bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary protein and sodium co‐limit cockroach growth and reproduction
Authors: Adams Tianjiao , Pennings Steven C.
Published: June 2022

Both dietary protein (N) and sodium (Na) are essential nutrients for invertebrate growth and reproduction. Field studies show that insects aggregate in areas with both high protein and sodium and their abundance is co‐limited by these two essential nutrients, but the mechanism behind this aggregation is not well known.

We examined a possible mechanism that dietary protein and sodium co‐limit insect herbivore growth and reproduction. To test this mechanism, we conducted a feeding experiment examining the effect of these two nutrients by using artificial diets with two levels of protein and three levels of sodium on a generalist herbivorous cockroach Blaptica dubia.

Elevated levels of dietary sodium interacted with low protein level to increase cockroach nymph relative growth rate during earlier instars.

Female cockroaches always weighed more and had a higher relative growth rate than males regardless of dietary treatment. When compared between different dietary treatments, female cockroaches' relative growth rates were higher when fed with a high protein diet, while male cockroaches reached the final instar faster when fed with a high sodium diet.

Cockroach reproduction was not affected by protein or sodium alone, but the combination of a high protein and high sodium diet resulted in the heaviest offspring.

Our results suggest that both protein and sodium may be important for both the growth and reproduction of insect herbivores. The interaction of these two nutrients to improve cockroach growth and reproduction indicate a level of co‐limitation.
Do foreign investors crowd out sell‐side analysts? Evidence from China
Authors: Cheng Xu , Kong Dongmin , Zheng Xinwei , Tang Qi
Published: June 2022

This paper examines whether foreign investors (FIs) affect the information production of analysts. Based on China's stock market, we find that FIs significantly reduce analysts’ coverage. Such negative association is more pronounced in firms with a high level of governance and information disclosure and varies with analyst characteristics. We also identify two possible economic mechanisms: the information channel and the governance channel. Further tests suggest that as FIs crowd out analysts, the number of research reports and brokerage site visits decreased, but analyst forecast accuracy improved, indicating that the demand and supply of information are generally in equilibrium. We further address the endogeneity issue using a change‐on‐change analysis and a quasi‐natural experiment, the Shanghai–Hong Kong Stock Connect (S‐HKSC), and the results still hold. Overall, our results present evidence of potential information production by FIs, providing policy implications and highlighting the positive effect of China's open‐door policy in capital markets.
Vertical distribution of planktonic ostracods (Halocyprididae) in the northeastern and central South China Sea: Significance of large‐sized species in deep waters
Authors: Liao Tongchen , Tan Yehui , Liu Hui , Yu Linghui , Li Kaizhi
Published: June 2022

The vertical distribution of species richness, abundance and biomass of planktonic ostracods down to a depth of 1000 m were studied in the northeastern South China Sea (NESCS) during March and in the central South China Sea (CTSCS) during September 2016. A total of 47 species of halocyprids were identified, with 46 species recorded in the NESCS and 28 species in the CTSCS. Most of the species observed were concentrated in the mesopelagic zone (200–1000 m), but the majority of species abundance and biomass occurred in the 25 m to 300 m water column. Results of statistical analysis showed that the vertical distribution of planktonic ostracods was associated with chlorophyll a concentration and sampling depth. The high abundance and species richness of ostracods in the NESCS were probably influenced by the Kuroshio intrusion and eddies leading to high levels of chlorophyll a concentration. The biomass of large‐sized individuals with low abundance is equal to or larger than, the extremely small‐sized individuals with high abundance, particularly in deep layers. The body sizes of planktonic ostracods were found to increase from surface to deeper water layers, indicating a trend of greater body length and higher biomass of ostracods in deep sea.
THE COST OF GREENING STIMULUS: A DYNAMIC ANALYSIS OF VEHICLE SCRAPPAGE PROGRAMS
Authors: Li Shanjun , Liu Youming , Wei Chao
Published: June 2022

This article investigates the potential trade‐off between the stimulus and environmental objectives in the context of the U.S. vehicle scrappage program. We develop and estimate a dynamic model of vehicle ownership and conduct a counterfactual analysis comparing the implemented policy with alternative designs. We find the cost of the implemented policy 25% higher in terms of induced sales and 64% higher in terms of induced spending than a policy design without the environmental objective. The findings serve as a caution for green stimulus programs to address both climate change and the economic crisis from the ongoing pandemic.
Supporting the agency of cities as climate migration destinations
Authors: Rosengärtner Sarah Katharina , De Sherbinin Alexander M. , Stojanov Robert
Published: June 2022

As climate migration has garnered the interest of research and policy communities over the last two decades, the focus has been on whether, how and where climate stresses might precipitate out‐migration, and how to assist and protect those affected. Less attention has gone to the places that receive climate migrants, and how their arrival might affect adaptation at destination. Against the backdrop of increasingly severe climate disruptions, this paper examines the likelihood of climate‐related movements going into urban areas, and the challenges that this may entail for those who move and for urban governance. With much of climate migration projected to feed into existing urbanization trends, we see the need for data and research to help bolster the agency of communities and cities to plan and act locally, and across geographies, for inclusion and resilience, and to advocate collectively for enabling policy frameworks and increased national and international support.
Stigmatization and discrimination towards human immunodeficiency virus seropositive patients in psychiatric and mental health facilities
Authors: Alenezi Atallah
Published: June 2022

Stigmatization and discriminatory attitudes of nurses towards human immunodeficiency (HIV) patients have been reported in many countries. The current study was undertaken to assess the knowledge, attitudes and factors associated with stigmatizing attitudes and discrimination among psychiatric and mental health nurses and nurse interns towards patients diagnosed with the human immunodeficiency virus; utilizing a single‐centre hospital‐based survey design. Primary data were collected using a previously validated questionnaire in a large mental health care hospital in Riyadh, Saudi Arabia. Knowledge, attitudes, acts of discrimination and associated factors on the part of mental health nurses towards those diagnosed with the HIV were identified. The study described herein is in accordance with the STROBE guideline. A total of 241 psychiatric and mental health nurses completed the questionnaire, yielding a completion rate of 74.4%. Overall, more than half of the nurses demonstrated gaps in knowledge and reported higher stigmatizing attitudes and acts of discrimination. Factors associated with stigmatization and/or discrimination include higher exposure to seropositive patients, no formal HIV training, lower religiousness, lower awareness of HIV testing policy and lower level of knowledge about HIV infection. There is an urgent need to implement a training program that will help to reduce stigma among nurses caring for people diagnosed with this illness.
Validity Arguments for AI‐Based Automated Scores: Essay Scoring as an Illustration
Authors: Ferrara Steve , Qunbar Saed
Published: June 2022

In this article, we argue that automated scoring engines should be transparent and construct relevant—that is, as much as is currently feasible. Many current automated scoring engines cannot achieve high degrees of scoring accuracy without allowing in some features that may not be easily explained and understood and may not be obviously and directly relevant to the target assessment construct. We address the current limitations on evidence and validity arguments for scores from automated scoring engines from the points of view of the Standards for Educational and Psychological Testing (i.e., construct relevance, construct representation, and fairness) and emerging principles in Artificial Intelligence (e.g., explainable AI, an examinee's right to explanations, and principled AI). We illustrate these concepts and arguments for automated essay scores.
Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review
Authors: Li Yijing , Xu Zhihua , Zhang Xu , Ma Dongfei , Meng Xiangfei , Zhang Mengting , Sun Jiao
Published: June 2022

Aims

The aim was to synthesise and discuss predictors of complete oral feeding resumption after feeding tube placement in stroke patients with dysphagia.

Design

This was a systematic review, following the PRISMA 2020 checklist.

Data sources

Eight databases (PubMed, Web of Science, Embase, Cochrane, CINAHL, CNKI, WanFang and Vip) were searched for eligible studies from inception up to June 2021.

Review methods

The JBI Manual for Evidence Synthesis was used to guide this systematic review. Any cross‐sectional survey, longitudinal study, cohort study or case–control study that explored the recovery from tube feeding to complete oral feeding in patients with dysphagia after stroke was included. Qualitative studies, review articles, case reports and conference abstracts were excluded. Two reviewers independently screened and appraised the studies. The Newcastle–Ottawa scale was used for quality assessment. Content analysis was used to categorise factors predicting feeding tube removal in stroke patients with dysphagia.

Results

This review included a total of 15 studies consisting of 1746 participants, of which 2 were case–control studies and 13 were cohort studies. Four studies were rated as having low risk of bias, and the other 11 had high risk of bias. The factors examined in the studies were categorised into demographic characteristics (age and sex), swallowing function (instrumental assessments and non‐instrumental assessments), stroke characteristics (stroke severity, past stroke history and location of the stroke), functional status (cognitive function and physical function) and clinical measures (body mass index, geriatric nutritional risk index, white blood cell count and C‐reactive protein level).

Conclusions

The major limitation of this review is the failure to identify predictors of different tube feeding types. Although the current evidence is insufficient to support or oppose the predictive effect of any single factor, these factors are still valuable data for clinical staff that provide information that researchers can use in developing prognostic models. Rigorously designed and high‐quality research is needed to further explore the predictive value of these factors.

Registration

This review was registered prospectively with PROSPERO [CRD42021272552].

Relevance to clinical practice

Healthcare providers should strengthen the monitoring of swallowing function in patients with stroke to promote complete oral feeding resumption. As the predictive value of the identified factors is still uncertain, large, well‐designed, studies are needed to better clarify the importance of these predictors.

No Patient or Public Contribution

No patient or public was involved in the design, analysis, preparation or writing of this review.
The role of manager's gender in mentoring: Evidence in the United Kingdom
Authors: Hu Xiaocheng
Published: June 2022

This article studies the role of managers' gender as a determinant of mentoring relationships between managers and employees in British firms by using data collected from the 2004 and 2011 Workplace Employment Relations Survey. Past literature suggests a rather mixed figure with datasets collected from either one point in time or in a single firm. Using longitudinal data collected from hundreds of British firms, this study shows that the results are inconsistent between classical pooled ordinary least squares (POLS) and fixed effects (FEs) regression models. The significant associations found in POLS regressions disappeared when firm FEs are included. This finding should encourage researchers to go beyond gender differences in mentoring relationships which often are the results of conventional stereotyping.
Fall time may be a reliable discriminator between neoplastic and non‐neoplastic urinary bladder lesions in dogs undergoing contrast‐enhanced ultrasound: a pilot study
Authors: Spediacci Carlotta , Manfredi Martina , Sala Giulia , Liuti Tiziana , Israeliantz Nicolas , Zani Davide Danilo , Di Giancamillo Mauro , Longo Maurizio
Published: June 2022

Contrast‐enhanced ultrasound (CEUS) can provide quantitative information on enhancement patterns and perfusion of lesions, based on time‐intensity curves (TICs). No published studies have compared CEUS parameters in neoplastic and non‐neoplastic urinary bladder lesions in dogs. The aim of the current prospective, pilot study was to quantitatively characterize the CEUS pattern of neoplastic and non‐neoplastic urinary bladder lesions in dogs, assessing the influence of contrast arrival time (CAT) on the final appearance of the curves. Fourteen dogs with cyto‐histopathological diagnoses were included (seven malignant and seven inflammatory lesions). B‐mode ultrasound was performed followed by CEUS examination after an intravenous bolus injection of 0.04 mL/kg of contrast medium, and TICs were elaborated by dedicated software. Receiver operating characteristic curves (ROC) for each TIC parameter were obtained. Neoplastic lesions had subjectively shorter rise time (RT), time to peak (TTP) and fall time (FT) than inflammatory lesions. Based on ROC curve analyses, fall time ≥ 10.49 s was the most reliable parameter for diagnosing non‐neoplastic disease in this small sample of dogs (area under the curve [AUC] 0.75, sensitivity 83.33%, specificity 66.67%). No difference was found between ROCs calculated for each parameter of TICs by adding or removing CAT. Results of the current study provide background for future, larger scale studies evaluating use of a CEUS FT threshold of 10.49 s as a possible discriminator for urinary bladder neoplastic lesions in dogs.
Consumo de basuco: aspectos relevantes para su tratamiento
Authors: Rodriguez Prada Catalina , Barrios Peralta Elkin Rene , Oviedo Lugo Gabriel Fernando , Castellanos Garzón Rafael Gustavo
Published: June 2022

La pasta de cocaína (PBC/basuco) es una droga ilícita consumida principalmente en los países de Latinoamérica que se encuentra combinada con otros productos químicos para lograr un costo menor en el mercado. Esto mismo hace que sea de más fácil acceso para muchas personas. El consumo del basuco produce efectos a corto y largo plazo sobre el organismo, la persona, la familia y la sociedad. En este artículo se exploran aspectos relacionados con la neurobiología de la adicción al basuco, el diagnóstico de la intoxicación y sus opciones terapéuticas.
Built for Speed
Authors: Gonzalez Carlos
Published: June 2022

The Drone Racing League holds contests between pilots flying UAVs through obstacle courses. The league's aspirations are more than just providing exhilarating races, however. It is working to innovate drone technology at a large scale. With 5G drones and FAA partnerships, the DRL is creating more than just a sports league. It is helping usher in the next wave of drone technology.
Manufacturing and the Great Resignation
Authors: Schmid Steven R. , Melkote Shreyes N.
Published: June 2022

The stress test of the COVID-19 pandemic uncovered vulnerabilities in the global supply chain, and subsequent shortages indicate they may not be displaying the robustness needed to cope with the increased level of economic activity. But restocking the nation’s shelves for the decades to come will require more than reestablishing logistics—it needs people. It demands renewed investment in the manufacturing and technical workforce and the training of millions of skilled workers required for high-tech manufacturing.
A Structural Optimization Framework to Design Compliant Constant Force Mechanisms With Large Energy Storage
Authors: Ou Haihua , Yi Haiping , Qaiser Zeeshan , Ur Rehman Tanzeel , Johnson Shane
Published: June 2022

In this study, we present a structural optimization framework to design constant force mechanisms (CFMs) with high energy storage capacity. In the framework, the constant force behavior with a zero preload is defined to be ideal, as this has the maximum energy storage given force and displacement limits. A graph-based topology selection, followed by shape optimization is conducted to select designs with energy storage most similar to the energy of the ideal constant force relation. The obtained CFM designs through this framework has a higher energy similarity index compared to typical designs from literature (0.95 versus 0.90). The constant force mechanisms developed through this study can be further applied in different robot/human–environment interfaces that benefit from both mitigating impact force and increasing energy storage.
Thermosolutal Marangoni Bioconvection of a Non-Newtonian Nanofluid in a Stratified Medium
Authors: Roy Subrata , Raut Santanu , Kairi Rishi Raj
Published: June 2022

Bioconvection due to the movement of the micro-organism cells is universal and affects many ecological and biological processes, including infection, reproduction, and marine life ecosystems. The impact of the bioconvection is more significant in nanofluids. In the present problem, we investigate the Marangoni triply stratified bioconvective flow of non-Newtonian (second-grade) nanofluid with the presence of motile micro-organisms over a permeable inclined plate. The problem provides an analysis of the impact of second-order effects, namely, viscous dissipation, radiation, and chemical reaction, allowing a set of similarity transformations to convert the governing PDEs into coupled nonlinear DEs. Thereafter, Runge–Kutta Fehlberg's numerical method is employed to find the solution of the DEs for some chosen values of different flow influencing parameters. The impact of crucial parameters on the velocity, temperature, nanoparticles volume fraction, the motile density of micro-organisms, and the quantities of physical interest, namely, local Nusselt number, local Sherwood number, and local motile micro-organism density number are illustrated through the plots and tables. It is revealed that the second-grade fluid parameter indicates a prominent correlation with the Marangoni convection in the bioconvective transport mechanism. Also, the Marangoni convection is significant in bioconvective flows for large Péclet numbers.
Effect of Simulated Mass-Tunable Auxetic Midsole on Vertical Ground Reaction Force
Authors: Ford Ryan R. , Misra Manjusri , Mohanty Amar K. , Brandon Scott C. E.
Published: June 2022

When runners impact the ground, they experience a sudden peak ground reaction force (GRF), which may be up to 4× greater than their bodyweight. Increased GRF impact peak magnitude has been associated with lower limb injuries in runners. Yet, shoe midsoles are capable of cushioning the impact between the runner and the ground to reduce GRF. It has been proposed that midsoles should be tunable with subject mass to minimize GRF and reduce risk of injury. Auxetic metamaterials, structures designed to achieve negative Poisson's ratios, demonstrate superior impact properties and are highly tunable. Recently, auxetic structures have been introduced in footwear, but their effects on GRF are not documented in literature. This work investigates the viability of a three-dimensional auxetic impact structure with a tunable force plateau as a midsole through mass-spring-damper simulation. An mass-spring-damper model was used to perform 315 simulations considering combinations of seven subject masses (45–90 kg), 15 auxetic plateau forces (72–1080 N), and three auxetic damping conditions (450, 725, and 1000 Ns/m) and regression analysis was used to determine their influence on GRF impact peak, energy, instantaneous, and average loading rate. Simulations showed that tuning auxetic plateau force and damping based on subject mass may reduce GRF impact and loading rate versus simulated conventional midsoles. Auxetic plateau force and damping conditions of 450 Ns/m and ∼1 bodyweight (BW), respectively, minimized peak impact GRF. This work demonstrates the need for tunable auxetic midsoles and may inform future work involving midsole testing.
Land management can contribute to net zero
Authors: DeFries Ruth , Ahuja Richie , Friedman Julio , Gordon Doria R. , Hamburg Steven P. , Kerr Suzi , Mwangi James , Nouwen Carlijn , Pandit Nitin
Published: June 2022

The voluntary carbon market needs to embrace changes for the land sector
SARS-CoV-2 Spike Furin Cleavage Site and S2′ Basic Residues Modulate the Entry Process in a Host Cell-Dependent Manner
Authors: Lavie Muriel , Dubuisson Jean , Belouzard Sandrine
Published: June 2022

SARS-CoV-2 is responsible for the current global pandemic that has resulted in several million deaths. As the key determinant of virus entry into host cells and the main target of host immune response, the spike glycoprotein constitutes an attractive target for therapeutics development.
Ten Nearly Complete Genome Sequences of Human Orthorubulavirus 4 Isolated from Pediatric Inpatients in Fukushima, Japan
Authors: Sugimoto Satoko , Kume Yohei , Suwa Reiko , Kawase Miyuki , Kakizaki Masatoshi , Egawa Kazutaka , Ono Takashi , Chishiki Mina , Okabe Hisao , Norito Sakurako , Sato Masatoki , Sakuma Hiroko , Suzuki Shigeo , Hosoya Mitsuaki , Takeda Makoto , Hashimoto Koichi , Shirato Kazuya
Published: June 2022

We report 10 nearly complete genomic sequences of human orthorubulavirus 4, also called human parainfluenza virus 4 (HPIV4), isolated from pediatric inpatients with respiratory infections in Fukushima, Japan, by using an air-liquid interface culture of human bronchial and tracheal epithelial cells.
Petrologic constraints on the origin of Proterozoic ferroan granites of the Laurentian margin
Authors: Frost Carol D. , Frost B. Ronald
Published: June 2022

Ferroan granite is a characteristic rock type of the Laurentian margin. It is commonly associated with anorthosite and related rocks. Ferroan granites are strongly enriched in iron, are alkalic to alkali-calcic, and are generally metaluminous. These geochemical characteristics reflect their tholeiitic parental magma source and relatively reducing and anhydrous conditions of crystallization. Their compositions distinguish them from arc magmas, which are magnesian and calcic to calc-alkalic. Ferroan granite magmas are hot, which promotes partial melting of their crustal wall rocks. Assimilation of these silica-rich and peraluminous melts drives the resulting magmas to higher silica and aluminum saturation values. Where Proterozoic ferroan granites intrude Archean crust, their mantle component is readily identified isotopically, but this is more difficult where they intrude relatively juvenile crust.

Ferroan granite forms in tectonic environments that allow partial melts of tholeiitic mantle to pond and differentiate at or near the base of the crust. Phanerozoic examples occur in plume settings, such as the Snake River Plain and Yellowstone, or under certain conditions involving slab rollback, such as those that formed the Cenozoic topaz rhyolites of the western United States or ferroan rhyolites of the Sierra Madre Occidental. It is possible that the long-lived supercontinent Nuna-Rodinia, of which Laurentia was a part, formed an insulating lid that raised underlying mantle temperatures and created a unique environment that enabled emplacement of large volumes of mafic melt at the base of the crust. Ascent of felsic differentiates accompanied by variable crustal assimilation may have created large volumes of Proterozoic ferroan granite and related rocks.
Late Paleoproterozoic to early Mesoproterozoic deposition of quartz arenites across southern Laurentia
Authors: Medaris Jr. L. Gordon , Daniel Christopher G. , Doe Michael F. , Jones III James V. , Schwartz Joshua J.
Published: June 2022

Supermature siliciclastic sequences were deposited between 1.64 Ga and 1.59 Ga over a broad swath of southern Laurentia in the Archean, Penokean, Yavapai, and Mazatzal Provinces. These siliciclastic sequences are notable for their extreme mineralogical and chemical maturity, being devoid of detrital feldspar and ferromagnesian minerals, containing the clay mineral kaolinite (or its metamorphic equivalent, pyrophyllite), and having a chemical index of alteration >95. Such maturity is the result of a perfect confluence of tectonic and climatic conditions, including a stable continental crust with low topographic relief (the Archean, Penokean, and Yavapai Provinces ca. 1.70 Ga), a warm humid climate, an elevated level of atmospheric CO2, and relatively acidic pore fluids in the critical zone. The weathered detritus was transported and deposited by southward-flowing streams across the Archean, Penokean, and Yavapai Provinces, ultimately to be deposited on 1.66 Ga volcanic and volcaniclastic rocks in the Mazatzal continental arc along the southern margin of Laurentia.
Supplemental Material: What controlled the thickness of continental crust in the Archean?
Authors: Mai Vuong V. , Korenaga Jun
Published: June 2022

Reanalysis of the deformation data of quartz aggregates and the details of strain rate modeling. 
Vitamin D deficiency in South-East Asian children: a systematic review
Authors: Oktaria Vicka , Putri Dwi Astuti Dharma , Ihyauddin Zulfikar , Julia Madarina , Sulistyoningrum Dian Caturini , Koon Poh Bee , Danchin Margaret , Murni Indah Kartika
Published: June 2022

Objective

To describe the prevalence and determinants of vitamin D deficiency (VDD) among healthy children aged between 0 and 18 years living in South-East Asia (SEA).

Design

We systematically searched Ovid MEDLINE and Ovid EMBASE for observational studies assessing VDD among healthy children in the SEA region as the primary or secondary outcome from database inception to 6 April 2021. PubMed was used for e-pubs and publications not indexed in Medline. Publications that included abstracts in English were included. We performed a systematic review to describe the prevalence of VDD in SEA children.

Results

Our initial search identified 550 publications with an additional 2 publications from manual screening. Of those, 21 studies from 5 different countries (Thailand, Indonesia, Vietnam, Malaysia and Cambodia) were summarised and included in forest plots. The prevalence of VDD (<50 nmol/L) ranged from 0.9% to 96.4%, with >50% of newborns having VDD, and severe VDD (<30 nmol/L) ranged from 0% to 55.8%. Female sex and urban living were the most common determinants of VDD.

Conclusions

VDD among healthy children living in the SEA region is common. Efforts to detect VDD and the implementation of preventive measures, including education on safe sun exposure and oral vitamin D supplementation or food fortification, should be considered for key target groups, including adolescent females and pregnant and lactating women to improve the vitamin D status of newborns.

Protocol registration number

This study is registered with PROSPERO (CRD42020181600).
Clinician approach to cardiopulmonary exercise testing for exercise prescription in patients at risk of and with cardiovascular disease
Authors: D'Ascenzi Flavio , Cavigli Luna , Pagliaro Antonio , Focardi Marta , Valente Serafina , Cameli Matteo , Mandoli Giulia Elena , Mueller Stephan , Dendale Paul , Piepoli Massimo , Wilhelm Matthias , Halle Martin , Bonifazi Marco , Hansen Dominique
Published: June 2022

Exercise training is highly recommended in current guidelines on primary and secondary prevention of cardiovascular disease (CVD). This is based on the cardiovascular benefits of physical activity and structured exercise, ranging from improving the quality of life to reducing CVD and overall mortality. Therefore, exercise should be treated as a powerful medicine and critical component of the management plan for patients at risk for or diagnosed with CVD. A tailored approach based on the patient’s personal and clinical characteristics represents a cornerstone for the benefits of exercise prescription. In this regard, the use of cardiopulmonary exercise testing is well-established for risk stratification, quantification of cardiorespiratory fitness and ventilatory thresholds for a tailored, personalised exercise prescription. The aim of this paper is to provide a practical guidance to clinicians on how to use data from cardiopulmonary exercise testing towards personalised exercise prescriptions for patients at risk of or with CVD.
Process evaluation of the New Interventions for independence in Dementia Study (NIDUS) Family stream randomised controlled trial: protocol
Authors: Wyman Danielle Laura , Butler Laurie , Cooper Claudia , Bright Peter , Morgan-Trimmer Sarah , Barber Julie
Published: June 2022

Introduction

New Interventions for independence in Dementia Study (NIDUS)-Family is an Alzheimer’s Society funded new manualised, multimodal psychosocial intervention to support people living with dementia (PLWD) to achieve goals that they and their family carers set, towards living as independently and as well as possible at home for longer. This process evaluation will be embedded within the NIDUS-Family Randomised Controlled Trial intervention-arm (n=199), testing how the intervention influences change, as measured by goal attainment. The evaluation will test, refine and develop the NIDUS-Family theoretical model, associated causal assumptions and logic model to identify key mechanisms of impact, implementation and contextual factors influencing the intervention’s effectiveness. Findings will inform how the programme is implemented in practice.

Methods and analysis

The process evaluation will be theory driven and apply a convergent mixed-methods design. Dyads (PLWD and family carer) will be purposively sampled based on high or low Goal Attainment Scaling scores (trial primary outcome). Qualitative interviews with dyads (approx. n=30) and their respective facilitators post-trial will explore their experiences of receiving and delivering the intervention. Interviews will be iteratively thematically analysed. Matching observational quantitative data will be collected concurrently from videorecordings and/or audiorecordings of NIDUS-Family dyad trial sessions. Further quantitative data will be collected through an acceptability questionnaire for all intervention-arm dyads (n=199). Mixed-method integration will use an interactive analysis strategy, considering qualitative and quantitative findings through mixed-method matrix for dyadic level ‘case studies’, and a joint display for ‘population’ level analysis and interpretation.

Ethics and dissemination

Ethical approval was received from Camden & Kings Cross Research Ethics Committee (REC). Study reference: 19/LO/1667. IRAS project ID: 271 363. This work is carried out within the UCL Alzheimer’s Society Centre of Excellence (grant 300) for Independence at home, NIDUS programme.

Findings will be disseminated through publications and conferences, and as recommendations for the implementation study and strategy.

Trial registration number

ISRCTN11425138.
Patient-reported systemic symptoms in women with silicone breast implants: a descriptive cohort study
Authors: Spit Karlinde Amber , Scharff Miranda , de Blok Christel JM , Niessen Frank B , Bachour Yara , Nanayakkara Prabath W
Published: June 2022

Objective

An unknown portion of women with silicone breast implants (SBI) report development of systemic symptoms, recently named as ‘breast implant illness (BII)’. We aim to describe the symptoms and characteristics of women with SBI reporting these systemic symptoms and compare the clinical course of women who chose to keep their implants, to women who had their implants removed.

Design

Observational cohort study.

Setting

Specialised BII out-patient clinic at Amsterdam UMC, the Netherlands, from 2011 to 2020.

Participants

All women presenting to the BII clinic with SBI and systemic symptoms.

Results

467 women were included for baseline analyses and 398 women for follow-up. Most frequently reported systemic symptoms at baseline included fatigue (88%), arthralgia (71%), morning stiffness (59%), myalgia (48%), cognitive impairment (33%), peripheral neurological symptoms (30%) and lymphadenopathy (22%). Furthermore, 56% reported pre-existing allergies at baseline and positive antinuclear antibodies were observed in 23%. At follow-up with a median of 3.3 years (IQR 2–4), 152 women had their implants removed on clinical grounds. Symptoms improved significantly in 65 women (43%), improved moderately in 37 women (24%), did not change in 37 women (24%) and deteriorated in 13 women (9%). Women who underwent explantation showed more improvement of their systemic symptoms compared with women who did not (OR 2.9, 95% CI 1.3 to 6.2). Additionally, women who underwent explantation within 10 years after implantation improved significantly better than women who got the implants removed after 10 years (p=0.007). Lastly, local symptoms decreased from 75% to 34% after implant removal (p<0.0001).

Conclusion

Most women with SBI who developed systemic symptoms experienced improvement after explantation, especially when removed within 10 years after implantation. Early recognition of the pattern of systemic symptoms in women with SBI is important and implant removal should be considered.
Community paramedicine: cost–benefit analysis and safety evaluation in paramedical emergency services in rural areas – a scoping review
Authors: Elden Odd Eirik , Uleberg Oddvar , Lysne Marianne , Haugdahl Hege Selnes
Published: June 2022

Objective

To examine the current knowledge and possibly identify gaps in the knowledge base for cost–benefit analysis and safety concerning community paramedicine in rural areas.

Design

Scoping review.

Data sources

MEDLINE via PubMed, CINAHL, Cochrane and Embase up to December 2020.

Study selection

All English studies involving community paramedicine in rural areas, which include cost–benefit analysis or safety evaluation.

Data extraction

This scoping review follows the methodology developed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We systematically searched for all types of studies in the databases and the reference lists of key studies to identify studies for inclusion. The selection process was in two steps. First, two reviewers independently screened 2309 identified articles for title and abstracts and second performed a full-text review of 24 eligible studies for inclusion.

Results

Three articles met the inclusion criteria concerning cost–benefit analysis, two from Canada and one from USA. No articles met the inclusion criteria for safety evaluation.

Conclusion

There are knowledge gaps concerning safety evaluation of community paramedicine in rural areas. Three articles were included in this scoping review concerning cost–benefit analysis, two of them showing positive cost-effectiveness with community paramedicine in rural areas.
Planned, ongoing and completed tuberculosis treatment trials in Brazil, Russia, India, China and South Africa: a 2019 cross-sectional descriptive analysis
Authors: Mathebula Lindi , Mapahla Lovemore , Nurkhametova Dilyara , Ziganshina Liliya Eugenevna , Mazinu Mikateko , Jordan Esme , Ndwandwe Duduzile Edith , Kredo Tamara
Published: June 2022

Tuberculosis (TB) remains a deadly challenge globally and Brazil, Russia, India, China and South Africa (BRICS) are among the countries with the highest TB burden. The objective of this study is to identify and describe ongoing, planned and completed TB trials conducted in the BRICS countries registered in WHO-International Clinical Trial Registry Platform (WHO-ICTRP); to report selective outcome reporting by comparing primary outcomes in published trials with their prespecified outcomes in registry records and to evaluate the time to publication.

Methods and analysis

We searched the WHO-ICTRP portal (20 January 2019) and the Russian Federation Registry (30 March 2019) to identify TB trials conducted in BRICS countries. We included only registered clinical trials conducted wholly in BRICS countries or with at least one recruitment centre in one of the BRICS countries that were investigating TB treatment.

Results

The search of the WHO-ICTRP yielded 408 trials and additional 32 trials were identified from the Russian registry. Of those, 253 were included in the analysis. We found that 77 trials were multicountry trials, followed by trials in China (55), India (53), South Africa (34), Russia (23) and Brazil (11). 163 trials were registered prospectively, 69 retrospectively and 21 trials had no registration status. Most trials (207) evaluated TB treatment, followed by 29 behaviour change interventions, 13 nutritional supplementation, 4 surgical treatment and 2 assessing rehabilitation. Based on ICJME recommendation of publishing 12 months after completion of trial, we found that 156 trials were completed 12 or more months by date and 101 trials had publications. Thirty-one of the 101 trials with publication had evidence of selective outcome reporting. The median time to publication was 25 months (IQR 15–37) from the time of anticipated end date stated in the registry.

Conclusion

TB trials conducted in BRICS countries are collaborative, mostly drug treatment oriented, potentially affecting policies. Selective outcome reporting remains a problem both for prospectively and retrospectively registered trials, only small fraction of which gets to publication.
Clinical features and direct medical cost of splenic injury in China: a cross-sectional study
Authors: Chen Yong , Liu Yan , Ma Yubo , Qi Yong , Zhang Qiu , Zhou Ji-Hong
Published: June 2022

Objectives

This study analyses the clinical features and direct medical cost (DMC) of splenic injury during 2000–2013 in China.

Design

This was a cross-sectional study.

Methods

We used ‘The No. 1 Military Medical Project’ information system to conduct a retrospective study. Patients’ information from 2000 to 2013 were identified. Demographic data, treatment, clinical data and DMC were collected. We performed a generalised linear method (GLM) using gamma distribution to assess the drivers of DMCs.

Results

We included 8083 patients with splenic injury who met the study criteria. Over the 14-year study period, 2782 (34.4%) patients were treated with non-operative management (NOM), 5301 (65.6%) with OM. From 2000 to 2013, the rate of NOM increased from 34.7% to 55.9%, while OM decreased from 65.3% to 44.1%. Mean per-patient DMC in both NOM and OM increased from 2000 to 2013. In GLM analysis, male, old age, length of stay, severe splenic injury grade, OM, intensive care unit, blood transfusion and tertiary hospitals were associated with higher DMC, while female and NOM was associated with lower DMC.

Conclusions

In China, management of splenic injury was the most important factor impacting the total DMC. Proper management and public policy could curtail the burden of splenic injury.
Geographical accessibility of emergency neonatal care services in Ethiopia: analysis using the 2016 Ethiopian Emergency Obstetric and Neonatal Care Survey
Authors: Kibret Getiye Dejenu , Demant Daniel , Hayen Andrew
Published: June 2022

Introduction

Access to emergency neonatal health services has not been explored widely in the Ethiopian context. Accessibility to health services is a function of the distribution and location of services, including distance, travel time, cost and convenience. Measuring the physical accessibility of health services contributes to understanding the performance of health systems, thereby enabling evidence-based health planning and policies. The physical accessibility of Ethiopian health services, particularly emergency neonatal care (EmNeC) services, is unknown.

Objective

To analyse the physical accessibility of EmNeC services at the national and subnational levels in Ethiopia.

Methods

We analysed the physical accessibility of EmNeC services within 30, 60 and 120 min of travel time in Ethiopia at a national and subnational level. We used the 2016 Ethiopian Emergency Obstetric and Neonatal Care survey in addition to several geospatial data sources.

Results

We estimated that 21.4%, 35.9% and 46.4% of live births in 2016 were within 30, 60 and 120 min of travel time of fully EmNeC services, but there was considerable variation across regions. Addis Ababa and the Hareri regional state had full access (100% coverage) to EmNeC services within 2 hours travel time, while the Afar (15.3%) and Somali (16.3%) regional states had the lowest access.

Conclusions

The physical access to EmNeC services in Ethiopia is well below the universal health coverage expectations stated by the United Nations. Increasing the availability of EmNeC to health facilities where routine delivery services currently are taking place would significantly increase physical access. Our results reinforce the need to revise service allocations across administrative regions and consider improving disadvantaged areas in future health service planning.
Development of a machine learning-based prediction model for extremely rapid decline in estimated glomerular filtration rate in patients with chronic kidney disease: a retrospective cohort study using a large data set from a hospital in Japan
Authors: Inaguma Daijo , Hayashi Hiroki , Yanagiya Ryosuke , Koseki Akira , Iwamori Toshiya , Kudo Michiharu , Fukuma Shingo , Yuzawa Yukio
Published: June 2022

Objectives

Trajectories of estimated glomerular filtration rate (eGFR) decline vary highly among patients with chronic kidney disease (CKD). It is clinically important to identify patients who have high risk for eGFR decline. We aimed to identify clusters of patients with extremely rapid eGFR decline and develop a prediction model using a machine learning approach.

Design

Retrospective single-centre cohort study.

Settings

Tertiary referral university hospital in Toyoake city, Japan.

Participants

A total of 5657 patients with CKD with baseline eGFR of 30 mL/min/1.73 m2 and eGFR decline of ≥30% within 2 years.

Primary outcome

Our main outcome was extremely rapid eGFR decline. To study-complicated eGFR behaviours, we first applied a variation of group-based trajectory model, which can find trajectory clusters according to the slope of eGFR decline. Our model identified high-level trajectory groups according to baseline eGFR values and simultaneous trajectory clusters. For each group, we developed prediction models that classified the steepest eGFR decline, defined as extremely rapid eGFR decline compared with others in the same group, where we used the random forest algorithm with clinical parameters.

Results

Our clustering model first identified three high-level groups according to the baseline eGFR (G1, high GFR, 99.7±19.0; G2, intermediate GFR, 62.9±10.3 and G3, low GFR, 43.7±7.8); our model simultaneously found three eGFR trajectory clusters for each group, resulting in nine clusters with different slopes of eGFR decline. The areas under the curve for classifying the extremely rapid eGFR declines in the G1, G2 and G3 groups were 0.69 (95% CI, 0.63 to 0.76), 0.71 (95% CI 0.69 to 0.74) and 0.79 (95% CI 0.75 to 0.83), respectively. The random forest model identified haemoglobin, albumin and C reactive protein as important characteristics.

Conclusions

The random forest model could be useful in identifying patients with extremely rapid eGFR decline.

Trial registration

UMIN 000037476; This study was registered with the UMIN Clinical Trials Registry.
Are free school meals failing families? Exploring the relationship between child food insecurity, child mental health and free school meal status during COVID-19: national cross-sectional surveys
Authors: Yang Tiffany C , Power Madeleine , Moss Rachael H , Lockyer Bridget , Burton Wendy , Doherty Bob , Bryant Maria
Published: June 2022

Objective

Food insecurity is linked to poor health and well-being in children and rising prevalence rates have been exacerbated by COVID-19. Free school meals (FSM) are considered a critical tool for reducing the adverse effects of poverty but apply a highly restrictive eligibility criteria. This study examined levels of food security and FSM status to support decision-making regarding increasing the current eligibility criteria.

Design

Two cross-sectional national surveys administered in August–September 2020 and January–February 2021 were used to examine the impact of COVID-19 on the food experiences of children and young people.

Setting

UK.

Participants

2166 children (aged 7–17 years) and parents/guardians.

Main outcome measures

Participant characteristics were described by food security and FSM status; estimated marginal means were calculated to obtain the probability of poor mental health, expressed as children reporting feeling stressed or worried in the past month, by food security status and FSM status.

Results

We observed food insecurity among both children who did and did not receive of FSM: 23% of children not receiving FSM were food insecure. Children who were food insecure had a higher probability of poor mental health (31%, 95% CI: 23%, 40%) than children who were food secure (10%, 95% CI: 7%, 14%). Food insecure children receiving FSM had a higher probability of poor mental health (51%, 95% CI: 37%, 65%) than those who were food insecure and not receiving FSM (29%, 95% CI: 19%, 42%).

Conclusion

Many children experienced food insecurity regardless of whether they received FSM, suggesting the eligibility criteria needs to be widened to prevent overlooking those in need.