bluuebunny/crossref_metadata_2025 huggingface dataset:
Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review
Authors: Hamilton Clayon B , Dehnadi Maryam , Snow M Elizabeth , Clark Nancy , Lui Michelle , McLean Janet , Mamdani Hussein , Kooijman Allison L , Bubber Vikram , Hoefer Tammy ,   Patients as Partners Team, Li Linda C
Published: October 2021

Objective

To identify the key themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making across the organisation and system domains of healthcare systems.

Methods

We conducted a scoping review. Seven databases of journal articles were searched from their inception to June 2019. Eligible articles were literature reviews published in English and provided useful information for determining aspects of engaging patients and family caregivers in decision-making to evaluate. We extracted text under three predetermined categories: structure, process and outcomes that were adapted from the Donabedian conceptual framework. These excerpts were then independently open-coded among four researchers. The subsequent themes and their corresponding excerpts were summarised to provide a rich description of each theme.

Results

Of 7747 unique articles identified, 366 were potentially relevant, from which we selected the 42 literature reviews. 18 unique themes were identified across the three predetermined categories. There were six structure themes: engagement plan, level of engagement, time and timing of engagement, format and composition, commitment to support and environment. There were four process themes: objectives, engagement approach, communication and engagement activities. There were eight outcome themes: decision-making process, stakeholder relationship, capacity development, stakeholder experience, shape policy/service/programme, health status, healthcare quality, and cost-effectiveness.

Conclusions

The 18 themes and their descriptions provide a foundation for identifying constructs and selecting measures to evaluate the quality of initiatives for engaging patients and family caregivers in healthcare system decision-making within the organisation and system domains. The themes can be used to investigate the mechanisms through which relevant initiatives are effective and investigate their effectiveness.
Promoting compassionate and respectful maternity care during facility-based delivery in Ethiopia: perspectives of clients and midwives
Authors: Jiru Hirut Dinku , Sendo Endalew G
Published: October 2021

Objective

The purpose of this qualitative study was to explore clients’ and midwives’ perceptions of compassionate and respectful care during facility-based delivery in Bishoftu District, the regional state of Oromia, Ethiopia.

Setting

Public health facilities (two health centres and one district hospital).

Study design

A qualitative exploratory descriptive research design was used.

Study participants

The research population included purposely sampled women who had given birth in a health facility in the previous 2 weeks and midwifery experts who provided maternity care in the health facility’s labour and delivery wards. Data were gathered through an individual interview (with 10 midwives and 12 women in labour). Interviews were audio-recorded and transcribed immediately. For the research, thematic analysis was performed manually. Both a priori codes (from the query guide) and emerging inductive codes were used in the study. In the thematic data analysis, three inter-related stages were involved, namely data reduction, data display and data conclusion.

Results

From the analysis of in-depth interviews with labouring women, three themes emerged, namely: dignified and respectful care, neglectful care and unqualified staff. Five main categories emerged from in-depth interviews with midwives: trusting relationships formed with labouring women, compassionate and respect-based behaviour, good communication skills and holistic care, intentional disrespect toward women, and barriers to compassionate and respectful maternity care due to structural factors. These themes were discovered to be a rich and detailed account of midwives’ perspectives on compassionate and respectful maternity care.

Conclusion

The majority of women who witnessed or suffered disrespect and violence during labour and childbirth were dissatisfied with their maternity care during labour and delivery. Despite midwives’ accounts showing that they were aware of the importance of compassionate and respectful maternity care, clients face verbal abuse, neglect, and a lack of supportive treatment during labour and childbirth. Clients’ human rights were violated by disrespectful or abusive acts, whether perpetrated or observed. It is essential to address structural problems such as provider workload, and all other initiatives aimed at improving midwives’ interpersonal relationships with women to provide compassionate and respectful client-centred maternity care.
Study protocol: the ear–nose–throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD)
Authors: Goutaki Myrofora , Lam Yin Ting , Alexandru Mihaela , Anagiotos Andreas , Armengot Miguel , Bequignon Emilie , Boon Mieke , Burgess Andrea , Coste Andre , Emiralioglu Nagehan , Erdem Ela , Haarman Eric G , Harris Amanda , Hool Sara-Lynn , Karadag Bulent , Kim Sookyung , Latzin Philipp , Lorent Natalie , Ozcelik Ugur , Reula Ana , Roehmel Jobst , van Gogh Christine , Yiallouros Panayiotis , Zappe Soeren Marian ,   On behalf of the EPIC-PCD team, Papon Jean Francois
Published: October 2021

Introduction

Primary ciliary dyskinesia (PCD) is a rare, genetic, multiorgan disease with an estimated prevalence of 1 in 10 000. It affects mainly the upper and lower airways due to impaired mucociliary clearance. Almost all patients have sinonasal or otologic (ear–nose–throat, ENT) problems, although the ENT clinical phenotype may present great variability. Despite that, data on PCD ENT manifestations are scarce and based on small single-centre studies. To date, we know little about the spectrum and severity of PCD ENT disease, its association with lung disease, its course over life and its determinants of prognosis.

This study protocol describes the aims and methods of the first prospective, observational, multinational cohort study focusing on ENT disease in patients with PCD.

Methods and analysis

The ENT prospective international cohort of patients with PCD (EPIC-PCD) is a prospective standardised observational clinical cohort set up as a multinational multicentre study, embedded into routine patient care. It aims to longitudinally characterise ENT disease in patients with PCD and its association with lung disease, and to identify determinants of its prognosis. Patients of all ages, diagnosed with PCD who undergo an ENT clinical assessment at least once a year at one of the participating centres will be invited to participate. Collected data include diagnostic test results, results of ENT examinations, lung function measurements, information on management of ENT disease and patient-reported data on clinical symptoms and health-related quality of life (QoL). Data are collected using the standardised PCD-specific FOLLOW-PCD form and the validated QoL-PCD questionnaire.

Ethics and dissemination

The study has been reviewed and approved by the Human Research Ethics Committees at all participating centres, based on local legislation. The results of the study will be published in scientific journals, presented at scientific conferences and disseminated to participants and national patient organisations.

Trial registration

NCT04611516.
Prospective randomised trial examining the impact of an educational intervention versus usual care on anticoagulation therapy control based on an SAMe-TT2R2score-guided strategy in anticoagulant-naïve Thai patients with atrial fibrillation (TREATS-AF): a study protocol
Authors: Phrommintikul Arintaya , Nathisuwan Surakit , Gunaparn Siriluck , Krittayaphong Rungroj , Wongcharoen Wanwarang , Sehmi Sukhi , Mehta Samir , Winkles Neil , Brocklehurst Peter , Mathers Jonathan , Jowett Sue , Jolly Kate , Lane Deirdre , Thomas G Neil , Lip Gregory Y H
Published: October 2021

Introduction

The burden of atrial fibrillation (AF) in Thailand is high and associated with increased morbidity, mortality and healthcare costs. Vitamin K antagonists (eg, warfarin), commonly used for stroke prevention in patients with AF in Thailand, are effective but are often suboptimally controlled. We aim to evaluate the impact of an SAMe-TT2R2score-guided strategy and educational intervention compared to usual care on anticoagulation control expressed by the time in therapeutic range (TTR) at 12 months, in anticoagulant-naïve Thai patients with AF.

Methods and analysis

Multicentre, open-label, parallel-group, randomised controlled trial conducted in Thailand among adult patients (age: 18 years) with AF who are anticoagulant naïve. Patients will be randomised to one of two groups; an SAMe-TT2R2score-guided strategy with educational intervention and usual care versus usual care alone. The planned follow-up period is 12 months. The primary outcome is TTR at 12 months. Secondary outcomes include: (1) TTR at 6 months; (2) thromboembolic and bleeding events at 12 months; (3) composite major adverse cardiovascular events at 12 months; (4) change in patients’ knowledge of AF between baseline and 6 months and 12 months; (5) cost effectiveness; (6) quality of life at baseline, 6 months and 12 months using EQ-5D-5L (Thai version) and (7) patient satisfaction/perceptions of the TREAT intervention. An embedded qualitative study will assess patient perceptions of the TREAT intervention.

Ethics and dissemination

The study has been approved by the Ethical Review Committee, Ministry of Public Health of Thailand, and registered in the Thai Clinical Trials Registry. The results of this trial will be submitted for publication in a peer-reviewed journal. Participants will be informed via a link to a preview of the publication. A lay summary will also be provided to all participants prior to publication.

Trial registration number

TCTR20180711003.
Development and application of a chronic kidney disease-specific health literacy, knowledge and disease awareness assessment tool for patients with chronic kidney disease in Taiwan
Authors: Wei Chung-Jen , Shih Chung-Liang , Hsu Yu-Juei , Chen Yin-Cheng , Yeh Jue-Zong , Shih Jia-Hui , Chiu Chiung-Hsuan
Published: October 2021

Objectives

This study aims to develop an assessment tool for health literacy and knowledge specific to chronic kidney disease (CKD) for use in examining the associations between health literacy, disease-specific knowledge and disease awareness among patients with CKD in Taiwan.

Design

An assessment tool in Mandarin and Taiwanese was developed based on patient input, panel discussions with experts and a literature review, and checked for validity and reliability in a pilot test. Formal data were collected through population-based sampling with a set quota according to region and hospital accreditation level. Cross-sectional data were collected to confirm the reliability and validity of the assessment tool. Levels of health literacy, disease knowledge, and disease awareness were then reported and analysed.

Setting

Sample hospitals included 10 medical centres, 18 regional hospitals and 15 local hospitals in Taiwan. Researchers were granted Internal Review Board approval and obtained agreement to collect data in all study settings.

Participants

Patients at least 20 years old who had been diagnosed with CKD of any stage were eligible to participate. The formal assessment collected 1155 valid questionnaires, yielding an 87.3% response rate. The mean age of participants was 67.48 years (SD=12.87, range 22–98), while 484 (41.95%) were female and 78% were aware they had CKD.

Results

The self-devised instrument proved to have excellent reliability and validity. Use of the instrument in the main study showed that CKD-specific health literacy was significantly associated with age (β=−0.33, p<0.00), educational attainment and disease awareness (β=0.13, p<0.00). CKD-specific knowledge was also significantly associated with age (β=−0.18, p<0.00), educational attainment and disease awareness (β=0.19, p<0.00).

Conclusions

This CKD-specific health literacy and knowledge assessment tool developed for Mandarin and Taiwanese-speaking patients is reliable and well validated. Patients with CKD who are aware of and understand their disease performed better in the assessment.
Testing the efficacy and acceptability of video-reflexive methods in personal protective equipment training for medical interns: a mixed methods study
Authors: Wyer Mary , Hor Su-Yin , Barratt Ruth , Gilbert G L
Published: October 2021

Objectives

To test the efficacy and acceptability of video-reflexive methods for training medical interns in the use of personal protective equipment (PPE).

Design

Mixed methods study.

Setting

A tertiary-care teaching hospital, Sydney, January 2018–February 2019.

Participants

72 of 90 medical interns consented to participate. Of these, 39 completed all three time points.

Interventions

Participants received a standard infection prevention and control (IPC) education module during their hospital orientation. They were then allocated alternately to a control or video group. At three time points (TPs) over the year, participants were asked to don/doff PPE items based on hospital protocol. At the first two TPs, all participants also participated in a reflexive discussion. At the second and third TPs, all participants were audited on their performance. The only difference between groups was that the video group was videoed while donning/doffing PPE, and they watched this footage as a stimulus for reflexive discussion.

Primary and secondary outcome measures

The efficacy and acceptability of the intervention were assessed using: (1) comparisons of audit performance between and within groups over time, (2) comparisons between groups on survey responses for evaluation of training and self-efficacy and (3) thematic analysis of reflexive discussions.

Results

Both groups improved in their PPE competence over time, although there was no consistent pattern of significant differences within and between groups. No significant differences were found between groups on reported acceptability of training, or self-efficacy for PPE use. However, analysis of reflexive discussions shows that the effects of the video-reflexive intervention were tangible and different in important respects from standard training.

Conclusions

Video reflexivity in group-based training can assist new clinicians in engagement with, and better understanding of, IPC in their clinical practice. Our study also highlights the need for ongoing and targeted IPC training during medical undergraduate studies as well as regular workplace refresher training.
Web-based internet searches for digital health products in the United Kingdom before and during the COVID-19 pandemic: a time-series analysis using app libraries from the Organisation for the Review of Care and Health Applications (ORCHA)
Authors: Leigh Simon , Daly Rob , Stevens Sebastian , Lapajne Luka , Clayton Charlotte , Andrews Tim , Ashall-Payne Liz
Published: October 2021

Objectives

To explore if consumer interest in digital health products (DHPs), changed following the COVID-19 pandemic and the lockdown measures that ensued.

Design

Retrospective time-series analysis of web-based internet searches for DHPs in the UK, split over two periods, pre-COVID-19 lockdown (January 2019–23 March 2020) and post-COVID-19 lockdown (24 March 2020–31 December 2020).

Setting

The UK.

Participants

Members of the UK general population using health-app libraries provided by the Organisation for the Review of Care and Health Applications.

Primary and secondary outcome measures

The primary outcome was volume of searches for DHPs. Secondary outcomes considered search volumes for 25 different therapeutic areas. Outcomes were assessed for significance using a two-stage Poisson test.

Results

There were 126 640 searches for DHPs over the study period. Searches for DHPs increased by 343% from 2446 per month prior to COVID-19 lockdown measures being introduced to 8996 per month in the period following the first COVID-19 lockdown in the UK. In total, 23/25 (92%) of condition areas experienced a significant increase in searches for DHPs, with the greatest increases occurring in the first 2 months following lockdown. Musculoskeletal conditions (2,036%), allergy (1,253%) and healthy living DHPs (1,051%) experienced the greatest increases in searches compared with pre-lockdown. Increased search volumes for DHPs were sustained in the 9 months following the introduction of lockdown measures, with 21/25 (84%) of condition areas experiencing monthly search volumes at least 50% greater than pre-lockdown levels.

Conclusions

The COVID-19 pandemic has profoundly disrupted the routine delivery of healthcare, making face-to-face interaction difficult, and contributing to unmet clinical needs. This study has demonstrated significant increases in internet searches for DHPs by members of the UK population since COVID-19, signifying an increased interest in this potential therapeutic medium. Future research should clarify whether this increased interest has resulted in increased acceptance and utilisation of these technologies also.
Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study
Authors: Brühwiler Lea Domenica , Niederhauser Andrea , Fischer Simone , Schwappach David L B
Published: October 2021

Objectives

The aim of the study was to develop quality standards reflecting minimal requirements for safe medication processes in nursing homes.

Design

In a first step, relevant key topics for safe medication processes were deducted from a systematic search for similar guidelines, prior work and discussions with experts. In a second step, the essential requirements for each key topic were specified and substantiated with a literature-based rationale. Subsequently, the requirements were evaluated with a piloted, two-round Delphi study.

Setting

Nursing homes in Switzerland.

Participants

Interprofessional panel of 25 experts from science and practice.

Primary and secondary outcome measures

Each requirement was rated for its relevance for a safer and resident-oriented medication on a 9-point Likert-Scale based on the RAND/UCLA method. The requirements were considered relevant if, in the second round, the median relevance rating was ≥7 and the proportion of ratings ≥7 was ≥80%.

Results

Five key topics with a total of 87 requirements were elaborated and rated in the Delphi study. After the second round (response rate in both rounds 100%), 85 requirements fulfilled the predefined criteria and were therefore included in the final set of quality standards. The five key topics are: (I) ‘The medication is reviewed regularly and in defined situations’, (II) ‘The medication is reviewed in a structured manner’, (III) ‘The medication is monitored in a structured manner’, (IV) ‘All healthcare professionals are committed to an optimal interprofessional collaboration’ and (V) ‘Residents are actively involved in medication process’.

Conclusions

We developed normative quality standards for a safer and resident-oriented medication in Swiss nursing homes. Altogether, 85 requirements define the medication processes and the behaviour of healthcare professionals. A rigorous implementation may support nursing homes in taking a step towards safer and resident-oriented medication.
Next move in movement disorders (NEMO): developing a computer-aided classification tool for hyperkinetic movement disorders
Authors: van der Stouwe A. M. Madelein , Tuitert Inge , Giotis Ioannis , Calon Joost , Gannamani Rahul , Dalenberg Jelle R. , van der Veen Sterre , Klamer Marrit R. , Telea Alex C. , Tijssen Marina A.J.
Published: October 2021

Introduction

Our aim is to develop a novel approach to hyperkinetic movement disorder classification, that combines clinical information, electromyography, accelerometry and video in a computer-aided classification tool. We see this as the next step towards rapid and accurate phenotype classification, the cornerstone of both the diagnostic and treatment process.

Methods and analysis

The Next Move in Movement Disorders (NEMO) study is a cross-sectional study at Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen. It comprises patients with single and mixed phenotype movement disorders. Single phenotype groups will first include dystonia, myoclonus and tremor, and then chorea, tics, ataxia and spasticity. Mixed phenotypes are myoclonus-dystonia, dystonic tremor, myoclonus ataxia and jerky/tremulous functional movement disorders. Groups will contain 20 patients, or 40 healthy participants. The gold standard for inclusion consists of interobserver agreement on the phenotype among three independent clinical experts. Electromyography, accelerometry and three-dimensional video data will be recorded during performance of a set of movement tasks, chosen by a team of specialists to elicit movement disorders. These data will serve as input for the machine learning algorithm. Labels for supervised learning are provided by the expert-based classification, allowing the algorithm to learn to predict what the output label should be when given new input data. Methods using manually engineered features based on existing clinical knowledge will be used, as well as deep learning methods which can detect relevant and possibly new features. Finally, we will employ visual analytics to visualise how the classification algorithm arrives at its decision.

Ethics and dissemination

Ethical approval has been obtained from the relevant local ethics committee. The NEMO study is designed to pioneer the application of machine learning of movement disorders. We expect to publish articles in multiple related fields of research and patients will be informed of important results via patient associations and press releases.
Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study
Authors: Chan King-Pui Florence , Ma Ting-Fung , Ip Mary Sau-Man , Ho Pak-Leung
Published: October 2021

Objectives

To compare the incidence and severity of invasive pneumococcal diseases (IPDs), pneumococcal pneumonia and all-cause pneumonia during the COVID-19 pandemic period with universal masking and social distancing with that of previous 5 years.

Design

Retrospective observational study on incidence of IPDs, pneumococcal pneumonia and all-cause pneumonia between January 2015–December 2019 and March 2020–March 2021. January–February 2020 was excluded from analysis as it was treated as a transitional period between normal time and pandemic.

Setting

Episode-based data by retrieval of hospitalisation records from the Hospital Authority’s territory-wide electronic medical record database in Hong Kong.

Participants

Hospitalised patients with IPD (n=742), pneumococcal pneumonia (n=2163) and all-cause pneumonia (including COVID-19 pneumonia, n=453 999) aged 18 years or above. Control diagnoses were included to assess confounding from health-seeking behaviours.

Primary and secondary outcomes

Primary outcome is the incidence of diseases between two periods. Secondary outcomes include disease severity surrogated by length of stay and mortality.

Results

Monthly average number of IPD, pneumococcal pneumonia and all-cause pneumonia hospitalisation significantly decreased by 88.9% (95% CI 79.8% to 98.0%, p<0.0005), 72.5% (95% CI 65.9% to 79.1%, p<0.0005) and 17.5% (95% CI 16.8% to 18.2%, p<0.0005), respectively. Changes in trend from January 2015–December 2019 to March 2020–March 2021 were −70% (95% CI −87% to −35%, p=0.0025), –43% (95% CI −59% to −19%, p=0.0014) and −11% (95% CI −13% to −10%, p<0.0005), respectively. Length of stay for IPD and pneumococcal pneumonia episodes were insignificantly different in the two periods. No reductions in hospitalisations for control diagnoses were observed.

Conclusions

Incidence of IPD, pneumococcal pneumonia and all-cause pneumonia decreased during the COVID-19 pandemic. This was observed with universal masking and social distancing. We postulated this is related to reduced transmission of respiratory viruses and bacteria.
Patient awareness of palliative care: systematic review
Authors: Masoud Bahrami , Imane Bagheri , Naiire Salmani
Published: October 2021

Background

One of the barriers to the integration of palliative care within the process of patient care and treatment is the lack of awareness of patients about palliative care. In order to develop efficient resources to improve patient awareness, comprehensive information is required to determine the specific aspects of palliative care where a paucity of evidence on patient awareness exists. This review aims to synthesise evidence from previous studies in order to provide a comprehensive information set about the current state of patient awareness of palliative care.

Methods

In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Magiran, Scientific Information Database(SID) and Islamic Science Citation (ISC) were searched to identify articles published between 2000 and 2021 that considered patients’ awareness of palliative care.

Results

Of the 5347 articles found, 22 studies were retained after quality evaluation; three full-text articles were excluded. Nineteen articles are included in this review. More than half of the patients did not have any information about palliative care or hospice care. Some patients accurately defined hospice care and palliative care; other patients had misunderstandings about palliative care. Patients had limited information about pastoral care, social care and bereavement care. Patients’ awareness about individuals or centres providing palliative care or hospice care was limited. Video presentation and distribution of information at the community level indicated that this method would be beneficial in increasing the awareness.

Conclusion

The review points to the need for patient education programmes and interventional studies to increase patients’ awareness.
Marked and widening socioeconomic inequalities in type 2 diabetes prevalence in Scotland
Authors: Wang Jack , Wild Sarah H
Published: October 2021

Background

This study investigated the association between socioeconomic status and type 2 diabetes (T2D) prevalence in Scotland in 2021 and tested the null hypothesis that inequalities had not changed since they were last described for 2001–2007.

Methods

Data from a national population-based diabetes database for 35-to-84-year-olds in Scotland for 2021 and mid-year population estimates for 2019 stratified by sex and fifths of the Scottish Index of Multiple Deprivation were used to calculate age-specific prevalence of T2D. Age-standardised prevalence was estimated using the European Standard Population with relative risks (RRs) compared between the most (Q1) and least (Q5) deprived fifths for each sex, and compared against similar estimates from 2001 to 2007.

Results

Complete data were available for 255 764 people (98.9%) with T2D. Age-standardised prevalence was lowest for women in Q5 (3.4%) and highest for men in Q1 (11.6%). RRs have increased from 2.00 (95% CI 1.52 to 2.62) in 2001–2007 to 2.48 (95% CI 2.43 to 2.53) in 2021 for women and from 1.58 (95% CI 1.20 to 2.07) in 2007 to 1.89 (95% CI 1.86 to 1.92) in 2021 for men.

Conclusions

Socioeconomic inequalities in T2D prevalence have widened between 2001–2007 and 2021. Further research is required to investigate potential medium-term effects of the COVID-19 pandemic.
Psychiatric consequences of a father’s leave policy by nativity: a quasi-experimental study in Sweden
Authors: Honkaniemi Helena , Katikireddi Srinivasa Vittal , Rostila Mikael , Juárez Sol P
Published: October 2021

Background

Parental leave use has been found to promote maternal and child health, with limited evidence of mental health impacts on fathers. How these effects vary for minority populations with poorer mental health and lower leave uptake, such as migrants, remains under-investigated. This study assessed the effects of a Swedish policy to encourage fathers’ leave, the 1995 Father’s quota, on Swedish-born and migrant fathers’ psychiatric hospitalisations.

Methods

We conducted an interrupted time series analysis using Swedish total population register data for first-time fathers of children born before (1992–1994) and after (1995–1997) the reform (n=198 589). Swedish-born and migrant fathers’ 3-year psychiatric hospitalisation rates were modelled using segmented negative binomial regression, adjusting for seasonality and autocorrelation, with stratified analyses by region of origin, duration of residence, and partners’ nativity.

Results

From immediately pre-reform to post-reform, the proportion of fathers using parental leave increased from 63.6% to 86.4% of native-born and 37.1% to 51.2% of migrants. Swedish-born fathers exhibited no changes in psychiatric hospitalisation rates post-reform, whereas migrants showed 36% decreased rates (incidence rate ratio (IRR) 0.64, 95% CI 0.47 to 0.86). Migrants from regions not predominantly consisting of Organisation for Economic Cooperation and Development countries (IRR 0.50, 95% CI 0.19 to 1.33), and those with migrant partners (IRR 0.23, 95% CI 0.14 to 0.38), experienced the greatest decreases in psychiatric hospitalisation rates.

Conclusion

The findings of this study suggest that policies oriented towards promoting father’s use of parental leave may help to reduce native–migrant health inequalities, with broader benefits for family well-being and child development.
Diffusion and functional MRI findings and their relationship to behaviour in postconcussion syndrome: a scoping review
Authors: Gumus Melisa , Santos Alexandra , Tartaglia Maria Carmela
Published: October 2021

Postconcussion syndrome (PCS) is a term attributed to the constellation of symptoms that fail to recover after a concussion. PCS is associated with a variety of symptoms such as headaches, concentration deficits, fatigue, depression and anxiety that have an enormous impact on patients’ lives. There is currently no diagnostic biomarker for PCS. There have been attempts at identifying structural and functional brain changes in patients with PCS, using diffusion tensor imaging (DTI) and functional MRI (fMRI), respectively, and relate them to specific PCS symptoms. In this scoping review, we appraised, synthesised and summarised all empirical studies that (1) investigated structural or functional brain changes in PCS using DTI or fMRI, respectively, and (2) assessed behavioural alterations in patients with PCS. We performed a literature search in MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) for primary research articles published up to February 2020. We identified 8306 articles and included 45 articles that investigated the relationship between DTI and fMRI parameters and behavioural changes in patients with PCS: 20 diffusion, 20 fMRI studies and 5 papers with both modalities. Most frequently studied structures were the corpus callosum, superior longitudinal fasciculus in diffusion and the dorsolateral prefrontal cortex and default mode network in the fMRI literature. Although some white matter and fMRI changes were correlated with cognitive or neuropsychiatric symptoms, there were no consistent, converging findings on the relationship between neuroimaging abnormalities and behavioural changes which could be largely due to the complex and heterogeneous presentation of PCS. Furthermore, the heterogeneity of symptoms in PCS may preclude discovery of one biomarker for all patients. Further research should take advantage of multimodal neuroimaging to better understand the brain–behaviour relationship, with a focus on individual differences rather than on group comparisons.
Early versus late start of direct oral anticoagulants after acute ischaemic stroke linked to atrial fibrillation: an observational study and individual patient data pooled analysis
Authors: De Marchis Gian Marco , Seiffge David J. , Schaedelin Sabine , Wilson Duncan , Caso Valeria , Acciarresi Monica , Tsivgoulis Georgios , Koga Masatoshi , Yoshimura Sohei , Toyoda Kazunori , Cappellari Manuel , Bonetti Bruno , Macha Kosmas , Kallmünzer Bernd , Cereda Carlo W. , Lyrer Philippe , Bonati Leo H. , Paciaroni Maurizio , Engelter Stefan T. , Werring David J.
Published: October 2021

Objective

The optimal timing to start direct oral anticoagulants (DOACs) after an acute ischaemic stroke (AIS) related to atrial fibrillation (AF) remains unclear. We aimed to compare early (≤5 days of AIS) versus late (>5 days of AIS) DOAC-start.

Methods

This is an individual patient data pooled analysis of eight prospective European and Japanese cohort studies. We included patients with AIS related to non-valvular AF where a DOAC was started within 30 days. Primary endpoints were 30-day rates of recurrent AIS and ICH.

Results

A total of 2550 patients were included. DOACs were started early in 1362 (53%) patients, late in 1188 (47%). During 212 patient-years, 37 patients had a recurrent AIS (1.5%), 16 (43%) before a DOAC was started; 6 patients (0.2%) had an ICH, all after DOAC-start. In the early DOAC-start group, 23 patients (1.7%) suffered from a recurrent AIS, while 2 patients (0.1%) had an ICH. In the late DOAC-start group, 14 patients (1.2%) suffered from a recurrent AIS; 4 patients (0.3%) suffered from ICH. In the propensity score-adjusted comparison of late versus early DOAC-start groups, there was no statistically significant difference in the hazard of recurrent AIS (aHR=1.2, 95% CI 0.5 to 2.9, p=0.69), ICH (aHR=6.0, 95% CI 0.6 to 56.3, p=0.12) or any stroke.

Conclusions

Our results do not corroborate concerns that an early DOAC-start might excessively increase the risk of ICH. The sevenfold higher risk of recurrent AIS than ICH suggests that an early DOAC-start might be reasonable, supporting enrolment into randomised trials comparing an early versus late DOAC-start.
A novel hybrid approach of gravitational search algorithm and decision tree for twitter spammer detection
Authors: Vives Luis , Tuteja Gurpreet Singh , Manideep A. Sai , Jindal Sonika , Sidhu Navjot , Jindal Richa , Bhatt Abhishek
Published: October 2021

With the increasing popularity of online social networking platforms, the amount of social data has grown exponentially. Social data analysis is essential as spamming activities and spammers are escalating over online social networking platforms. This paper focuses on spammer detection on the Twitter social networking platform. Although existing researchers have developed numerous machine learning methods to detect spammers, these methods are inefficient for appropriately detecting spammers on Twitter due to the imbalance of spam and nonspam data distribution, the involvement of diverse features and the applicability of data mechanisms by spammers to avoid their detection. This research work proposes a novel hybrid approach of the gravitational search algorithm and the decision tree (HGSDT) for detecting Twitter spammers. The individual decision tree (DT) algorithm is not able to address the challenges as it is unstable and ineffective for the higher level of favorable data for a particular attribute. The gravitational search algorithm (GSA) constructs the DTs with improved performance as the gravitational forces act as the information-transferring agents through mass agents. Moreover, the GSA is efficient in handling the data of higher dimensional search space. In the HGSDT approach, the construction of the DT and splitting of nodes are performed with the heuristic function and Newton’s laws. The performance of the proposed HGSDT approach is determined for the Social Honeypot dataset and 1KS-10KN dataset by conducting three different experiments to analyze the impact of training data size, features and spammer ratio. The result of the first experiment shows the need of a higher proportion of training data size, the second experiment signifies the more importance of textual content-based features compared to the other feature categories and the third experiment indicates the requirement of balanced data to attain the effective performance of the proposed approach. The overall performance comparison indicates that the proposed HGSDT approach is superior to the incorporated machine learning methods of DT, support vector machine and back propagation neural network for detecting Twitter spammers.
Schisandrin B Attenuates Colitis-Associated Colorectal Cancer through SIRT1 Linked SMURF2 Signaling
Authors: Pu Zhichen , Zhang Weiwei , Wang Minhui , Xu Maodi , Xie Haitang , Zhao Jun
Published: October 2021

Colon cancer, a common type of malignant tumor, seriously endangers human health. However, due to the relatively slow progress in diagnosis and treatment, the clinical therapeutic technology of colon cancer has not been substantially improved in the past three decades. The present study was designed to investigate the effects and involved mechanisms of schisandrin B in cell growth and metastasis of colon cancer. C57BL/6 mice received AOM and dextran sulfate sodium. Mice in treatment groups were gavaged with 3.75–30 mg/kg/day of schisandrin B. Transwell chamber migration, enzyme-linked immunosorbent assay (ELISA), Western blot analysis, immunoprecipitation (IP) and immunofluorescence were conducted, and HCT116 cell line was employed in this study. Data showed that schisandrin B inhibited tumor number and tumor size in the AOD+DSS-induced colon cancer mouse model. Schisandrin B also inhibited cell proliferation and metastasis of colon cancer cells. We observed that schisandrin B induced SMURF2 protein expression and affected SIRT1 in vitro and in vivo. SMURF2 interacted with SIRT1 protein, and there was a negative correlation between SIRT1 and SMURF2 expressions in human colorectal cancer. The regulation of SMURF2 was involved in the anticancer effects of schisandrin B in both in vitro and in vivo models. In conclusion, the present study revealed that schisandrin B suppressed SIRT1 protein expression, and SIRT1 is negatively correlated with the induction of SMURF2, which inhibited cell growth and metastasis of colon cancer. Schisandrin B could be a leading compound, which will contribute to finding novel potential agents and therapeutic targets for colon cancer.
Analysis of influence of guide vane wrap angle and blade number on propulsive performance of a water jet propulsor
Authors: Han Wei , Xie Wenjuan , Li Rennian , Wang Haojie , Pan Yanzhi , Chen Ran , Han Jinzhi
Published: October 2021

In this paper, the propulsion performance of a screw mixed-flow jet propulsion pump is studied systematically. The optimum thrust performance is achieved by changing the geometrical dimensions of the guide vanes. Under the condition of keeping other parameters unchanged, the operating conditions of the pump can be effectively adjusted by changing the number of guide vanes and wrap angle. The focus of this paper is on the presentation and demonstration of a strategy that takes the number of guide vanes and wraps angle as the main research object and its propulsion efficiency as the main reference index to analyze the advantages and disadvantages of each working condition in detail. The CFD numerical simulation technology has been used for numerical calculation. The simulation results are compared with the experimental results, and the numerical calculation results are in good agreement with the experimental values. The results show that the kinetic energy of the propulsion pump increases with the number of guide vane blades and the angle of wrap angle. The increase of guide angle and the number of blades will reduce the overall propulsion efficiency of the propeller. Finally, a mathematical model of propeller efficiency with the number of guide vane blades and the angle coefficient of guide vanes is established.
A variety of exact solutions of the (2+1)-dimensional modified Zakharov–Kuznetsov equation
Authors: Zahran Emad H. M. , Bekir Ahmet , Ahmed Hijaz
Published: October 2021

From the point of view of two distinct methods, we will construct new multiple types of private exact solutions of the (2+1)-dimensional modified Zakharov–Kuznetsov equation (MZKE) which is a famous model in plasma physics. The suggested methods for this purpose are the extended simple equation method (ESEM) and the Paul–Painleve approach method (PPAM). Moreover, the numerical solutions corresponding to the achieved solutions are demonstrated in the framework of the variational iteration method (VIM). Furthermore, we will demonstrate a good comparison not only between our achieved solutions but also with that realized previously by other authors who studied this model before.
Distance Metric Learnt Kernel-Based Music Classification Using Timbral Descriptors
Authors: Rajan Rajeev , Mohan B. S. Shajee
Published: October 2021

Automatic music genre classification based on distance metric learning (DML) is proposed in this paper. Three types of timbral descriptors, namely, mel-frequency cepstral coefficient (MFCC) features, modified group delay features (MODGDF) and low-level timbral feature sets are combined at the feature level. We experimented with k nearest neighbor (kNN) and support vector machine (SVM)-based classifiers for standard and DML kernels (DMLK) using GTZAN and Folk music dataset. Standard kernel-based kNN and SVM-based classifiers report classification accuracy (in%) of 79.03 and 90.16, respectively, on GTZAN dataset and 86.60 and 92.26, respectively, for Folk music dataset, with the best performing RBF kernel. A further improvement was observed when DML kernels were used in place of standard kernels in the kernel kNN and SVM-based classifiers with an accuracy of 84.46%, 92.74% (GTZAN), 90.00 and 96.23 (Folk music dataset) for DMLK-kNN and DMLK-SVM, respectively. The results demonstrate the potential of DML kernels in music genre classification task.
Forecast-Island and Bidding A*-Euclidean Selecting Boustrophedon Coordination Algorithm for Exploration
Authors: Yao Zhifeng , Xu Fengxia , Han Chunsong
Published: October 2021

Exploration algorithms based on the Boustrophedon path seldom consider the impacts of a robot turning at corners on the exploration time. This paper proposes the Forecast-Island and Bidding A*-Euclidean Selecting Boustrophedon Coordination (FIBA*ESBC) algorithm to calculate the turning time at corners in the overall exploration time and introduces a method to estimate the walking time in the Boustrophedon paths in order to determine the directions for path execution. Typically, in bidding-based exploration tasks, the cost is the Euclidean distance between the current position of the robot and the target point. When there is an obstacle between two points, the cost is set to infinity. Therefore, the selected target point is sometimes not optimal. The FIBA*ESBC algorithm is based on the exploration cost of a combination of the Euclidean distance and A* algorithm walking path, which can effectively solve this problem. Because the bidding is based on a greedy algorithm, the robot has a small unexplored island in the later exploration stage; therefore, full exploration is not possible or requires a long time with several repeated paths. The FIBA*ESBC algorithm prioritizes the exploration and estimation of hidden and existing unexplored islands. It can realize complete exploration and decrease the exploration time. Through simulation experiments conducted using Gazebo and RViz, the feasibility of the FIBA*ESBC algorithm is verified. Moreover, a simulation experiment is conducted in MATLAB for comparison with other algorithms. The analysis of the experimental data shows that the proposed algorithm has a relatively short exploration time.
EXISTENCE RESULTS FOR A COUPLED SYSTEM OF NONLINEAR FRACTIONAL q-INTEGRO-DIFFERENCE EQUATIONS WITH q-INTEGRAL-COUPLED BOUNDARY CONDITIONS
Authors: ALSAEDI AHMED , AL-HUTAMI HANA , AHMAD BASHIR , AGARWAL RAVI P.
Published: October 2021

In this paper, we introduce and investigate a new class of coupled fractional [Formula: see text]-integro-difference equations involving Riemann–Liouville fractional [Formula: see text]-derivatives and [Formula: see text]-integrals of different orders, equipped with [Formula: see text]-integral-coupled boundary conditions. The given problem is converted into an equivalent fixed-point problem by introducing an operator whose fixed-points coincide with solutions of the problem at hand. The existence and uniqueness results for the given problem are, respectively, derived by applying Leray–Schauder nonlinear alternative and Banach contraction mapping principle. Illustrative examples for the obtained results are constructed. This paper concludes with some interesting observations and special cases dealing with uncoupled boundary conditions, and non-integral and integral types nonlinearities.
Attractors for multi-valued lattice dynamical systems with nonlinear diffusion terms
Authors: Zhang Panpan , Gu Anhui
Published: October 2021

This paper is devoted to the long-term behavior of nonautonomous random lattice dynamical systems with nonlinear diffusion terms. The nonlinear drift and diffusion terms are not expected to be Lipschitz continuous but satisfy the continuity and growth conditions. We first prove the existence of solutions, and establish the existence of a multi-valued nonautonomous cocycle. We then show the existence and uniqueness of pullback attractors parameterized by sample parameters. Finally, we establish the measurability of this pullback attractor by the method based on the weak upper semicontinuity of the solutions.
Detection of diabetic retinopathy in its early stages using textural features of optical coherence tomography angiography
Authors: Gao W. , Li B. , Chen S. , Shi Y. , Lin P. , Myakinin O. O. , Zakharov V. P.
Published: October 2021

The aim of this study is to detect whether the quantitative textural features of optical coherence tomography angiography (OCTA) images can be used to detect the eyes in the early stage of diabetic retinopathy (DR) from eyes with diabetes and no DR (NDR). Textural features including fractal dimension, contrast, correlation, entropy, energy, and homogeneity were calculated from the OCTA images. The Student’s [Formula: see text]-test was performed to identify the textural features that can be able to detect DR in the early stage. The area under the receiver operating characteristic (AUROC) curves, sensitivity, and specificity were calculated between the study groups. Our results indicated that the fractal dimension in ICP and SVP and the correlation in SVC showed the statistical significance between mild NPDR patients and NDR patients. The ROC analysis results showed that the AUROC of the fractal dimension in ICP was 0.736 with 0.773 sensitivity and 0.700 specificity. The cutoff point in ICP was 2.616. The OCTA-based fractal dimension was able to discriminate diabetic eyes with early retinopathy from healthy and NDR with higher sensitivity and specificity. The OCTA-based correlation showed the power to differentiate the mild NPDR eyes from the normal healthy and diabetic eyes. These results suggest that texture-based features of OCTA have the potential to assist in the assessment of therapeutic interventions to prevent early DR in diabetic subjects.