondary outcome measures

First, based on previous studies, the vessel diameter was calculated as the mean value of the maximum long diameter plus the maximum short diameter orthogonal to it. Second, the size of the PIVC to be recommended was evaluated based on previous studies. For the development and validation of an automatic detection tool, we used a fully convoluted network for automatic estimation of vein location and diameter. The agreement between manually generated correct data and automatically estimated data was assessed using Pearson’s product correlation coefficient, systematic error was identified using the Bland-Altman plot, and agreement between catheter sizes recommended by the research nurse and those recommended by the system was evaluated.

Results

Through supervised machine learning, automated determination was performed using 998 ultrasound images, of which 739 and 259 were used as the training and test data set, respectively. There were 24 false-negatives indicating no arteries detected and 178 true-positives indicating correct detection. Correlation of the results between the system and the nurse was calculated from the 178 images detected (r=0.843); no systematic error was identified. The agreement between the sizes of the PIVC recommended by the research nurse and the system was 70.2%; 7% were underestimated and 21.9% were overestimated.

Conclusions

Our automated AI-based image processing system may aid nurses in assessing peripheral veins using ultrasound images for catheterisation; however, further studies are still warranted.t
Comparisons of the short-term effectiveness and safety of surgical treatment for neovascular glaucoma: a systematic review and network meta-analysis
Authors: Lin Peijie , Zhao Qian , He Jing , Fan Wei , He Wenyi , Lai Mingying
Published: May 2022

Objective

To compare the effectiveness and safety of the six interventions for neovascular glaucoma.

Design

A systematic review and network meta-analysis.

Methods

Randomised controlled trials and cohort studies which compared the six interventions in neovascular glaucoma were identified using the following databases searched up to 1 September 2020: PubMed, Cochrane Library, Embase and Web of Science. The quality assessment was conducted by using the Cochrane risk of bias tool and the Newcastle-Ottawa scale. The primary outcome measure was the weighted mean differences for intraocular pressure reduction. Secondary one was ORs for success rate. Outcome measures were reported with a 95% CI and p<0.05 was considered statistically significant. Network meta-analysis was performed using Stata V.15.0.

Results

Twenty-three studies involving a total of 1303 patients were included. The types of surgical treatments included Ahmed glaucoma valve (AGV) implant surgery, AGV combined with intravitreal anti-vascular endothelial growth factor (AGV +IVAV), cyclophotocoagulation (CPC), cyclocryotherapy (CCT), trabeculectomy with mitomycin (Trab(MMC)) and Trab(MMC) combined with IVAV (Trab(MMC)+IVAV). Network meta-analysis showed that in comparison with AGV, AGV +IVAV (MD=4.74, 95% CI 1.04 to 8.45) and Trab(MMC)+IVAV (MD=6.19, 95% CI 0.99 to 11.40) showed a favourable effect in intraocular pressure reduction (IOPR) 6 months after surgery. Compared with CCT, AGV (OR=−0.17, 95% CI −0.53 to −0.05), AGV +IVAV (OR=−0.10, 95% CI −3.48 to −1.19), CPC (OR=−0.12, 95% CI −0.53 to −0.05), Trab(MMC) (OR=3.54, 95% CI 1.15 to 10.91) and Trab(MMC)+IVAV (OR=5.78, 95% CI 2.29 to 14.61) showed a superior impact in success rate. The order of efficacy as best intervention ranked as follows: Trab(MMC)+IVAV (IOPR 6 months after surgery, surface under the cumulative ranking (SUCRA)=88.1), CPC (IOPR 12 months after surgery, SUCRA=81.9), AGV +IVAV (IOPR 12 months after surgery, SUCRA=79.9) and AGV +IVAV (success rate, SUCRA=92.7). Adverse events were also summarised in detail.

Conclusion

In the treatment of neovascular glaucoma, AGV+IVAV and CPC were more effective in IOPR and success rate than the other four interventions. Additionally, AGV+IVAV is superior to CPC concerning the success rate in the long-term treatment. However, considering the limitations of this review, more high-quality trials, especially those surgical interventions not mentioned in this review, should be carried out in the future to further confirm the current findings.
SARS-CoV-2 RBD-specific and NP-specific antibody response of healthcare workers in the westernmost Austrian state Vorarlberg: a prospective cohort study
Authors: Atzl Michele , Muendlein Axel , Winder Thomas , Fraunberger Peter , Brandtner Eva-Maria , Geiger Kathrin , Klausberger Miriam , Duerkop Mark , Sprenger Lukas , Mutschlechner Beatrix , Volgger Andreas , Benda Magdalena , Severgnini Luciano , Jaeger Johannes B , Drexel Heinz , Lang Alois , Leiherer Andreas
Published: May 2022

Objectives

Austria, and particularly its westernmost federal state Vorarlberg, developed an extremely high incidence rate during the COVID-19 pandemic. Healthcare workers (HCWs) worldwide are known to have an increased risk of contracting the disease within the working environment and, therefore, the seroprevalence in this population is of particular interest. We thus aimed to analyse SARS-CoV-2-specific antibody dynamics in Vorarlberg HCWs.

Design

Prospective cohort study of HCWs including testing at three different time points for the prevalence of anti-SARS-CoV-2 IgG antibodies specific for nucleocapsid protein (NP) and receptor-binding domain (RBD).

Setting

All five state hospitals of Vorarlberg.

Participants

A total of 395 HCWs, enrolled in June 2020 (time point 1 (t1)), 2 months after the end of the first wave, retested between October and November at the beginning of the second wave (time point 2 (t2)) and again at the downturn of the second wave in January 2021 (time point 3 (t3)).

Main outcomes

We assessed weak and strong seropositivity and associated factors, including demographic and clinical characteristics, symptoms consistent with COVID-19 infection, infections verified by reverse transcription PCR (RT-PCR) and vaccinations.

Results

At t1, 3% of HCWs showed strong IgG-specific responses to either NP or RBD. At t2, the rate had increased to 4%, and at t3 to 14%. A strong response was found to be stable for up to 10 months. Overall, only 55% of seropositive specimen had antibodies against both antigens RBD and NP; 29% had only RBD-specific and 16% only NP-specific antibodies. Compared with the number of infections found by RT-PCR, the number of HCWs being seropositive was 38% higher.

Conclusion and relevance

Serological testing based on only one antigen implicates the risk of missing infections; thus, the set of antigens should be broadened in the future. The seroprevalence among participating HCWs was comparable to the general population in Austria. Nevertheless, in view of undetected infections, monitoring and surveillance should be reconsidered.
Organisation of care in paediatric intensive care units during the first 18 months of the COVID-19 pandemic: a scoping review protocol
Authors: Hill Katie , McCabe Catherine , Brenner Maria
Published: May 2022

Introduction

The emergence of COVID-19 has had a significant impact on hospital services, particularly care delivered to those in intensive care units (ICUs) and paediatric ICUs (PICUs) across the world. Although much has been written about healthcare delivery and the healthcare setting since COVID-19 began, to the authors’ knowledge, this is the first scoping review to investigate the organisation of care and changes implemented in PICUs during the COVID-19 pandemic. The aim is to conduct a scoping review of the literature to map out the existing studies about care delivery in PICUs during the COVID-19 pandemic and the changes made to the organisation of care in these units during the first 18 months of the pandemic. This review will also identify gaps in current knowledge in this area.

Methods and analysis

This study will be guided by the Joanna Briggs Institute’s methodology for scoping reviews, using Arksey and O’Malley’s six-stage scoping review framework: (1) identifying the research question; (2) identifying relevant studies; (3) selecting the studies; (4) data charting; (5) collating, summarising and reporting results; and (6) consulting with experts. A comprehensive search will be conducted using the following databases: CINAHL Complete; MEDLINE; PsycINFO; PsycARTICLES and EMBASE. A search strategy with predefined inclusion and exclusion criteria will be used to uncover relevant research in this area. This study will include quantitative, qualitative and mixed research methods studies published in English from 2019 to May 2021.

Ethics and dissemination

Ethical approval is not required for this scoping review. The results from this study will be disseminated through conferences and in peer-reviewed academic journals for those working in the healthcare arena.
How do diverse low-income and middle-income countries implement primary healthcare team integration to support the delivery of comprehensive primary health care? A mixed-methods study protocol from India, Mexico and Uganda
Authors: Joshi Rohina , Besigye Innocent , Heredia-Pi Ileana , Sharma Manushi , Peiris David , Mash Robert James , Reyes-Morales Hortensia , Goodyear-Smith Felicity , John Renu , Ortega-Altamirano Doris V , Orozco-Núñez Emanuel , Ávila-Burgos Leticia , Jeyakumar Ragavi , Serván-Mori Edson , Upadhyaya Sanjeev , Arora Varun , Praveen D
Published: May 2022

Introduction

Attainment of universal health coverage is feasible via strengthened primary health systems that are comprehensive, accessible, people-centred, continuous and coordinated. Having an adequately trained, motivated and equipped primary healthcare workforce is central to the provision of comprehensive primary healthcare (CPHC). This study aims to understand PHC team integration, composition and organisation in the delivery of CPHC in India, Mexico and Uganda.

Methods and analysis

A parallel, mixed-methods study (integration of quantitative and qualitative results) will be conducted to gain an understanding of PHC teams. Methods include: (1) Policy review on PHC team composition, organisation and expected comprehensiveness of PHC services, (2) PHC facility review using the WHO Service Availability and Readiness Assessment, and (3) PHC key informant interviews. Data will be collected from 20, 10 and 10 PHCs in India, Mexico and Uganda, respectively, and analysed using descriptive methods and thematic analysis approach. Outcomes will include an in-depth understanding of the health policies for PHC as well as understanding PHC team composition, organisation and the delivery of comprehensive PHC.

Ethics and dissemination

Approvals have been sought from the Institutional Ethics Committee of The George Institute for Global Health, India for the Indian sites, School of Medicine Research Ethics Committee at Makerere University for the sites in Uganda and the Research, Ethics and Biosecurity Committees of the Mexican National Institute of Public Health for the sites in Mexico. Results will be shared through presentations with governments, publications in peer-reviewed journals and presentations at conferences.
How are patient-related characteristics associated with shared decision-making about treatment? A scoping review of quantitative studies
Authors: Keij Sascha M , de Boer Joyce E , Stiggelbout Anne M , Bruine de Bruin Wändi , Peters Ellen , Moaddine Saïda , Kunneman Marleen , Pieterse Arwen H
Published: May 2022

Objectives

To identify what patient-related characteristics have been reported to be associated with the occurrence of shared decision-making (SDM) about treatment.

Design

Scoping review.

Eligibility criteria

Peer-reviewed articles in English or Dutch reporting on associations between patient-related characteristics and the occurrence of SDM for actual treatment decisions.

Information sources

COCHRANE Library, Embase, MEDLINE, PsycInfo, PubMed and Web of Science were systematically searched for articles published until 25 March 2019.

Results

The search yielded 5289 hits of which 53 were retained. Multiple categories of patient characteristics were identified: (1) sociodemographic characteristics (eg, gender), (2) general health and clinical characteristics (eg, symptom severity), (3) psychological characteristics and coping with illness (eg, self-efficacy) and (4) SDM style or preference. Many characteristics showed no association or unclear relationships with SDM occurrence. For example, for female gender positive, negative and, most frequently, non-significant associations were seen.

Conclusions

A large variety of patient-related characteristics have been studied, but for many the association with SDM occurrence remains unclear. The results will caution often-made assumptions about associations and provide an important step to target effective interventions to foster SDM with all patients.
Sintilimab combined with bevacizumab in relapsed/persistent ovarian clear cell carcinoma (INOVA): an investigator-initiated, multicentre clinical trial—a study protocol of clinical trial
Authors: Li Ruyuan , Liu Xingyu , Song Chunyan , Zhang Wei , Liu Jiahao , Jiao Xiaofei , Yu Yang , Zeng Shaoqing , Chi Jianhua , Zhao Yingjun , Ma Guanchen , Huo Yabing , Li Ming , Peng Zikun , Li Guiling , Jiang Jie , Gao Qing-Lei
Published: May 2022

Background

Ovarian clear cell carcinoma (OCCC) has an abysmal prognosis with a median overall survival (OS) of 25.3 months because of a low response to chemotherapy. The 5-year disease-specific survival rate after recurrence is 13.2%, with more than two-thirds of the patients dying within a year. Therefore, it is urgent to explore new therapeutic options for OCCC. Based on the characteristic immune-suppressive tumour microenvironment derived from the gene expression profile of OCCC, the combination of immunoantiangiogenesis therapy might have certain efficacy in recurrent/persistent OCCC. This trial aims to evaluate the efficacy and safety of sintilimab and bevacizumab in patients who have failed platinum-containing chemotherapy with recurrent or persistent OCCC.

Method and analysis

In this multicentre, single-arm, open-label, investigator-initiated clinical trial, 38 patients will be assigned to receive sintilimab 200 mg plus bevacizumab 15 mg/kg every 3 weeks. The eligibility criteria include histologically diagnosed patients with recurrent or persistent OCCC who have been previously treated with at least one-line platinum-containing chemotherapy; patients with Eastern Cooperative Oncology Group (ECOG) performance status 0–2 with an expected survival greater than 12 weeks. The exclusion criteria include patients previously treated with immune checkpoint inhibitor and patients with contraindications of bevacizumab and sintilimab. The primary endpoint is the objective response rate. The secondary endpoints are progression-free survival, time to response, duration of response, disease control rate, OS, safety and quality of life. Statistical significance was defined as p<0.05.

Ethics and dissemination

This trial was approved by the Research Ethics Commission of Tongji Medical College of Huazhong University of Science and Technology (2020-S337). The protocol of this study is registered at www.clinicaltrials.gov. The trial results will be published in peer-reviewed journals and at conferences.

Trial registration number

NCT04735861; Clinicaltrials. gov.
Trends in bacterial sepsis incidence and mortality in France between 2015 and 2019 based on National Health Data System (Système National des données de Santé (SNDS)): a retrospective observational study
Authors: Pandolfi Fanny , Guillemot Didier , Watier Laurence , Brun-Buisson Christian
Published: May 2022

Objective

This study aims to provide a case definition of sepsis of presumed bacterial aetiology based on 10th revision of the International Classification of Diseases (ICD-10) codes, to assess trends in sepsis incidence and mortality between 2015 and 2019 in France, and to describe the characteristics of affected patients and hospital stays.

Design

Nationwide, population-based, retrospective observational study.

Setting

Metropolitan France between 2015 and 2019.

Participants

Between 2015 and 2019, 1 224 433 patients with sepsis of presumed bacterial aetiology were selected from the French National Hospital Discharge Database (Programme de Médicalisation des Systèmes d’Information) and were identified from corresponding ICD-10 codes for explicit sepsis or implicit sepsis.

Main outcomes measures

Annual overall and age-specific and gender-specific incidence and 95% CI, as well as trends in sepsis incidence and mortality, were estimated. Comorbidities, length of hospital stay and outcomes were described.

Results

The sex-standardised and age-standardised incidence per 100 000 (95% CI) increased from 357 (356.0 to 359.0) in 2015 to 403 (401.9 to 405.0) in 2019 and remained higher for males compared with females. Children under 1 year and patients over 75 years consistently had the highest incidence. The most common comorbidities were cancer and chronic heart failure. The median hospital length of stay was 12 days. Most patients came from home, but only half returned home after their hospital stay and approximately 15% were discharged to long-term care. In-hospital mortality was about 25% and declined along the study period.

Conclusions

Medico-administrative databases can be used to provide nationwide estimates of the in-hospital burden of bacterial sepsis. The results confirm the high burden of sepsis in France. These data should be complemented by estimating the additional burden associated with fungal and viral infections during the COVID-19 pandemic.
How many of persistent coughers have pulmonary tuberculosis? Population-based cohort study in Ethiopia
Authors: Banti Abiot Bezabeh , Datiko Daniel Gemechu , Hinderaker Sven Gudmund , Heldal Einar , Dangisso Mesay Hailu , Mitiku Gebeyehu Assefa , White Richard Aubrey , Winje Brita Askeland
Published: May 2022

Objective

Many individuals with persistent cough and smear microscopy-negative sputum test for tuberculosis (TB) remain at risk of developing the disease. This study estimates the incidence of pulmonary TB (PTB) among initially smear-negative persistent coughers and its risk factors.

Design

A prospective population-based follow-up study.

Setting

Health extension workers visited all households in Dale woreda three times at 4-month intervals in 2016–2017 to identify individuals with symptoms compatible with TB (presumptive TB) using pretested and semistructured questionnaires.

Participants

We followed 3484 presumptive TB cases (≥15 years) with an initial smear-negative TB (PTB) test.

Outcome measures

Bacteriologically confirmed PTB (PTB b+) and clinically diagnosed PTB (PTB c+).

Results

3484 persons with initially smear-negative presumptive PTB were followed for 2155 person-years (median 0.8 years); 90 individuals had PTB b+ and 90 had PTB c+. The incidence rates for PTB b+ and PTB c+ were both 4176 (95% CI 3378 to 5109) per 100 000 person-years. We used penalised (lasso) and non-penalised proportional hazards Cox regression models containing all exposures and outcomes to explore associations between exposures and outcomes. In lasso regression, the risk of development of PTB b+ was 63% (HR 0.37) lower for people aged 35–64 years and 77% (HR 0.23) lower for those aged ≥65 years compared with 15–34 year-olds. Men had a 62% (HR 1.62) greater risk of PTB b+ development than women. The risk of PTB c+ was 39% (HR 0.61) lower for people aged 35–54 years than for those aged 15–34 years. Men had a 56% (HR 1.56) greater risk of PTB c+ development than women.

Conclusions

PTB incidence rate among persistent coughers was high, especially among men and young adults, the latter signifying sustained transmission. Awareness about this among healthcare workers may improve identification of more new TB cases.
Public versus patient health preferences: protocol for a study to elicit EQ-5D-5L health state valuations for patients who have survived a stay in intensive care
Authors: Halling Christine Marie Bækø , Gudex Claire , Perner Anders , Jensen Cathrine Elgaard , Gyrd-Hansen Dorte
Published: May 2022

Introduction

The value set used when calculating quality-adjusted life-years (QALYs) is most often based on stated preference data elicited from a representative sample of the general population. However, having a severe disease may alter a person’s health preferences, which may imply that, for some patient groups, experienced QALYs may differ from those that are estimated via standard methods. This study aims to model 5-level EuroQol 5-dimensional questionnaire (EQ-5D-5L) valuations based on preferences elicited from a sample of patients who have survived a stay in a Danish intensive care unit (ICU) and to compare these with the preferences of the general population. Further, the heterogeneity in the ICU patients’ preferences will be investigated.

Methods and analysis

This valuation study will elicit EQ-5D-5L health state preferences from a sample of 300 respondents enrolled in two randomised controlled trials at Danish ICUs. Patients’ preferences will be elicited using composite time trade-off based on the EuroQol Valuation Technology, the same as that used to generate the EQ-5D-5L value set for the Danish general population. The patient-based and the public-based EQ-5D-5L valuations will be compared. Potential underlying determinants of the ICU preferences will be investigated through analyses of demographic characteristics, time since the ICU stay, self-reported health, willingness to trade-off length of life for quality of life, health state reference dependency and EQ-5D dimensions that patients have experienced themselves during their illness.

Ethics and dissemination

Under Danish regulations, ethical approval is not required for studies of this type. Written informed consent will be obtained from all patients. The study results will be published in peer-reviewed scientific journals and presented at national and international conferences. The modelling algorithms will be publicly available for statistical software, such as Stata and R.
Efficacy and safety of endovenous microwave ablation versus laser ablation for great saphenous vein varicosis: study protocol for a multicentre, randomised controlled non-inferiority trial
Authors: Li Yongjun , Wu Weiwei , Li Younan , Li Jing , Sun Mengnan
Published: May 2022

Introduction

Endovenous microwave ablation (EMA) is a relatively novel thermal ablation treatment for great saphenous vein (GSV) varicosis, and its efficacy and safety are rarely reported. This study aims to explore whether EMA can be comparable to endovenous laser ablation (EVLA), which is a widely used thermal ablation treatment in clinical practice.

Methods and analysis

This is a multicentre, randomised controlled non-inferiority trial to compare the efficacy and safety of EMA and EVLA in patients with GSV varicosis. We will recruit 180 patients in 6 centres and randomly assign them into treatment group (EMA group) and control group (EVLA group) in a 1:1 ratio. The patients will return to the hospitals at 7 days, 3 months, 6 months and 12 months, and will be called at 1 month after the treatment for follow-up visits. The primary outcome is the occlusion rate of GSV immediately, at 6 months, and at 12 months after the treatment. The secondary outcomes are Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) Score, operation time and instrument performance evaluation.

Ethics and dissemination

This protocol has been approved by the Clinical Trial Ethics Committee of Beijing Hospital (2020BJYYEC-126–02), Peking Union Medical College Hospital (KS2020393), Beijing Tsinghua Changgung Hospital (No.20279-2-02), Beijing Luhe Hospital.Capital Medical University (2020-LHYW-030–01), the First Hospital of Hebei Medical University (No.2020249), and the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2021LSY-12). The trial results will be published in peer-reviewed journals.

Trial registration number

NCT04726124.
Reports of myocarditis and pericarditis following mRNA COVID-19 vaccination: a systematic review of spontaneously reported data from the UK, Europe and the USA and of the scientific literature
Authors: Lane Samantha , Yeomans Alison , Shakir Saad
Published: May 2022

Objectives

To combine spontaneously reported data from multiple countries to estimate reporting rate, and better understand risk factors for myocarditis and pericarditis following COVID-19 messenger RNA (mRNA) vaccines.

Design

Systematic review of spontaneously reported data from UK, USA and European Union/European Economic Area (EU/EEA) and of the scientific literature.

Data sources

UK Yellow Card scheme, Vaccine Adverse Event Reporting System (VAERS), EudraVigilance were searched from date of vaccine launch to 14 March 2022–16 March 2022. PubMed/MEDLINE and Embase were searched to 15 March 2022.

Eligibility criteria

We included publicly available spontaneous reporting data for ‘Myocarditis’ and ‘Pericarditis’ from UK, USA and EU/EEA following COVID-19 mRNA vaccines. Pharmacoepidemiological observational studies investigating myocarditis/pericarditis following mRNA COVID-19 vaccines were included (no restrictions on language or date). Critical Appraisal Skills Programme tools assessed study quality.

Data extraction and synthesis

Two researchers extracted data. Events of myocarditis and pericarditis were presented for each data source, stratified by vaccine, age, sex and dose (where available). Reporting rates were calculated for myocarditis and pericarditis for each population. For published pharmacoepidemiological studies, design, participant characteristics, and study results were tabulated.

Results

Overall, 18 204 myocarditis and pericarditis events were submitted to the UK, USA and EU/EEA regulators during the study period. Males represented 62.24% (n=11 331) of myocarditis and pericarditis reports. In the UK and USA, most reports concerned vaccinees aged <40 years (59.7% and 47.3% of reported events, respectively); trends in age were less clear for EU/EEA. Reports were more frequent following a second dose (47.1% of reports, where data available). Reporting rates were consistent between the data sources. Thirty-two pharmacoepidemiological studies were included; results were consistent with our spontaneous report analyses.

Conclusions

Younger vaccinees more frequently report myocarditis and pericarditis following mRNA COVID-19 vaccines than older vaccinees. Results from published literature supported the results of our analyses.