bluuebunny/crossref_metadata_2025 huggingface dataset:
Military family dynamics in transition: The experiences of young people when their families leave the Australian Defence Force
Authors: Wells Hannah , Heinsch Milena , Brosnan Caragh , Kay‐Lambkin Frances
Published: December 2021

Many families experience a smooth transition from military to civilian life. However, some can face intense challenges and significant disruption to family functioning, including mental health and substance use issues, domestic and family violence, marriage dissatisfaction or family breakdown, and even suicide. While some research has examined these transition experiences of ex‐serving men and women, few studies have focused on their children. Understanding the challenges and opportunities the military–civilian transition poses for young people is crucial if we are to develop effective interventions to meet their needs in the future. This paper reports on findings from a qualitative study that retrospectively explored the experiences of young people from ex‐serving Australian Defence Force families when their parents left the military. Using thematic analyses, three key themes relating to military family dynamics were identified: (i) increased mental health stress, (ii) shifts in family relationships and dynamics, and (iii) domestic violence and maltreatment. These themes are discussed alongside the existing literature, revealing the challenges experienced by young people during the military–civilian transition, but also their innate strengths and resources in coping with this major life event. Implications for the social work profession and for developing effective transition supports for young people from ex‐serving families are considered.
Guidelines for diagnosis, prevention, and treatment of hand eczema
Authors: Thyssen Jacob P. , Schuttelaar Marie L. A. , Alfonso Jose H. , Andersen Klaus E. , Angelova‐Fischer Irena , Arents Bernd W. M. , Bauer Andrea , Brans Richard , Cannavo Alicia , Christoffers Wianda A. , Crépy Marie‐Noelle , Elsner Peter , Fartasch Manigé , Filon Francesca Larese , Giménez‐Arnau Ana M. , Gonçalo Margarida , Guzmán‐Perera Maria G. , Hamann Carsten R. , Hoetzenecker Wolfram , Johansen Jeanne Duus , John Swen M. , Kunkeler Amalia C. M. , Hadzavdic Suzana Ljubojevic , Molin Sonja , Nixon Rosemary , Oosterhaven Jart A. F. , Rustemeyer Thomas , Serra‐Baldrich Esther , Shah Mili , Simon Dagmar , Skudlik Christoph , Spiewak Radoslaw , Valiukevičienė Skaidra , Voorberg Angelique N. , Weisshaar Elke , Agner Tove
Published: December 2021

Background

Hand eczema is a common inflammatory skin disorder. Health care providers need continuously updated information about the management of hand eczema to ensure best treatment for their patients.

Objectives

To update the European Society of Contact Dermatitis guideline on the diagnosis, prevention, and treatment on of hand eczema.

Method

The Guideline Development Group (GDG) was established on behalf of the ESCD. A call for interest was launched via the ESCD website and via the ESCD members' mailing list. Appraisal of the evidence for therapeutic and preventive interventions was applied and a structured method of developing consensus was used and moderated by an external methodologist. The final guideline was approved by the ESCD executive committee and was in external review on the ESCD webpage for 1 month.

Results

Consensus was achieved for several statements and management strategies.

Conclusion

The updated guideline should improve management of hand eczema.
The ecological and evolutionary significance of effectiveness landscapes in mutualistic interactions
Authors: Gómez José María , Schupp Eugene W. , Jordano Pedro
Published: December 2021

Mutualism effectiveness, the contribution of an interacting organism to its partner's fitness, is defined as the number of immediate outcomes of the interactions (quantity component) multiplied by the probability that an immediate outcome results in a new individual (quality component). These components form a two‐dimensional effectiveness landscape with each species’ location determined by its values of quantity (x‐axis) and quality (y‐axis). We propose that the evolutionary history of mutualistic interactions leaves a footprint that can be identified by three properties of the spatial structure of effectiveness values: dispersion of effectiveness values, relative contribution of each component to the effectiveness values and correlation between effectiveness components. We illustrate this approach using a large dataset on synzoochory, seed dispersal by seed‐caching animals. The synzoochory landscape was clumped, with effectiveness determined primarily by the quality component, and with quantity and quality positively correlated. We suggest this type of landscape structure is common in generalised coevolved mutualisms, where multiple functionally equivalent, high‐quality partners exert similarly strong selection. Presumably, only those organisms located in high‐quality regions will impact the evolution of their partner. Exploring properties of effectiveness landscapes in other mutualisms will provide new insight into the evolutionary and ecological consequences of mutualisms.
Assessment of human parvovirus B19 infection in Egyptian hemodialysis patients
Authors: Mohammad Mai H. S. , Fawzy Mohamed , Rabie Abeer G. E. , Attia Fadia M. , Anani Maha M.
Published: December 2021

Introduction

Parvovirus B19V has been shown to be associated with end‐stage renal disease (ESRD) with increased risk of post‐infection anemia, especially in hemodialysis (HD) patients. This effect may be due to immunosuppression, insufficient erythropoietin, or short lifespan of red blood cells. Therefore, parvovirus infection should be investigated in this group of patients suffering from anemia or pancytopenia. We assessed the frequency of parvovirus B19 in HD patients attending Suez Canal University Hospital and analyzed the correlation of this infection with hematological parameters in those patients compared with normal individuals.

Methods

We recruited 80 ESRD patients on hemodialysis and 70 healthy controls. History‐taking, full examination, and complete blood count (CBC) were performed for all study subjects. Parvovirus B19 detection was performed through polymerase chain reaction (PCR), which included the QIAamp DNA Mini Kit for extracting DNA, which was amplified using TaqMan Universal Master Mix and detected using TaqMan MGB probes by real‐time PCR using Rotor Gene Analyzer (6000).

Findings

HD patients had a significantly higher frequency of B19V infection than the control group (p = .02). We also found that parvovirus B19‐infected HD patients had significantly lower CBC values than uninfected patients.

Conclusion

The frequency of parvovirus B19 was significantly higher in HD patients and was associated with lower hematological parameters than in uninfected patients, suggesting a significant role of this virus in the pathogenesis of anemia and/or pancytopenia in ESRD.
Uridine alleviates carbon tetrachloride‐induced liver fibrosis by regulating the activity of liver‐related cells
Authors: Zheng Wei V. , Li Yaqin , Cheng Xianyi , Xu Yanwei , Zhou Tao , Li Dezhi , Xiong Yu , Wang Shaobin , Chen Zaizhong
Published: December 2021

At present, liver fibrosis is a major challenge of global health. When hepatocyte regeneration cannot compensate for hepatocyte death, it will develop into liver fibrosis in chronic liver disease. Initially, collagen produced by myofibroblasts plays a role in maintaining liver integrity, but excessive collagen accumulation can inhibit the residual liver function, leading to liver failure. At present, many scientists are actively looking for drugs to alleviate liver fibrosis. In the current study, we investigated the potential role of uridine in the treatment of liver fibrosis (uridine is a plant/animal‐derived pyrimidine nucleoside, therefore uridine can also be ingested and absorbed by the body, accompanied by the process of food intake). For this, we systematically studied the effect of uridine on CCl4‐induced liver fibrosis in vitro and in vivo through a series of technologies, such as Western blot, laser confocal scanning microscope, ELISA and immunohistochemistry. The experimental results showed that uridine can effectively reduce the accumulation of collagen in liver. Furthermore, uridine can improve the activity of liver cells and alleviate CCl4‐induced liver injury. Furthermore, uridine can significantly alleviate the risk factors caused by hepatic stellate cell activation, uridine treatment significantly down‐regulated the expression of α‐SMA, collagen type‐I and fibronectin. In conclusion, the current research shows that uridine can alleviate CCl4‐induced liver fibrosis, suggesting that uridine can be used as a potential drug to alleviate liver fibrosis.
Research Review: Neuropsychological functioning in young anorexia nervosa: A meta‐analysis
Authors: Stedal Kristin , Scherer Ronny , Touyz Stephen , Hay Phillipa , Broomfield Catherine
Published: December 2021

Background

Cognitive inflexibility and compulsive behaviours are commonly observed in patients with anorexia nervosa (AN) and are often considered to be caused by impairments in executive functioning and visuospatial processing. Despite an increasing number of young individuals presenting with AN, there is a lack of meta‐analytic evidence on the neuropsychological functioning in this population. Our primary aim was to review and synthesize the differences in neuropsychological test performance between young people with AN and healthy controls, and to explore potential moderators.

Methods

A database search following PRISMA guidelines of MEDLINE, PsycINFO, ISI Web of Science and Epistemonikos was conducted. Hedges' g served as an effect size indicating the standardized mean differences. We utilized mixed‐effects meta‐regression and machine learning meta‐analyses to identify relevant moderators.

Results

Sixteen studies met the inclusion criteria with a total of 1333 participants (665 with AN) and 59 effect sizes. Random‐effects meta‐analyses demonstrated a small and insignificant difference between young individuals with AN and controls ( = −0.144, 95% CI [−0.328, 0.041]) in overall neuropsychological functioning. However, the difference was significant for the cognitive domains of memory, working memory and visuospatial abilities. Moderator and machine‐learning analyses revealed a stronger negative effect in older participants and moderator effects of country and assessment quality.

Conclusions

Our findings highlight the significant impact of age on neuropsychological test performance in patients with AN. There is a need for a more widespread inclusion of potentially confounding variables in primary studies as well as instruments specifically targeted at younger populations.
Esthetic evaluation of single implant‐supported prostheses: Comparative analysis of the reliability of the esthetic indices
Authors: Hamdane Khaireddine , Nasri Wafa
Published: December 2021

Objectives

To carry out a detailed analysis of four indices proposed for the esthetic evaluation of implant‐supported single crowns in the anterior maxillary sector.

Material and methods

Four esthetic indices were selected: the Pink and white esthetic score, the Copenhagen Index Score, the peri‐implant and crown index (PICI), and the implant restoration esthetic index (IREI). The examiners were 15 expert subjects and 30 nonexpert ones. The intraclass correlation coefficient was used to assess reproducibility. The validity and the correlation of the esthetic indices results with the perception of nonexpert subjects were evaluated using the Pearson's correlation.

Results

For inter‐ and intra‐observer reproducibility, all the esthetic indices had an intraclass correlation coefficient value>0.8. As for validity, the highest correlation values were found for the PICI and for the IREI. The values of correlation with the perception of nonexpert subjects did not exceed 0.3 for all esthetic indices.

Conclusions

All esthetic indices evaluated presented good intra‐ and inter‐rater reproducibility. Validity was considered satisfactory only for the PICI and the IREI. The correlation with the perception of nonexpert subjects showed a weak correlation with all the indices considered.

Clinical significance

An approved esthetic indice with proven reproducibility and validity could provide a better objective overview of one's own esthetic results in the daily practice. It could also help to record the results over time to analyze the stability of the treatment procedure. The esthetic results of the different surgical and prosthetic protocols can also be compared, which facilitates the analysis of the indications relevance and clinical effects. However, low reproducibility according to the specialty and the practitioner's level of expertise was observed. A heterogeneity of results was also noted when compared with those of nonexpert subjects.
Cast‐tape drying and freeze drying of tucumã pulp into powder
Authors: da Silva Rafael Sarmento , Aguiar Nayara Vilhena , Durigon Angelise , de Oliveira Antônio Martins
Published: December 2021

This study aimed to investigate the drying of tucumã pulp into powder by cast‐tape drying (CTD) and freeze drying (FD). Bioactive compounds and the physicochemical properties of the pulp and powder were investigated. Tucumã pulp (2 mm thick pulp) was dehydrated by cast‐tape drying in a short time (8 min) due to the high drying rate, and by freeze drying for 21 h at 0.02 kPa. The powders presented moisture content of 0.04 g/g (d.b.) and water activity lower than 0.40. The degradation of bioactive compounds was of 55.8 and 37.5% of antioxidant activity index, as well as 50.1 and 26.9% of total phenolic compounds in the pulp dried by CTD and by FD, respectively. The greater degradation of bioactive compounds in the powder obtained by CTD is due to the higher pulp temperature and oxidation reactions. Both drying processes reduced β‐carotene, accounting for 45.8% for powders obtained by CTD and 31.2% by FD. However, the degradation of carotenoids did not influence the color of the pulp reconstituted when compared to the raw pulp. Despite possible biocomposite losses due to drying, the results showed that tucumã powders present relatively good values of bioactive compounds in relation to the data reported in the literature. Therefore, FD and CTD processes are appropriate to dehydrate tucumã pulp without adding carrier agents and that can be marketed without refrigeration, which is essential in regions with transport logistics issues. The advantage of CTD over FD is the higher drying rates.

Practical Applications

Tucumã is a typical exotic fruit from the Amazon region, which is rich in phenolics and antioxidants. This fruit is of great importance in the Amazon and deserves studies that make its conservation viable. Freeze drying and cast‐tape drying processes are considered appropriate conservation methods for the tucumã pulp, as they enable to retain a part of the bioactive compounds of the raw material. Moreover, tucumã powder has potential applications in food, chemical, and pharmaceutical areas.
Factors associated with food choice among long‐term weight loss maintainers
Authors: Young Jacob , Phelan Suzanne , Alarcon Noemi , Roake James , Rethorst Chad D. , Foster Gary D.
Published: December 2021

Background

The present study aimed to examine motivations for food choice among long‐term weight loss maintainers (WLM) in a widely used commercial weight management program.

Methods

A cross‐sectional study was employed where determinants of food choice were measured in the USA using validated scales: Food Choice Questionnaire, Consideration of Future Consequences, and Eating in the Absence of Hunger. Participants were 3806 WLM following a commercial weight management program (WW International, Inc.) who had maintained a weight loss ≥ 9.1 kg (mean 24.7 kg) for 3.3 years and had a body mass index (BMI) of 27.6 kg m2. A control group of weight stable individuals with obesity (controls; n = 519) had a BMI of 38.9 kg m2 and a weight change < 2.3 kg over the previous 5 years.

Results

WLM vs. controls made food decisions more based on health (18.9 vs. 16.3; ηp2 = 0.052) and weight control (9.9 vs. 7.5; ηp2 = 0.16) and less based on price (8.4 vs. 9.1; ηp2 = 0.10). WLM also scored higher than controls with respect to considering future consequences of behaviours (44.3 vs. 38.4; ηp2 = 0.060) and reported less external eating in the absence of hunger (7.1 vs. 7.5; ηp2 = 0.058). Standard canonical coefficients indicated that making food choices based on weight (0.717) with less value placed on price (−0.33) and greater consideration of future consequences (0.262) contributed independently and most (overall r = 0.593; p = 0.0001) to discriminating WLM from controls.

Conclusions

In a widely used commercial weight management program, successful WLM reported food decisions based more on weight and less on price and considered future consequences of current behaviours.
SGIP1 modulates kinetics and interactions of the cannabinoid receptor 1 and G protein‐coupled receptor kinase 3 signalosome
Authors: Gazdarica Matej , Noda Judith , Durydivka Oleh , Novosadova Vendula , Mackie Ken , Pin Jean‐Philippe , Prezeau Laurent , Blahos Jaroslav
Published: December 2021

Cannabinoid receptor 1 (CB1R), a G protein‐coupled receptor, plays a fundamental role in synaptic plasticity. Abnormal activity and deregulation of CB1R signaling result in a broad spectrum of pathological conditions. CB1R signaling is regulated by receptor desensitization including phosphorylation of residues within the intracellular C terminus by G protein‐coupled receptor kinases (GRKs) that may lead to endocytosis. Furthermore, CB1R signaling is regulated by the protein Src homology 3‐domain growth factor receptor‐bound 2‐like (SGIP1) that hinders receptor internalization, while enhancing CB1R association with β‐arrestin. It has been postulated that phosphorylation of two clusters of serine/threonine residues, 425SMGDS429 and 460TMSVSTDTS468, within the CB1R C‐tail controls dynamics of the association between receptor and its interaction partners involved in desensitization. Several molecular determinants of these events are still not well understood. We hypothesized that the dynamics of these interactions are modulated by SGIP1. Using a panel of CB1Rs mutated in the aforementioned serine and threonine residues, together with an array of Bioluminescence energy transfer‐based (BRET) sensors, we discovered that GRK3 forms complexes with Gβγ subunits of G proteins that largely independent of GRK3’s interaction with CB1R. Furthermore, CB1R interacts only with activated GRK3. Interestingly, phosphorylation of two specific residues on CB1R triggers GRK3 dissociation from the desensitized receptor. SGIP1 increases the association of GRK3 with Gβγ subunits of G proteins, and with CB1R. Altogether, our data suggest that the CB1R signalosome complex is dynamically controlled by sequential phosphorylation of the receptor C‐tail and is also modified by SGIP1.

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Class formation and capital accumulation in the countryside: Artisanal and small‐scale gold mining in South Kivu, DR Congo
Authors: Radley Ben
Published: December 2021

To date, the expansive social science literature on artisanal and small‐scale mining (ASM) in Africa has received little attention from scholars of agrarian political economy. This paper attempts to bridge this gap, based on an in‐depth study of ASM in South Kivu Province of the Democratic Republic of the Congo. The main argument is that the capital–labour social relation underpinning ASM in South Kivu has facilitated the emergence of a capitalist managerial class of dynamic and prosperous rural Congolese. This class has, in turn, been driving increasing sectoral productivity via technological assimilation and capital formation, while also making commercial and productive investments in other, non‐mining sectors. Drawing from the findings, the common conceptualisation of African ASM as a low productivity, subsistence activity is questioned, and the perception in the existing literature that African ASM miners and foreign mining corporations are not in competition for the same mineral deposits is challenged.
A randomized comparative study of the effect of two different flow rates of carboxytherapy in the treatment of infraorbital dark circles
Authors: Roshdy Ossama Hussein , Abd Elall Heba Mahmoud , Eid Amira Abulfotooh
Published: December 2021

Background

Carboxytherapy is a minimally invasive, relatively safe modality that has been used for the treatment of dark circles; however, different flow rates and different injection techniques have been described in the literature.

Aim

To study the effect of the flow rate on the therapeutic outcome of carboxytherapy in infraorbital dark circles.

Methods

Eighty patients with infraorbital dark circles were divided into two equal groups: Group A received carboxytherapy at a flow rate of 30 ml/min, and group B received carboxytherapy at a flow rate of 60 ml/min. Patients received weekly sessions for 6 weeks, and the treatment response was evaluated 6 weeks after the last treatment session.

Results

Significant improvement of the dark circles was detected in both treatment groups. However, no significant difference in the treatment response was found when both flow rates were compared. The frequency of development of side effects was significantly higher in the group receiving CO2 at a flow rate of 60 ml/min. No significant difference in the overall post‐treatment patient satisfaction between the two groups was detected.

Conclusion

Carboxytherapy is an effective therapeutic modality for infraorbital dark circles. Lower flow rates achieve therapeutic responses similar to higher flow rates but with fewer side effects.
How can bibliometric approaches help to understand the field of medical education?
Authors: Møller Jane Ege , Malling Bente
Published: December 2021

The authors argue the merits of a ‘community of practice’ based understanding when trying to identify the field of medical education and medical education research.
Interplay between abiotic (drought) and biotic (virus) stresses in tomato plants
Authors: Mishra Ritesh , Shteinberg Moshik , Shkolnik Doron , Anfoka Ghandi , Czosnek Henryk , Gorovits Rena
Published: December 2021

With climate warming, drought becomes a vital challenge for agriculture. Extended drought periods affect plant–pathogen interactions. We demonstrate an interplay in tomato between drought and infection with tomato yellow leaf curl virus (TYLCV). Infected plants became more tolerant to drought, showing plant readiness to water scarcity by reducing metabolic activity in leaves and increasing it in roots. Reallocation of osmolytes, such as carbohydrates and amino acids, from shoots to roots suggested a role of roots in protecting infected tomatoes against drought. To avoid an acute response possibly lethal for the host organism, TYLCV down‐regulated the drought‐induced activation of stress response proteins and metabolites. Simultaneously, TYLCV promoted the stabilization of osmoprotectants' patterns and water balance parameters, resulting in the development of buffering conditions in infected plants subjected to prolonged stress. Drought‐dependent decline of TYLCV amounts was correlated with HSFA1‐controlled activation of autophagy, mostly in the roots. The tomato response to combined drought and TYLCV infection points to a mutual interaction between the plant host and its viral pathogen.
Understanding the root xylem plasticity for designing resilient crops
Authors: Cornelis Salves , Hazak Ora
Published: December 2021

Xylem is the main route for transporting water, minerals and a myriad of signalling molecules within the plant. With its onset during early embryogenesis, the development of the xylem relies on hormone gradients, the activity of unique transcription factors, the distribution of mobile microRNAs, and receptor–ligand pathways. These regulatory mechanisms are often interconnected and together contribute to the plasticity of this water‐conducting tissue. Environmental stresses, such as drought and salinity, have a great impact on xylem patterning. A better understanding of how the structural properties of the xylem are regulated in normal and stress conditions will be instrumental in developing crops of the future. In addition, vascular wilt pathogens that attack the xylem are becoming increasingly problematic. Further knowledge of xylem development in response to these pathogens will bring new solutions against these diseases. In this review, we summarize recent findings on the molecular mechanisms of xylem formation that largely come from Arabidopsis research with additional insights from tomato and monocot species. We emphasize the impact of abiotic factors and pathogens on xylem plasticity and the urgent need to uncover the underlying mechanisms. Finally, we discuss the multidisciplinary approach to model xylem capacities in crops.
Gamer's nodulesBRIEF REPORT
Authors: O’Sullivan Sorcha Louise , Mellerio Jemima E. , Semkova Kristina
Published: December 2021

A 15‐year‐old boy presented with a two‐year history of subcutaneous nodules on his feet that were painful on palpation and with footwear. The patient is an avid gamer, and his mother had noted a distinct sitting position as he sat playing his console. Skin biopsy showed features of a collagenoma, consistent with previous reports of repetitive pressure lesions associated with various sports and religious practices. It is important to be aware of these “gamer's nodules” that result from prolonged periods of fixed seating postures.
Approaches to ethics in the Laozi (Lao‐Tzu)
Authors: D’Ambrosio Paul J.
Published: December 2021

This paper will look at five major approaches to interpreting “ethics” in theLaozi. There is a good deal of controversy over what type of ethics might be promoted in theLaoziand additional discussions of whether or not any the text includes ethical concerns at all. We begin with a basic introduction todao道 (way) and certain patterns of thinking in theLaozibefore moving on to a sketch ofziran自然 or “self‐so” andwuwei無為 or “nonaction.” The first approach finds an account of ethics already within these two concepts. The second sees Confucian virtues along with sincerity, simplicity, purity, and genuineness as ethical guides. Looking to the underpinnings of these reading, the third approach findsdaoitself as moral, and any action in accordance withdaois deemed ethical. However, likedao, being ethical in this manner is considered ineffable. The fourth type of interpretation argues that theLaoziis critical of ethics itself. Finally, we look at how the model of the “sage” can be related to “ethics” or “êthos” in a broad sense. In the short conclusion general agreements that pervade all five approaches will be outlined. These include resisting standardization of ethics and an implicit understanding of human nature as “okay.”
Formation of Coelenteramine from 2‐Peroxycoelenterazine in the Ca2+‐Binding Photoprotein Aequorin
Authors: Inouye Satoshi , Nakamura Mitsuhiro , Hosoya Takamitsu
Published: December 2021

Aequorin consists of apoprotein (apoAequorin) and (S)‐2‐peroxycoelenterazine (CTZ‐OOH) and is considered to be a transient‐state complex of an enzyme (apoAequorin) and a substrate (coelenterazine and molecular oxygen) in the enzymatic reaction. The degradation process of CTZ‐OOH in aequorin was characterized under various conditions of protein denaturation. By acid treatment, the major product from CTZ‐OOH was coelenteramine (CTM), but not coelenteramide (CTMD), and no significant luminescence was observed. The counterparts of CTM from CTZ‐OOH were identified as 4‐hydroxyphenylpyruvic acid (4HPPA) and 4‐hydroxyphenylacetic acid (4HPAA) by liquid chromatography/electrospray ionization–time‐of‐flight mass spectrometry (LC/ESI‐TOF‐MS). In the luminescence reaction of aequorin with Ca2+, similar amounts of 4HPPA and 4HPAA were detected, indicating that CTM is formed by two pathways from CTZ‐OOH through dioxetanone anion and not by hydrolysis from CTMD.
Operational collaboration between rivals: The impact of cost reduction
Authors: Geng Xin , Krishnan Harish , Sohoni Milind G.
Published: December 2021

Business rivals often collaborate on specific aspects of their operations in order to achieve cost efficiency. To better understand and manage such an operational collaboration, we formulate a multi‐stage duopoly competition model to study the strategic and welfare implications of a cost‐reducing cooperation between competing firms. Without any additional agreement beyond the collaborative effort in deterministic cost reduction, we characterize intuitive conditions under which there exists a unique equilibrium for the operational collaboration, where the high‐cost firm inputs more effort. Furthermore, the equilibrium cost reduction would benefit both firms when they have similar costs and/or their products have small substitutability. Moreover, such a pure operational collaboration never hurts consumer surplus. We then consider the effect of facilitating agreements and find that, with a properly designed unit transfer payment, the competition may be softened so that both firms are willing to collaborate. However, consumer surplus may decrease as a consequence. Finally, we assume that firms could receive signals of some random shock on the cost reduction process and examine the resulting Bayesian game. If the random shock is on the cost reduction fraction, then firms' equilibrium efforts could be independent of the random signal. If, however, the random shock is on the effort, then we apply simplifying assumptions and use special stochastic orders to capture the impact of signal variability on firms' effort levels. Our findings provide useful managerial insights into the underlying drivers of an operational collaboration between rivals.
Spatial pattern of COVID-19 in Bangladesh: an ecological study
Authors: Islam Jahirul , Guo Xiya , Ali Md Ahasan , Islam Md Ashraful , Qi Xin , Zhuang Guihua
Published: December 2021

Objective

To analyse the spatial clustering of COVID-19 case fatality risks in the districts of Bangladesh and to explore the association of sociodemographic indicators with these risks.

Study design

Ecological study.

Study setting

Secondary data were collected for a total of 64 districts of Bangladesh.

Methods

The data for district-wise COVID-19 cases were collected from the Ministry of Health and Family Welfare, Bangladesh from March 2020 to June 2020. Socioeconomic and demographic data were collected from National Census Data, 2011. Retrospective spatial analysis was conducted based on district-wise COVID-19 cases in Bangladesh. Global Moran’sIwas adopted to find out the significance of the clusters. Furthermore, generalised linear model was conducted to find out the association of COVID-19 cases with sociodemographic variables.

Results

Total 87 054 COVID-19 cases were included in this study. The epidemic hotspots were distributed in the 11 most populous cities. The most likely clusters are primarily situated in the central, south-eastern and north-western regions of the country. High-risk clusters were found in Dhaka (Relative Risk (RR): 5.22), Narayanganj (RR: 2.70), Chittagong (RR: 1.69), Munshiganj (RR: 2.31) Cox’s Bazar (RR: 1.63), Faridpur (RR: 1.65), Gazipur (RR: 1.33), Bogra (RR: 1.35), Khulna (RR: 1.22), Barishal (RR: 1.07) and Noakhali (RR: 1.06). Weekly progression of COVID-19 cases showed spatially clustered by Moran’sIstatistics (p value ranging from 0.013 to 0.436). After fitting a Poisson linear model, we found a positive association of COVID-19 with floating population rate (RR=1.542, 95% CI 1.520 to 1.564), and urban population rate (RR=1.027, 95% CI 1.026 to 1.028).

Conclusion

This study found the high-risk cluster areas in Bangladesh and analysed the basic epidemiological issues; further study is needed to find out the common risk behaviour of the patients and other relative issues that involve the spreading of this infectious disease.
Association between functional disability and depressive symptoms among older adults in rural China: a cross-sectional study
Authors: Rong Jian , Wang Xueqin , Ge Yanhong , Chen Guimei , Ding Hong
Published: December 2021

Objectives

The aim of this study was to explore the relationship between functional disability and depressive symptoms, focusing on whether an interaction exists between functional disability, demographic characteristics and depressive symptoms among older adults in rural China.

Design

A cross-sectional study using multistage, stratified random sampling.

Setting

Data from 18 villages in Anhui Province of China between January to July 2018.

Participants

3491 Chinese participants aged 60 and over.

Primary and secondary outcome measures

The 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. Data were analysed using SPSS statistics V.25.0 program with χ2test, Mann-Whitney U test, binary logistic regression analysis and classification and regression tree (CART) model.

Results

The prevalence of depressive symptoms in 3336 interviewed older people was 52.94%. After adjustment, subjects who had problems in mobility domain (adjusted OR (AOR) 1.842, 95% CI 1.503 to 2.258), getting along domain (AOR 1.616, 95% CI 1.299 to 2.010), life activities domain (AOR 1.683, 95% CI 1.370 to 2.066) and participation domain (AOR 3.499, 95% CI 2.385 to 4.987) had an increased depressive symptoms risk. However, cognition domain (AOR 0.785, 95% CI 0.647 to 0.953) negatively correlated with depressive symptoms. Additionally, the CART model showed that those who had problems in mobility domain, getting along domain and were unemployed, the possibility of having depressive symptoms was the highest.

Conclusions

More attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along and mobility and no problems in cognition to maintain a good psychological state.
Smoking prevention in adolescents: a cross-sectional and qualitative evaluation of a newly implemented prevention program in Switzerland
Authors: Meienberg Andrea , Mayr Michael , Vischer Annina , Zellweger Michael J , Burkard Thilo
Published: December 2021

Objectives

In 2014, a hospital-based smoking prevention programme ‘Nichtrauchen ist clever!’ (NIC!) for adolescents aged 12–14 was initiated. The aim of the study was to evaluate participants’ smoking behaviour and to explore the acceptance of the programme, and participants’ awareness on smoking-related diseases and factors that promote smoking initiation.

Design

We performed a cross-sectional survey to evaluate participant’s acceptance of the NIC! program and their smoking habits. A total of 1658 participants completed the survey between January 2016 and December 2019. A qualitative approach, including analysing feedback from students gathered at 77 prevention events between June 2014 and December 2019, was used to assess their view on reasons for smoking initiation and their knowledge about smoking-related diseases.

Results

Twenty-six per cent (429/1658) have already tried tobacco products (so called triers), specifically cigarettes, electronic (e)-cigarettes and shisha. The use of e-cigarettes was most popular among triers 58% (252/429). Eighty-eight per cent of participants (1408/1604) reported they had acquired good or excellent knowledge about smoking, and 89% (1439/1617) of participants stated that they intend not to smoke in the future. Particularly lung cancer and cancer in general, heart—and vascular diseases were frequently mentioned to be smoking related; where, on the other hand, a large number of relevant smoking-associated diseases were mentioned irregularly. Peer pressure, stress and coolness were identified as reasons for smoking initiation, whereas the influence of marketing and multimedia, as well as socioeconomic—and lifestyle-related factors on smoking behaviour was barely noticed.

Conclusion

NIC! had a high acceptance among the participants and a large number of students reported relevant gain of knowledge. We identified important knowledge-gaps relating to smoking initiation and smoking-related diseases, helping to improve further smoking prevention approaches.
Life-years lost by COVID-19 patients in public hospitals of Marseille (APHM-South-Eastern France): a limited death toll: a retrospective analysis
Authors: Arlotto Sylvie , Garès Alice , Giraud-Gatineau Audrey , Lagier Jean Cristophe , Jimeno Marie-Thérèse , Peretti-Watel Patrick , Million Matthieu , Parola Philippe , Brouqui Philippe , Raoult Didier , Gentile Stephanie
Published: December 2021

Objective

Between 1 March and 15 June, France experienced the first wave of the COVID-19 pandemic, during which 29 549 deaths occurred among COVID-19 patients, 17 250 of whom died in hospital. Our hypothesis is that crude mortality rates are not sufficient to assess the impact of the epidemic on public health. The objective of this paper is to estimate the potential years of life lost (YLL) of patients who died from COVID-19.

Method

We realised a retrospective analysis of the exhaustive sample of COVID-19 PCR-positive patients who died in public hospitals of Marseille during this first wave. Data on demographic characteristics, comorbidities and care pathways were collected from medical records. The Charlson Comorbidity Index (CCI) was used to assess what would have been the probability of dying within 1 year of these patients in the absence of COVID-19 and to estimate total YLL.

Results

Among the 1631 patients who were hospitalised for COVID-19, 178 patients died, at an average age of 80 years. According to CCI, 88.8% of the deceased patients had an 85% probability of dying within 1 year before COVID-19. Among the 11.2% who had a lower CCI probability, 18 out of 20 had at least one additional comorbidity known to be a major risk factor of mortality in COVID-19 disease. Cumulative total number of YLL was estimated to be 541 in this deceased population, that is, an average of 3 YLL.

Conclusion

Although our results should be interpreted with caution, this analysis confirms that mortality due to COVID-19 translates into a limited number of YLL due to both old age and preexisting comorbidities in the most vulnerable patients. This fact should be better considered in public health management of the pandemic both for risk communication and design of the most appropriate protective measures.
Comprehensive geriatric assessment in perioperative care: a protocol for a systematic review and qualitative synthesis
Authors: Miller Rachael Lucia , Barnes Jonathan David , Mouton Ronelle , Braude Philip , Hinchliffe Robert
Published: December 2021

Introduction

Comprehensive geriatric assessment (CGA) is an intervention that has been deployed in the perioperative setting with the aim to improve outcomes for older patients admitted to hospital. Older patients undergoing surgery are more likely to have postoperative complications, a longer hospital stay and be discharged to a care facility. Despite the increasing application of this intervention within surgical services, the evidence for CGA remains limited in this group. The aim of this systematic review is to describe CGA as in intervention applied to surgical populations in randomised controlled trials (RCTs) as well as the outcomes assessed.

Methods and analysis

A systematic search of RCTs of CGA in surgery will be run in Embase, Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Cochrane library. Further articles will be identified from reference lists in relevant studies found in the search. A narrative synthesis will be undertaken outlining specialties included, detailed descriptions of the intervention and outcomes.

Ethics and dissemination

No ethical approval is required. The results of this review will be published and used as the basis of work to optimise this intervention for future trials in surgical populations.

PROSPERO registration number

This review is registered with PROSPERO CRD42020221797.
Development and validation of an algorithm to estimate the risk of severe complications of COVID-19: a retrospective cohort study in primary care in the Netherlands
Authors: Herings Ron M C , Swart Karin M A , van der Zeijst Bernard A M , van der Heijden Amber A , van der Velden Koos , Hiddink Eric G , Heymans Martijn W , Herings Reinier A R , van Hout Hein P J , Beulens Joline W J , Nijpels Giel , Elders Petra J M
Published: December 2021

Objective

To develop an algorithm (sCOVID) to predict the risk of severe complications of COVID-19 in a community-dwelling population to optimise vaccination scenarios.

Design

Population-based cohort study.

Setting

264 Dutch general practices contributing to the NL-COVID database.

Participants

6074 people aged 0–99 diagnosed with COVID-19.

Main outcomes

Severe complications (hospitalisation, institutionalisation, death). The algorithm was developed from a training data set comprising 70% of the patients and validated in the remaining 30%. Potential predictor variables included age, sex, chronic comorbidity score (CCS) based on risk factors for COVID-19 complications, obesity, neighbourhood deprivation score (NDS), first or second COVID-19 wave and confirmation test. Six population vaccination scenarios were explored: (1) random (naive), (2) random for persons above 60 years (60plus), (3) oldest patients first in age band of 5 years (oldest first), (4) target population of the annual influenza vaccination programme (influenza), (5) those 25–65 years of age first (worker), and (6) risk based using the prediction algorithm (sCOVID).

Results

Severe complications were reported in 243 (4.8%) people with 59 (20.3%) nursing home admissions, 181 (62.2%) hospitalisations and 51 (17.5%) deaths. The algorithm included age, sex, CCS, NDS, wave and confirmation test (c-statistic=0.91, 95% CI 0.88 to 0.94) in the validation set. Applied to different vaccination scenarios, the proportion of people needed to be vaccinated to reach a 50% reduction of severe complications was 67.5%, 50.0%, 26.1%, 16.0%, 10.0% and 8.4% for theworker, naive,influenza, 60plus, oldest firstandsCOVIDscenarios, respectively.

Conclusion

The sCOVID algorithm performed well to predict the risk of severe complications of COVID-19 in the first and second waves of COVID-19 infections in this Dutch population. The regression estimates can and need to be adjusted for future predictions. The algorithm can be applied to identify persons with highest risks from data in the electronic health records of general practitioners (GPs).
Identifying patient-important outcomes for treatment of bipolar disorder: a systematic review protocol
Authors: D'Elia Alessia , Orsini Olivia , Sanger Stephanie , Hillmer Alannah , Sanger Nitika , Panesar Balpreet , Rodrigues Myanca , Kapczinski Flavio , Thabane Lehana , Samaan Zainab
Published: December 2021

Introduction

Treatment of bipolar disorder is the focus of several clinical trials, however the understanding of the outcomes for establishing treatment effectiveness within these trials is limited. Further, there is limited literature which reports on the outcomes considered to be important to patients, indicating that patient perspectives are often not considered when selecting outcomes of effectiveness within trials. This protocol describes a systematic review which aims to describe the outcomes being used within trials to measure treatment effectiveness, commenting on the inclusion of patient-important outcomes within previous trials.

Methods and analysis

This protocol is reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols statement. OVID MEDLINE, OVID Embase, OVID APA PsycINFO, Web of Science, the Wiley Cochrane Library, ClinicalTrials.gov and the International Clinical Trials Registry Platform databases will be searched for eligible studies. Screening, full-text and data extraction stages will be completed in duplicate using the Covidence platform for systematic reviews. Eligible studies will include clinical trials of interventions in bipolar disorder, in order to identify outcomes used to assess treatment effectiveness, and qualitative studies, to determine which outcomes have been reported as important by patients. Risk of bias for included studies will be assessed using the Cochrane Risk of Bias Tool for randomised controlled trials, and the Newcastle-Ottawa Scale for observational research.

Ethics and dissemination

This review will involve dissemination to key stakeholders, including primary end users such as patients, clinicians and trialists. Knowledge translation tools will be generated to share the relevant conclusions of this review. Results will be communicated to the scientific community through peer-reviewed publications, conferences and workshops. No ethics approval will be sought as this study is based on literature.

PROSPERO registration number

CRD42021214435.
Impact of healthcare strikes on patient mortality: a protocol for a systematic review and meta-analysis of observational studies
Authors: Essex Ryan , Weldon Sharon Marie , Thompson Trevor , Kalocsanyiova Erika , McCrone Paul , Deb Sanjoy
Published: December 2021

Introduction

A strike is a collective, temporary and calculated action, which involves a temporary stoppage of work. For healthcare professionals strike action poses a unique dilemma. Perhaps most fundamentally, as strike action is designed to be disruptive it has the potential to impact the delivery of care and place patient well-being in jeopardy. The objective of this study is therefore to evaluate the impact of healthcare strike action on patient mortality outcomes globally using meta-analysis in order to provide a comprehensive evidence base that can advise healthcare professionals, governments and regulatory bodies on the impact that strike action has on patients.

Methods and analysis

A comprehensive literature search of major electronic databases (EMBASE, MEDLINE, CINAHL, BIOETHICSLINE, EconLit, WEB OF SCIENCE, OPEN GREY and SIGMA REPOSITORY) will be undertaken to identify observational studies of strike action among healthcare professionals where in-hospital/clinic and population/community mortality is examined, prestrike, during and poststrike. Meta-analysis will be performed to estimate in-hospital/clinic and population/community mortality during periods of strike action. The quality of evidence will be assessed using the National Institute of Health quality assessment tool for observational cohort and cross-sectional studies. Risk of bias will be assessed using the Cochrane Risk Of Bias In Non-Randomized Studies - of Interventions tool.

Ethics and dissemination

This study does not require ethical approval. Findings will be submitted to an appropriate peer-reviewed journal.

Trial registration number

CRD42021238879.