bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Cold-Water Immersion After Strength Training Attenuate Training Adaptation?
Authors: Poppendieck Wigand , Wegmann Melissa , Hecksteden Anne , Darup Alexander , Schimpchen Jan , Skorski Sabrina , Ferrauti Alexander , Kellmann Michael , Pfeiffer Mark , Meyer Tim
Published: November 2020

Purpose: Cold-water immersion is increasingly used by athletes to support performance recovery. Recently, however, indications have emerged suggesting that the regular use of cold-water immersion might be detrimental to strength training adaptation. Methods: In a randomized crossover design, 11 participants performed two 8-week training periods including 3 leg training sessions per week, separated by an 8-week “wash out” period. After each session, participants performed 10 minutes of either whole-body cold-water immersion (cooling) or passive sitting (control). Leg press 1-repetition maximum and countermovement jump performance were determined before (pre), after (post) and 3 weeks after (follow-up) both training periods. Before and after training periods, leg circumference and muscle thickness (vastus medialis) were measured. Results: No significant effects were found for strength or jump performance. Comparing training adaptations (pre vs post), small and negligible negative effects of cooling were found for 1-repetition maximum (g = 0.42; 95% confidence interval [CI], −0.42 to 1.26) and countermovement jump (g = 0.02; 95% CI, −0.82 to 0.86). Comparing pre versus follow-up, moderate negative effects of cooling were found for 1-repetition maximum (g = 0.71; 95% CI, −0.30 to 1.72) and countermovement jump (g = 0.64; 95% CI, −0.36 to 1.64). A significant condition × time effect (P = .01, F = 10.00) and a large negative effect of cooling (g = 1.20; 95% CI, −0.65 to 1.20) were observed for muscle thickness. Conclusions: The present investigation suggests small negative effects of regular cooling on strength training adaptations.
Coupled Gluteus Maximus and Gluteus Medius Recruitment Patterns Modulate Hip Adduction Variability During Single-Limb Step-Downs: A Cross-Sectional Study
Authors: Hollman John H. , Beise Nicholas J. , Fischer Michelle L. , Stecklein Taylor L.
Published: November 2020

Context: Examining the coordinated coupling of muscle recruitment patterns may provide insight into movement variability in sport-related tasks. Objective: The purpose of this study was to examine the relationship between coupled gluteus maximus and medius recruitment patterns and hip-adduction variability during single-limb step-downs. Design: Cross-sectional. Setting: Biomechanics laboratory. Participants: Forty healthy adults, including 26 women and 14 men, mean age 23.8 (1.6) years, mean body mass index 24.2 (3.1) kg/m2, participated. Interventions: Lower-extremity kinematics were acquired during 20 single-limb step-downs from a 19-cm step height. Electromyography (EMG) signals were captured with surface electrodes. Isometric hip-extension strength was obtained. Main Outcome Measures: Hip-adduction variability, measured as the SD of peak hip adduction across 20 repetitions of the step-down task, was measured. The mean amplitudes of gluteus maximus and gluteus medius EMG recruitment were examined. Determinism and entropy of the coupled EMG signals were computed with cross-recurrence quantification analyses. Results: Hip-adduction variability correlated inversely with determinism (r = −.453, P = .018) and positively with entropy (r = .409, P = .034) in coupled gluteus maximus/medius recruitment patterns but not with hip-extensor strength nor with magnitudes of mean gluteus maximus or medius recruitment (r = −.003, .081, and .035; P = .990, .688, and .864, respectively). Conclusion: Hip-adduction variability during single-limb step-downs correlated more strongly with measures of coupled gluteus maximus and medius recruitment patterns than with hip-extensor strength or magnitudes of muscle recruitment. Examining coupled recruitment patterns may provide an alternative understanding of the extent to which hip neuromuscular control modulates lower-extremity kinematics beyond examining muscle strength or EMG recruitment magnitudes.
Community-led governance for gene-edited crops
Authors: Kuzma Jennifer , Grieger Khara
Published: November 2020

A post–market certification process could promote transparency and trust
Georgina Mace (1953–2020)
Authors: Purvis Andy , Jones Kate E.
Published: November 2020

Pioneering conservation biologist and sustainability scientist
Drugs from bugs in creatures of the sea
Authors: Cowen Leah E.
Published: November 2020

A bacterium from the sea squirt microbiome makes a natural product with antifungal activity
Brain mapping, from molecules to networks
Authors: Allen William E.
Published: November 2020

Bridging multiple levels of brain function reveals the neural basis of thirst motivation
The excellence question
Authors: Leyser Ottoline
Published: November 2020

Five months ago, when I stepped into my new role as the chief executive officer of the UK Research and Innovation (UKRI) organization, a question loomed large for me: What is excellence? After all, UKRI is the major public funder of science in the United Kingdom, spending billions of taxpayer money every year. To spend this money well, UKRI must support a portfolio of truly excellent work. So, what then is excellence?
What’s Your Diagnosis? A Rapid Inquiry–Based Game To Differentiate and Review Medically Important Microbes
Authors: Axler-DiPerte Grace L. , Ortiz Mary T.
Published: November 2020

A central component of science education involves teaching the process of hypothesis development and modification.  This is often done through repeated cycles of questioning, followed by data collection and refinement of hypotheses.  Microbiology courses often include units on infectious diseases grouped by body system, with the goal of allowing students to make observations and use data to identify a specific microbe or class of microbes.  Given that disease syndromes often have similar signs and symptoms, but diverse etiologies, it can be difficult for students to distinguish and differentiate them.  We present a rapid-paced and engaging game that enables students to practice deductive and inductive cycles of reasoning to distinguish among various causes of infectious disease.  This game requires students to identify a microbe from a field of diverse, yet medically important, microorganisms by asking a series of Yes/No questions and replicating the process of elimination used in differential diagnosis. Students compete against each other, individually or in teams, to be the first to reach a “diagnosis” and learn to quickly refine their hypotheses and determine the most direct line of investigation using simple Yes/No questioning.  This game can be played in 15 to 30 minute sessions, and can be easily customized to a particular course’s content.
COVID-19 and the Central Dogma: an Activity To Improve Student Learning and Engagement
Authors: Roush Carli , Burmeister Alita R.
Published: November 2020

The Central Dogma of molecular biology describes the transfer of genetic information within organisms and is a core concept in the biological sciences. However foundational, the Central Dogma is often misrepresented when taught in introductory college biology courses. In particular, the Central Dogma is often taught with a requisite DNA step, an incorrect conception that omits the possibility of RNA-based molecular systems, such as SARS-CoV-2, the causative agent of COVID-19. In this new contribution, we offer a practical way to clarify correct conceptions and make them immediately relevant through COVID-19. In this new digital ‘sorting cards’ activity, students collaboratively synthesize and map their knowledge of core molecular biology. Building off of the typically-presented concepts of the Central Dogma, we also introduce two sorting card “expansion packs” for double-stranded DNA viruses and single-stranded RNA viruses. We provide activity templates for all sets of cards using a free web-based collaborative platform suitable for sudden shifts to online learning (as in our implementation), pre-planned online learning, and in-person classes. While truly hands-on activities can be difficult to replicate in the context of online learning, the use of collaborative websites and creative freedom in this activity encourages student engagement in and ownership of their learning.
Facilitating Long-Term Mentoring To Effectively Implement Active Learning Instruction: Formation of the Promoting Active Learning and Mentoring (PALM) Network
Authors: Moore Michael E. , Naganathan Anusha , Blumer Stephanie Levi , Goller Carlos C. , Misra Anjali , Raut Samiksha A. , Swamy Uma , Wick Sue , Wolyniak Michael J.
Published: November 2020

A large body of data suggests that implementing active learning practices in a STEM classroom contributes to increased success in both achievement of student learning outcomes and retention of students. Despite these findings, significant barriers exist for instructors implementing active learning strategies in their undergraduate classrooms. These barriers can be effectively addressed by providing sustained support to instructors and postdoctoral trainees interested in implementing active learning strategies in their teaching practice. The Promoting Active Learning and Mentoring (PALM) network attains this objective by connecting instructors interested in learning more about active learning (Fellows) with individuals who have extensive expertise related to this practice (mentors). These facilitated connections occur in the form of active mentorship for a year or more, virtual journal clubs, and biannual gatherings of PALM Fellows and mentors. Here, we describe the foundation on which PALM was built and explain how a successful mentorship program can pave the way for educators to adapt and implement evidence-based practices like active learning in a college classroom.
Proteomics of Herpes Simplex Virus 1 Nuclear Capsids
Authors: El Bilali Nabil , Khadivjam Bita , Bonneil Eric , Thibault Pierre , Lippé Roger
Published: November 2020

Much is known about the biology of herpesviruses. This includes their unique ability to traverse the two nuclear envelopes by sequential budding and fusion steps.
Supplemental Material: Fluid compositions reveal fluid nature, metal deposition mechanisms, and mineralization potential: An example at the Haobugao Zn-Pb skarn, China
Authors: Shu Qihai , al. et
Published: November 2020

Methods, results, Figures S1–S6, and Tables S1–S6.
Supplemental Material: Drill core from seismically active sandstone gas reservoir yields clues to internal deformation mechanisms
Authors: Verberne Berend , Hangx Suzanne , al. et
Published: November 2020

Detailed description of the materials and methods employed in this study, Figures S1–S8, and Tables S1–S4.
Low-cost exercise interventions improve long-term cardiometabolic health independently of a family history of type 2 diabetes: a randomized parallel group trial
Authors: Wasenius Niko S , Isomaa Bo A , Östman Bjarne , Söderström Johan , Forsén Björn , Lahti Kaj , Hakaste Liisa , Eriksson Johan G , Groop Leif , Hansson Ola , Tuomi Tiinamaija
Published: November 2020

Introduction

To investigate the effect of an exercise prescription and a 1-year supervised exercise intervention, and the modifying effect of the family history of type 2 diabetes (FH), on long-term cardiometabolic health.

Research design and methods

For this prospective randomized trial, we recruited non-diabetic participants with poor fitness (n=1072, 30–70 years). Participants were randomly assigned with stratification for FH either in the exercise prescription group (PG, n=144) or the supervised exercise group (EG, n=146) group and compared with a matched control group from the same population study (CON, n=782). The PG and EG received exercise prescriptions. In addition, the EG attended supervised exercise sessions two times a week for 60 min for 12 months. Cardiometabolic risk factors were measured at baseline, 1 year, 5 years, and 6 years. The CON group received no intervention and was measured at baseline and 6 years.

Results

The EG reduced their body weight, waist circumference, diastolic blood pressure, and low-density lipoprotein-cholesterol (LDL-C) but not physical fitness (p=0.074) or insulin or glucose regulation (p>0.1) compared with the PG at 1 year and 5 years (p≤0.011). The observed differences were attenuated at 6 years; however, participants in the both intervention groups significantly improved their blood pressure, high-density lipoprotein-cholesterol, and insulin sensitivity compared with the population controls (p≤0.003). FH modified LDL-C and waist circumference responses to exercise at 1 year and 5 years.

Conclusions

Low-cost physical activity programs have long-term beneficial effects on cardiometabolic health regardless of the FH of diabetes. Given the feasibility and low cost of these programs, they should be advocated to promote cardiometabolic health.

Trial registration number

ClinicalTrials.gov identifierNCT02131701.
Measuring experiences of facility-based care for pregnant women and newborns: a scoping review
Authors: Larson Elysia , Sharma Jigyasa , Nasiri Khalidha , Bohren Meghan A , Tunçalp Özge
Published: November 2020

Background

Access to high-quality, person-centred care during pregnancy and childbirth is a global priority. Positive experience of care is key in particular, because it is both a fundamental right and can influence health outcomes and future healthcare utilisation. Despite its importance for accountability and action, systematic guidance on measuring experience of care is limited.

Methods

We conducted a scoping review of published literature to identify measures/instruments for experience of facility-based pregnancy and childbirth (abortion, antenatal, intrapartum, postnatal and newborn) care. We systematically searched five bibliographic databases from 1 January 2007 through 1 February 2019. Using a predefined evidence template, we extracted data on study design, data collection method, study population and care type as reported in primary quantitative articles. We report results narratively.

Results

We retrieved 16 528 unique citations, including 171 eligible articles representing, 157 unique instruments and 144 unique parent instruments across 56 countries. Half of the articles (90/171) did not use a validated instrument. While 82% (n=141) of articles reported on labour and childbirth care, only one reported on early pregnancy/abortion care. The most commonly reported sub-domains of user experience were communication (84%, 132/157) and respect and dignity (71%, 111/157). The primary purpose of most papers was measurement (70%, 119/171), largely through cross-sectional surveys.

Conclusion

There are alarming gaps in measurement of user experience for abortion, antenatal, postnatal and newborn care, including lack of validated instruments to measure the effects of interventions and policies on user experience.

Protocol registration details

This review was registered and published on PROSPERO (CRD42017070867). PROSPERO is an international database of prospectively registered systematic reviews in health and social care.
Coassessment framework to identify person-centred unmet needs in stroke rehabilitation: a case report in Norway
Authors: Kværner Kari Jorunn , Støme Linn Nathalie , Romm Jonathan , Rygh Karianne , Almquist Frida , Tornaas Sveinung , Berg Marianne Storen
Published: November 2020

Objective

To describe unmet needs and values in stroke rehabilitation using the Health Value Framework and the associated coassessment tool Health Value Spider, a framework designed to identify and prioritise unmet needs based on health technology assessment (HTA).

Setting

The study took place at Oslo University Hospital, Norway, from February to April 2019. Participants in three consecutive workshops were recruited from Sunnaas Rehabilitation Hospital, Oslo Municipality, Hospital Procurement Trust and Oslo University Hospital. Twenty-four hospital workers (medical and allied health staff and administrative staff) participated in workshop 1 and 29 patients, user representatives and hospital workers in workshop 2. Twenty-one patients and hospital workers participated in workshop 3.

Interventions

Stakeholder analysis and scenario building was performed in a coassessment setting where unmet needs were identified applying the Health Value Framework. Two of the authors are also the developers of the Health Value Framework (KJK and LNS).

Results

In the two first workshops where health workers, patients and next of kin perspectives were elicited, three needs were identified: patient insecurity in patient journey transitions, lack of stroke rehabilitation expertise in primary care and invisible patient problems, such as fatigue and cognitive impairment. In workshop 3, 12 opportunity areas were identified. Four opportunity areas were selected by the stakeholders based on a prioritisation process: early discovery of cognitive impairment, rehabilitation continuity, empowered patients and next of kin and remote monitoring and digital touchpoints.

Conclusion

Health Value Spider successfully identified and prioritised unmet needs and described associated values.
Effects of diurnal temperature range on first-ever strokes in different seasons: a time-series study in Shenzhen, China
Authors: Lei Lin , Bao Junzhe , Guo Yanfang , Wang Qiong , Peng Ji , Huang Cunrui
Published: November 2020

Objective

Diurnal temperature range (DTR) is an important meteorological indicator of global climate change; high values of DTR may induce stroke morbidity, while the related high-risk periods and sensitive populations are not clear. This study aims to evaluate the effects of DTR on first-ever strokes in different seasons and in relation to sensitive populations.

Methods

We collected data on 142 569 first-ever strokes during 2005–2016 in Shenzhen. We fitted a time-series Poisson model in our study, estimating the associations between DTR and first-ever strokes, with a distributed lag non-linear model. Then, we calculated strokes attributable to high DTR in different genders, age groups, education levels and stroke subtypes.

Results

High DTR had a significant association with first-ever strokes, and the risk of stroke increased with the rise of DTR in the summer and winter. In total, 3.65% (95% empirical CI (eCI) 1.81% to 5.53%) of first-ever strokes were attributable to high DTR (5.5°C and higher) in the summer, while 2.42% (95% eCI 0.05% to 4.42%) were attributable to high DTR (8°C and higher) in the winter. In the summer, attributable fraction (AF) was significant in both genders, middle-aged and old patients, patients with different levels of education, as well as patients with cerebral infarction (CBI); in the winter, AF was significant in middle-aged patients, patients with primary and lower education level, as well as patients with CBI.

Conclusions

High DTR may trigger first-ever strokes in the summer and winter, and CBI is more sensitive than intracerebral haemorrhage to DTR. Most people are sensitive to high DTR in the summer, while middle-aged and low-education populations are sensitive in the winter. It is recommended that the DTR values be reported and emphasised in weather forecast services, together with the forecasts of heat and cold.
Consumption and market share of cholesterol-lowering drugs in high-risk patients before and after the release of the 2013 ACC/AHA cholesterol guidelines: a retrospective observational study
Authors: Kuo Tzu-Tsen , Huang Yaw-Bin , Hsieh Ching-Jung
Published: November 2020

Objective

We examined the use of cholesterol-lowering drugs in Taiwan in high-risk patients before and after the release of the 2013 American College of Cardiology and the American Heart Association (ACC/AHA) cholesterol guidelines.

Design

Retrospective observational study.

Setting

Kaohsiung Chang Gung Memorial Hospital database, Kaohsiung City, Taiwan.

Participants

Outpatients aged ≥20 years with atherosclerosis cardiovascular disease, familial hypercholesterolaemia and diabetes.

Primary and secondary outcome measures

Data on brand and generic names, use and dosage of cholesterol-lowering drugs in 2012 and 2015 were compiled and the total amount used was calculated. Differences in usage and market share were compared. Usage rates of single and fixed-dose combination (FDC) products were compared.

Results

The number of patients receiving ambulatory care increased from 36 367 in 2012 to 41 807 in 2015. Single (3 679 979–4 568 086 tablets) and FDC (540 522–572 954 tablets) product use increased from 2012 to 2015, respectively. Statins were the most commonly prescribed medications in 2012 (71.14%) and 2015 (72.91%). The average monthly consumption of statin among high-risk patients in 2012 was 269 948.8 tablets, and it increased significantly to 343 975.3 tablets in 2015. The average monthly consumption of pitavastatin was 34 113.4 tablets in 2015, which was significantly higher than 0 in 2012. Conversely, the highest decline was observed for fluvastatin use, with the average monthly consumption being 38 754.3 tablets in 2015, which was significantly lower than 45 929.8 tablets consumed in 2012. Regarding FDC therapy for cholesterol-lowering drugs, Vytorin (ezetimibe 10 mg + simvastatin 20 mg) use was the highest among all FDCs in 2015.

Conclusions

The 2013 ACC/AHA cholesterol guidelines likely promoted the use of fixed-dose, high-intensity and moderate-intensity monotherapy and FDC therapy statins in high-risk groups, and this was consistent with the use of high-intensity or moderate-intensity statins in the present study. Furthermore, these changes were associated with increased effectiveness and reduced adverse effects.
Protocol for the REPAT study: role of emotional processing in art therapy for breast cancer palliative care patients
Authors: Czamanski-Cohen Johanna , Wiley Joshua , Weihs KL
Published: November 2020

Introduction

Patients with breast cancer (BC) cope with depression which is linked to functional limitations in survivorship and to physical symptoms. Pain and fatigue are prominent symptoms that affect the well-being of cancer survivors. Emotional processing has been associated with improved physical and psychological health in survivors. Art therapy is a form of psychotherapy that involves the use of visual art-making for expression and communication. It encourages emotional processing and has been linked to symptom reduction in patients with cancer. This protocol is designed to examine two mechanistic changes: emotional processing (awareness, expression and acceptance) and cholinergic anti-inflammatory processes (heart rate variability and cytokine expression) through which an art therapy intervention may reduce depression, pain and fatigue. In addition, we will examine ethnocultural differences in the effect of art therapy in women from different ethnocultural backgrounds.

Methods and analysis

A randomised controlled study with careful controls will randomise 240 patient with BC (50% Jewish and 50% Arab) to an 8-week group art therapy intervention or an 8-week Mandala colouring comparison group. This design will test the mechanisms of art therapy on the targeted outcomes beyond the effects of time with a group, focus on a task and engagement with art materials. We will examine two potential mechanisms: emotional processing and cholinergic anti-inflammatory processes; of the intervention effects on depression, pain and fatigue and compare these effects in Arab versus Jewish women.

Ethics and dissemination

Participants will sign informed consent before participation and will be informed that they can leave the study at any point in time without effect on their medical treatment. The Helsinki committees of each participating hospital have approved the study. Data collected in this study will be published in peer-review journals, and we will use the platform of the study website (http://repat.haifa.ac.il/en/) for further dissemination to the general public.

Trial registration number

The study is registered in ClinicalTrials.gov:NCT03377816; Pre-results.
Electronic cigarettes as a smoking cessation aid for patients with cancer: beliefs and behaviours of clinicians in the UK
Authors: Brett Jo , Davies Emma L , Matley Fiona , Aveyard Paul , Wells Mary , Foxcroft David , Nicholson Brian , De Silva Minor Shiroma , Sinclair Lesley , Jakes Sarah , Watson Eila
Published: November 2020

Objectives

To explore UK clinicians’ beliefs and behaviours around recommending e-cigarettes as a smoking cessation aid for patients with cancer.

Design

Cross-sectional online survey.

Setting

England, Wales, Scotland and Northern Ireland.

Participants

Clinicians involved in the care of patients with cancer.

Primary and secondary outcomes

Behavioural Change Wheel capability, opportunity and motivation to perform a behaviour, knowledge, beliefs, current practice around e-cigarettes and other smoking cessation practices.

Method

Clinicians (n=506) completed an online survey to assess beliefs and behaviours around e-cigarettes and other smoking cessation practices for patients with cancer. Behavioural factors associated with recommending e-cigarettes in practice were assessed.

Results

29% of clinicians would not recommend e-cigarettes to patients with cancer who continue to smoke. Factors associated with recommendation include smoking cessation knowledge (OR 1.56, 95% CI 1.01 to 2.44) and e-cigarette knowledge (OR 1.64, 95% CI 1.06 to 2.55), engagement with patients regarding smoking cessation (OR 2.12, 95% CI 1.12 to 4.03), belief in the effectiveness of e-cigarettes (OR 2.36 95% CI 1.61 to 3.47) and belief in sufficient evidence on e-cigarettes (OR 2.08 95% CI 1.10 to 4.00) and how comfortable they felt discussing e-cigarettes with patients (OR 1.57 95% CI 1.04 to 2.36).

Conclusion

Many clinicians providing cancer care to patients who smoke do not recommend e-cigarettes as a smoking cessation aid and were unaware of national guidance supporting recommendation of e-cigarettes as a smoking cessation aid.
Early neuromuscular blocking agents for adults with acute respiratory distress syndrome: a systematic review, meta-analysis and meta-regression
Authors: Shao Shuai , Kang Hanyujie , Tong Zhaohui
Published: November 2020

Objective

To determine whether neuromuscular blocking agents (NMBAs) can decrease the mortality of patients with acute respiratory distress syndrome (ARDS) and improve their clinical outcomes.

Design

Systematic review, meta-analysis and meta-regression.

Data sources

PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov.

Methods

Randomised controlled trials (RCTs) comparing the treatment effect of NMBAs with that of placebo (or traditional treatment) in patients with ARDS were carefully selected. The primary outcome was 90-day mortality. The secondary outcomes were 21–28 days mortality, NMBA-related complications (barotrauma, pneumothorax and intensive care unit (ICU)-acquired muscle weakness), days free of ventilation and days not in the ICU by day 28, Medical Research Council score, Acute Physiology and Chronic Health Evaluation II score and arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) (at 48 hours and 72 hours). Random-effects meta-regression was used to explore models involving potential moderators. Trial sequential analysis was performed to estimate the cumulative effect on mortality across RCTs.

Results

NMBAs were not associated with reduced 90-day mortality (risk ratio (RR) 0.85; 95% CI 0.66 to 1.09; p=0.20). However, they decreased the 21–28 days mortality (RR 0.71; 95% CI 0.53 to 0.96; p=0.02) and the rates of pneumothorax (RR 0.46; 95% CI 0.28 to 0.77; p=0.003) and barotrauma (RR 0.56; 95% CI 0.37 to 0.86; p=0.008). In addition, NMBAs increased PaO2/FiO2 at 48 hours (mean difference (MD) 18.91; 95% CI 4.29 to 33.53; p=0.01) and 72 hours (MD 12.27; 95% CI 4.65 to 19.89; p=0.002). Meta-regression revealed an association between sample size (p=0.042) and short-term mortality. Publication year (p=0.050), sedation strategy (p=0.047) and sample size (p=0.046) were independently associated with PaO2/FiO2 at 48 hours.

Conclusions

In summary, the results suggested that use of NMBAs might reduce 21–28 days mortality, NMBA-related complications and oxygenation. However, NMBAs did not reduce the 90-day mortality of patients with ARDS, which contradicts a previous meta-analysis.

PROSPERO registration number

CRD42019139440.
Routes to diagnosis of symptomatic cancer in sub-Saharan Africa: systematic review
Authors: Martins Tanimola , Merriel Samuel William David , Hamilton William
Published: November 2020

Background

Most cancers in sub-Saharan Africa (SSA) are diagnosed at advanced stages, with limited treatment options and poor outcomes. Part of this may be linked to various events occurring in patients’ journey to diagnosis. Using the model of pathways to treatment, we examined the evidence regarding the routes to cancer diagnosis in SSA.

Design and settings

A systematic review of available literature was performed.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Between 30 September and 30 November 2019, seven electronic databases were searched using terms relating to SSA countries, cancer and routes to diagnosis comprising the population, exposure and outcomes, respectively. Citation lists of included studies were manually searched to identify relevant studies. Furthermore, ProQuest Dissertations & Theses Global was searched to identify appropriate grey literature on the subject.

Results

18 of 5083 references identified met the inclusion criteria: eight focused on breast cancer; three focused on cervical cancer; two each focused on lymphoma, Kaposi’s sarcoma and childhood cancers; and one focused on colorectal cancer. With the exception of Kaposi’s sarcoma, definitive diagnoses were made in tertiary healthcare centres, including teaching and regional hospitals. The majority of participants initially consulted within primary care, although a considerable proportion first used complementary medicine before seeking conventional medical help. The quality of included studies was a major concern, but their findings provided important insight into the pathways to cancer diagnosis in the region.

Conclusion

The proportion of patients who initially use complementary medicine in their cancer journey may explain a fraction of advanced-stage diagnosis and poor survival of cancer in SSA. However, further research would be necessary to fully understand the exact role (or activities) of primary care and alternative care providers in patient cancer journeys.
Concurrent use of opioids and benzodiazepines/Z-drugs in Alberta, Canada and the risk of hospitalisation and death: a case cross-over study
Authors: Sharma Vishal , Simpson Scot H , Samanani Salim , Jess Ed , Eurich Dean T
Published: November 2020

Objectives

Coprescribing of benzodiazepines/Z-drugs (BZDs) and opioids is a drug-use pattern of considerable concern due to risk of adverse events. The objective of this study is to estimate the effect of concurrent use of BZDs on the risk of hospitalisations/emergency department (ED) visits and deaths among opioid users.

Design, setting and participants

We conducted a population-based case cross-over study during 2016–2018 involving Albertans 18 years of age and over who received opioids. From this group, we identified 1 056 773 people who were hospitalised or visited the ED, and 31 998 who died.

Intervention

Concurrent use of opioids and BZDs.

Outcomes

We estimated the risk of incident all-cause hospitalisation/ED visits and all-cause mortality associated with concurrent BZD use by applying a matched-pair analyses comparing concurrent use to opioid only use.

Results

Concurrent BZD use occurred in 17% of opioid users (179 805/1 056 773). Overall, concurrent use was associated with higher risk of hospitalisation/ED visit (OR 1.13, p<0.001) and all cause death (OR 1.90; p<0.001). The estimated risk of hospitalisation/ED visit was highest in those >65 (OR 1.5; p<0.001), using multiple health providers (OR 1.67; p<0.001) and >365 days of opioid use (OR 1.76; p<0.001). Events due to opioid toxicity were also associated with concurrent use (OR 1.8; p<0.001). Opioid dose-response effects among concurrent patients who died were also noted (OR 3.13; p<0.001).

Interpretation

Concurrent use of opioids and BZDs further contributes to the risk of hospitalisation/ED visits and mortality in Alberta, Canada over opioid use alone, with higher opioid doses, older age and increased number of unique health providers carrying higher risks. Regulatory bodies and health providers should reinforce safe drug-use practices and be vigilant about coprescribing.
Effectiveness, cost-effectiveness and safety of gabapentin versus placebo as an adjunct to multimodal pain regimens in surgical patients: protocol of a placebo controlled randomised controlled trial with blinding (GAP study)
Authors: Baos Sarah , Rogers Chris A , Abbadi Reyad , Alzetani Aiman , Casali Gianluca , Chauhan Nilesh , Collett Laura , Culliford Lucy , de Jesus Samantha E , Edwards Mark , Goddard Nicholas , Lamb Jennifer , McKeon Holly , Molyneux Mat , Stokes Elizabeth A , Wordsworth Sarah , Gibbison Ben , Pufulete Maria
Published: November 2020

Introduction

Gabapentin is an antiepileptic drug currently licensed to treat epilepsy and neuropathic pain but has been used off-label to treat acute postoperative pain. The GAP study will compare the effectiveness, cost-effectiveness and safety of gabapentin as an adjunct to standard multimodal analgesia versus placebo for the management of pain after major surgery.

Methods and analysis

The GAP study is a multicentre, double-blind, randomised controlled trial in patients aged 18 years and over, undergoing different types of major surgery (cardiac, thoracic or abdominal). Patients will be randomised in a 1:1 ratio to receive either gabapentin (600 mg just before surgery and 600 mg/day for 2 days after surgery) or placebo in addition to usual pain management for each type of surgery. Patients will be followed up daily until hospital discharge and then at 4 weeks and 4 months after surgery. The primary outcome is length of hospital stay following surgery. Secondary outcomes include pain, total opioid use, adverse health events, health related quality of life and costs.

Ethics and dissemination

This study has been approved by the Research Ethics Committee . Findings will be shared with participating hospitals and disseminated to the academic community through peer-reviewed publications and presentation at national and international meetings. Patients will be informed of the results through patient organisations and participant newsletters.

Trial registration number

ISRCTN63614165.
Seroprevalence of SARS-CoV-2 antibodies in children of United Kingdom healthcare workers: a prospective multicentre cohort study protocol
Authors: Corr Michael , Christie Sharon , Watson Chris , Maney Julieann , Fairley Derek , Ladhani Shamez N , Lyttle Mark David , McFetridge Lisa , Mitchell Hannah , Shields Michael David , McGinn Claire , McKenna James , Mallett Peter , Ferris Kathryn , Rowe-Setz Gala , Moore Rebecca , Foster Steven , Evans Jennifer , Waterfield Tom
Published: November 2020

Background

A novel coronavirus SARS-CoV-2 has been responsible for a worldwide pandemic. Children typically have very mild, or no, symptoms of infection. This makes estimations of seroprevalence in children difficult. Research is therefore required to determine the seroprevalence of SARS-CoV-2 antibodies in children. The primary objective of this study is to report the seroprevalence of SARS-CoV-2 IgM and/or IgG antibodies in healthy children at baseline, 2 months and 6 months. This is the only longitudinal UK study of seroprevalence in an exclusively paediatric population. Determining the changing seroprevalence is of vital public health importance and can help inform decisions around the lifting of paediatric specific social distancing measures such as school closures and the cancellation of routine paediatric hospital services.

Methods and analysis

1000 healthy children of healthcare workers aged between 2 and 15 years will be recruited from five UK sites (Belfast, Cardiff, Glasgow, London and Manchester). The children will undergo phlebotomy at baseline, 2 months and 6 months to measure IgM and/or IgG positivity to SARS-CoV-2. A sample size of 675 patients is required to detect a 5% change in seroprevalence at each time point assuming an alpha of 0.05 and a beta of 0.2. Adjusted probabilities for the presence of IgG and/or IgM antibodies and of SARS-CoV-2 infection will be reported using logistic regression models where appropriate.

Ethics and dissemination

Ethical approval was obtained from the London - Chelsea Research Ethics Committee (REC Reference—20/HRA/1731) and the Belfast Health & Social Care Trust Research Governance (Reference 19147TW-SW). Results of this study will be made available as preprints and submitted for publication in peer-reviewed journals.

Trial registration number

NCT0434740; Results
Influenza-associated cardiovascular mortality in older adults in Beijing, China: a population-based time-series study
Authors: Liu Rong , Liu Xiaoshuang , Yang Peng , Du Xin , He Liu , Chen Tiange , Li Xiang , Xie Guotong , Wu Shuangsheng , Su Jianting , Xia Shijun , Jiang Chao , Huffman Mark D. , MacIntyre Chandini Raina , Wei Zaihua , Wang Quanyi , Dong Jianzeng , Anderson Craig
Published: November 2020

Objective

This study comprehensively estimated the excess cardiovascular disease (CVD) mortality attributable to influenza in an older (age ≥65 years) population.

Design

Ecological study.

Setting

Aggregated data from administrative systems on CVD mortality, influenza surveillance and meteorological data in Beijing, China.

Main outcome measure

Excess overall CVD, and separately for ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke mortality attributable to influenza, adjusting for influenza activity, time trend, seasonality and ambient temperature.

Results

CVD (risk ratio (RR) 1.02, 95% CI 1.01, 1.02), IHD (RR 1.01, 95% CI 1.01, 1.02), ischaemic stroke (RR=1.03, 95% CI 1.02, 1.04), but not haemorrhagic stroke (RR=1.00, 95% CI 0.99, 1.01) mortality, were significantly associated with every 10% increase in influenza activity. An increase in circulating A(H1N1)09pdm, A(H3N2) and B type virus were all significantly associated with CVD and ischaemic stroke mortality, but only A(H3N2) and B type virus with IHD mortality. The strongest increase in disease mortality was in the same week as the increase in influenza activity. Annual excess CVD mortality rate attributable to influenza ranged from 54 to 96 per 100 000 population. The 3%–6% CVD mortality attributable to influenza activity was related to an annual excess of 916–1640 CVD deaths in Beijing, China.

Conclusions

Influenza activity has moderate to strong associations with CVD, IHD and ischaemic stroke mortality in older adults in China. Promoting influenza vaccination could have major health benefit in this population.

Background

Influenza may trigger serious CVD events. An estimation of excess CVD mortality attributable to influenza has particular relevance in China where vaccination is low and CVD burden is high.

Methods

This study analysed data at the population level (age ≥65 years) using linked aggregated data from administrative systems on CVD mortality, influenza surveillance and meteorological data during 2011 to 2018. Quasi-Poisson regression models were used to estimate the excess overall CVD, and separately for IHD, ischaemic stroke, haemorrhagic stroke mortality attributable to influenza, adjusting for influenza activity, time trend, seasonality and ambient temperature. Analyses were also undertaken for influenza subtypes (A(H1N1)09pdm, A(H3N2) and B viruses), and mortality risk with time lags of 1–5 weeks following influenza activity in the current week.
Upriver sightings of beluga whales (Delphinapterus leucas) follow storm surges and high water in the Mackenzie Delta, Northwest Territories, Canada
Authors: Scharffenberg Kevin C. , MacPhee Shannon A. , Loseto Lisa L.
Published: November 2020

Each summer, Eastern Beaufort Sea beluga whales (Delphinapterus leucas (Pallas, 1776)) form a large congregation in the Tarium Niryutait Marine Protected Area (TNMPA) in the Mackenzie River estuary, a behaviour thought to be linked to warm, freshwater conditions. In 2018, >50 belugas were observed upriver near Aklavik in the Mackenzie River Delta. Community members noted that this upriver occurrence of belugas was unusual and suggested that wind-driven high water levels in the Mackenzie River were a primary driver. We investigated this explanation by searching past communications and reports for documentation of beluga sightings upriver and identifying storm surges and water-level changes at six hydrometric stations in the Mackenzie River Delta. We found three previous occurrences of belugas upriver dating back to 2000, all of which followed prominent surges in river level attributable to coastal storms. Although acknowledging a small sample size, we suggest that upriver occurrences of beluga whales warrant further investigation through extension of the TNMPA beluga monitoring program. As climate-driven changes cause more frequent and intense Arctic storm surges, we expect storm events to increasingly overlap with the annual summer beluga congregation. This may cause upriver movements to become more common, and population-level implications are not known.
String fragmentation with a time-dependent tension
Authors: Hunt-Smith Nicholas , Skands Peter
Published: November 2020

Motivated by recent theoretical arguments that expanding strings can be regarded as having a temperature that is inversely proportional to the proper time, $$\tau $$
τ
, we investigate the consequences of adding a term $$\propto 1/\tau $$

∝
1
/
τ

to the string tension in the Lund string-hadronization model. The lattice value for the tension, $$\kappa _0 \sim 0.18\,{\mathrm {GeV}}^2\sim 0.9\,{\mathrm {GeV}}/{\mathrm {fm}}$$

κ
0

∼
0.18

GeV

2

∼
0.9

GeV
/
fm

, is then interpreted as the late-time/equilibrium limit. A generic prediction of this type of model is that early string breaks should be associated with higher strangeness (and baryon) fractions and higher fragmentation $$\langle p_\perp \rangle $$

⟨

p
⊥

⟩

values. It should be possible to use archival ee data sets to provide model-independent constraints on this type of scenario, and we propose a few simple key measurements to do so.
Evolution of SARS-CoV-2 in the state of Alagoas-Brazil via an adaptive SIR model
Authors: Dos Santos I. F. F. , Almeida G. M. A. , De Moura F. A. B. F.
Published: November 2020

We investigate the spreading of SARS-CoV-2 in the state of Alagoas, northeast of Brazil, via an adaptive susceptible-infected-removed (SIR) model featuring dynamic recuperation and propagation rates. Input parameters are defined based on data made available by Alagoas Secretary of Health from April 19, 2020 on. We provide with the evolution of the basic reproduction number [Formula: see text] and reproduce the historical series of the number of confirmed cases with less than [Formula: see text] error. We offer predictions, from November 16 forward, over the epidemic situation in the near future and show that it will keep decelerating. Furthermore, the same model can be used to study the epidemic dynamics in other countries with great easiness and accuracy.
NEW ITERATIVE TRANSFORM METHOD FOR TIME AND SPACE FRACTIONAL (n + 1)-DIMENSIONAL HEAT AND WAVE TYPE EQUATIONS
Authors: FARID S. , NAWAZ R. , SHAH ZAHIR , ISLAM SAEED , DEEBANI WEJDAN
Published: November 2020

In this study, we examine and using Laplace Transform as a way to find approximate solutions to multi-dimensional space and time fractional order problems and propose numerical algorithm for solving ([Formula: see text])-dimensional time and space fractional order heat like and time and space fractional wave-like equations. This method is a combination of Laplace Transform and iterative method. The fractional derivative is described in the Caputo sense. The results obtained by proposed scheme are compared with different other schemes. This scheme is found to be very efficient and effective for linear and nonlinear time and space fractional order problems.
Finite solvable groups with few imprimitive irreducible characters
Authors: Erkoç Temha , Çınarcı Burcu
Published: November 2020

In this paper, we classify all finite solvable groups having at most two imprimitive irreducible characters.
Multi-Response Optimization of Magnetic Abrasive Flow Finishing Process on Aluminum (6061-T6) Using Utility Concept Embedded Firefly’s Algorithm
Authors: Yadav Pawan Kumar , Jayswal S. C.
Published: November 2020

Surface finish is the most desired properties of any sophisticated machinery parts for its proper functioning and long endurance. The surface finish must be in the order of micrometer to nanometer for most of the machinery parts. The nontraditional surface finish processes prepare these parts; in these processes, the uses of electromagnet play a vital role in the surface finishing mechanism. Magnetic abrasive flow finishing (MAFF) is such a hybrid process, which gives a combined effect of abrasive flow finishing (AFF) and magnetic abrasive finishing (MAF). In this method, a pair of electromagnets are attached to the AFF setup. By using electromagnet in the AFF process, it enhanced material removal and surface finishing. The main process parameters selected in the MAFF process were magnetic flux density, number of cycles, percentage abrasive content, piston speed, and corresponding responses selected were material removal, percentage improvement in surface finish. In this research paper, the responses were optimized by a combination of utility theory and meta-heuristic firefly’s algorithm. The utility theory based-firefly algorithm’s predicted global optimum parameters set, which was more suitable for reducing the finishing time and required surface finish. The confirmatory test validated this optimized parameter set and it was revealed that the meta-heuristic firefly algorithm embedded with utility theory had given optimized results in the MAFF process.
Self-Standing Flexible N-Doped Graphene/CNTs Supported Spiral Low-Crystalline Ni(OH)2 Electrode with Ultra-Long Cycling Stability for Supercapacitors
Authors: Tong Hao , Liu Jiang , Li Tingting , Gong Daxiong , Xiao Jinpan , Lu Liang , Shen Laifa , Zhang Xiaogang
Published: November 2020

Carbon materials are widely used as anodes of supercapacitors due to the long cycling stability, but the low capacitance results in low energy density of the supercapacitor device in aqueous solution, greatly limiting the application field of the supercapacitor. Here, the spiral low-crystalline Ni(OH)2 supported on self-standing layered film structure of N-doped graphene/carbon nanotubes film (NCF) is reported. The prepared flexible film electrode of low-crystalline Ni(OH)2/NCF is functioned as cathode directly, presenting high gravimetric capacitance (GC) and areal capacitance of 2130[Formula: see text]F[Formula: see text]g[Formula: see text] (2[Formula: see text]A[Formula: see text]g[Formula: see text]) and 2.88[Formula: see text]F[Formula: see text]cm[Formula: see text] (1[Formula: see text]A[Formula: see text]g[Formula: see text]). Also, this self-standing electrode film shows ultra-long cycle life, retaining 111.4% of initial capacitance after 30 000 circles at large current densities (20[Formula: see text]A[Formula: see text]g[Formula: see text]) and almost 0% fade before 10 000 circles. Moreover, Ni(OH)2/NCF and activated polyaniline derived carbon (APDC) have been assembled into an asymmetric supercapacitor, exhibiting a high gravimetric energy density of 60[Formula: see text]Wh[Formula: see text]kg[Formula: see text] at 800[Formula: see text]W[Formula: see text]kg[Formula: see text], suggesting that the obtained electrode has a good prospect application in long cycling stability with high energy density of supercapacitor devices.