bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Integrated Design Method of Parallel Mechanisms Based on Performance Requirements
Authors: Li Shihua , Niu Yunzhan , Xu Jilong , Yu Haibo
Published: May 2023

Due to the lack of connection between configuration synthesis and performance indices, many configurations obtained cannot meet the performance requirements, increasing the difficulty of configuration selection and prolonging the design cycle of the parallel mechanism (PM). In order to solve this problem, this paper proposes an inverse Jacobian matrix construction method based on performance indices. The method is realized by constructing singular values and singular vectors directly related to the performance indices. Furthermore, based on the screw expression form of the inverse Jacobian matrix, a new integrated design method that can directly meet the performance requirements is proposed. Finally, a novel ankle rehabilitation mechanism is presented using this method, and the correctness and effectiveness of the integrated design method are verified by theoretical analysis. Meanwhile, the analysis results show that the proposed method can effectively shorten PM’s design time and simplify PM’s design process, which has a good application value.
Magnetic Resonance Velocimetry Measurements of Internal Blade Cooling Flow and Computational Fluid Dynamic Validation by Data Matching With the Experimental Data
Authors: Wüstenhagen Carolin , Domnick Clemens , John Kristine , Bruschewski Martin , Grundmann Sven
Published: May 2023

The optimal Reynolds-averaged Navier–Stokes (RANS) turbulence model to be used in a Computational Fluid Dynamics (CFD) simulation varies depending on the application. Conventionally, the model is selected from benchmark tests and experience, but its performance is difficult to predict. For this reason, this study presents a cost-effective CFD validation routine, which uses three-dimensional experimental velocity data obtained in replicas of the specific flow system. Magnetic Resonance Velocimetry is used as the measurement technique. Since the objective is only the validation of the turbulence model, the experiment and the simulation are performed with simplified flow conditions, hence stationary isothermal isovolumetric flow without inertial forces. The routine applies a data-matching routine to align the two three-dimensional data sets before they are interpolated on a common grid. Various error metrics are presented, which provide the degree of the CFD modeling error and indicate its source. For demonstration, the validation routine is used to evaluate RANS-CFD results of a three-pass internal cooling system of a high-pressure turbine airfoil used in a small industrial gas turbine. The simulations are performed with the eddy-viscosity-based turbulence model k–ω shear stress transport (SST), the Reynolds-stress Speziale, Sarkar and Gatski (SSG), and baseline-Explicit algebraic Reynolds stress model turbulence (BSL-EARSM) models. The results indicate strong local errors in the examined turbulence models. None of the models performed well enough, underlining that every RANS-CFD application needs to be validated.
Computational Study of Heat Exchange and Thermal Oxidative Coking of Supercritical-Pressure Kerosene With Compressed Air in Counterflows
Authors: Tan Ting , Yuan Yuan , Sun Xing , Meng Hua
Published: May 2023

The Cooled Cooling Air (CCA) technology could be effectively used in an advanced gas turbine engine to reduce temperature of the highly compressed air and recover its cooling capacity, using the onboard fuel as coolant. Computational investigations are conducted to analyze heat exchange between the supercritical-pressure aviation kerosene and the compressed high-temperature air in a double-pipe counterflow configuration, intended for the CCA applications. The thermal oxidation reactions and surface coking of kerosene are taken into consideration based on a validated chemical mechanism. Results indicate that the air tube diameter should be determined to obtain not only the improved overall thermal performance on the air side, regarding both heat transfer and pressure drop, but also the properly limited maximum temperature on the fuel side to avoid the strong pyrolysis chemical reactions of kerosene and the resulting fast surface coking process. Although the ribbed and dimpled surface structures are both able to improve the overall thermal performance in the fuel tube and increase the bulk air temperature reduction, they also lead to the increased surface coking rate from the thermal oxidation reactions. The thermal oxidative coking process would gradually increase heat transfer barrier and cause an adverse effect on the long-time and efficient operation of a heat exchanger. Numerical results obtained in this paper should have fundamental and practical importance in CCA applications.
XPS spectra from nucleobases, DNA, and RNA
Authors: Ramstedt Madeleine , Shchukarev Andrey
Published: May 2023

X-ray photoelectron spectroscopy was used to analyze commercially available powders of thymine, uracil, cytosine, guanine, adenine, as well as DNA isolated from salmon testes and RNA from torula yeast. The powders were pressed onto a sample holder and analyzed as received from the manufacturer. Survey spectra and high-resolution spectra of O 1s, N 1s, C 1s of all nucleobases are reported, including a small Na 1s contamination in cytosine. Spectra of DNA and RNA are also included for comparison. Furthermore, the presented data are compared with previously published results, as well as theoretical values, and differences are discussed.
The behavior of standing waves near the end of an open pipe with low mean flow
Authors: Moore Thomas R. , Kellison Makayle S. , Coyle Whitney L.
Published: May 2023

The acoustic standing wave near the end of an open pipe is investigated using spectrally analyzed high-speed transmission electronic speckle pattern interferometry. It is shown that the standing wave extends beyond the open end of the pipe and the amplitude decays exponentially with distance from the end. Additionally, a pressure node is observed near the end of the pipe in a position that is not spatially periodic with the other nodes in the standing wave. A sinusoidal fit to the amplitude of the standing wave inside the pipe indicates that the end correction is well predicted by current theory.
Population Pharmacokinetic Analyses for Tebipenem after Oral Administration of Pro-Drug Tebipenem Pivoxil Hydrobromide
Authors: Ganesan H. , Gupta V. K. , Safir M. C. , Bhavnani S. M. , Talley A. K. , Melnick D. , Rubino C. M.
Published: May 2023

Tebipenem pivoxil hydrobromide (TBP-PI-HBr) is an oral (PO) carbapenem pro-drug that is converted to the active moiety tebipenem in the enterocytes. Tebipenem has activity against multidrug-resistant Gram-negative pathogens, including extended-spectrum beta lactamase-producing Enterobacterales, and is being developed for the treatment of patients with complicated urinary tract infections (cUTI) and acute pyelonephritis (AP).
Arginine Metabolism Powers Salmonella Resistance to Oxidative Stress
Authors: Margolis Alyssa , Liu Lin , Porwollik Steffen , Till James Karl A. , Chu Weiping , McClelland Michael , Vázquez-Torres Andrés
Published: May 2023

Salmonella
invades host cells and replicates inside acidified, remodeled vacuoles that are exposed to reactive oxygen species (ROS) generated by the innate immune response. Oxidative products of the phagocyte NADPH oxidase mediate antimicrobial activity, in part, by collapsing the ΔpH of intracellular
Salmonella
.
The Unique N-Terminal Domain of Chlamydial Bactofilin Mediates Its Membrane Localization and Ring-Forming Properties
Authors: Lee Junghoon , Cox John V. , Ouellette Scot P.
Published: May 2023

Bacteria use a variety of filament-forming cytoskeletal proteins to regulate and control various aspects of their physiology. For example, the tubulin-like FtsZ recruits division proteins to the septum whereas the actin-like MreB recruits peptidoglycan (PG) synthases to generate the cell wall in rod-shaped bacteria.
CsrA-Mediated Translational Activation of the
hmsE
mRNA Enhances HmsD-Dependent C-di-GMP-Enabled Biofilm Production in Yersinia pestis
Authors: Silva-Rohwer Amelia R. , Held Kiara , Yakhnin Helen , Babitzke Paul , Vadyvaloo Viveka
Published: May 2023

Mutations enhancing c-di-GMP biosynthesis drove the evolution of
Y. pestis
to flea-borne transmissibility. c-di-GMP-dependent biofilm-mediated blockage of the flea foregut enables regurgitative transmission of
Y. pestis
by fleabite. The
Y. pestis
diguanylate cyclases (DGC), HmsT and HmsD, which synthesize c-di-GMP, play significant roles in transmission.
Clinical Performance Evaluation of a Rapid Real-Time PCR Assay for Monkeypox Diagnosis: a Retrospective and Comparative Study
Authors: Peris María Paz , Clusa Laura , Alonso Henar , Escolar Cristina , Fortuño Blanca , Rezusta Antonio , Milagro Ana
Published: May 2023

Given that a large number of mpox outbreaks have been reported worldwide since 2022 in countries in which the disease is not endemic, the main concern for clinicians and global health systems should be to develop effective, available, and easy-to-implement diagnostic strategies to interrupt mpox transmission as soon as possible. This retrospective study demonstrates the satisfactory clinical parameters of a commercially available molecular diagnostic kit for routine testing for mpox in clinical diagnostic laboratories.
Whole-Genome Analysis of Bordetella pertussis MT27 Isolates from School-Associated Outbreaks: Single-Nucleotide Polymorphism Diversity and Threshold of the Outbreak Strains
Authors: Kamachi Kazunari , Koide Kentaro , Otsuka Nao , Goto Masataka , Kenri Tsuyoshi
Published: May 2023

Bordetella pertussis
is a highly infectious bacterium that easily causes pertussis outbreaks in humans, especially in school-aged children. In detection and investigation of outbreaks, excluding non-outbreak isolates is important for understanding the bacterial transmission routes.
Using Genomics To Investigate an Outbreak of Vancomycin-Resistant Enterococcus faecium ST78 at a Large Tertiary Hospital in Queensland
Authors: Permana Budi , Harris Patrick N. A. , Runnegar Naomi , Lindsay Margaret , Henderson Belinda C. , Playford E. G. , Paterson David L. , Beatson Scott A. , Forde Brian M.
Published: May 2023

Vancomycin-resistant
Enterococcus faecium
(VREfm) is a leading cause of health care-associated infections (HAIs) globally. In Australia, the spread of hospital-adapted VREfm is largely driven by a single clonal group (clonal complex [CC]), CC17, to which the lineage ST78 belongs.
Characteristics of the Salivary Microbiota in Periodontal Diseases and Potential Roles of Individual Bacterial Species To Predict the Severity of Periodontal Disease
Authors: Ji Suk , Kook Joong-Ki , Park Soon-Nang , Lim Yun Kyong , Choi Geum Hee , Jung Jae-Suk
Published: May 2023

Periodontal disease is one of the most widespread medical conditions and the leading cause of tooth loss, imposing high economic costs and an increasing burden worldwide as life expectancy increases. Changes in the subgingival bacterial community during the progression of periodontal disease can affect the entire oral ecosystem, and bacteria in saliva can reflect the degree of bacterial imbalance in the oral cavity.
Plasmodium falciparum Gametes and Sporozoites Hijack Plasmin and Factor H To Evade Host Complement Killing
Authors: Ernest Medard , Rosa Thiago F. A. , Pala Zarna Rajeshkumar , Kudyba Heather M. , Sweeney Brendan , Reiss Timo , Pradel Gabriele , Vega-Rodríguez Joel
Published: May 2023

Current approaches to control malaria are complicated by the development of antimalarial-resistant parasites and insecticide-resistant vectors. Vaccines that block transmission to mosquitoes and humans are a plausible alternative to overcome these setbacks.
Assay Harmonization Study To Measure Immune Response to SARS-CoV-2 Infection and Vaccines: a Serology Methods Study
Authors: Kemp Troy J. , Hempel Heidi A. , Pan Yuanji , Roy Daisy , Cherry James , Lowy Douglas R. , Pinto Ligia A.
Published: May 2023

Previous studies have shown significant variability in SARS-CoV-2 antibody serology assays, highlighting the need for evaluation and comparison of these assays using the same set of samples covering a wide range of antibody responses induced by infection or vaccination. This study demonstrated that there are high performing assays that can be used reliably to evaluate immune responses to SARS-CoV-2 in the context of infection and vaccination.
Cross-Platform Transcriptomic Data Integration, Profiling, and Mining in
Vibrio cholerae
Authors: Qin Zi-Xin , Chen Guo-Zhong , Yang Qian-Qian , Wu Ying-Jian , Sun Chu-Qing , Yang Xiao-Man , Luo Mei , Yi Chun-Rong , Zhu Jun , Chen Wei-Hua , Liu Zhi
Published: May 2023

We used two techniques to integrate RNA-seq data for laboratory studies with clinical microarray data for the first time. The interactions between
V. cholerae
genes were obtained from a global perspective, as well as comparing the similarity between clinical human samples and the current experimental conditions, and uncovering the functional modules that play a major role under different conditions.
U–Pb Age of Detrital Zircon in the Cement of Early Precambrian Polymict Conglomerates of the Central Karelia Domain, Karelian Province, Fennoscandian Shield
Authors: Kucherovskiy G. A. , Chekulaev V. P. , Kuznetsov A. B. , Egorova J. S. , Arestova N. A. , Zaitseva T. S. , Adamskaya E. V. , Plotkina Yu. V.
Published: May 2023

U–Th–Pb LA-ICP-MS was used for dating detrital zircon extracted from the cement of Neoarchean and Paleoproterozoic polymict conglomerates of the Karelian Province, Fennoscandian Shield. The chemical composition of terrigenous and volcanogenic rocks of the Gimolskaya Formation is presented for the first time. The data obtained showed that the detrital zircon from the cement of conglomerates of different ages yields similar results of about 2750 Ma. The clasts of the gneiss tonalite and plagioporphyry dominate in the Neoarchean conglomerates of the Sukkosero area. They are identical in chemical composition with the Neoarchean (2.78–2.73 Ga) TTG, granodiorite, and metadacite of the Central Karelian domain. These rocks are distinguished by an increased content of Ba (900–1200 ppm) and Sr (600–700 ppm), and the ratios Sr/Y = 34–90 and (La/Yb)n = 17–30. The chemical composition of the cement (values of CIA < 55 and negative values of the function DF(x)) from –1.0 to –0.4 is similar to the composition of clasts, which means the cement is composed of finer clasts of the same rocks. The Paleoproterozoic conglomerates of the Vottomuks area contain zircon from felsic rocks of the Neoarchean basement. The chemical composition of the cement of the Paleoproterozoic conglomerates and the predominance of basaltic andesites of Sumian are evidence of the post-Sumian(<2.45 Ga) age of these rocks. The absence of the Paleoproterozoic zircon in cement could have resulted from its absence in the Paleoproterozoic source rocks. The age of Neoarchean conglomerates from the Gimolskaya Formation is less than 2.75 Ga.
Defining representativeness of study samples in medical and population health research
Authors: Rudolph Jacqueline E , Zhong Yongqi , Duggal Priya , Mehta Shruti H , Lau Bryan
Published: May 2023

Medical and population health science researchers frequently make ambiguous statements about whether they believe their study sample or results are representative of some (implicit or explicit) target population. This article provides a comprehensive definition of representativeness, with the goal of capturing the different ways in which a study can be representative of a target population. It is proposed that a study is representative if the estimate obtained in the study sample is generalisable to the target population (owing to representative sampling, estimation of stratum specific effects, or quantitative methods to generalise or transport estimates) or the interpretation of the results is generalisable to the target population (based on fundamental scientific premises and substantive background knowledge). This definition is explored in the context of four covid-19 studies, ranging from laboratory science to descriptive epidemiology. All statements regarding representativeness should make clear the way in which the study results generalise, the target population the results are being generalised to, and the assumptions that must hold for that generalisation to be scientifically or statistically justifiable.
Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: a single-centre, cross-sectional study in Morocco
Authors: Alahiane Latifa , Zaam Youssef , Abouqal Redouane , Belayachi Jihane
Published: May 2023

Objectives

To describe the sociodemographic, occupational and health factors that influence nurses’ recognition at work and to examine a recognition pathway model to assess the relationship between recognition at work and health-related quality of life (HRQOL), job satisfaction, anxiety and depression.

Design

This is a cross-sectional observational study with prospective data collection based on a self-report questionnaire.

Setting

University hospital centre in Morocco.

Participants

The study included 223 nurses with at least 1 year of practice at the bedside in care units.

Measures

We included the sociodemographic, occupational and health characteristics of each participant. The Fall Amar instrument was used to measure job recognition. HRQOL was measured using the Medical Outcome Study Short Form 12. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Job satisfaction was measured using a rating scale (ranging from 0 to 10). Path analysis was used to examine the nurse recognition pathway model to assess the relationship between nurse recognition at work and key variables.

Results

The participation rate in this study was 79.3%. Institutional recognition was significantly correlated with gender, midwifery specialty and normal work schedule: β=−5.10 (−8.06, −2.14), β=−5.13 (−8.66, −1.60) and β=−4.28 (−6.85, −1.71), respectively. Significant correlations were found between recognition from superiors and gender, mental health specialisation and normal work schedule: β=−5.71 (−9.39, −2.03), β=−5.96 (−11.17, −0.75) and β=−4.04(−7.23, −0.85), respectively. Recognition from coworkers was significantly associated with mental health specialisation: β=−5.09 (−9.16, −1.01). The trajectory analysis model found that supervisor recognition had the best impact on anxiety, job satisfaction and HRQOL.

Conclusions

Recognition from superiors is important in maintaining nurses’ psychological health, HRQOL and job satisfaction. Therefore, managers in hospitals should address the issue of recognition at work as a potential personal, professional and organisational lever.
Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions: evidence from a mixed methods observational study in Busia and Mandera counties
Authors: Kaduka Lydia , Olale Joanna , Karamanos Alexis , Mutai Joseph , Coultas Clare , Ahmed Ismail , L'Esperance Veline , Read Ursula , Dazzan Paola , Cruickshank John Kennedy , Muniu Erastus , Harding Seeromanie
Published: May 2023

Objectives

Kenya has long and porous borders with its neighbouring countries. These regions, predominantly inhabited by highly mobile rural communities with strong cross-border cultural ties, present major challenges in managing movement of people and COVID-19 preventive measures. Our study sought to assess knowledge of COVID-19 prevention behaviours, how these varied by socioeconomic (SEC) factors and the challenges of engagement and implementation, in two border counties of Kenya.

Methods

We conducted a mixed methods study using a household e-survey (Busia, N=294; Mandera, N=288; 57% females, 43% males), and qualitative telephone interviews (N=73: Busia 55; Mandera 18) with policy actors, healthcare workers, truckers and traders, and community members. Interviews were transcribed, English translated and analysed using the framework method. Associations between SEC (wealth quintiles, educational level) and knowledge of COVID-19 preventive behaviours were explored using Poisson regression.

Results

Participants were mostly educated to primary school level (54.4% Busia, 61.6% Mandera). Knowledge of COVID-19 prevention varied by behaviour: hand washing-86.5%, use of hand sanitiser-74.8%, wearing a face mask-63.1%, covering the mouth when sneezing or coughing-56.3% and social distancing-40.1%. Differences in knowledge by area, educational level and the wealth index were marked, greatest for Mandera, the less educated and the poor. Interviews with stakeholders revealed challenges in health messaging, psychosocial and socioeconomic factors, lack of preparedness for truck border crossings, language barrier, denial and livelihood insecurity as key challenges to engagement with and implementation of COVID-19 prevention behaviours in the border regions.

Conclusion

The influence of SEC disparities and border dynamics on knowledge and engagement with COVID-19 prevention behaviours calls for contextually appropriate risk communication strategies that are cognisant of community needs and local patterns of information flow. Coordinating response measures across border points is crucial in winning communities’ trust and maintaining essential economic and social activities.
Predisposing, enabling and reinforcing factors associated with opioid addiction helping behaviour in tri-state Appalachian counties: application of the PRECEDE–PROCEED model–cross-sectional analysis
Authors: Wilkerson Amanda H , Sharma Manoj , Davis Robert E , Stephens Philip M , Kim Richard W , Bhati Deepak , Nahar Vinayak K
Published: May 2023

Objectives

The overdose epidemic was designated a ‘Public Health Emergency’ in the USA on 26 October 2017, bringing attention to the severity of this public health problem. The Appalachian region remains substantially impacted by the effects from years of overprescription of opioids, and subsequently opioid non-medical use and addiction. This study aims to examine the utility of the PRECEDE–PROCEED model constructs (ie, predisposing, reinforcing and enabling factors) to explain opioid addiction helping behaviour (ie, helping someone who has an opioid addiction) among members of the public living in tri-state Appalachian counties.

Design

Cross-sectional study.

Setting

Rural county in the Appalachian region of the USA.

Participants

A total of 213 participants from a retail mall in a rural Appalachian Kentucky county completed the survey. Most participants were between the ages of 18 and 30 years (n=68; 31.9%) and identified as men (n=139; 65.3%).

Primary outcome measure

Opioid addiction helping behaviour.

Results

The regression model was significant (F(6, 180)=26.191, p<0.001) and explained 44.8% of the variance in opioid addiction helping behaviour (R2=0.448). Attitude towards helping someone with opioid addiction (B=0.335; p<0.001), behavioural skills (B=0.208; p=0.003), reinforcing factors (B=0.190; p=0.015) and enabling factors (B=0.195; p=0.009) were all significantly associated with opioid addiction helping behaviour.

Conclusions

PRECEDE–PROCEED model constructs have utility to explain opioid addiction helping behaviour among individuals in a region greatly impacted by the overdose epidemic. This study provides an empirically tested framework for future programmes addressing helping behaviour related to opioid non-medical use.
Impact of pausing elective hip and knee replacement surgery during winter 2017 on subsequent service provision at a major NHS Trust: a descriptive observational study using interrupted time series
Authors: Jones Tim , Penfold Chris , Redaniel Maria Theresa , Eyles Emily , Keen Tim , Elliott Andrew , Blom Ashley W , Judge Andrew
Published: May 2023

Objectives

To explore the impact of a temporary cancellation of elective surgery in winter 2017 on trends in primary hip and knee replacement at a major National Health Service (NHS) Trust, and whether lessons can be learnt about efficient surgery provision.

Design and setting

Observational descriptive study using interrupted time series analysis of hospital records to explore trends in primary hip and knee replacement surgery at a major NHS Trust, as well as patient characteristics, 2016–2019.

Intervention

A temporary cancellation of elective services for 2 months in winter 2017.

Outcomes

NHS-funded hospital admissions for primary hip or knee replacement, length of stay and bed occupancy. Additionally, we explored the ratio of elective to emergency admissions at the Trust as a measure of elective capacity, and the ratio of public to private provision of NHS-funded hip and knee surgery.

Results

After winter 2017, there was a sustained reduction in the number of knee replacements, a decrease in the proportion of most deprived people having knee replacements and an increase in average age for knee replacement and comorbidity for both types of surgery. The ratio of public to private provision dropped after winter 2017, and elective capacity generally has reduced over time. There was clear seasonality in provision of elective surgery, with less complex patients admitted during winter.

Conclusions

Declining elective capacity and seasonality has a marked effect on the provision of joint replacement, despite efficiency improvements in hospital treatment. The Trust has outsourced less complex patients to independent providers, and/or treated them during winter when capacity is most limited. There is a need to explore whether these are strategies that could be used explicitly to maximise the use of limited elective capacity, provide benefit to patients and value for money for taxpayers.
Disease-modifying therapies and cost-of-illness progression among people newly diagnosed with multiple sclerosis: a national register-based cohort study covering treatment initiation with interferons, glatiramer acetate or natalizumab
Authors: Karampampa Korinna , Gyllensten Hanna , Friberg Emilie , Murley Chantelle , Kavaliunas Andrius , Hillert Jan , Olsson Tomas , Alexanderson Kristina
Published: May 2023

Objectives

Disease-modifying therapies (DMTs) can slow disease progression in multiple sclerosis (MS). The objective of this study was to explore the cost-of-illness (COI) progression among newly diagnosed people with MS in relation to the first DMT received.

Design and setting

A cohort study using data from nationwide registers in Sweden.

Participants

People with MS (PwMS) in Sweden first diagnosed in 2006–2015, when aged 20–55, receiving first-line therapy with interferons (IFN), glatiramer acetate (GA) or natalizumab (NAT). They were followed up through 2016.

Outcome measures

Outcomes (in Euros, €) were: (1) secondary healthcare costs: specialised outpatient and inpatient care including out-of-pocket expenditure, DMTs including hospital-administered MS therapies, and prescribed drugs, and (2) productivity losses: sickness absence and disability pension. Descriptive statistics and Poisson regression were computed, adjusting for disability progression using the Expanded Disability Status Scale.

Results

3673 newly diagnosed PwMS who were treated with IFN (N=2696), GA (N=441) or NAT (N=536) were identified. Healthcare costs were similar for the INF and GA groups, while the NAT group had higher costs (p value<0.05), owing to DMT and outpatient costs. IFN had lower productivity losses than NAT and GA (p value>0.05), driven by fewer sickness absence days. NAT had a trend towards lower disability pension costs compared with GA (p value>0.05).

Conclusions

Similar trends over time for healthcare costs and productivity losses were identified across the DMT subgroups. PwMS on NAT maintained their work capacity for a longer time compared with those on GA, potentially leading to lower disability pension costs over time. COI serves as an objective measure to explore the importance of DMTs in maintaining low levels of progression of MS over time.
Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey
Authors: Russell James Baligeh Walter , Koroma Theresa Ruba , Sesay Santigie , Samura Sallieu Kabay , Lakoh Sulaiman , Bockarie Ansumana , Abir Onome Thomas , Kanu Joseph Sam , Coker Joshua , Jalloh Abdul , Conteh Victor , Conteh Sorie , Smith Mohamed , Mahdi Othman Z , Lisk Durodami R
Published: May 2023

Objective

To investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage (TOD) and its associated factors among adults in Freetown, Sierra Leone.

Design

This community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants.

Setting

The health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Sierra Leone.

Participants

A total of 2394 adult Sierra Leoneans aged 20 years or older were enrolled.

Outcome measure

Anthropometric data, fasting lipid profiles, fasting plasma glucose, TOD, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to TOD.

Results

The prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidaemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by ECG, 14.2% had LVH by two-dimensional echo and 11.4% had chronic kidney disease (CKD). The odds of developing ECG-LVH were higher with diabetes (OR=1.255, 95% CI (0.822 to 1.916) and dyslipidaemia (OR=1.449, 95% CI (0.834 to 2.518). Associated factors for higher odds of Left Ventricular Mass Index by echo were dyslipidaemia (OR=1.844, 95% CI (1.006 to 3.380)) and diabetes mellitus (OR=1.176, 95% CI (0.759 to 1.823)). The odds of having CKD were associated with diabetes mellitus (OR=1.212, 95% CI (0.741 to 1.983)) and hypertension (OR=1.163, 95% CI (0.887 to 1.525)). A low optimal cut-off point for ECG-LVH (male 24.5 mm vs female 27.5 mm) was required to maximise sensitivity and specificity by a receiver operating characteristics curve since the odds for LVH by ECG were low.

Conclusions

This study provides novel data-driven information on the burden of CMRF and its association with preclinical TOD in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management in Sierra Leonean.
Stakeholder’s perspectives on acceptable interventions for promoting hypertension medication adherence in Namibia: nominal group technique
Authors: Nakwafila Olivia , Sartorius Benn , Shumba Tonderai Washington , Dzinamarira Tafadzwa , Mashamba-Thompson Tivani Phosa
Published: May 2023

Objective

To determine the most acceptable hypertension intervention package to promote hypertension adherence based on stakeholders’ perspectives.

Design

We employed the nominal group technique method and purposively sampled and invited key stakeholders offering hypertension services and patients with hypertension. Phase 1 was focused on determining barriers to hypertension adherence, phase 2 on enablers and phase 3 on the strategies. We employed the ranking method based on a maximum of 60 scores to establish consensus regarding hypertension adherence barriers, enablers and proposed strategies.

Setting and participants

12 key stakeholders were identified and invited to participate in the workshop in Khomas region. Key stakeholders included subject matter experts in non-communicable diseases, family medicine and representatives of our target population (hypertensive patients).

Results

The stakeholders reported 14 factors as barriers and enablers to hypertension adherence. The most important barriers were: lack of knowledge on hypertension (57 scores), unavailability of drugs (55 scores) and lack of social support (49 scores). Patient education emerged as the most important enabler (57 scores), availability of drugs emerged second (53 scores) and third having a support system (47 scores). Strategies were 17 and ranked as follows: continuous patient education as the most desirable (54 scores) strategy to help promote hypertension adherence, followed by developing a national dashboard to primarily monitor stock (52 scores) and community support groups for peer counselling (49 scores).

Conclusions

Multifaceted educational intervention package targeting patient and healthcare system factors may be considered in implementing Namibia’s most acceptable hypertension package. These findings will offer an opportunity to promote adherence to hypertension therapy and reduce cardiovascular outcomes. We recommend a follow-up study to evaluate the proposed adherence package’s feasibility.
JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts
Authors: Quan Cindy , Clark Nancy , Costigan Catherine L , Murphy Jill , Li Michael , David Anita , Ganesan Soma , Guzder Jaswant , Cross Barbara
Published: May 2023

Introduction

Racialized population groups have worse health outcomes across the world compared with non-racialized populations. Evidence suggests that collecting race-based data should be done to mitigate racism as a barrier to health equity, and to amplify community voices, promote transparency, accountability, and shared governance of data. However, limited evidence exists on the best ways to collect race-based data in healthcare contexts. This systematic review aims to synthesize opinions and texts on the best practices for collecting race-based data in healthcare contexts.

Methods and Analyses

We will use the Joanna Briggs Institute (JBI) method for synthesizing text and opinions. JBI is a global leader in evidence-based healthcare and provides guidelines for systematic reviews. The search strategy will locate both published and unpublished papers in English in CINAHL, Medline, PsycINFO, Scopus and Web of Science from 1 January 2013 to 1 January 2023, as well as unpublished studies and grey literature of relevant government and research websites using Google and ProQuest Dissertations and Theses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement methodology for systematic reviews of text and opinion will be applied, including screening and appraisal of the evidence by two independent reviewers and data extraction using JBI’s Narrative, Opinion, Text, Assessment, Review Instrument. This JBI systematic review of opinion and text will address gaps in knowledge about the best ways to collect race-based data in healthcare. Improvements in race-based data collection, may be related to structural policies that address racism in healthcare. Community participation may also be used to increase knowledge about collecting race-based data.

Ethics and dissemination

The systematic review does not involve human subjects. Findings will be disseminated through a peer-reviewed publication in JBI evidence synthesis, conferences and media.

PROSPERO registration number

CRD42022368270.
Development and evaluation of a data-driven integrated management app for perioperative adverse events: protocol for a mixed-design study
Authors: Li Peiyi , Wang Ce , Zhou Ruihao , Tan Lingcan , Deng Xiaoqian , Zhu Tao , Chen Guo , Li Weimin , Hao Xuechao
Published: May 2023

Introduction

A patient record review study conducted in 2006 in a random sample of 21 Dutch hospitals found that 51%–77% of adverse events are related to perioperative care, while Centers for Disease Control and Prevention data in USA in 2013 estimated that the medical error is the third-leading cause of mortality. To capitalise on the potential of apps to enhance perioperative medical quality, there is a need for interventions developed in consultation with real-world users designed to support integrated management for perioperative adverse events (PAEs). This study aims: (1) to access the knowledge, attitude and practices for PAEs among physicians, nurses and administrators, and to identify the needs of healthcare providers for a mobile-based PAEs tool; (2) to develop a data-driven app for integrated PAE management that meets those needs and (3) to test the usability, clinical efficacy and cost-effectiveness of the developed app.

Methods and analysis

We will adopt an embedded mixed-methods research technique; qualitative data will be used to assess user needs and app adoption, while quantitative data will provide crucial insights to establish the demand for the app, and measure the app effects. Phase 1 will enrol surgery-related healthcare providers from the West China Hospital and identify their latent demand for mobile-based PAEs management using a self-designed questionnaire underpinned by the knowledge, attitude and practice model, as well as expert interviews. In phase 2, we will develop the app for integrated PAE management and test its effectiveness and sustainability. In phase 3, the effects on the total number and severity of reported PAEs will be evaluated using Poisson regression with interrupted time-series analysis over a 2-year period, while users’ engagement, adherence, process evaluation and cost-effectiveness will be evaluated using quarterly surveys and interviews.

Ethics and dissemination

The West China Hospital of Sichuan University’s Institutional Review Board authorised this study after approving the study protocol, permission forms and questionnaires (number: 2022-1364). Participants will be provided with study information, and informed written consent will be obtained. Study findings will be disseminated through peer-reviewed publications and conference presentations.
Effects of ethical climate in association with tenure on work addiction, quality of care and staff retention: a cross-sectional study
Authors: Maisonneuve Francis , Groulx Patrick , Chênevert Denis , Grady Colleen , Coderre-Ball Angela
Published: May 2023

Objectives

Work addiction is not contingent on personality alone; it is also impacted by social contextual factors. Work addiction influences the perceived quality of care and intention to remain in healthcare sector. The current study seeks to understand the role of ethical climate as a potential organisational lever to reduce such addiction, especially among newcomers.

Design

We contacted a sample of Canadian healthcare organisations to collect quantitative data using an online questionnaire from November 2021 to February 2022. All constructs (ethical climate, work addiction, perceived quality of care, intention to quit the profession) were measured using validated psychometric scales. 860 respondents provided complete questionnaires. We analysed the data using structural equation modelling and regression analysis.

Results

Work addiction mediated the indirect relationship between ethical climate and the intention to quit the profession (β=−0.053; 95% CI (−0.083 to –0.029); p<0.001) and with quality of care (β=0.049; 95% CI (0.028, 0.077); p<0.001). For each increase of 1 SD of ethical climate, the total effects regarding the variations in the outcomes were more important at low rather than high levels of tenure for work addiction (−11%, −2%), perceived quality of care (23%, 11%) and intention to quit the profession (−30%, −23%), respectively.

Conclusion

Ethical climate in healthcare organisations has a significant and beneficial relationship with healthcare workers’ (HCWs) work addiction behaviours. In turn, this relationship is related to greater perceived quality of care and higher intention to remain, especially for HCWs with lower tenure.
Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
Authors: Mphahlele Reratilwe , Lesosky Maia , Masekela Refiloe
Published: May 2023

Background

Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC.

Methods

A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.

Results

A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.

Conclusion

Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
WEB shape modifications: angiography–histopathology correlations in rabbits
Authors: Janot Kevin , Boulouis Grégoire , Forestier Géraud , Bala Fouzi , Cortese Jonathan , Szatmáry Zoltán , Bardet Sylvia M. , Baudouin Maxime , Perrin Marie-Laure , Mounier Jérémy , Couquet Claude , Yardin Catherine , Segonds Guillaume , Dubois Nicolas , Martinez Alexandra , Lesage Pierre-Louis , Ding Yong-Hong , Kadirvel Ramanathan , Dai Daying , Mounayer Charbel , Terro Faraj , Rouchaud Aymeric
Published: May 2023

Background

WEB Shape Modification (WSM) over time is frequent after aneurysm treatment. In this study, we explored the relationship between histopathological changes and angiographic evolution over time in experimental aneurysms in rabbits treated with the Woven EndoBridge (WEB) procedure.

Methods

Quantitative WSM was assessed using flat-panel computed tomography (FPCT) during follow-up by calculating height and width ratio (HR, WR), defined as the ratio between either measurement at an index time point and the measurement immediately after WEB implantation. The index time point varied from 1 day to 6 months. HR and WR were evaluated with angiographic and histopathological assessments of aneurysm healing.

Results

Final HR of devices varied from 0.30 to 1.02 and final WR varied from 0.62 to 1.59. Altogether, at least 5% of HR and WR variations were observed in 37/40 (92.5%) and 28/40 (70%) WEB devices, respectively, at the time of final assessment. There was no significant correlation between complete or incomplete occlusion groups and HR or WR (p=0.15 and p=0.43). Histopathological analysis revealed a significant association between WR and aneurysm healing and fibrosis 1 month following aneurysm treatment (both p<0.05).

Conclusion

Using longitudinal FPCT assessment, we observed that WSM affects both the height and width of the WEB device. No significant association was found between WSM and aneurysm occlusion status. Although presumably a multifactorial phenomenon, the histopathological analysis highlighted a significant association between width variations, aneurysm healing and fibrosis in the first month following aneurysm treatment.
Nongrowing season soil nitrous oxide emissions as influenced by cover crops and fall tillage termination
Authors: Gao Yuanpei , Borden Kira A. , Brown Shannon E. , Wagner-Riddle Claudia
Published: May 2023

Cropland soil is a major driver of global nitrous oxide (N2O) emissions. In cold climates, nongrowing season (NGS) emissions can be significant due to high fluxes during freeze–thaw (FT) cycles. Cover crops can alter key soil conditions that govern N2O-producing microbial processes, with multiple potential pathways to either increase or decrease N2O production during FT cycles. Cultivating cover crops in the fall to terminate may further disrupt these processes and the overall impact of cover crops on N2O emissions. Yet, few studies have touched on how termination practices of cover crops impact FT emissions over the NGS. Using the flux gradient method to continuously measure N2O emissions from a conventional corn–soybean rotation, we investigated the effects of summer-established cover crops (perennial ryegrass and crimson clover) (with cover crops, +CC; without cover crops, −CC) when terminated by fall cultivation (with fall cultivation, +FC; without fall cultivation, −FC) over a six-month NGS that was characterized by several freezing and thawing periods. Crimson clover cover crop was completely winterkilled, while the ryegrass survived on the +CC−FC field. Total NGS (Nov–Apr) emissions varied nearly 2.5-fold among treatments from 395.1 (−CC−FC) to 978.1 (+CC+FC) g N2O-N ha−1. Compared with the control treatment (−CC−FC), fall cultivation alone (−CC+FC) and cover crops alone (+CC−FC) increased total NGS N2O emissions, and fall cultivation with cover crops (+CC+FC) increased N2O fluxes even more. Careful CC species selection and management are important to avoid elevated NGS emissions.
Frugal Exoscope: A Minimal Cost Option for Microsurgery and Training Program in Male Infertility
Authors: Khoa Le Dang , Hoang Le , Thang Le Duc , Vy Ngo Dinh Trieu , Dung Mai Ba Tien , Huy Duong Quang , Nhu Giang Huynh , Handelsman David
Published: May 2023

Background: Conventional microscopes and exoscopes currently play pivotal roles in the microsurgery or training for male infertility. However, they are expensive and unaffordable in low-resource settings, which limits training or application of advanced methods.

Objectives: To introduce a new, low-cost exoscope system and to determine whether it is an effective frugal innovation.

Methods: Using animal models, we evaluated a new frugal exoscope system named DKTA in experimental microsurgery of vas deferens repair. Five experts in male infertility surgery undertook an anonymous survey to elucidate their experience with DKTA system use. Three crucial criteria (i.e., substantial cost reduction, concentration on core functionalities, and optimized performance level) were evaluated to determine whether the DKTA is effective as frugal innovation. The survey used a 5-point Likert scale of responses to eight statements investigating surgical, ergonomic, and educational aspects.

Results: The DKTA system, including an optical microscope and ultra-high-definition (UHD) camera (4K), was an exoscope placed between 20 and 40 cm from the surgical field. It was held in position with a camera support arm on casters and connected to a 65-in. smart TV. DKTA system met the three crucial criteria of frugal innovation. Five male infertility microsurgeons reported positive evaluations based on modal scores of the DKTA system when performing experimental vasovasostomy.

Conclusions: DKTA system, a frugal innovation, has a valuable contribution to the training program and performance of male infertility microsurgery in low-resource settings.
Wikibase Model for Premodern Manuscript Metadata Harmonization, Linked Data Integration, and Discovery
Authors: Koho Mikko , Coladangelo L. P. , Ransom Lynn , Emery Doug
Published: May 2023

To facilitate discovery of premodern manuscripts in U.S. memory institutions, Digital Scriptorium, a growing consortium of over 35 institutional members representing American libraries, museums, and other cultural heritage institutions, has developed a digital platform for an online national union catalog. The platform will allow low-barrier and efficient collection, aggregation, and enrichment of member metadata and sustainably publish it as Linked Open Data. This article describes the methods and principles behind the data model development and the decision to use Wikibase. The results of the prototype implementation and testing phase demonstrate the practicality and sustainability of Digital Scriptorium’s approach to building an online national union catalog based on Linked Open Data technologies and practices.