bluuebunny/crossref_metadata_2025 huggingface dataset:
Intra‐ and interobserver agreement in computed tomography localization of primary nonhematopoietic hepatic masses and comparison with surgical and histopathological outcomes in 21 cats
Authors: Bentley Carli , Fouriez‐Lablée Virginie , Rossanese Matteo
Published: May 2024

Computed tomography (CT) is commonly used in the staging of hepatic masses and for liver lobectomy planning. Mass location is an important factor in determining the feasibility of resection, including surgical technique and the likelihood of surgical complications. The objectives of this retrospective descriptive cross‐sectional, observer agreement, method comparison study were to assess the reliability of CT in correctly determining the hepatic division and lobar site of origin of feline primary nonhematopoietic hepatic masses, compared with surgically confirmed locations. Furthermore, it provides an overview of the types and locations of liver masses found in a cohort of cats. Pre‐ and postcontrast CT images of 21 cats were independently and simultaneously reviewed by two observers. Intra‐ and interobserver agreements and descriptive statistics on demographic and histological diagnoses were calculated. Based on surgical assessment, it was found that masses most frequently originated from the left hepatic division (13/24, 54%). The most frequent lobar origins were the left lateral (8/24, 33%), left medial (5/24, 21%), and right medial lobes (5/24, 21%). No masses were found originating from the right lateral lobe. CT correctly determined hepatic division and lobar origin in 76% of cases, with good‐to‐excellent intra‐ and interobserver agreement. The hepatic division had higher agreements overall for both observers. Most of the masses were benign (17/21, 81%), and the most prevalent histological diagnoses were biliary cystadenoma (11/21, 52%) and hepatocellular adenoma (6/21, 29%). Findings suggest that postcontrast CT is a reliable method for correctly determining hepatic mass division and lobar origin in cats.
Computed tomographic findings in canine and feline heart base tumors (25 cases)
Authors: Ruiz de Alejos Blanco Laura , Brust Kelsey , Szladovits Balázs , Drees Randi
Published: May 2024

Tumors located at the heart base are rare in dogs and cats and aortic body tumors (chemodectoma/paraganglioma), hemangiosarcoma, ectopic thyroid carcinoma, lymphoma, and other uncommon neoplasia can be found at that location. The objective of this retrospective case series was to describe the CT characteristics of canine and feline heart base tumors. CT studies of 21 dogs and four cats with histologically or cytologically confirmed heart base tumors were reviewed for size, location, shape, margination, contrast enhancement, adjacent neovascularization, invasion, mass effect, cavitary effusions, and metastasis. Neuroendocrine tumors (15 aortic body tumors, three ectopic thyroid carcinoma, and three nonspecific neuroendocrine) were more commonly observed than hemangiosarcoma (4) and were frequently located between the cranial vena cava and aortic arch (12/21; 57%) and or dorsal to the pulmonary trunk bifurcation/pulmonary arteries (10/21; 48%). Hemangiosarcoma was more commonly found cranioventral to the aortic arch and cranial to the right auricular appendage (3/4; 75%). Mediastinal and peritumoral neovascularization was associated with 16/21 (76%) neuroendocrine tumors but none of the hemangiosarcoma. Median postcontrast attenuation in Hounsfield units (HU) was higher in neuroendocrine (110 HU) than in hemangiosarcoma (51 HU). Pericardial effusion was frequently observed with hemangiosarcoma (3/4; 75%) and infrequently in neuroendocrine (3/21; 14%). In four cases (all neuroendocrine), concurrent cranial mediastinal masses were present. CT provides useful information regarding the characteristics of heart base tumors, indicating differences between the appearance of neuroendocrine tumors and hemangiosarcoma. However, no differences were found between aortic body tumors and ectopic thyroid carcinoma.
Three‐dimensionally printed osteotomy and reaming guides for correction of a multiplanar femoral deformity stabilized with an interlocking nail in a dog
Authors: Scheuermann Logan M. , Kim Stanley E.
Published: May 2024

Objective

To describe the use of virtual surgical planning (VSP) and three‐dimensionally (3D) printed surgical guides for corrective osteotomies stabilized with an interlocking nail in a dog with a multiplanar femoral deformity.

Study design

Case report.

Animals

An 8‐year‐old male neutered mixed breed dog weighing 44 kg.

Methods

A dog was presented for a right grade 3 lateral patellar luxation secondary to a multiplanar femoral deformity due to a suspected femoral malunion. A computed tomography (CT) scan was obtained to create virtual femoral models. Corrective osteotomies were simulated with VSP. Custom osteotomy guides and reaming guides were designed to facilitate the correction and the placement of an interlocking nail. The preoperative femoral model, virtually aligned femoral model, custom osteotomy guides, and reaming guides were 3D printed, sterilized, and utilized intraoperatively. A CT scan was performed postoperatively to assess femoral length and alignment.

Results

Custom osteotomy and reaming guides were used as intended by the VSP. Postoperative femoral length as well as frontal, sagittal, and axial plane alignment were within 0.7 mm, 2.2°, 0.5°, and 1.6°, respectively, of the virtually planned femoral model. Two months postoperatively, the dog was sound on visual gait examination, and the patella tracked in the trochlear groove throughout stifle range of motion and was unable to be manually luxated. Radiographs obtained 2 months postoperatively revealed static femoral alignment and implants. Both osteotomies were discernable with callus bridging.

Conclusion

Virtual surgical planning and custom osteotomy and reaming guides facilitated complex femoral corrective osteotomies and interlocking nail placement.
Human cat borne rabies as the new epidemiology of the disease in the Andes mountains
Authors: Meriño‐Olivella Samir , del Pilar Sánchez‐Bonilla María , Escobar Luis E. , Correa‐Valencia Nathalia M.
Published: May 2024

Background

Rabies virus (RABV) is the etiologic agent of rabies, a fatal brain disease in mammals. Rabies circulation has historically involved the dog has the main source of human rabies worldwide. Nevertheless, in Colombia, cats (Felis catus) have become a relevant species in the epidemiology of rabies.

Aims

To characterize rabies cases in humans in Colombia in the last three decades in the context of the epidemiology of the aggressor animal.

Materials and Methods

We conducted a retrospective longitudinal epidemiological study of human rabies caused by cats’ aggression, collecting primary and secondary information. Variables considered included the demography of the patient, symptoms, information about the aggressor animal as the source of infection and the viral variant identified.

Results

We found that the distribution of rabies incidence over the years has been constant in Colombia. Nevertheless, between 2003 and 2012 a peak of cases occurred in rural Colombia where cats were the most frequent aggressor animal reported. Most cats involved in aggression were unvaccinated against rabies. Cat's clinical signs at the time of the report of the human cases included hypersalivation and changes in behaviour. Human patients were mostly children and female and the exposure primarily corresponded to bite and puncture lacerations in hands. The RABV lineage detected in most cases corresponded to variant 3, linked to the common vampire bat (Desmodus rotundus). The geographical presentation of cat borne RABV in humans occurred along the Andes mountains, epidemiologically known as the rabies red Andean corridor.

Discussion

By finding cats as the primary source of rabies spillover transmission in Colombia, this report highlights the importance of revising national rabies control and prevention protocol in countries in the Andes region.

Conclusion

Our results demonstrate that rabies vaccination for outdoor cats needs to prioritize to reduce the number of rabies‐related human deaths.
Muscle contractile properties directly influence shared synaptic inputs to spinal motor neurons
Authors: Cabral Hélio V. , Inglis J. Greig , Cudicio Alessandro , Cogliati Marta , Orizio Claudio , Yavuz Utku S. , Negro Francesco
Published: May 2024

Alpha band oscillations in shared synaptic inputs to the alpha motor neuron pool can be considered an involuntary source of noise that hinders precise voluntary force production. This study investigated the impact of changing muscle length on the shared synaptic oscillations to spinal motor neurons, particularly in the physiological tremor band. Fourteen healthy individuals performed low‐level dorsiflexion contractions at ankle joint angles of 90° and 130°, while high‐density surface electromyography (HDsEMG) was recorded from the tibialis anterior (TA). We decomposed the HDsEMG into motor units spike trains and calculated the motor units’ coherence within the delta (1–5 Hz), alpha (5–15 Hz), and beta (15–35 Hz) bands. Additionally, force steadiness and force spectral power within the tremor band were quantified. Results showed no significant differences in force steadiness between 90° and 130°. In contrast, alpha band oscillations in both synaptic inputs and force output decreased as the length of the TA was moved from shorter (90°) to longer (130°), with no changes in delta and beta bands. In a second set of experiments (10 participants), evoked twitches were recorded with the ankle joint at 90° and 130°, revealing longer twitch durations in the longer TA muscle length condition compared to the shorter. These experimental results, supported by a simple computational simulation, suggest that increasing muscle length enhances the muscle's low‐pass filtering properties, influencing the oscillations generated by the Ia afferent feedback loop. Therefore, this study provides valuable insights into the interplay between muscle biomechanics and neural oscillations.

image

Key points

We investigated whether changes in muscle length, achieved by changing joint position, could influence common synaptic oscillations to spinal motor neurons, particularly in the tremor band (5–15 Hz).

Our results demonstrate that changing muscle length from shorter to longer induces reductions in the magnitude of alpha band oscillations in common synaptic inputs. Importantly, these reductions were reflected in the oscillations of muscle force output within the alpha band.

Longer twitch durations were observed in the longer muscle length condition compared to the shorter, suggesting that increasing muscle length enhances the muscle's low‐pass filtering properties.

Changes in the peripheral contractile properties of motor units due to changes in muscle length significantly influence the transmission of shared synaptic inputs into muscle force output.

These findings prove the interplay between muscle mechanics and neural adaptations.
Influence of Scallops on Windage Loss and Flow Characteristics in Disk-Type Gap
Authors: Zhao Zhuobin , Deng Qinghua , Li Jun , Feng Zhenping
Published: May 2024

Windage loss and flow characteristics in a disk-type gap featuring scalloped structures are investigated in this paper. Special attention is paid to the size of the scallops and the associated loss models. The respective losses and scallop effects in the gap are explored with various combinations of depths, quantities, and rotating speeds. The results indicate that scallop structures positively contribute to increased windage losses, accounting for more than 60% of the overall losses. An internal spiral vortex band is formed along the scallop wall, with the scallop depth ratio exerting influences on loss, reaching a maximum of 8.1%. The current scallop loss model overlooks the consideration of the total arc length ratio of scallops to the circumference, presenting a limitation, and the maximum relative deviation from numerical simulation results is observed to be 111.4%. An increase in arc length ratio results in a higher total loss, although the loss per individual scallop is diminished, manifesting in reduced vortices and pressure differences. Furthermore, a modified model is proposed to increase the precision of the current loss model. The maximal relative deviations of 13.8% confirm that the modified model is accepted to predict the windage loss in disk-type gaps with scallops. The conclusions offer valuable insights into the structural design of impellers and high-speed electrical machines with superior efficiency.
Theoretical Analysis for the Mechanical Properties of the Knitted Structures
Authors: Ji Dongcan , Dong Shaotong , Zhu Yunfan , Li Min , Fan Xuanqing , Li Yuhang
Published: May 2024

Knitting is a technology that has a thousand-year-old history, and can be normally seen in our daily lives. The knitted structure is constructed by the interwoven yarns that are constrained by themselves, exhibiting extreme stretchability. The mechanical properties of the knit fabric also enable their integration with flexible electronic devices. Nonetheless, it is yet problematic to expose the mechanical behaviors of knitting intrinsically. This paper investigates the mechanical characteristics of knitted structures subjected to uniaxial stretching. The analysis includes a structural assessment of the unit cell, with a focus on half of the cell accounting for symmetry. Mechanical analysis for three distinct scenarios (without elongation and friction, with elongation and no friction, with elongation and friction) is also presented. The stress–strain curve of the knitted structure and the correlation between stiffness and geometric parameters are illustrated. Additionally, simulations are carried out based on the finite element analysis, yielding consistent results with the theoretical calculations. Subsequently, a uniaxial stretching experiment is conducted, and the experimental outcomes also verify the theoretical analysis. Our analysis successfully explains the mechanical behavior of knitted structures, and also provides a reference for studying knitted fabrics with other topologies.
Investigating different carbon-based target materials: Can we improve ionization in HiPIMS for the deposition of diamondlike carbon films?
Authors: Fenker Martin , Balzer Martin , Kaßner Holger
Published: May 2024

Diamondlike carbon (DLC) thin films have attracted growing interest due to their extraordinary properties, which occur if the fraction of sp3 C-bonds in the amorphous carbon films is high. This high fraction of sp3 C-bonds requires a high ionization rate of the sputtered carbon and a high kinetic energy of the carbon species. The first part of this article provides a detailed overview of the possibilities to increase the ionized fraction of the sputtered carbon and a brief description of the DLC growth models. The overview will include previously unpublished calculations by our group that include the ionization rate of carbon compared to some metals, the mean ionization path length of carbon, and the carbon ion flux at the substrate. In addition, the problem of simultaneous deposition of sp2- and sp3-bonded carbon during a HiPIMS pulse is explained for the first time. In the second part, we will present the influence of different carbon-based target materials on ionization, arcing, and deposition rates. Therefore, three different carbon-based target materials were investigated for high-power impulse magnetron sputtering (HiPIMS) depositions of a-C films: (a) graphite target, (b) fine-grained graphite target, and (c) glassy carbon target. The acquired data were compared to dc magnetron sputtering (dcMS). For HiPIMS, the pulse parameters and the total argon gas pressure were varied. The deposition process was characterized by the acquisition of the target currents and voltages, the arcing rate, optical emission spectroscopy (OES), and monitoring the deposition rate using a quartz crystal microbalance. The studies revealed that with HiPIMS, arcing was increased strongly with the peak current density for the graphite target. With the glassy carbon target, arcing was low at the beginning but increased with the duration of the tests. This target had a polished surface in the as-delivered state, which became rougher during sputtering. Similar deposition rates have been measured for dcMS and HiPIMS. With OES, only a low ionization of carbon was identified. The deposition of a-C coatings produced films with a low hardness of about 1200 HV (about 12 GPa) for both sputtering methods (dcMS and HiPIMS), as no substrate bias was applied. It can be concluded that arcing was lowest with the glassy carbon target and that the ionization rate was not significantly influenced by the change in the target material.
The link between the acoustic characteristics of worship spaces and their emotional impact
Authors: Algargoosh Alaa
Published: May 2024

The emotional impact of sound depends on its characteristics. Given that such characteristics can be modified when the sound is played in a room, it is crucial to examine how the acoustic characteristic of a room can impact the emotional experience. Researchers have investigated the links between the acoustic parameters of concert halls and the emotional impact; however, the applicability of such links to other building types, such as worship spaces, needs to be studied. In a previous study, the author analyzed the emotional response to the acoustic environments of worship spaces using self-report and physiological indicators. This paper builds on the previous work by analyzing the acoustic parameters of the buildings from the previous study and establishing links between such parameters and the emotional response indicators. It also analyzes the frequency domain to study the role of the interaction between the room and sound source in enhancing the emotional experience and introduces resonance quality (Q) and resonance width (Δf) as important parameters to consider in room acoustics. The results showed the significance of considering frequencies < 1000 Hz in analyzing the acoustics of the studied worship spaces and demonstrated that amplifying the dominant frequency range of the sound source was linked to enhancing the emotional experience.
Single-cell analysis reveals an active and heterotrophic microbiome in the Guaymas Basin deep subsurface with significant inorganic carbon fixation by heterotrophs
Authors: Meyer Nicolette R. , Morono Yuki , Dekas Anne E.
Published: May 2024

The marine subsurface is a long-term sink of atmospheric carbon dioxide with significant implications for climate on geologic timescales. Subsurface microbial cells can either enhance or reduce carbon sequestration in the subsurface, depending on their metabolic lifestyle. However, the activity of subsurface microbes is rarely measured. Here, we used nanoscale secondary ion mass spectrometry (nanoSIMS) to quantify anabolic activity in 3,203 individual cells from the thermally altered deep subsurface in the Guaymas Basin, Mexico (3–75 m below the seafloor, 0–14°C). We observed that a large majority of cells were active (83%–100%), although the rates of biomass generation were low, suggesting cellular maintenance rather than doubling. Mean single-cell activity decreased with increasing sediment depth and temperature and was most strongly correlated with porewater sulfate concentrations. Intracommunity heterogeneity in microbial activity decreased with increasing sediment depth and age. Using a dual-isotope labeling approach, we determined that all active cells analyzed were heterotrophic, deriving the majority of their cellular carbon from organic sources. However, we also detected inorganic carbon assimilation in these heterotrophic cells, likely via processes such as anaplerosis, and determined that inorganic carbon contributes at least 5% of the total biomass carbon in heterotrophs in this community. Our results demonstrate that the deep marine biosphere at Guaymas Basin is largely active and contributes to subsurface carbon cycling primarily by not only assimilating organic carbon but also fixing inorganic carbon. Heterotrophic assimilation of inorganic carbon may be a small yet significant and widespread underappreciated source of labile carbon in the global subsurface.

IMPORTANCE

The global subsurface is the largest reservoir of microbial life on the planet yet remains poorly characterized. The activity of life in this realm has implications for long-term elemental cycling, particularly of carbon, as well as how life survives in extreme environments. Here, we recovered cells from the deep subsurface of the Guaymas Basin and investigated the level and distribution of microbial activity, the physicochemical drivers of activity, and the relative significance of organic versus inorganic carbon to subsurface biomass. Using a sensitive single-cell assay, we found that the majority of cells are active, that activity is likely driven by the availability of energy, and that although heterotrophy is the dominant metabolism, both organic and inorganic carbon are used to generate biomass. Using a new approach, we quantified inorganic carbon assimilation by heterotrophs and highlighted the importance of this often-overlooked mode of carbon assimilation in the subsurface and beyond.
The biotechnological potential of the
Chloroflexota
phylum
Authors: Freches André , Fradinho Joana Costa
Published: May 2024

In the next decades, the increasing material and energetic demand to support population growth and higher standards of living will amplify the current pressures on ecosystems and will call for greater investments in infrastructures and modern technologies. A valid approach to overcome such future challenges is the employment of sustainable bio-based technologies that explore the metabolic richness of microorganisms. Collectively, the metabolic capabilities of
Chloroflexota
, spanning aerobic and anaerobic conditions, thermophilic adaptability, anoxygenic photosynthesis, and utilization of toxic compounds as electron acceptors, underscore the phylum’s resilience and ecological significance. These diverse metabolic strategies, driven by the interplay between temperature, oxygen availability, and energy metabolism, exemplify the complex adaptations that enabled
Chloroflexota
to colonize a wide range of ecological niches. In demonstrating the metabolic richness of the
Chloroflexota
phylum, specific members exemplify the diverse capabilities of these microorganisms:
Chloroflexus aurantiacus
showcases adaptability through its thermophilic and phototrophic growth, whereas members of the
Anaerolineae
class are known for their role in the degradation of complex organic compounds, contributing significantly to the carbon cycle in anaerobic environments, highlighting the phylum’s potential for biotechnological exploitation in varying environmental conditions. In this context, the metabolic diversity of
Chloroflexota
must be considered a promising asset for a large range of applications. Currently, this bacterial phylum is organized into eight classes possessing different metabolic strategies to survive and thrive in a wide variety of extreme environments. This review correlates the ecological role of
Chloroflexota
in such environments with the potential application of their metabolisms in biotechnological approaches.
Open Resources for Biology Education (ORBE): a resource collection
Authors: Ahmed Sanah , Adjei-Opong Tiffany , Heim Ashley B. , Noyes Keenan , Schmid Kelly , Couch Brian A. , Stetzer MacKenzie R. , Senn Lillian G. , Vinson Erin , Smith Michelle K. , Treibergs Kira
Published: May 2024

In undergraduate life sciences education, open educational resources (OERs) increase accessibility and retention for students, reduce costs, and save instructors time and effort. Despite increasing awareness and utilization of these resources, OERs are not centrally located, and many undergraduate instructors describe challenges in locating relevant materials for use in their classes. To address this challenge, we have designed a resource collection (referred to as Open Resources for Biology Education, ORBE) with 89 unique resources that are primarily relevant to undergraduate life sciences education. To identify the resources in ORBE, we asked undergraduate life sciences instructors to list what OERs they use in their teaching and curated their responses. Here, we summarize the contents of the ORBE and describe how educators can use this resource as a tool to identify suitable materials to use in their classroom context. By highlighting the breadth of unique resources openly available for undergraduate biology education, we intend for the ORBE to increase instructors’ awareness and use of OERs.
Increased utilisation and quality: a focus on inequality and a learning health system approach—explaining Nepal’s success in reducing maternal and newborn mortality 2000–2020
Authors: Sharma Sudha , Campbell Oona Maeve Renee , Oswald William Edward , Adhikari Dadhi , Paudel Punya , Lal Bibek , Penn-Kekana Loveday
Published: May 2024

Introduction

Maternal mortality in Nepal dropped from 553 to 186 per 100 000 live births during 2000–2017 (66% decline). Neonatal mortality dropped from 40 to 21 per 1000 live births during 2000–2018 (48% decline). Stillbirths dropped from 28 to 18 per 1000 births during 2000–2019 (34% decline). Nepal outperformed other countries in these mortality improvements when adjusted for economic growth, making Nepal a ‘success’. Our study describes mechanisms which contributed to these achievements.

Methods

A mixed-method case study was used to identify drivers of mortality decline. Methods used included a literature review, key-informant interviews, focus-group discussions, secondary analysis of datasets, and validation workshops.

Results

Despite geographical challenges and periods of political instability, Nepal massively increased the percentage of women delivering in health facilities with skilled birth attendance between 2000 and 2019. Although challenges remain, there was also evidence in improved quality and equity-of-access to antenatal care and childbirth services. The study found policymaking and implementation processes were adaptive, evidence-informed, made use of data and research, and involved participants inside and outside government. There was a consistent focus on reducing inequalities.

Conclusion

Policies and programmes Nepal implemented between 2000 and 2020 to improve maternal and newborn health outcomes were not unique. In this paper, we argue that Nepal was able to move rapidly from stage 2 to stage 3 in the mortality transition framework not because of what they did, but how they did it. Despite its achievements, Nepal still faces many challenges in ensuring equal access to quality-care for all women and newborns.
Associations between knowledge of health issues and health care satisfaction and propensity to complain: a cross-sectional survey of adult men in Denmark
Authors: Birkeland Søren , Bismark Marie , Barry Michael John , Möller Sören
Published: May 2024

Objectives

The objective of this study was to investigate associations between knowledge of health issues and healthcare satisfaction and propensity to complain including the association between knowledge and greater patient involvement.

Design

The present study is a secondary analysis of a larger cross-sectional case vignette survey.

Setting

Survey conducted in adult Danish men.

Participants

Participants included 6755 men aged 45–70 years.

Interventions

Participants responded to a survey with scenarios illustrating prostate-specific antigen (PSA) testing and different information provision.

Primary and secondary outcome measures

Using Likert scales (scored 1–5), participants rated their satisfaction with the care described and their inclination to complain and responded to a short quiz (scored 0–3) assessing their knowledge about the PSA test.

Results

Satisfaction with healthcare increased with better quiz performance (Likert difference 0.13 (95% CI .07 to 0.20), p <0.001, totally correct vs totally incorrect responders) and correspondingly, the desire to complain significantly decreased (Likert difference −0.34 (95% CI 0.40 to −0.27), p <0.001). Respondents with higher education performed better (mean quiz score difference 0.59 (95% CI 0.50 to 0.67), p <0.001, most educated vs least educated). Responders who received information about the PSA test generally performed better (quiz score difference 0.41 (95% CI 0.35 to 0.47), p<0.001, neutral vs no information). Overestimation of PSA merits was more common than underestimation (7.9% vs 3.8%).

Conclusions

Mens’ knowledge of the benefits of screening varies with education, predicts satisfaction with care and the desire to complain, and may be improved through greater involvement in decision-making.
EvolvRehab–MoveWell telerehabilitation for stroke survivors: study protocol for a feasibility with embedded initial proof-of-concept study
Authors: Perks Jemma , McBride Philip , Mansoubi Maedeh , Clatworthy Philip , Hulme Claire , Taylor Gordon , Warner Martin , Dawes Helen
Published: May 2024

Introduction

Stroke is a leading cause of disability throughout the world. Unilateral upper limb impairment is common in people who have had a stroke. As a result of impaired upper limb function, people who have had a stroke often employ abnormal ‘compensatory’ movements. In the short term, these compensatory movements allow the individual to complete tasks, though long-term movement in this manner can lead to limitations. Telerehabilitation offers the provision of rehabilitation services to patients at a remote location using information and communication technologies. ‘EvolvRehab’ is one such telerehabilitation system, which uses activities to assess and correct compensatory upper body movements, although the feasibility of its use is yet to be determined in National Health Service services. Using EvolvRehab, we aim to assess the feasibility of 6 weeks telerehabilitation in people after a stroke.

Methods and analysis

A multisite feasibility study with embedded design phase. Normally distributed data will be analysed using paired samples t-tests; non-normally distributed data will be analysed using related samples Wilcoxon signed rank tests. Thematic content analysis of interview transcripts will be used to investigate the usability and perceived usefulness of the EvolvRehab kit.

Ethics and dissemination

This study has received ethical approval from Solihull Research Ethics Committee (REC reference: 23/WM/0054). Dissemination will be carried out according to the dissemination plan co-written with stroke survivors, including academic publications and presentations; written reports; articles in publications of stakeholder organisations; presentations to and publications for potential customers.

Trial registration number

NCT05875792.
COS-PPA: protocol to develop a core outcome set for primary progressive aphasia
Authors: Volkmer Anna , Copland David A , Henry Maya L , Warren Jason D , Varley Rosemary , Wallace Sarah J , Hardy Chris JD
Published: May 2024

Introduction

The term primary progressive aphasia (PPA) describes a group of language-led dementias. Disease-modifying treatments that delay, slow or reverse progression of PPA are currently lacking, though a number of interventions to manage the symptoms of PPA have been developed in recent years. Unfortunately, studies exploring the effectiveness of these interventions have used a variety of different outcome measures, limiting comparability. There are more constructs, apart from word retrieval, that are important for people with PPA that have not received much attention in the research literature. Existing core outcome sets (COS) for dementia and non-progressive aphasia do not meet the needs of people with PPA, highlighting a need to develop a specific COS for PPA.

Methods and analysis

This protocol describes a three-stage study to identify a COS for PPA interventions in research and clinical practice. The stage 1 systematic review will identify existing speech, language and communication measures used to examine the effectiveness of interventions for PPA in the research literature. Employing a nominal group technique, stage 2 will identify the most important outcomes for people with PPA and their families. The data collected in stages 1 and 2 will be jointly analysed with the project PPI group and will inform the stage 2 modified Delphi consensus study to identify a core outcome measurement set for PPA among a range of research disciplines undertaking intervention studies for people with PPA.

Ethics and dissemination

Ethical approval for stage 2 of the study has been sought individually in each country at collaborating institutions and is stated in detail in the manuscript. Stage 3 has been granted ethical approval by the Chairs of UCL Language and Cognition Department Ethics, Project ID LCD-2023-06. Work undertaken at stages 1, 2 and 3 will be published in open-access peer-reviewed journal articles and presented at international scientific conferences.

PROSPERO registration number

CRD42022367565.
Evaluation of system based psychological first aid training on the mental health proficiency of emergency medical first responders to natural disasters in China: a cluster randomised controlled trial
Authors: Peng Min , Xiao Tao , Carter Ben , Shearer James
Published: May 2024

Objective

To evaluate the effectiveness of a system based psychological first aid (PFA) training programme for emergency medical first responders in China.

Design

Parallel-group, assessor-blinded, cluster randomised controlled trial.

Setting

42 clusters of health workers from various health facilities in China.

Participants

1399 health workers who provide emergency service for survivors of disasters.

Interventions

One-day system based PFA training programme (PFA) or training as usual (TAU).

Primary and secondary outcome measures

The primary outcome was the PFA skills, knowledge and attitude (SKA-PFA) score at 2 months postintervention. Secondary outcomes included post-traumatic growth, self-efficacy and professional quality of life.

Results

The intervention group (n=690) had significantly higher SKA-PFA scores than the control group (n=709) at 2 months postintervention (adjusted mean difference=4.44; 95% CI 1.17 to 7.52; p=0.007; Cohen’s d=0.35). The intervention group also had higher scores on post-traumatic growth (p=0.113, d=0.24), self-efficacy (p=0.032, d=0.20) and professional quality of life (p=0.281, d=0.04).

Conclusions

The system based PFA training programme was more effective than the TAU in enhancing the PFA knowledge and skills of the emergency medical first responders and in increasing their competence to provide emergency service for survivors in China.

Trial registration number

ChiCTR2200060464.
Australian trial of behavioural activation for people with schizophrenia experiencing negative symptoms: a feasibility randomised controlled trial protocol
Authors: Muyambi Kuda , Walsh Sandra , Dettwiller Pascale , Tan Kuan Liung , Dennis Shaun , Bressington Daniel , Gray Richard John , McCall Audrey , Jones Martin
Published: May 2024

Introduction

Negative symptoms are frequently experienced by people with schizophrenia. People with negative symptoms often have impaired social functioning and reduced quality of life. There is some evidence that cognitive–behavioural therapy results in a modest reduction in negative symptoms. Behavioural activation may be an effective alternative treatment for negative symptoms.The study aims to examine the feasibility and acceptability of implementing a behavioural activation trial delivered in three community mental health services in South Australia to support adult consumers experiencing negative symptoms of schizophrenia.

Method and analysis

This randomised controlled study will recruit a total of 60 consumers aged 18 years or above with mild-moderate negative symptoms of schizophrenia. The consumers will be randomly allocated to receive behavioural activation plus usual mental healthcare or usual mental healthcare alone. The intervention group will receive twelve 30 min sessions of behavioural activation, which will be delivered twice weekly over 6 weeks. In addition, we aim to recruit nine mental health workers from the three rural mental health services who will complete a 10-week online training programme in behavioural activation. Changes in negative symptoms of schizophrenia and depressive symptoms will be assessed at three time points: (a) at baseline, at 6 weeks and 3 month follow-ups. Changes in health-related quality of life (Short Form F36; secondary outcome) will be assessed at two time points: (a) at baseline and (b) immediately at postintervention after 6 weeks. At the end of the trial, interviews will be conducted with purposively selected mental health workers and consumers. Descriptive statistics and thematic analysis will be used to assess feasibility and acceptability.

Ethics and dissemination

The findings from our feasibility study will inform the design of a fully powered randomised controlled trial to test the effectiveness of behavioural activation as a treatment for negative symptoms in schizophrenia. The study protocol was approved by the Central Adelaide Local Health Network Human Research Ethics Committee. The findings from this study will be disseminated through peer-reviewed scientific journals and conferences.

Trial registration number

ACTRN12623000348651p.
Contextually appropriate nurse staffing models: a realist review protocol
Authors: Tate Kaitlyn , Penconek Tatiana , Booth Andrew , Harvey Gillian , Flynn Rachel , Lalleman Pieterbas , Wolbers Inge , Hoben Matthias , Estabrooks Carole A , Cummings Greta G
Published: May 2024

Introduction

Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results. No evidence has been synthesised and consolidated on how, why and under what contexts certain staffing models produce different outcomes. We aim to describe how we will (1) conduct a realist review to determine how nurse staffing models produce different client, staff and health system outcomes, in which contexts and through what mechanisms and (2) coproduce recommendations with decision-makers to guide future research and implementation of nurse staffing models.

Methods and analysis

Using an integrated knowledge translation approach with researchers and decision-makers as partners, we are conducting a three-phase realist review. In this protocol, we report on the final two phases of this realist review. We will useCitation tracking, tracingLead authors, identifyingUnpublished materials, GoogleScholar searching,Theory tracking, ancestry searching forEarly examples, and follow-up ofRelated projects (CLUSTER) searching, specifically designed for realist searches as the review progresses. We will search empirical evidence to test identified programme theories and engage stakeholders to contextualise findings, finalise programme theories document our search processes as per established realist review methods.

Ethics and dissemination

Ethical approval for this study was provided by the Health Research Ethics Board of the University of Alberta (Study ID Pro00100425). We will disseminate the findings through peer-reviewed publications, national and international conference presentations, regional briefing sessions, webinars and lay summary.
Effects of state opioid prescribing laws on rates of fatal crashes in the USA
Authors: White Sarah A , McGinty Emma E , Origenes Alexandra N , Vernick Jon S
Published: May 2024

Background

State opioid prescribing cap laws, mandatory prescription drug monitoring programme query or enrolment laws and pill mill laws have been implemented across US states to curb high-risk opioid prescribing. Previous studies have measured the impact of these laws on opioid use and overdose death, but no prior work has measured the impact of these laws on fatal crashes in a multistate analysis.

Methods

To study the association between state opioid prescribing laws and fatal crashes, 13 treatment states that implemented a single law of interest in a 4-year period were identified, together with unique groups of control states for each treatment state. Augmented synthetic control analyses were used to estimate the association between each state law and the overall rate of fatal crashes, and the rate of opioid-involved fatal crashes, per 100 000 licensed drivers in the state. Fatal crash data came from the Fatality Analysis Reporting System.

Results

Results of augmented synthetic control analyses showed small-in-magnitude, non-statistically significant changes in all fatal crash outcomes attributable to the 13 state opioid prescribing laws. While non-statistically significant, results attributable to the laws varied in either direction—from an increase of 0.14 (95% CI, −0.32 to 0.60) fatal crashes per 100 000 licensed drivers attributable to Ohio’s opioid prescribing cap law, to a decrease of 0.30 (95% CI, −1.17 to 0.57) fatal crashes/100 000 licensed drivers attributable to Mississippi’s pill mill law.

Conclusion

These findings suggest that state-level opioid prescribing laws are insufficient to help address rising rates of fatally injured drivers who test positive for opioids. Other options will be needed to address this continuing injury problem.
UK junior doctors’ strikes and patients with cancer: a morally questionable association
Authors: Wilkinson David J P
Published: May 2024

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency.
Low-profile mechanical thrombectomy devices for large vessel occlusion in pediatric ischemic stroke
Authors: Oushy Soliman , Garton Andrew , Orbach Darren B , See Alfred Pokmeng
Published: May 2024

Background

Mechanical thrombectomy (MT) is a well-established treatment modality for large vessel occlusion (LVO) in adults, but there are limited data in the pediatric population. The rarity of the condition makes prospective trial design difficult, and therefore evaluation of MT devices and outcomes is sparse. In pediatric LVO cases, some newer devices may be appropriate for use in revascularization procedures. Furthermore, illustrative specific device-access combinations have rarely been presented in young patients under the age of 5 years.

Methods

This was a single institution experience in intracranial MT procedures for pediatric acute ischemic stroke (AIS). A given procedure was included if there was an attempt at MT between 2015 and 2023.

Results

Sixteen endovascular procedures were performed in 15 patients with AIS, with a mean age of 7.4 years; eight patients were <5 years of age. MT was attempted in 15/16 (93.7%) procedures, including 11 (73.3%) in the anterior circulation and four (26.7%) in the posterior circulation; one case recanalized after medical treatment. The most common MT techniques were combined aspiration with a stentriever (n=10, 66.7%) and aspiration alone (n=3, 20%). Traditional stentrievers (4–6 mm) were used in seven cases and low-profile stentrievers in four cases. Improved reperfusion was achieved in all low-profile stentriever cases. Reperfusion of modified Thrombolysis in Cerebral Infaction ≥2b was obtained in 73.3% of cases, including 72.7% of those in which a stentriever was used.

Conclusions

Low-profile thrombectomy devices may achieve similar revascularization results to other approaches in challenging clinical scenarios observed in younger children.
Use of a dedicated open transcarotid access system for neurovascular disease
Authors: Sujijantarat Nanthiya , Renedo Daniela , Antonios Joseph , Koo Andrew B , Amllay Abdelaziz , Nowicki Kamil , Cord Branden J , Hebert Ryan , de Havenon Adam , Sheth Kevin N , Petersen Nils H , Matouk Charles
Published: May 2024

Background

Transcarotid artery revascularization (TCAR) is an increasingly popular technique for the management of extracranial carotid stenosis. Its off-label use in the treatment of intracranial neurovascular disease is poorly described. Our objective is to describe the use of a dedicated open transcarotid access system for the treatment of neurovascular pathologies other than extracranial carotid stenosis.

Methods

We conducted a retrospective review of a prospectively maintained database of consecutive patients who underwent treatment of neurovascular disease at a single academic center using the ENROUTE Transcarotid Arterial Sheath. Demographics, procedural characteristics, and patient outcomes were reported.

Results

Twenty patients were included in the study between September 2017 and March 2023. The following pathologies were treated: intracranial atherosclerotic disease (ICAD, nine patients), complex cervico-petrous carotid disease (five patients), intracranial aneurysms (three patients), and large vessel occlusion-acute ischemic stroke (three patients). Eighteen of the 20 cases were performed with active carotid flow reversal. All cases were successfully completed. There were no access-related complications. One periprocedural complication was incurred: a microguidewire perforation during an exchange maneuver for the treatment of ICAD.

Conclusion

An open transcarotid approach using a dedicated transcarotid system may offer a safe alternative access strategy for the endovascular treatment of complex neurovascular pathologies when a traditional transfemoral or transradial approach is contraindicated or failed.