bluuebunny/crossref_metadata_2025 huggingface dataset:
PP28  Pros and cons of using anonymised linked routine data to improve efficiency of randomised controlled trials in healthcare: experience in primary and emergency care
Authors: Snooks Helen , Jones Matthew , Khanom Ashra , Lyons Ronan , Watkins Alan
Published: September 2020

Background

The use of anonymised routine linked data in designing and conducting randomised controlled trials (RCTs) has great potential. Sample sizes can be large, inclusion rates high and follow up periods prolonged, while the disruption to participants’ usual routines may be minimised. However, challenges and limitations in using routine linked data in RCTs remain. We sought to describe challenges and opportunities associated with designing and conducting RCTs using anonymised linked routine data in primary and emergency settings.

Methods

Synthesis of trial designs used, regulatory processes followed and findings from three trials: PRISMATIC; SAFER 2; TIME

Results

In each of these trials we have used routine linked data as a key part of the research study design:

PRISMATIC (a stepped wedge trial of predictive risk stratification in primary care) utilised linked data outcomes related to emergency admissions to hospital, GP activity and outpatient appointments. Outcomes were included for 230,000 people registered to participating GP practices in the Swansea area

SAFER 2: a cluster randomised trial of referral to falls services by ambulance paramedics included linked data outcomes related to subsequent emergency episodes for 4,655 patients across three UK regions

TIME: feasibility trial of Take Home Naloxone randomised by city; routine linked data used to identify population for inclusion in follow up and outcomes

Ethics, research and information governance permissions have caused delay in each trial; inclusion rates have been much higher than is usual in RCTs (outcomes for >80% of eligible patients); large trials have been achievable at reasonable cost (each trial <£2,000,000). Questions remain about differences between self-reported and routinely available outcomes; and between routine data outcomes collected prospectively and through the anonymised linked route.

Conclusions

There are clear benefits in using anonymised linked data outcomes in trials but further research is required to understand costs and limitations
PP29  The paramedic will see you now: understanding new roles in primary care
Authors: Porter Alison , Driscoll Timothy , Edwards Adrian , Evans Bridie , Griffiths Lesley , Hussain Ather , James Mari , Jones Jenna , Keen Leigh , Kingston Mark , Phillips Ceri , Snooks Helen , Thomas Rhys , Watkins Alan , Mclean Grayham
Published: September 2020

Background

In response to rising healthcare demand and shortages of general practitioners (GPs), policy across the UK supports paramedics joining the clinical team in primary care. Numbers of paramedics in primary care (PPC) are increasing in England and Wales through a range of local initiatives. As the first stage in the ARRIVE feasibility study evaluating PPC, we conducted preliminary qualitative research to:

Understand the key components of the PPC intervention and its potential impacts

Identify sites with PPC and describe the range of existing interventions

Develop a logic model to describe PPC.

Methods

We interviewed a total of 19 stakeholders from across Wales, including Health Board managers, GPs, practice managers and paramedics. Interviews were recorded and transcribed in full, then analysed thematically. We held a stakeholder event, bringing together 21 people involved in commissioning, planning and delivering PPC to discuss the key components of a logic model, including outcome measures for evaluation.

Results

We developed a logic model describing how paramedics provide direct clinical contact with patients in a primary care setting. Potential positive impacts include better patient experience, reductions in emergency admissions through better proactive care, increased sustainability of primary care, and increased levels of clinical skills and satisfaction for paramedics. Components of the intervention which varied across sites included type of patient contact (home visit or surgery); approaches to patient selection and triage; employment model; training and induction; and clinical supervision and support from GPs.

Implications

PPC is a rapidly developing area of provision in primary care, but there is great variation in the nature of models which have been implemented, and there is still uncertainty about the risks and benefits of PPC, and about how best to deliver it. Our logic model underpins the ARRIVE feasibility study, which will help to build the evidence base urgently needed on the PPC innovation.
PP30  The ambulance service and the child and young person’s advance care plan: listening to families and professionals
Authors: Shaw Karen , Spry Jenna , Cottrell Serena , Cummins Carole , Fitzmaurice Nicki , Greenfield Sheila , Heath Gemma , Miller Joshua , Neilson Sue , Skrybant Magdalena , Thompson Paul , Vyse Janette
Published: September 2020

Background

The Child and Young Person’s Advance Care Plan (CYPACP) is a set of resources to help families and professionals agree a plan of care to be followed when a child/young person with a life-limiting condition develops potentially (i) reversible intercurrent illnesses or (ii) life-threatening complications of their condition. It covers clinical, psychosocial and spiritual issues, is designed for use in all environments that the child encounters, and can be used as a resuscitation and/or end-of-life plan. Little is known about the experiences of Ambulance Service staff who receive copies of these plans and may be called upon to follow the recommendations for treatment and resuscitation.

Methods

As part of a regional qualitative research study, families who have a CYPACP and members of the ambulance service were invited to share their views and experiences of the CYPACP via an online survey, in focus groups or individual interviews. Underpinned by an interpretative framework, thematic and linguistic analyses are being used to understand the implementation in ‘real-world’ settings, and how the CYPACP shapes the experience, delivery and quality of care.

Results

To date 20 families with a CYPACP and 25 members of the ambulance service have taken part. Analysis is on-going. Preliminary findings show that despite families with CYPACPs having multiple experiences of interactions with the ambulance service, it is rare for ambulance crews to attend a call where a child has a CYPACP in place. Findings also suggest that there are critical points within the process of conveying the information contained within the CYPACP document that could be improved.

Conclusion

Following full analysis, it is anticipated that the ambulance services involvement with the CYPACP planning process will be better understood and that improvement strategies, including revision to existing documentation and identification of specific support needs can be made.
PP33  A service evaluation of the experiences of specialist paramedics working in rotational environments using a retrospective cohort
Authors: Creton Daniel , Halter Mary , LaTrobe Clayre
Published: September 2020

Background

The number of ambulance service-employed paramedic practitioners moving to work in primary care is increasing. Several Health Education England-supported pilot rotational programmes are underway. This study aimed to evaluate the experiences of nine paramedic practitioners in one ambulance service their first year of working on a similar local commissioner-led rotational project (segment one GP home visiting [GPHV], segment two ambulance service solo response vehicle [SRV] and emergency operations control room [EOC] whose aim was to mitigate attrition rates for both the ambulance service and primary care.

Methods

We conducted a retrospective cohort study, using electronic anonymous, self-completion, mixed methods questionnaires administered seven times – pre-project, at the end of each rotation, and at the end of the first year of the rotational project. Descriptive statistics of closed questions on challenges, influence over practice, skills used, satisfaction and likelihood of leaving were conducted, and thematic analysis of the open responses conducted.

Results

The survey response rate was 100% pre-project, 62.2% (n=28/45) over five rotations (n=15 after GPHV and n=13 after SRV/EOC] and 100% at end year one. Reported challenges included inappropriate utilisation of skills (33% GPHV, 55% SRV/EOC) and poor work life balance (27% GPHV), while opportunities were identified as clinical autonomy, collaboration with other healthcare professionals and clinical development (67%, 60%, 33% GPHV; 54%, 69%, 62% SRV/EOC, respectively). Satisfaction was 67% at year one, attributed to support and development from peers, GPs and immediate managers. Likelihood of leaving was reported to be decreased.

Conclusion

Although small in scale, in one locality and only quantitatively descriptive this study has identified that a rotational model contributes to clinically developing and retaining PPs, and offers PPs’ views on why that is. Findings support the rotational model, though further research with a larger sample across regions and/or greater qualitative depth is required.
PP35  Evaluation of a rotational model of advanced paramedic practice in north wales: a logic model approach to demonstrate effectiveness
Authors: Robertson Duncan , Baines Bob , Nosworthy Gemma , Thomas Wyn , Timmins Mark , Watson Robyn , Wright Stella
Published: September 2020

Background

UK Ambulance Services are under pressure to retain paramedics as diverse career options become increasingly available throughout the NHS for this valuable group of staff. Rotational working is one means of providing a varied clinical portfolio with the aim of sustaining an ambulance service based career over a longer work-span. Prior to implementing a test of an Advanced Paramedic Practitioner (APP) focussed three-part model of rotation which included Primary Care, Clinical Contact Centre and Solo Responding, an effective evaluation framework was required.

Methods

The aims of the project were refined during initial team planning and a project workshop which articulated the conditions for success. The theory of change was subsequently developed through a team-based facilitated session culminating in the development of a driver diagram. Due to the predominantly linear nature of the project and design, a Logic Model approach was selected to then map and construct the detailed evaluations required for each of the key areas identified.

Results

Seven individual elements for evaluation were identified through this design process. These comprised of four core areas including the impact of the rotation on Patients, Primary Care, The APPs and Welsh Ambulance Services NHS Trust which would be managed by the project team. In addition, the framework identified elements suitable for external evaluation which consisted of the economic evaluation, a deeper exploration of patient experiences and project effectiveness. External evaluation would test the validity of the overall approach to the project by the internal team and stakeholders. The derived Logic Models were designed to enable formative and summative evaluation throughout the opening phase of the rotation.

Conclusions

Using this approach, the project team have constructed a robust, but testable model of evaluation, with the flexibility to map changes as the evaluation yields specific learning points about the project.
PP36  Using linked health data to explore compliance with and appropriateness of ambulance telephone advice
Authors: Coster Joanne , O’Cathain Alicia , Nicoll Jon
Published: September 2020

Background

In England, approximately 10% of patients who contact the ambulance service receive clinical telephone advice rather than a face-to-face ambulance response. This analysis identifies whether patients who receive ambulance telephone advice to attend ED comply with this advice and explores the appropriateness of subsequent ED attendances.

Methods

Ambulance CAD, HES (A&E/inpatient) was linked for 2521 hear and treat callers as part of the PhOEBE study. For data linking reasons, the sample includes only patients who had other experiences of contacting the ambulance service. Additional information from the ambulance telephone advice call was linked to the PhOEBE data using the CAD ID and date/time of call. Appropriateness of ED attendances was determined using a method that assesses whether patients receive investigations/treatments in the ED and that appropriateness denotes care that is proportionate to need.

Results

This analysis is based on 1892/2521 (75%) cases which have both ambulance telephone advice and ED attendance data, as some ambulance advice information was unavailable. 522 patients (28%) attended ED within 3 days of the ambulance call. Of these, 235 were advised by the ambulance service to attend ED. The remaining 287 patients were advised to seek other care, with most advised to seek GP care (n=180). 81.6% of ED attendances were assessed as appropriate. 129 patients were advised to attend ED and did not attend within 3 days.

Conclusions

Ambulance telephone advice information was successfully linked to other health-service information. Patients included in this analysis are older and more likely to be sicker than the general hear and treat population, as all had other experiences of using the ambulance service. Most ED attendances were appropriate. Some patients did not comply with advice to attend ED. More research is required to investigate the factors around compliance with advice to attend ED and to find out what happens to these patients.
04  ‘What is the rate of general practitioner registration amongst homeless patients who present to an english ambulance service?’
Authors: Miller Joshua , McBride Shaun
Published: September 2020

Background

Marginalised groups such as homeless people and migrants experience barriers to registration with a general practitioner (GP). While various interventions have been trialed to improve registration rates, the potential for opportunistic interventions through the ambulance service has not yet been considered. The aim of this study was to determine the scope for these interventions by researching the prevalence of GP registration amongst the homeless population that present to a regional English ambulance service that covers both rural and urban areas.

Methods

A retrospective search of electronic patient records was carried out for cases where a box for the attending clinician to click to indicate homelessness had been ticked between 1st April 2016 and 30th September 2019. A search of these records for GP registration was then performed.

Results

A total of 14 707 ambulance attendances were marked as being for a homeless patient. 10 511 (71.5%) had a GP recorded, while 4 196 (28.5%) did not. On average, the ambulance service had face-to-face contact with 11.5 homeless patients per day, and 3 face-to-face contacts with patients who did not have GP registration per day.

Conclusion

This indicates ambulance services could perform opportunistic interventions to improve GP registration rates amongst the homeless population. The data also suggests that the ambulance service is well-placed to perform other opportunistic interventions targeted at the homeless population.
OP6  Long term outcomes of participants in the paramedic-2 randomised trial of adrenaline in out of hospital cardiac arrest
Authors: Haywood Kirstie L , Ji Chen , Quinn Tom , Nolan Jerry P , Deakin Charles D , Scomparin Charlotte , Lall Ranjit , Gates Simon , Long John , Regan Scott , Fothergill Rachael T , Pocock Helen , Rees Nigel , O’Shea Lyndsey , Perkins Gavin D
Published: September 2020

Background

We recently reported early outcomes in patients enrolled in a randomised trial of adrenaline in out-of-hospital cardiac arrest: the PARAMEDIC-2 (Prehospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration in Cardiac Arrest) trial. The purpose of the present paper is to report long-term survival, quality of life, functional and cognitive outcomes in cardiac arrest patients who survived.

Methods

PARAMEDIC-2 was a pragmatic, individually randomised, double blind, controlled trial and economic evaluation. Patients were randomised to either adrenaline or placebo. The 12-months survival post randomisation was checked. The 3- and 6-months outcomes included the modified Rankin Scale (0–3 defined as favourable neurological outcome), Two Simple Questions, the Mini Mental State Examination, the Informant Questionnaire on Cognitive Decline Evaluation for Cardiac Arrest, Hospital Anxiety and Depression Scale, the Post Traumatic Stress Disorder Checklist - Civilian Version and general health-related quality of life (HRQoL) assessed with both the Short-Form 12-item Health Survey and the EuroQoL EQ-5D-5L.

Results

8,014 patients were randomised with confirmed trial drug administration. Adrenaline survivors had marginally better 12-months survival (adjusted odds ratio: 1.385, 95% confidence interval: [1.000, 1.917], p=0.050). There was no significant treatment difference in favourable neurological outcome at both follow-ups. Similarly, no significant difference was found in other outcomes. Moderate to large effect sizes are reported in both arms when survivors were compared to the UK general population regarding general HRQoL and physical health.

Conclusions

Adrenaline had a short to long-term effect on survival to 12-months post OHCA, compared to placebo, but more survivors in the adrenaline arm had poor functional, cognitive and HRQoL. A large proportion of the survivors experienced significant cognitive impairment and an important reduction in mental and physical wellbeing over the initial 6-months when compared to the general population.
OP7  Did west midlands ambulance service paramedics’ usage of adrenaline change after the publication of the paramedic2 results, but prior to any guideline change? A service evaluation
Authors: Gunson Imogen M
Published: September 2020

Background

This project evaluated whether practice change occurred amongst Paramedics directly after the publication of the PARAMEDIC2 trial, regarding adrenaline administration during out-of-hospital cardiac arrest (OHCA) without a change in guidelines. When Paramedics are exposed to a seminal publication there is anecdotal concern their autonomous practice changes, based on comprehension of findings ahead of potential guideline changes, however little evidence appraises whether this really occurs.

Methods

A service evaluation to determine any variation in adrenaline administration during OHCA, before and after publication of the PARAMEDIC2 trial.

WMAS electronic patient record data that has been collected for use within OHCA ambulance quality indicators was used to evaluate practice variation.

Proportion of adult patients receiving adrenaline, number of administrations and time to first administration from EMS arrival (or arrest if EMS witnessed) are reported.

This evaluation assesses from the day after recruitment ended on 18th October 2017 until the trial results publication on 19th July 2018, and the same timeframe (273 days) post-publication.

Results

Proportion receiving adrenaline

Pre-publication: 88.7% of 3026 cases

Post-publication: 88.0% of 2682 cases

Mean number of adrenaline administrations

Pre-publication: 4

Post-publication: 4

Mean time to adrenaline

Pre-publication: 30:02 minutes

Post-publication: 30:11 minutes

Conclusions

In both datasets, average time to first adrenaline administration and number of administrations were found to be similar. This suggests Paramedic practice adheres to current guidelines when a highly anticipated article is published, however this may vary by intervention so further work is recommended. Limitations of retrospective observational evaluations include uncontrolled treatment variables; however randomised controlled trials cannot assess standard practice. Individuals need continued awareness for implications of changing practice following a trial publication, as patient safety could be breached whilst the wider medical community are scrutinising the trial results. This demonstrates how routine data can be used to evaluate practice and changes within it.
Exploring the structure of social media application-based information-sharing clinical networks in a community in Japan using a social network analysis approach
Authors: Haruta Junji , Tsugawa Sho , Ogura Kazunari
Published: September 2020

Objective

Currently, use of social networking services (SNSs) for interprofessional collaboration is increasing. However, few studies have reported on virtual interprofessional interactions in community healthcare services. Revealing such structural characteristics of the networks can provide insight into the functions of the interprofessional information-sharing network and lead to smoother collaboration. Thus, we aimed to explore the structure of SNS-based information-sharing clinical networks.

Design

Social network analysis (SNA).

Setting

We selected a community in City X in Japan.

Data collection

We analysed SNS-based information-sharing clinical network data linked to patients receiving home medical care or care services between January and December 2018. A network was created for each patient to allow healthcare professionals to post and view messages on the web platform. In the SNA, healthcare professions registered in a patient group were represented as nodes, and message posting/viewing relationships were represented as links in the patient network. We investigated the structural characteristics of the target networks using several measures for SNA, including indegree centrality and outdegree centrality, which reflect the number of incoming and outgoing links to/from a node, respectively. Additionally, the professions forming the most central nodes were investigated based on their ranking to identify those with a central role in the networks. Finally, to compare the networks of nursing care levels 1–3 (lighter care requirement) and those with nursing care levels 4–5 (heavier care requirement), we analysed the structural differences in the networks and investigated the roles of healthcare professionals using centrality measures of nodes.

Results

Among 844 groups, 247 groups with any nursing care level data were available for analysis. Increasing nursing care level showed higher density, reciprocity and lower centralisation. Healthcare professions with high indegree centrality (physicians, care workers and physical therapists) differed from those with high outdegree centrality (home care workers, physical therapists, and registered dieticians). Visiting nurses and nurses in the clinic played a central role, but visiting nurses tended to have higher indegree and outdegree centrality, while nurses in the clinic had higher closeness and betweenness centrality in networks with heavier care requirement.

Conclusion

The SNS-based information-sharing clinical network structure showed that different professions played some form of a central role. Associations between network structures and patient outcomes, cost effectiveness and other factors warrant further investigation.
Bacteria-derived long chain fatty acid exhibits anti-inflammatory properties in colitis
Authors: Pujo Julien , Petitfils Camille , Le Faouder Pauline , Eeckhaut Venessa , Payros Gaelle , Maurel Sarah , Perez-Berezo Teresa , Van Hul Matthias , Barreau Frederick , Blanpied Catherine , Chavanas Stephane , Van Immerseel Filip , Bertrand-Michel Justine , Oswald Eric , Knauf Claude , Dietrich Gilles , Cani Patrice D , Cenac Nicolas
Published: September 2020

Objective

Data from clinical research suggest that certain probiotic bacterial strains have the potential to modulate colonic inflammation. Nonetheless, these data differ between studies due to the probiotic bacterial strains used and the poor knowledge of their mechanisms of action.

Design

By mass-spectrometry, we identified and quantified free long chain fatty acids (LCFAs) in probiotics and assessed the effect of one of them in mouse colitis.

Results

Among all the LCFAs quantified by mass spectrometry inEscherichia coliNissle 1917 (EcN), a probiotic used for the treatment of multiple intestinal disorders, the concentration of 3-hydroxyoctadecaenoic acid (C18-3OH) was increased in EcN compared with otherE. colistrains tested. Oral administration of C18-3OH decreased colitis induced by dextran sulfate sodium in mice. To determine whether other bacteria composing the microbiota are able to produce C18-3OH, we targeted the gut microbiota of mice with prebiotic fructooligosaccharides (FOS). The anti-inflammatory properties of FOS were associated with an increase in colonic C18-3OH concentration. Microbiota analyses revealed that the concentration of C18-3OH was correlated with an increase in the abundance inAllobaculum,HoldemanellaandParabacteroides. In culture,Holdemanella biformisproduced high concentration of C18-3OH. Finally, using TR-FRET binding assay and gene expression analysis, we demonstrated that the C18-3OH is an agonist of peroxisome proliferator activated receptor gamma.

Conclusion

The production of C18-3OH by bacteria could be one of the mechanisms implicated in the anti-inflammatory properties of probiotics. The production of LCFA-3OH by bacteria could be implicated in the microbiota/host interactions.
Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study
Authors: Niedzwiedz Claire L , Green Michael James , Benzeval Michaela , Campbell Desmond , Craig Peter , Demou Evangelia , Leyland Alastair , Pearce Anna , Thomson Rachel , Whitley Elise , Katikireddi Srinivasa Vittal
Published: September 2020

Background

There are concerns that COVID-19 mitigation measures, including the ‘lockdown’, may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups.

Methods

Repeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of over 27,000 adults (aged 18+) interviewed in four survey waves between 2015 and 2020. A total of 9748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity.

Results

Psychological distress increased 1 month into lockdown with the prevalence rising from 19.4% (95% CI 18.7% to 20.1%) in 2017–2019 to 30.6% (95% CI 29.1% to 32.3%) in April 2020 (RR=1.3, 95% CI 1.2 to 1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI 0.6 to 1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI 1.3 to 1.5), as did binge drinking (RR=1.5, 95% CI 1.3 to 1.7).

Conclusions

Psychological distress increased 1 month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate negative impacts on health.
Critical factors for successful management of VUCA times
Authors: Pandit Meghana
Published: September 2020

Background

COVID-19 pandemic exposed leadership teams to novel challenges that required many changes to their practices. This has been the most volatile, uncertain, complex and ambiguous (VUCA) times in healthcare.

Interventions

This brief report uses experiences at Oxford University Hospitals to propose that an organisation’s culture serves as a bedrock on which management of a crisis such as the COVID-19 pandemic is reliant. The other two critical factors are partnership working and clarity of the strategic intent of the organisation.

Conclusions

While many of the actions described in this report are likely to be in common with those of other leadership teams across the National Health Service, some organisations seem to manage the response to the VUCA situations better than others and the three factors are repeatedly observed in these organisations. This brief report explores what actions support the three critical factors that make some organisations more resilient and their leaders’ actions more effective.
Payment in challenge studies: ethics, attitudes and a new payment for risk model
Authors: Grimwade Olivia , Savulescu Julian , Giubilini Alberto , Oakley Justin , Osowicki Joshua , Pollard Andrew J , Nussberger Anne-Marie
Published: September 2020

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.

Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated.
SARS-CoV-2 challenge studies: ethics and risk minimisation
Authors: Bull Susan , Jamrozik Euzebiusz , Binik Ariella , Parker Michael J
Published: September 2020

COVID-19 poses an exceptional threat to global public health and well-being. Recognition of the need to develop effective vaccines at unprecedented speed has led to calls to accelerate research pathways ethically, including by conducting challenge studies (also known as controlled human infection studies (CHIs)) with SARS-CoV-2 (the virus which causes COVID-19). Such research is controversial, with concerns being raised about the social, legal, ethical and clinical implications of infecting healthy volunteers with SARS-CoV-2 for research purposes. Systematic risk evaluations are critical to inform assessments of the ethics of any proposed SARS-CoV-2 CHIs. Such evaluations will necessarily take place within a rapidly changing and at times contested epidemiological landscape, in which differing criteria for the ethical acceptability of research risks have been proposed. This paper critically reviews two such criteria and evaluates whether the use of effective treatment should be a necessary condition for the ethical acceptability of SARS-CoV-2 CHIs, and whether the choice of study sites should be influenced by COVID-19 incidence levels. The paper concludes that ethical evaluations of proposed SARS-CoV-2 CHIs should be informed by rigorous, consultative and holistic approaches to systematic risk assessment.
Crassicauda sp. in an Indo‐Pacific humpback dolphin (Sousa chinensis)
Authors: Mauroo Nathalie France , Beh Philip S L , Harris Eileen , Chan San Y , Gibson David I
Published: September 2020

A female Indo‐Pacific humpback dolphin (Sousa chinensis) stranded in Hong Kong waters presented on postmortem examination with a single nematode with a diameter of 0.1 cm in the mammary gland, as well as mild multifocal chronic mastitis on histological examination. The parasitic material was recognised as a species of Crassicauda. To our knowledge, this is the first record of a species of Crassicauda occurring in an Indo‐Pacific humpback dolphin and also represents a new geographical record for this genus in the South China Sea.
Fermion number 1/2 of sphalerons and spectral mirror symmetry
Authors: Mehraeen M. , Gousheh S. S.
Published: September 2020

We present a rederivation of the baryon and lepton numbers $$\frac{1}{2}$$

1
2

of the $$SU(2)_L$$

S
U

(
2
)

L

S sphaleron of the standard electroweak theory based on spectral mirror symmetry. We explore the properties of a fermionic Hamiltonian under discrete transformations along a noncontractible loop of field configurations that passes through the sphaleron and whose endpoints are the vacuum. As is well known, CP transformation is not a symmetry of the system anywhere on the loop, except at the endpoints. By augmenting CP with a chirality transformation, we observe that the Dirac Hamiltonian is odd under the new transformation precisely at the sphaleron, and this ensures the mirror symmetry of the spectrum, including the continua. As a consistency check, we show that the fermionic zero mode presented by Ringwald in the sphaleron background is invariant under the new transformation. The spectral mirror symmetry which we establish here, together with the presence of the zero mode, are the two necessary conditions whence the fermion number $$\frac{1}{2}$$

1
2

of the sphaleron can be inferred using the reasoning presented by Jackiw and Rebbi or, equivalently, using the spectral deficiency $$\frac{1}{2}$$

1
2

of the Dirac sea. The relevance of this analysis to other solutions is also discussed.
Partial spectral flow and the Aharonov–Bohm effect in graphene
Authors: Katsnelson Mikhail I. , Nazaikinskii Vladimir
Published: September 2020

We study the Aharonov–Bohm effect in an open-ended tube made of a graphene sheet whose dimensions are much larger than the interatomic distance in graphene. An external magnetic field vanishes on and in the vicinity of the graphene sheet and its flux through the tube is adiabatically switched on. It is shown that, in the process, the energy levels of the tight-binding Hamiltonian of $$\pi $$
π
-electrons unavoidably cross the Fermi level, which results in the creation of electron–hole pairs. The number of pairs is proven to be equal to the number of magnetic flux quanta of the external field. The proof is based on the new notion of partial spectral flow, which generalizes the ordinary spectral flow already having well-known applications (such as the Kopnin forces in superconductors and superfluids) in condensed matter physics.
Kac–Wakimoto conjecture for the periplectic Lie superalgebra
Authors: Entova-Aizenbud Inna , Serganova Vera
Published: September 2020

We prove an analogue of the Kac–Wakimoto conjecture for the periplectic Lie superalgebra [Formula: see text], stating that any simple module lying in a block of non-maximal atypicality has superdimension zero.
HEARTBEAT CLASSIFICATION ALGORITHM BASED ON ONE-DIMENSIONAL CONVOLUTION NEURAL NETWORK
Authors: WAN XIANGKUI , JIN ZHIYAO , WU HAIBO , LIU JUNJIE , ZHU BINRU , XIE HONGGANG
Published: September 2020

The morbidity of cardiovascular disease increasingly rises, which makes great impact upon people’s health and life. Electrocardiogram (ECG) beat classification is of great significance to clinical diagnosis of cardiovascular diseases. Traditional ECG signal classification algorithm relies heavily on the accuracy of feature extraction or increases the complexity of the calculation process by means of the correlation characteristic coefficient transformation, which results in that the ECG beat classification effect is still not satisfactory. Aimed at this problem, a novel method based on convolution neural network (CNN) is presented in this paper. First, ECG signal is preprocessed to suppress the noise and to locate the R peaks, and five kinds of ECG beat waveform data are obtained. Then taking ECG beat sampling points as input, four layers of one-dimensional CNN are constructed for feature extraction and classification. Finally, experimental verification is carried out on the data from MIT-BIH database, and the accuracy of recognition and classification of the presented method reaches 99.10%. Comparison with the methods based on artificial features, this method shows better performance, which avoids serious dependence on the accuracy of feature extraction, skips the steps of feature extraction and selection, and reduces the complexity of computational process.
Synthesis of Metal-Organic Framework Cr-MIL-101 by a 4-Nitroimidazole-Assistant Route
Authors: Chen Heng , Cui Mengbing , Miao Cuilan , Chen Gairong , Zhang Yongchun
Published: September 2020

In this work, the function of 4-nitroimidazole (4-NIm) in the formation of Cr-MIL-101 was confirmed. It was found that 4-NIm is an effective additive in the formation of Cr-MIL-101 synthesized at lower temperature. The investigation of crystallization time showed that 4-NIm can prevent Cr-MIL-101 phase converting into Cr-MIL-53 phase. The effect of concentration of 4-NIm on the morphology and the yield of Cr-MIL-101 may therefore be explained by increasing the nucleation rate. The investigation of crystallization temperature revealed that 4-NIm changes the synthesis temperature range of Cr-MIL-101 into 423–463 K. The assistant function of 4-NIm was played through interaction with H[Formula: see text] and NO[Formula: see text] in the synthesis system, which may lead to enhancement of the deprotonation of H2BDC.
BOXREC
Authors: Banerjee Debopriyo , Rao Krothapalli Sreenivasa , Sural Shamik , Ganguly Niloy
Published: September 2020

Fashionable outfits are generally created by expert fashionistas, who use their creativity and in-depth understanding of fashion to make attractive outfits. Over the past few years, automation of outfit composition has gained much attention from the research community. Most of the existing outfit recommendation systems focus on pairwise item compatibility prediction (using visual and text features) to score an outfit combination having several items, followed by recommendation of top-n outfits or a capsule wardrobe having a collection of outfits based on user’s fashion taste. However, none of these consider a user’s preference of price range for individual clothing types or an overall shopping budget for a set of items. In this article, we propose a box recommendation framework—BOXREC—which at first collects user preferences across different item types (namely, top-wear, bottom-wear, and foot-wear) including price range of each type and a maximum shopping budget for a particular shopping session. It then generates a set of preferred outfits by retrieving all types of preferred items from the database (according to user specified preferences including price ranges), creates all possible combinations of three preferred items (belonging to distinct item types), and verifies each combination using an outfit scoring framework—BOXREC-OSF. Finally, it provides a box full of fashion items, such that different combinations of the items maximize the number of outfits suitable for an occasion while satisfying maximum shopping budget. We create an extensively annotated dataset of male fashion items across various types and categories (each having associated price) and a manually annotated positive and negative formal as well as casual outfit dataset. We consider a set of recently published pairwise compatibility prediction methods as competitors of BOXREC-OSF. Empirical results show superior performance of BOXREC-OSF over the baseline methods. We found encouraging results by performing both quantitative and qualitative analysis of the recommendations produced by BOXREC. Finally, based on user feedback corresponding to the recommendations given by BOXREC, we show that disliked or unpopular items can be a part of attractive outfits.
Pharmacogenomics in Pediatric Oncology: Mitigating Adverse Drug Reactions While Preserving Efficacy
Authors: Elzagallaai Abdelbaset A. , Carleton Bruce C. , Rieder Michael J.
Published: September 2020

Cancer is the leading cause of death in American children older than 1 year of age. Major developments in drugs such as thiopurines and optimization in clinical trial protocols for treating cancer in children have led to a remarkable improvement in survival, from approximately 30% in the 1960s to more than 80% today. Short-term and long-term adverse effects of chemotherapy still affect most survivors of childhood cancer. Pharmacogenetics plays a major role in predicting the safety of cancer chemotherapy and, in the future, its effectiveness. Treatment failure in childhood cancer—due to either serious adverse effects that limit therapy or the failure of conventional dosing to induce remission—warrants development of new strategies for treatment. Here, we summarize the current knowledge of the pharmacogenomics of cancer drug treatment in children and of statistically and clinically relevant drug–gene associations and the mechanistic understandings that underscore their therapeutic value in the treatment of childhood cancer.
Voltage Hysteresis Model for Silicon Electrodes for Lithium Ion Batteries, Including Multi-Step Phase Transformations, Crystallization and Amorphization
Authors: Jiang Yang , Offer Gregory , Jiang Jun , Marinescu Monica , Wang Huizhi
Published: September 2020

Silicon has been an attractive alternative to graphite as an anode material in lithium ion batteries (LIBs). The development of better silicon electrodes and optimization of their operating conditions for longer cycle life require a quantitative understanding of the lithiation/delithiation mechanisms of silicon and how they are linked to the electrode behaviors. Herein we present a zero-dimensional mechanistic model of silicon anodes in LIBs. The model, for the first time, considers the multi-step phase transformations, crystallization and amorphization of different lithium-silicon phases during cycling while being able to capture the electrode behaviors under different lithiation depths. Based on the model, a linkage between the underlying reaction processes and electrochemical performance is established. In particular, the two sloping voltage plateaus at low lithiation depth are correlated with two electrochemical phase transformations and the emergence of the single broad plateau at high lithiation depth is correlated with the amorphization of c-Li15Si4. The model is then used to study the effects of crystallization rate and surface energy barriers, which clarifies the role of surface energy and particle size in determining the performance behaviors of silicon. The model is a necessary tool for future design and development of high-energy-density, longer-life silicon-based LIBs.
DFT-Based Calculation of Dissolution Activation Energy and Kinetics of Ni–Cr Alloys
Authors: Ke Huibin , Taylor Christopher D.
Published: September 2020

A density functional theory investigation of the process of dissolution of Ni and Cr adatoms from model Ni–Cr(111) alloy surfaces is presented, both in vacuum and with explicit water molecules. The goal is to understand how the electronic structures solved using DFT can provide insights as to changes in valence, energy and coordination of the adatoms in the process of dissolving from the alloy surface. It is found that nearby Cr solute atoms increase the dissolution activation energy of Ni. Cr adatoms have a similar dissolution activation energy as Ni adatoms, except for one particular surface configuration that has a much smaller dissolution activation energy, which might promote selective dissolution of Cr in Ni–Cr alloys. To interpret the first-principles modeling results for the potential energy trajectory along the dissolution reaction coordinate, we provide a thermodynamic breakdown of the various terms that contribute to the dissolution activation and total reaction energy. The role of addition of Cr is explored on the dissolution kinetics of a Ni–Cr alloys of varying composition by constructing a model for the corrosion current density with DFT-based activation energies. Finally, dissolution resistance index is proposed as a quantifiable descriptor of the dissolution resistance of corrosion resistant alloys.
The ECS Community Adapts and Advances Through the Pandemic
Authors: Chaves Frances
Published: September 2020

When the COVID-19 global pandemic hit, everything changed—and changes keep coming. This spring, the Society, with support from TBI Communications, interviewed 20 members—from students to long-term supporters—to understand how this unprecedented crisis affects our community. Their entire personal and scientific responses are recorded in The ECS Community Adapts and Advances Series blogs and YouTube videos. They give voice to our challenges and showcase inspiring ways members adapt, connect, help others’ professional development, and advance research (including COVID-19-related projects). What is clear: our community is resilient. Everyone longs to return to their labs, yet research, collaboration, teaching, and learning continue in new ways.
App Corner - Fall 2020
Authors: Suroviec Alice
Published: September 2020

A collection of applications that can assist the end user in their daily routine.
Looking at Patent Law: Patenting a Trivalent Chromium Plating Invention: Obviousness Rejections – Not So Obvious
Authors: Taylor E. Jennings , Inman Maria
Published: September 2020

In this installment of the “Looking at Patent Law” articles, we discuss obviousness rejections in view of a case study of a trivalent chromium plating invention. We have chosen this invention to align with the sustainability focus of this issue of Interface. The article begins with a brief review of obviousness followed by a brief description of the trivalent plating invention. The article concludes with a case study of the inventions/patent applications related to the trivalent plating process with a focus on the obviousness rejections.
Electrochemical Separations for Metal Recycling
Authors: Su Xiao
Published: September 2020

Recycling of waste is critical for sustainability. Modern industrialization has caused a rapid decline in natural resources, and a dramatic rise in hazardous pollutants released into the environment. A recent study reported that global resource usage rose from 23.7 billion tons in 1970 to 70.1 billion tons in 2010. Global consumption of metals has increased at a significant pace, placing severe environmental and economic pressure for recycling. Electrochemical processes are particularly well suited for metal recovery. Due to the ionic nature of the metals after leaching, both Faradaic and non-Faradaic electrochemical processes can play an important role in separating and purifying these elements. Here, an overview of electrochemical approaches for chemical recycling will be presented, with a focus on metal recovery from electronic waste, battery components, as well as methods for selective recycling specialty metals and rare earth elements. This article discusses emerging recycling methods for value-added compounds beyond metals, including organic compounds, which may point to new directions in chemical recycling. In sum, electrochemical separation processes are expected to play a significant role in waste recycling and contribute towards a sustainable circular economy.