bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group
Authors: Parker Richard , Allison Michael , Anderson Seonaid , Aspinall Richard , Bardell Sara , Bains Vikram , Buchanan Ryan , Corless Lynsey , Davidson Ian , Dundas Pauline , Fernandez Jeff , Forrest Ewan , Forster Erica , Freshwater Dennis , Gailer Ruth , Goldin Robert , Hebditch Vanessa , Hood Steve , Jones Arron , Lavers Victoria , Lindsay Deborah , Maurice James , McDonagh Joanne , Morgan Sarah , Nurun Tania , Oldroyd Christopher , Oxley Elizabeth , Pannifex Sally , Parsons Graham , Phillips Thomas , Rainford Nicole , Rajoriya Neil , Richardson Paul , Ryan J , Sayer Joanne , Smith Mandy , Srivastava Ankur , Stennett Emma , Towey Jennifer , Vaziri Roya , Webzell Ian , Wellstead Andrew , Dhanda Ashwin , Masson Steven
Published: October 2023

Objective

Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations for the management of ALD, based on evidence and consensus expert opinion, with the aim of improving patient care.

Design

A multidisciplinary group of experts from the British Association for the Study of the Liver and British Society of Gastroenterology ALD Special Interest Group developed the quality standards, with input from the British Liver Trust and patient representatives.

Results

The standards cover three broad themes: the recognition and diagnosis of people with ALD in primary care and the liver outpatient clinic; the management of acutely decompensated ALD including acute alcohol-related hepatitis and the posthospital care of people with advanced liver disease due to ALD. Draft quality standards were initially developed by smaller working groups and then an anonymous modified Delphi voting process was conducted by the entire group to assess the level of agreement with each statement. Statements were included when agreement was 85% or greater. Twenty-four quality standards were produced from this process which support best practice. From the final list of statements, a smaller number of auditable key performance indicators were selected to allow services to benchmark their practice and an audit tool provided.

Conclusion

It is hoped that services will review their practice against these recommendations and key performance indicators and institute service development where needed to improve the care of patients with ALD.
Are diabetes self-management interventions delivered in the psychiatric inpatient setting effective? A protocol for a systematic review
Authors: Goff Zoe , Palmer Charlotte , Jadhakhan Ferozkhan , Barber Alice
Published: October 2023

Introduction

Diabetes is a major risk factor for cardiovascular disease, which is the most significant contributor to increased mortality due to natural causes in those with severe mental illness (SMI). Self-management interventions for diabetes have been shown to be effective in the general population, however, effects of these interventions in those with SMI is still unclear. Psychiatric admission could be used opportunistically to deliver interventions of this kind and help improve diabetes self-management. This review aims to assess whether interventions of this kind improve diabetes outcomes and have an effect on reducing cardiovascular risk.

Methods and analysis

This review will include studies assessing diabetes self-management interventions designed to be delivered to those aged 18 and over with comorbid type 2 diabetes and SMI during admission to psychiatric inpatient settings. Databases including the Cochrane Library, Medline, Psychinfo, CINAHL, Embase, WHO’s International Clinical Trials Registry Platform, International Health Technology Assessment Database, UK Clinical Research Network and ClinicalTrials.gov will be searched from inception to September 2022. Where possible, meta-analysis of included studies will be conducted. If heterogeneity is high and meta-analysis is not possible, we will use other means of data synthesis and will include a narrative description of included studies.

Ethics and dissemination

Ethical approval is not required as the systematic review will only include data from existing studies. The results will be disseminated via peer-reviewed publication and presentation at relevant national and international conferences.

PROSPERO registration number

CRD42022357672
Mental health data available in representative surveys conducted in Latin America and the Caribbean countries: a scoping review
Authors: Ramírez-Bontá Francesca , Vásquez-Vílchez Rafaela , Cabrera-Alva Milagros , Otazú-Alfaro Sharlyn , Almeida-Huanca Guillermo , Ambrosio-Melgarejo Juan , Figueroa-Quiñones Joel , Romero-Cabrera Alejandra B , Huaman-Santa Cruz Anayeli , Chávez-Hinostroza Esthefani , Rosado-Medina Melanie , Siancas-Villano Wildo , Quintana-Castro Camilo , Bazo-Alvarez Juan Carlos , Villarreal-Zegarra David
Published: October 2023

Background

Mental health data from Latin America and the Caribbean countries (LACC) national and international surveys are essential for public health surveillance. This review aimed to identify and describe available mental health survey data in LACC, providing access details for researchers.

Methods

Our study was a scoping review. The search for available mental health survey data was conducted in PubMed and through grey literature searches, and the search dates were between 26 August 2021 and 15 October 2021. Included survey data were/had (1) nationally representative, (2) the latest version available from 2012 onward, (3) collected in at least one LACC and (4) at least one mental health variable or related factor. We accepted all written languages, including Spanish and English.

Results

A total of 56 national and 13 international surveys were included, with data available on 95 mental health variables classified into 10 categories. Most national surveys were performed in upper-middle-income countries. Variables categorised as ‘Substance use’ and ‘Violence’ were the most frequent. Mexico and Colombia had the highest production in both the national and international surveys. The main target population was the adult population. However, there are several mental health topics and LACC yet unsurveyed.

Conclusion

We identified a total of 69 representative surveys from LACCs since 2012. We categorised the available data on mental health variables into 10 categories, and provided technical details to facilitate the future selection and use of these surveys.
Euvichol-plus vaccine campaign coverage during the 2017/2018 cholera outbreak in Lusaka district, Zambia: a cross-sectional descriptive study
Authors: Mukonka Victor M , Sialubanje Cephas , Matapo Belem Blamwell , Chewe Orbrie , Ngomah Albertina Moraes , Ngosa Willaim , Hamoonga Raymond , Sinyange Nyambe , Mzyece Hannah , Mazyanga Lucy , Bakyaita Nathan , Kapata Nathan
Published: October 2023

Objective

To determine the coverage for the oral cholera vaccine (OCV) campaign conducted during the 2017/2018 cholera outbreak in Lusaka, Zambia.

Study design

A descriptive cross-sectional study employing survey method conducted among 1691 respondents from 369 households following the second round of the 2018 OCV campaign.

Study setting

Four primary healthcare facilities and their catchment areas in Lusaka city (Kanyama, Chawama, Chipata and Matero subdistricts).

Participants

A total of 1691 respondents 12 months and older sampled from 369 households where the campaign was conducted. A satellite map-based sampling technique was used to randomly select households.

Data management and analysis

A pretested electronic questionnaire uploaded on an electronic tablet (ODK V.1.12.2) was used for data collection. Descriptive statistics were computed to summarise respondents’ characteristics and OCV coverage per dose. Bivariate analysis (χ2test) was conducted to stratify OCV coverage according to age and sex for each round (p<0.05).

Results

The overall coverage for the first, second and two doses were 81.3% (95% CI 79.24% to 83.36%), 72.1% (95% CI 69.58% to 74.62%) and 66% (95% CI 63.22% to 68.78%), respectively. The drop-out rate was 18.8% (95% CI 14.51% to 23.09%). Of the 81.3% who received the first dose, 58.8% were female. Among those who received the second dose, the majority (61.0%) were females aged between 5 and 14 years (42.6%) and 15 and 35 years (27.7%). Only 15.5% of the participants aged between 36 and 65 and 2.5% among those aged above 65 years received the second dose.

Conclusion

These findings confirm the 2018 OCV campaign coverage and highlight the need for follow-up surveys to validate administrative coverage estimates using population-based methods. Reliance on health facility data alone may mask low coverage and prevent measures to improve programming. Future public health interventions should consider sociodemographic factors in order to achieve optimal vaccine coverage.
Safety and feasibility of faecal microbiota transplantation for patients with Parkinson’s disease: a protocol for a self-controlled interventional donor-FMT pilot study
Authors: Vendrik Karuna EW , Chernova Vlada O , Kuijper Ed J , Terveer Elisabeth M , van Hilten Jacobus J , Contarino Maria Fiorella
Published: October 2023

Introduction

Experimental studies suggest a role of gut microbiota in the pathophysiology of Parkinson’s disease (PD) via the gut–brain axis. The gut microbiota can also influence the metabolism of levodopa, which is the mainstay of treatment of PD. Therefore, modifying the gut microbiota by faecal microbiota transplantation (FMT) could be a supportive treatment strategy.

Methods and analysis

We have developed a study protocol for a single-centre, prospective, self-controlled, interventional, safety and feasibility donor-FMT pilot study with randomisation and double-blinded allocation of donor faeces. The primary objectives are feasibility and safety of FMT in patients with PD. Secondary objectives include exploring whether FMT leads to alterations in motor complications (fluctuations and dyskinesias) and PD motor and non-motor symptoms (including constipation), determining alterations in gut microbiota composition, assessing donor–recipient microbiota similarities and their association with PD symptoms and motor complications, evaluating the ease of the study protocol and examining FMT-related adverse events in patients with PD. The study population will consist of 16 patients with idiopathic PD that use levodopa and experience motor complications. They will receive FMT with faeces from one of two selected healthy human donors. FMT will be administered via a gastroscope into the duodenum, after treatment with oral vancomycin, bowel lavage and domperidone. There will be seven follow-up moments during 12 months.

Ethics and dissemination

This study was approved by the Medical Ethical Committee Leiden Den Haag Delft (ref. P20.087). Study results will be disseminated through publication in peer-reviewed journals and international conferences.

Trial registration number

International Clinical Trial Registry Platform: NL9438.
Perceptions, attitudes, awareness and perspectives towards sustainability practices and climate change among nurses: a systematic review protocol
Authors: Akore Yeboah Ebenezer , Adegboye Amanda Rodrigues Amorim , Kneafsey Rosie
Published: October 2023

Introduction

Climate change has been described as the most significant threat to humanity and human health to have emerged this century. It is widely accepted that contemporary human activities are the major causes of climate change. It is also acknowledged that damaging human activities could be amenable to change through proactive environmental behaviours. Healthcare professionals have the potential to promote climate advocacy and mitigation through collective effort and individual actions. However, research suggests that nurses may not be aware of their potential to effect positive action. This review will synthesise evidence regarding nurses’ perceptions, attitudes, awareness and perspectives towards sustainable nursing practices and climate change.

Methods and analysis

The Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews will be applied to this proposed systematic review. It will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. CINAHL, PsycINFO, SCOPUS and PubMed databases will be searched. Data appraisal will be completed using the JBI and Mixed Methods Assessment Tool critical appraisal tool. Data synthesis and integration will follow the JBI convergent integrated approach.

Ethics and dissemination

In compliance with university ethics requirements for secondary research and postgraduate researchers, ethical approval will be sought from the Coventry University Ethics Committee, UK. Dissemination of findings will be achieved through peer-review publications, conference presentations and seminars with local, national and international audiences.
Methods for measuring short-term geographical mobility used in infectious disease research: a scoping review protocol
Authors: Robsky Katherine O. , Tram Khai Hoan , Dowdy David W. , Zelner Jon
Published: October 2023

Introduction

Geographical mobility, the movement of individuals or populations, may increase an individual’s risk of acquiring or transmitting infectious diseases, including HIV, tuberculosis, malaria and COVID-19. Many studies have collected information on short-term mobility through self-reported travel histories or using GPS trackers, but there has been no consistent conceptualisation and operationalisation of such geographical mobility in global health research. This protocol aims to describe and synthesise different approaches to measuring short-term mobility.

Methods and analysis

We will search three databases (PubMed, Embase and Global Health) for peer-reviewed articles. After removing duplicates, two reviewers will first screen the titles and abstracts and then proceed to full-text screening. We will include studies that measure mobility at the individual level in the context of infectious diseases, including clinical trials, epidemiological studies and analyses of register data. Additional articles for inclusion may be identified through review of references in selected papers. We will summarise the method of data collection (GPS trackers, cellphones, retrospective self-report, travel journal, etc) and the specific measures used (overnight travel, having a secondary residence, travel outside of district, etc).

Ethics and dissemination

This study consists of reviewing and abstracting existing data from publicly available materials, and therefore does not require ethical approval. The results of this study will be submitted for peer reviewed publication and may be presented at a relevant global health conference.
Effects of tele-prehabilitation on clinical and muscular recovery in patients awaiting knee replacement: protocol of a randomised controlled trial
Authors: Guida Stefania , Vitale Jacopo , Gianola Silvia , Castellini Greta , Swinnen Eva , Beckwée David , Gelfi Cecilia , Torretta Enrica , Mangiavini Laura
Published: October 2023

Background

The increasing prevalence of knee osteoarthritis and total knee arthroplasty (TKA) impose a significant socioeconomic burden in developed and developing countries. Prehabilitation (rehabilitation in the weeks immediately before surgery) may be crucial to prepare patients for surgery improving outcomes and reducing assistance costs. Moreover, considering the progress of telemedicine, candidates for TKA could potentially benefit from a tele-prehabilitation programme. We aim to evaluate the effects of a home-based tele-prehabilitation program for patients waiting for total knee replacement.

Methods and analysis

Forty-eight male patients, aged 65–80, on a waiting list for TKA will be recruited and randomly assigned to the tele-prehabilitation intervention or control groups. Both groups will undergo the same 6-week exercise program (five sessions/week) and the same educational session (one per week). The tele-prehabilitation group will perform asynchronous sessions using a tablet, two accelerometers and a balance board (Khymeia, Padova, Italy), while the control group will use a booklet. The Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire, at the end of the prehabilitation, will be the primary outcome. Secondary outcomes will include self-reported outcomes, performance tests and change in expressions of blood and muscle biomarkers. Ten healthy subjects, aged 18–30, will be also recruited for muscle and blood samples collection. They will not undergo any intervention and their data will be used as benchmarks for the intervention and control groups’ analyses.

Ethics and dissemination

This randomised controlled trial will be conducted in accordance with the ethical principles of the Declaration of Helsinki. This study has been approved by the Ethics Committee of Vita-Salute San Raffaele University (Milan, Italy. No. 50/INT/2022). The research results will be published in peer-reviewed publications.

Trial registration number

NCT05668312.
Technologies for the diagnosis of angle closure glaucoma (ACE): protocol of a prospective, multicentre, cross-sectional diagnostic study
Authors: Azuara-Blanco Augusto , Lawrenson John G , King Anthony J , Foster Paul J , Virgili Gianni , Guiney Mary , Nolan Winnie , Jindal Anish , Sharma Meenakshi , O'Neill Ciaran , Cardwell Christopher R , Clarke Mike
Published: October 2023

Introduction

Angle-closure is responsible for half of all glaucoma blindness globally. Patients with suspected glaucoma require assessment of the drainage angle by an experienced clinician. The goal of this study is to evaluate the diagnostic performance and cost-effectiveness of two non-contact tests, anterior segment OCT (Optical Coherence Tomography) (AS-OCT) and limbal anterior chamber depth for patients referred to hospital with suspected angle closure compared with gonioscopy by ophthalmologist.

Methods and analysis

Study design: prospective, multicentre, cross-sectional diagnostic accuracy study. Inclusion criteria: adults referred from community optometry to hospital with suspected angle closure. Primary outcome: Sensitivity and specificity. Secondary outcomes: Positive/negative likelihood ratios, concordance, cost-effectiveness, proportion of patients requiring subsequent clinical assessment by ophthalmologist. Sample size: 600 individuals who have been referred with suspected angle closure from primary care (community optometry). We will have a 95% probability of detecting the true sensitivity of either test to within ±3.5% based on a sensitivity of 90%. The study would also have a 95% probability of detecting the true specificity of either test to within ±5%, assuming a specificity of 75%.

Ethics and dissemination

Ethical Review Board approval was obtained. REC reference: 22/LO/0885. Our findings will be disseminated to those involved in eye care services. We will have a knowledge exchange event at the end of the study, published via the Health Technology Assessment web page and in specialist journals. The results will be presented at professional conferences and directly to patients via patient group meetings and the Glaucoma UK charity.

Trial registration number

ISRCTN15115867.
How to predict the death risk after an in-hospital cardiac arrest (IHCA) in intensive care unit? A retrospective double-centre cohort study from a tertiary hospital in China
Authors: Zhang Youping , Rao Caijun , Ran Xiao , Hu Hongjie , Jing Liang , Peng Shu , Zhu Wei , Li Shusheng
Published: October 2023

Objectives

Our objective is to develop a prediction tool to predict the death after in-hospital cardiac arrest (IHCA).

Design

We conducted a retrospective double-centre observational study of IHCA patients from January 2015 to December 2021. Data including prearrest diagnosis, clinical features of the IHCA and laboratory results after admission were collected and analysed. Logistic regression analysis was used for multivariate analyses to identify the risk factors for death. A nomogram was formulated and internally evaluated by the boot validation and the area under the curve (AUC). Performance of the nomogram was further accessed by Kaplan-Meier survival curves for patients who survived the initial IHCA.

Setting

Intensive care unit, Tongji Hospital, China.

Participants

Adult patients (≥18 years) with IHCA after admission. Pregnant women, patients with ‘do not resuscitation’ order and patients treated with extracorporeal membrane oxygenation were excluded.

Interventions

None.

Primary and secondary outcome measures

The primary outcome was the death after IHCA.

Results

Patients (n=561) were divided into two groups: non-sustained return of spontaneous circulation (ROSC) group (n=241) and sustained ROSC group (n=320). Significant differences were found in sex (p=0.006), cardiopulmonary resuscitation (CPR) duration (p<0.001), total duration of CPR (p=0.014), rearrest (p<0.001) and length of stay (p=0.004) between two groups. Multivariate analysis identified that rearrest, duration of CPR and length of stay were independently associated with death. The nomogram including these three factors was well validated using boot calibration plot and exhibited excellent discriminative ability (AUC 0.88, 95% CI 0.83 to 0.93). The tertiles of patients in sustained ROSC group stratified by anticipated probability of death revealed significantly different survival rate (p<0.001).

Conclusions

Our proposed nomogram based on these three factors is a simple, robust prediction model to accurately predict the death after IHCA.
Adherence to diabetic foot care recommendations and associated factors among people with diabetes in Eastern Ethiopia: a multicentre cross-sectional study
Authors: Sertsu Addisu , Nigussie Kabtamu , Lami Magarsa , Bekele Dechasa Deribe , Abdisa Lemesa , Eyeberu Addis , Dereje Jerman , Mohammed Aminu , Kassa Taffese Obsan , Bete Tilahun , Adugna Damte , Negash Abraham , Goshu Abel Tibebu , Debella Adera , Letta Shiferaw
Published: October 2023

Objective

This study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia.

Setting

An institutional-based cross-sectional study was conducted in public hospitals found in Eastern Ethiopia from 25 February to 25 March 2022.

Participants

A total of 419 patients with chronic diabetes who visited diabetic clinics in public hospitals in Eastern Ethiopia for follow-up were included.

Main outcome measure

The level of adherence to diabetic foot care recommendations and associated factors.

Results

The findings indicated that 44.3% (95% CI: 39.3, 49.0) of people with diabetes had inadequate adherence to diabetic foot care recommendations. Age between 28–37 (adjusted OR (AOR)=1.10; 95% CI: 1.27, 5.63) and 38–47 years (AOR=2.19; 95% CI: 2.74, 8.89), rural residence (AOR=1.71; 95% CI: 1.15, 2.57), absence of comorbidity (AOR=2.22; 95% CI:1.34, 5.14), obesity (AOR=1.43; 95% CI: 1.10, 5.05) and inadequate foot care knowledge (AOR=2.10; 95% CI: 1.52, 4.35) were factors significantly associated with inadequate adherence to diabetic foot care recommendations.

Conclusion

More than two-fifths of people with diabetes had inadequate adherence to diabetic foot care recommendations. Younger age, rural residence, absence of comorbidity, obesity and inadequate foot care knowledge were significantly associated with inadequate adherence to diabetic foot care recommendations. It is very essential to educate people with diabetes about the importance of foot care recommendations in preventing and delaying the risks of foot-related problems and complications.
Single-arm, phase II study of intra-arterial chemotherapy plus total neoadjuvant therapy to optimise complete response in distal rectal cancer: a study protocol
Authors: Huang Wenpeng , Huang Puda , Guo Houji , Huang Zanyi , Wei Mingwei , Guo Junyu , Lin Cheng , Li Yepeng , Luo Biao , Lin Jie , Wang Lixue
Published: October 2023

Introduction

Organ preservation is now considered an acceptable alternative option in distal rectal cancer patients with clinical complete response (cCR) after neoadjuvant chemoradiation (CRT). But the cCR rate is low and about one-third of tumour will regrow, which requires more effective local treatment. CRT combined with intra-arterial chemotherapy (IAC) might be a promising approach. Additionally, total neoadjuvant therapy using FOLFIRINOX induction chemotherapy improved survival while consolidation chemotherapy improved organ preservation. We assess whether IAC plus CRT and FOLFIRINOX consolidation chemotherapy can improve the chance of organ preservation and survival in distal rectal cancer.

Methods and analysis

This prospective, monocentric, open-label, single-arm phase II study will include 32 patients with cT3-4NanyM0 distal rectal adenocarcinoma. All patients will receive one cycle of IAC (irinotecan, raltitrexed and oxaliplatin), followed by CRT (50 Gy/25 fractions with concomitant capecitabine) and then with six cycles of FOLFIRINOX (leucovorin, 5-fluorouracil, oxaliplatin and irinotecan). After final evaluation, patients with cCR will receive non-operative management or surgery at their own discretion and others are mandatorily referred to surgery. Adjuvant chemotherapy with six cycles of mFOLFOX6 (leucovorin, 5-fluorouracil and oxaliplatin) will be used for patients with adverse pathological features. The primary endpoint is the rate of complete response (CR; pathological CR or sustained cCR≥2 years). The main secondary endpoints are toxicity, compliance, short-term and long-term oncological outcomes, surgical morbidity and quality of life. This protocol has been designed in accordance with the Standard Protocol Items: Recommendations for Interventional Trials 2013 guidelines.

Ethics and dissemination

This study was approved by the Academic and Ethics Committee of The Affiliated Hospital of Youjiang Medical University for Nationalities in March 2023. Trial results will be published in peer-reviewed international journals and on the ChiCTR website.

Protocol version

Registered on 18 April 2023; version #1.

Trial registration number

ChiCTR2300070620.
Demographic and socioeconomic disparities in receipt of ophthalmology consultation for facial trauma
Authors: Gervasio Kalla A , Camarena Joab , Hampton Jessica , Chopra Nitin , Kalosza Brittany , Shumate Lauren , Wu Albert Y
Published: October 2023

Objective

Functional outcomes following facial and ocular trauma are time-sensitive and require prompt evaluation to minimise long-term vision loss, yet few studies have systematically evaluated disparities in the management of these cases. This study investigates whether a patient’s race/ethnicity, primary language, insurance status, gender or age affects receipt of ophthalmology consultation for facial trauma.

Methods and analysis

This study was a retrospective cohort analysis of patients from the Elmhurst City Hospital Trauma Registry in Queens, New York who were seen for facial trauma including open globe injuries and orbital fractures between January 2014 and May 2016.

Results

Of the 264 patients included, 43% reported as Hispanic, 23% white, 11% Asian, 8% black and 15% other/unknown. After controlling for confounding variables by multivariable logistic regression, neither race/ethnicity, gender, nor primary language were significantly associated with the likelihood of receiving an ophthalmology consult. However, patients with private insurance had 2.57 times greater odds of receiving an ophthalmology consultation than those with Medicaid or state corrections insurance (95% CI 1.37 to 4.95). As age increased, the likelihood of receiving an ophthalmology consultation decreased (p=0.009); patients 60 years of age and older had one-third the odds of ophthalmology consultation as younger patients (OR 0.33; 95% CI 0.16 to 0.68).

Conclusions

This study highlights that lack of ophthalmology consultation in patients with facial trauma is linked to age and underinsurance. Extra attention must be paid during primary assessments to ensure elderly patients and those with public insurance have equitable access to timely and appropriate care for facial trauma.
Short subcutaneous infusions for symptom control in palliative medicine
Authors: Howard Paul , Clawson Sandra , Curtin John
Published: October 2023

Objectives

To investigate the efficacy and safety of short subcutaneous infusions (SSCIs) for refractory symptoms in the palliative setting.

Methods

A retrospective chart review of SSCIs in a single palliative care centre over an 18-month period. All clinical notes, medication administration records and infusion monitoring documentation were examined to ascertain therapeutic aim, efficacy and tolerability.

Results

111 patients received one or more SSCIs, 28 in the community and 83 in the inpatient hospice (21% of all admissions). SSCIs were used for a wide variety of reasons including loading doses (to achieve steady state and, thus, symptom relief, sooner), as required doses (for medications too irritant to give as bolus SC injections) and regular maintenance doses (where continuous subcutaneous infusion (CSCI), were unnecessary). 84 single drug SSCIs types and 51 admixtures SSCIs types (2 or more medications) were given. One infusion was poorly absorbed, but SSCIs were otherwise well tolerated.

Conclusions

SSCIs appear to be a promising additional option for administering medicines that are too irritant or large in volume for SC bolus injection. For medications with longer half-lives (eg, phenobarbital, valproate, levetiracetam), SSCI loading doses would be expected to achieve steady state and, thus, symptom relief, sooner than CSCIs alone.
Dynamic response of a low plasticity silt deposit: comparison of in-situ and laboratory responses
Authors: Dadashiserej Ali , Jana Amalesh , Xu Zhongze , Stuedlein Armin W. , Evans T. Matthew , Stokoe Kenneth H. , Cox Brady R.
Published: October 2023

This study compares the in-situ dynamic response of a low plasticity silt deposit subjected to multidirectional loading from vibroseis shaking and controlled blasting to a suite of element-scale, cyclic laboratory test specimens. The agreement between excess pore pressures and simple shear strain relationships over a wide range in strains is remarkable. Slightly larger excess pore pressures observed in-situ are attributed to three-dimensional loading and pore pressure migration/redistribution in the shallower portions of the deposit. Noted differences in shear modulus, G, are attributed to strain rate effects, spatial variability in the in-situ stiffness, and hydraulic boundary conditions. The variation in in-situ G/Gmax follows the trend from torsional shear specimens up to 0.4% shear strain; larger strains in the silt deposit imposed by controlled blasting yielded a stiffer response than that from cyclic torsional shear and direct simple shear specimens due in part to field drainage for deeper portions of the deposit. The in-situ cyclic resistance ratio for the deeper portion of the deposit in which plane body waves could be assumed and for the selected excess pore pressure ratio criterion was larger than that of stress-controlled cyclic direct simple shear (CDSS) test specimens, despite the detrimental effect of multidirectional shaking in the field. The effect of strain history, spatial variability, and drainage boundary conditions to drive differences between the in-situ and laboratory test specimens is identified.
Exclusive $$J/\Psi $$ plus jet associated production in ultraperipheral PbPb collisions
Authors: Gonçalves Victor P. , Klasen Michael , Moreira Bruno D.
Published: October 2023

The study of exclusive processes in ultraperipheral collisions at the Large Hadron Collider (LHC) has allowed us to test several aspects of the Standard Model and to search for New Physics. In this letter, we investigate the possibility of using these processes to improve our understanding of the quarkonium production mechanism through the study of the exclusive $$J/\Psi $$

J
/
Ψ

plus jet associate production in ultraperipheral PbPb collisions. We estimate the transverse-momentum and rapidity distributions considering that the $$\gamma \gamma \rightarrow J/\Psi + X$$

γ
γ
→
J
/
Ψ
+
X

$$(X = \gamma , \, g)$$

(
X
=
γ
,

g
)

subprocess is described by the Non-Relativistic QCD (NRQCD) formalism and present predictions for the rapidity ranges covered by central and forward detectors. The experimental separation of these events is discussed and the results indicate that a future experimental analysis is, in principle, feasible in future runs of the LHC and the Future Circular Collider (FCC).
Dipole instability in molecules irradiated by XUV pulses
Authors: Hughes D. , Dundas D. , Dinh P. M. , Vincendon M. , Reinhard P.-G. , Suraud E.
Published: October 2023

We study the response of small covalent molecules to XUV laser pulses. The theoretical description relies on a real-time and real-space Time-Dependent Density Functional Theory (TDDFT) approach at the level of the local density approximation complemented by an efficient self-interaction correction.
We observe the development of a dipole instability well after the laser pulse has died out. We find that this instability mechanism is robust with respect to ionic motion, to a wide variety of laser characteristics and to the inclusion of incoherent correlations at the level of a relaxation time ansatz. To rule out any potential numerical effects, we use two independent computational implementations of the TDDFT approach. A comparison of the various laser parameters together with the widely used model approach consisting in an instantaneous hole excitation shows the generic character of this instability in terms of the level depletion of a deep lying electron state. An experimental verification of the phenomenon is proposed in terms of a time-resolved measurement of the photoelectron spectrum.
Grazing Bifurcations, Homoclinic Orbits and Chaos in a Ring Network of Linear Neuron-Like Elements with a Single Nonmonotonic Piecewise Constant Output Function
Authors: Horikawa Yo
Published: October 2023

The bifurcations and chaos of a ring of three unidirectionally coupled neuron-like elements are examined as a minimal chaotic neural network. The output function of one neuron is nonmonotonic and piecewise constant while those of the other two neurons are linear. Two kinds of nonmonotonic output functions are considered and it is shown that periodic solutions undergo grazing bifurcations owing to discontinuity in the nonmonotonic functions. Chaotic attractors are created directly through a grazing bifurcation and homoclinic orbits based at pseudo steady states are generated. It is shown that homoclinic/heteroclinic orbits satisfying the condition of Shil’nikov chaos are caused by overshoot in the nonmonotonic functions.
Contributions of M- and Persistent Sodium Currents in Regulating Locomotor Rhythms: A Computational Modeling Study
Authors: Zhu Qinghua , Wang Fengjie , Han Fang
Published: October 2023

Physiological experiments have demonstrated that M-current ([Formula: see text]) and persistent sodium current ([Formula: see text]) expressed in rhythm-generating neurons play a key role in the generation and regulation of locomotor rhythms. However, the intrinsic mechanisms by which these two ionic currents control the locomotor rhythms are poorly understood. Here, a computational model is constructed to investigate the roles of [Formula: see text] and [Formula: see text] in regulating locomotor rhythms and explain the underlying ionic mechanisms. The simulation results show that decreasing [Formula: see text] or increasing [Formula: see text] facilitates the generation of the bursting activity; during the bursting activity, the burst frequency of the model has a positive dependence on [Formula: see text], and the flexion-extension as well as left-right coordination are not affected by varying [Formula: see text]. These results accurately reproduce the experimental results. In addition, the results also show that the dependence of burst frequency-[Formula: see text] is similar to that of burst frequency-[Formula: see text], but with distinct regulation mechanisms, i.e. [Formula: see text] regulates the burst frequency by affecting the burst and interburst durations, whereas [Formula: see text] regulates the burst frequency via manipulating the interburst duration. Finally, a dynamical analysis is given to reveal the intrinsic neural mechanisms of [Formula: see text] and [Formula: see text] in regulating the burst properties. Our study provides new insights into how outward and inward currents work in tandem to set the speed of locomotion, and provides testable predictions for biological experimental studies.
A Chen-Like Model: High Periodicity Leading to Chaotic Dynamics
Authors: Hassan Sk. Sarif , Goldar Sujay
Published: October 2023

The Chen circuit system, a three-dimensional autonomous system with intriguing dynamics, has gained considerable attention due to its potential applications in diverse scientific fields. In this article, a Chen-like system is defined and a comprehensive dynamics studied. The system exhibits chaotic dynamics, limit cycles, and bifurcations, making it a captivating subject of study. By employing numerical simulations and analytical techniques, we explore the system’s stability and identify critical parameter values leading to qualitative changes. Notably, we delve into Hopf bifurcations, which give rise to stability changes and the emergence of limit cycles. Furthermore, we analyze the fractal dimension of the system’s attractor, providing insights into its complexity and self-similarity. Through a systematic examination of the Chen-like system, we deepen our understanding of its intricate dynamics and offer valuable insights into the underlying mechanisms. The findings contribute to the field of dynamical systems and hold potential implications in areas such as chaos-based secure communications, signal processing, and nonlinear control. This work serves as a valuable reference for researchers and practitioners interested in the dynamics and bifurcation analysis of nonlinear systems.
Economics of Crop Residue Management
Authors: Krishna Vijesh V. , Mkondiwa Maxwell
Published: October 2023

More than five billion metric tons of agricultural residues are produced annually worldwide. Despite having multiple uses and significant potential to augment crop and livestock production, a large share of crop residues is burned, especially in Asian countries. This unsustainable practice causes tremendous air pollution and health hazards while restricting soil nutrient recycling. In this review, we examine the economic rationale for unsustainable residue management. The sustainability of residue utilization is determined by several economic factors, such as local demand for and quantity of residue production, development and dissemination of technologies to absorb excess residue, and market and policy instruments to internalize the social costs of residue burning. The intervention strategy to ensure sustainable residue management depends on public awareness of the private and societal costs of open residue burning.
Innovative techniques for developing an inclusive teaching environment
Authors: Fortepiani Lourdes A. , Marsh Susan A.
Published: October 2023

The educational landscape is becoming increasingly diverse, and there is a pressing need to ensure equity and inclusion in the classroom. In this article, we offer innovative techniques addressed during the 2022 Experimental Biology symposium on inclusive teaching and provide six practical recommendations for educators: 1) being intentional about how and what content is taught, 2) not making assumptions about students, 3) not being afraid to introduce students to difficult subjects, 4) designing a pedagogical approach to include all students, 5) being transparent about personal intentions, and 6) adjusting an approach that isn’t working for both teacher and students.
Ethnoveterinary Study of Plant‐Based Remedies for Treating Diseases in Small Ruminants in Maputo Province, Mozambique
Authors: Barbosa Filomena M. A. , Cala Aida C. , Sevastyanov Viktor , Boane Ernesto , Hlashwayo Delfina F.
Published: October 2023

Small ruminants, particularly goats and sheep, are key livestock species in Mozambique, and their production is mainly undertaken by families. However, small ruminants are often plagued by diseases that can cause considerable economic damage. In this context, traditional remedies, including various plant species, have been widely used to manage these diseases. The aim of this study was to explore the use of plant‐based remedies and other treatments for managing diseases in small ruminants in Maputo Province, Mozambique. Data collection involved conducting interviews with 44 small ruminant breeders across 5 districts in Maputo Province to identify the plants and other remedies commonly used for managing diseases in their animals. We identified a total of 38 plant species belonging to 22 families. Among these plants, four were not identified by their scientific name. The most important plants reported were Cissus quadrangularis, Euphorbia kirkii, and Aloe sp., with Cissus quadrangularis being particularly noteworthy as it was frequently cited for the treatment of wounds. The most commonly cited botanical families were Fabaceae, Euphorbiaceae, and Asphodelaceae. Interestingly, in addition to plant‐based remedies, we also identified other nonplant sources of treatment, such as alkaline batteries, which are commonly used to treat wounds in small ruminants. The use of plants for ethnoveterinary purposes remains prevalent in Maputo province, with older breeders serving as the primary custodians of this traditional knowledge. Efforts should be made to document and share the knowledge of these older breeders, ensuring that it is not lost over time. This preservation of ethnoveterinary knowledge can contribute to sustainable livestock management and support the wellbeing of both rural communities and their animals.
Microenvironmental GABA Signaling Regulates Melanomagenesis through Reciprocal Melanoma–Keratinocyte Communication
Authors: Ceol Craig J.
Published: October 2023

GABA signaling by melanoma cells was found by Tagore and colleagues to trigger keratinocyte-driven growth of melanomas. This study reveals new roles for nonneuronal signaling by a neurotransmitter in regulating tumor initiation and outgrowth.

See related article by Tagore et al., p. 2270 (4).
Nondental Invasive Procedures and Risk of Infective Endocarditis: Time for a Revisit: A Science Advisory From the American Heart Association
Authors: Baddour Larry M. , Janszky Imre , Thornhill Martin H. , Esquer Garrigos Zerelda , DeSimone Daniel C. , Welty-Wolf Karen , Baker Annette L. , Jone Pei-Ni , Prendergast Bernard , Dayer Mark J. ,   on behalf of the American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young (Young Hearts) and Council on Cardiovascular and Stroke Nursing
Published: October 2023

There have been no published prospective randomized clinical trials that have: (1) established an association between invasive dental and nondental invasive procedures and risk of infective endocarditis; or (2) defined the efficacy and safety of antibiotic prophylaxis administered in the setting of invasive procedures in the prevention of infective endocarditis in high-risk patients. Moreover, previous observational studies that examined the association of nondental invasive procedures with the risk of infective endocarditis have been limited by inadequate sample size. They have typically focused on a few potential at-risk surgical and nonsurgical invasive procedures. However, recent investigations from Sweden and England that used nationwide databases and demonstrated an association between nondental invasive procedures, and the subsequent development of infective endocarditis (in particular, in high-risk patients with infective endocarditis) prompted the development of the current science advisory.
Glycolysis Promotes Angiotensin II–Induced Aortic Remodeling Through Regulating Endothelial-to-Mesenchymal Transition via the Corepressor C-Terminal Binding Protein 1
Authors: Wang Litao , Guo Shuai , Cao Kaixiang , Li Ziling , Li Zou , Song Mingchuan , Wang Cailing , Chen Peiling , Cui Ying , Dai Xiaoyan , Feng Du , Fu Xiaodong , He Jun , Xu Yiming
Published: October 2023

BACKGROUND:

Endothelial dysfunction plays a crucial role in aortic remodeling. Aerobic glycolysis and endothelial-to-mesenchymal transition (EndoMT) have, respectively, been suggested to contribute to endothelial dysfunction in many cardiovascular diseases. Here, we tested the hypothesis that glycolytic reprogramming is critical for EndoMT induction in aortic remodeling through an epigenetic mechanism mediated by a transcriptional corepressor CtBP1 (C-terminal binding protein 1), a sensor of glycolysis-derived NADH.

METHODS:

EndoMT program, aortic remodeling, and endothelial expression of the glycolytic activator PFKFB3 (6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase isoform 3) were evaluated in Ang (angiotensin) II–infused mice. Mice with endothelial-specific
Pfkfb3
deficiency or CtBP1 inactivation, immunoprecipitation, chromatin immunoprecipitation, and luciferase reporter assay were employed to elucidate whether and how PFKFB3/CtBP1 epigenetically controls EndoMT.

RESULTS:

The EndoMT program and increased endothelial PFKFB3 expression were induced in remodeled thoracic aortas. In TGF-β (transforming growth factor-β)–treated human endothelial cells, activated SMAD2/3 (SMAD Family Member 2/3) transcriptionally upregulated PFKFB3 expression. In turn, the TGF-β/SMAD signaling and EndoMT were compromised by silencing or inhibition of PFKFB3. Mechanistic studies revealed that PFKFB3-mediated glycolysis increased NADH content and activated the NADH-sensitive CtBP1. Through interaction with the transcription repressor E2F4 (E2F Transcription Factor 4), CtBP1 enhanced E2F4-mediated transcriptional repression of SMURF2 (SMAD ubiquitin regulatory factor 2), a negative regulator of TGF-β/SMAD2 signaling. Additionally, EC-specific
Pfkfb3
deficiency or CtBP1 inactivation in mice led to attenuated Ang II–induced aortic remodeling.

CONCLUSIONS:

Our results demonstrate a glycolysis-mediated positive feedback loop of the TGF-β signaling to induce EndoMT and indicate that therapeutically targeting endothelial PFKFB3 or CtBP1 activity could provide a basis for treating EndoMT-linked aortic remodeling.