bluuebunny/crossref_metadata_2025 huggingface dataset:
Brief contact interventions to reduce suicide among discharged patients with mental health disorders—A meta‐analysis of RCTs
Authors: Tay Jing Ling , Li Ziqiang
Published: July 2022

Background

Worldwide, about 1 million died from suicide in 2000. People with mental health disorders are at greater risk of suicide, and they are especially susceptible during 1‐week period after discharge from the hospital.

Objective

This meta‐analysis paper aims to evaluate the effectiveness of brief contact interventions in preventing (1) suicidal deaths, (2) suicidal attempts, and (3) suicidal ideations among mental health patients discharged from the hospital.

Methods

Search for published and unpublished articles were conducted using 10 databases: CINAHL, Cochrane Central Register of Controlled Trials, Embase, Scopus, Pubmed, PsycINFO, Web of Science, Randomised Control Trial Registry Website, ClinicalTrials.gov, and Proquest Dissertation and Theses Global, using the keywords “suicide” AND “discharged,” AND “patients.” All articles printed in English and published from the year 1995 to August 2019 were included.

Results

A total of 23 articles were included in the meta‐analysis. Contact interventions significantly reduced suicidal attempts within (1) 12–14 months and (2) suicide ideations within 12 months. There were no significant findings on suicidal deaths.

Discussion

A new finding of this meta‐analysis is that combining several brief contact interventions could potentially reduce suicidal attempts and ideations. This is important in preserving the lives of discharged patients.
Use of a telovelar approach for complete resection of a choroid plexus tumor in a dog
Authors: Antonakakis Markos G. , Carletti Beatrice E. , Anselmi Carlo , McGrath Stephanie , Minguez Juan J.
Published: July 2022

Objective

To describe a telovelar approach to the fourth ventricle for excision of a choroid plexus tumor within the ventricle.

Animal

A 3‐year‐old entire male Chihuahua.

Study design

Case report

Methods

A 3‐year‐old dog with two‐month history of progressive vestibular signs and subdued mentation was diagnosed with a fourth ventricle tumor. Gross total resection of the tumor was achieved through a telovelar approach to the fourth ventricle.

Results

Complete removal of the tumor was confirmed on immediate postoperative MRI. The dog recovered from the surgical procedure without complications, displaying some neurological deficits as preoperatively. His neurological examination was normal 2 weeks after surgery and remained so until the time of writing this case report (28 months) without additional treatment.

Conclusion

The telovelar approach allowed complete excision of a choroid plexus tumor located in the fourth ventricle of the dog reported here.
A Computational Investigation of Microstructural Damage of the Anterior Cruciate Ligament Under High Loading of the Knee Joint
Authors: Knapp Alexander , Williams Lakiesha N.
Published: July 2022

The anterior cruciate ligament plays a major role in maintaining the stability of the knee joint and is susceptible to injury under strenuous activity. Anterior cruciate ligament (ACL) injuries can lead to joint instability and complications such as osteoarthritis. Despite this, there is a lack of material models capable of predicting damage at a localized fiber level, hindering our ability to understand how damage develops in real-time. This work develops a continuum-damage material model of the ACL and applies the model to a finite element simulation of the knee undergoing high quadriceps tendon loading. Using quadriceps tendon loadings of 1000, 1500, and 2000 N, the development of microstructural damage within the ACL tissue was examined, and the effects of localized damage on the joint kinematics were investigated. Damage tended to develop in the midsubstance of the ACL in the present model in the anterior medial bundle region and could induce significant changes in the joint kinematics. Using this model, new insights into the development of ACL injury mechanisms can be investigated.
A Computational Procedure to Derive the Curve of Carus for Childbirth Computational Modeling
Authors: Chen Sheng , Routzong Megan R. , Abramowitch Steven D. , Grimm Michele J.
Published: July 2022

Computational modeling serves an important role in childbirth-related research. Prescribed fetal descent trajectory is a key characteristic in childbirth simulations. Two major types of fully prescribed fetal descent trajectories can be identified in the literature: straight descent trajectories and curve of Carus. The straight descent trajectory has the advantage of being simpler and can serve as a reasonable approximation for relatively small fetal movements during labor, but it cannot be used to simulate the entire childbirth process. The curve of Carus is the well-recognized fetal descent trajectory with physiological significance. However, no detailed procedure to geometrically define the curve of Carus can be found in existing computational studies. This status of curve of Carus simulation in the literature hinders the direct comparison of results across different studies and the advancement of computational techniques built upon previous research. The goals of this study are: (1) propose a universal approach to derive the curve of Carus for the second stage of labor, from the point when the fetal head engages the pelvis to the point when the fetal head is fully delivered; and (2) demonstrate its utility when considering various fetal head sizes. The current study provides a detailed formulation of the curve of Carus, considering geometries of both the mother and the fetus. The maternal geometries were obtained from MRI data, and the fetal head geometries were based on laser scanning of a replica of a real fetal head.
Optimization Method for Pneumatic Conveying Parameters and Energy Consumption Performance Analysis of a Compact Blow Tank
Authors: de Freitas Adriano Gomes , de Oliveira Vitor Furlan , dos Santos Ricardo Borges , Riascos Luis Alberto Martinez , Zou Ruiping
Published: July 2022

Pneumatic conveying of powders is a unit process extensively used in industries for the handling of particulate material of several segments. Academic studies started with empirical dilute-phase pneumatic conveying and, in order to produce better economic results in industrial settings, evolved to include energy efficiency techniques as a significant component. Much work has been done to understand and model pneumatic conveying systems; however, they are highly empirical and the conclusions are, in most cases, limited to a narrow range of experimental conditions. This paper introduces a systematic method to select the air pressure and flow necessary to operate an energy-optimized pneumatic conveying system. This method has been tested and applied to a pressure conveyor fed by a compact blow tank of 100 L in a 133 m long pipeline with a diameter of 3 in. conveying limestone. The tests demonstrated that it is possible to control this pneumatic conveying system with only two input parameters, while operating at the desired pressure and airflow and maintaining the respective conveying rate and power requirements.
Contrast-Enhanced Ultrasound Tumor Therapy With Abdominal Imaging Transducer
Authors: Morrison Ryan G. , Karmacharya Mrigendra B. , Sehgal Chandra M.
Published: July 2022

A diagnostic ultrasound machine add-on module (AOM) was created to enable an off-the-shelf abdominal imaging transducer to perform contrast-enhanced therapeutic ultrasound. The AOM creates plane-wave ultrasound through an abdominal imaging transducer targeting intravascular microbubbles within tumors. This therapeutic antivascular ultrasound (AVUS) causes heating and cavitation effects that destroy tumor vasculature and starves it of nutrients. The AOM can switch between therapeutic and imaging modes for monitoring AVUS treatment. The therapeutic capability of the AOM was validated in murine hepatocellular carcinomas (HCC) grown in adult mice. Contrast-enhanced ultrasound imaging performed before and after the therapeutic treatment evaluated the AVUS response to the treatment. The peak enhancement (PE), perfusion index (PI), and area under the curve (AUC) were measured for the control and AOM treatment groups. The AOM group showed a substantial decrease in these parameters compared to the control group. The difference between the pre- and post-therapy was significant, (p < 0.001) for the AOM group and not significant (p > 0.5) for the control group. Tumor temperatures increased markedly for the AOM group with a thermal dose (CEM43) of 124.8 (±2.5). Histochemical analysis of the excised HCC samples revealed several hemorrhagic pools in tumors from the AOM group, absent in the tumors of the control group. These results demonstrate the theranostic potential of the AOM to induce and monitor vascular disruption within murine tumors.
The Combined Impact of Thermal Radiation and Thermophoresis on Buoyancy-Driven Flow Near an Inclined Porous Plate
Authors: Jha Basant K. , Samaila Gabriel
Published: July 2022

This report presents a similarity solution for the buoyancy-driven flow of viscous incompressible fluid past an inclined porous plate influenced by nonlinear thermal radiation and thermophoresis. The boundary layer equations are reduced to some set of ODEs through similarity variables. Furthermore, the ODEs are converted to IVP through the shooting technique. The numerical solution is obtained through the Runge–Kutta algorithm in Maple software. The impact of the emergence parameters present in the mathematical model is explained through graphs and tables. Results obtained showed that with combined effects of suction/injection and nonlinear thermal radiation, the heat transfer rate is directly proportional to the angle of inclination but inversely proportional to plate shear stress and mass transfer rate. Furthermore, it was observed that the heat transfer rate declines with higher buoyancy force but enhances the plate shear stress. Also, the mass transfer rate could be enhanced with a higher thermophoresis effect. Suction propagates the velocity and temperature profiles whereas it decreases the rate of particle concentration, while the contrast is true for injection. In addition, nonlinear thermal radiation complements the fluid temperature, particle concentration, and fluid transport.
High-resolution modal wavenumber estimation in range-dependent shallow water waveguides using vertical line arrays
Authors: Song Wenhua , Wang Pengyu
Published: July 2022

Estimation of modal wavenumbers is important for inference of geoacoustic properties and matched field processing in shallow water waveguides. However, it is challenging in a range-dependent environment, because modal content varies locally in response to changes in the environment. Moreover, the scales of the spatial variations in the waveguide may be on the same order as the range aperture required for resolvability of the individual modes. To this end, high-resolution (HR) wavenumber estimation methods have been widely used. In this paper, the matrix pencil and MUSIC algorithms are generalized to geometry involving a synthetic horizontal aperture (SHA) formed by a towed acoustic source and a fixed full-spanning vertical line array (VLA). The performance of the proposed methods is evaluated by simulated data in a noisy shallow water environment. Numerical results show that, when compared with the previous methods, the proposed methods significantly outperform the previous methods in terms of aperture requirement.
Aquatic Aerobic and Combined Training in Management of Type 2 Diabetes: The Diabetes and Aquatic Training Study (DATS): A Randomized Clinical Trial
Authors: Delevatti Rodrigo Sudatti , Reichert Thais , Bracht Cláudia Gomes , Lisboa Salime Donida Chedid , Marson Elisa Corrêa , Costa Rochelle Rocha , Kanitz Ana Carolina , Bones Vitória , Stein Ricardo , Kruel Luiz Fernando Martins
Published: July 2022

Background: To compare the effects of aquatic aerobic and combined (aerobic more resistance) training on glycemic control and other cardiometabolic outcomes in patients with type 2 diabetes. Methods: Patients were randomized to an aquatic aerobic training (AERO, n = 19; 57.5 [7.4] y; 9 [47%] women), or an aquatic combined training (COMBI, n = 19; 60.9 [7.4] y; 10 [53%] women), or an aquatic active procedure control (n = 19; 58.6 [9.7] y; 10 [53%] women) in 3 weekly sessions (50 min each), during 15 weeks. Glycated hemoglobin was the primary outcome, whereas insulin resistance markers, lipid profile, systemic inflammation, renin concentration, blood pressure, physical activity levels, and sitting time were secondary outcomes. Results: Glycated hemoglobin was reduced in all groups (P = .021), although changes were more marked in AERO (−0.36%) and COMBI (−0.44%) than in active control (−0.26%) group. Lipid profile was similarly modified in all groups. Diastolic blood pressure and renin concentration were also reduced in all groups; however, renin showed more marked reductions in AERO (−17.7 uIU/mL) and COMBI (−15.1 uIU/mL) than in active control (0.2 uIU/mL) group. Fasting insulin, triglycerides, C-reactive protein, systolic blood pressure, walking time, and sitting time on weekends were not modified. Conclusion: AERO and COMBI presented similar effect to improve glycemic control and some cardiometabolic risk factors in patients with type 2 diabetes.
Effects of an Environmental Intervention on High School Students’ Expanded Physical Activity Programming Participation and Activity Levels
Authors: Lorenz Kent A. , van der Mars Hans , McMullen Jaimie , Norris Jason , Jahn Julie
Published: July 2022

Partial Comprehensive School Physical Activity Programming (CSPAP) has been studied extensively in recent years. However, there is little evidence on the efficacy and feasibility of such interventions in high school settings. Physical education teacher education (PETE) programs have been slow in preparing future physical educators for CSPAP implementation. Therefore, the purpose of this study was to assess the effects of PETE interns implementing a partial CSPAP intervention in high schools. Methods: Data were collected at three high schools during before- and during-school time periods using a direct observation instrument. The intervention consisted of PETE interns providing access to physical activity areas, equipment, and supervision with assistance from the schools’ resident teachers. A hybrid multiple baseline research design was used to assess the effects of the intervention on high school students’ participation and moderate to vigorous physical activity levels during the partial CSPAP sessions. Data were analyzed using both standard visual analysis of graphically plotted data and supplementary statistical treatments. Data were deemed credible based on interobserver agreement data collected across experimental phases and schools; the data were deemed trustworthy. Results: Experimental control was established as the total number of students engaged in moderate to vigorous physical activity during the partial CSPAP sessions increased substantially upon the start of the intervention. Compared with girls, boys demonstrated higher amounts of moderate to vigorous physical activity. Discussion/Conclusion: High school students respond similarly to a partial CSPAP intervention as do elementary and middle school-aged students, thereby strengthening the generalization of CSPAP-type interventions. Moreover, PETE interns can be successful in implementing a partial CSPAP in high school settings.
The hidden costs of batteries
Charged
James Morton Turner
University of Washington Press, 2022. 256 pp.
Authors: Sovacool Benjamin K.
Published: July 2022

Clean energy plans must include safer, more sustainable, worker-friendly power storage
Targeting brain cancer
Authors: Reddel Roger , Aref Adel
Published: July 2022

A new drug is designed to hit an old target with increased precision
In Science Journals
Authors: Lopez Bianca , Suleymanov Yury , Kelly Priscilla N. , Hurtley Stella M. , Hines Pamela J. , Li Meimei , Williams Ifor , Szuromi Phil , Jiang Di , Lavine Marc S. , Alderton Gemma , Maroso Mattia , VanHook Annalisa M.
Published: July 2022

Highlights from the
Science
family of journals
Antibiotic after sex could help curb infections
Authors: Cohen Jon
Published: July 2022

Doxycycline reduces risk of sexually transmitted diseases—but will it fuel drug resistance?
A Bacteriophage-Based, Highly Efficacious, Needle- and Adjuvant-Free, Mucosal COVID-19 Vaccine
Authors: Zhu Jingen , Jain Swati , Sha Jian , Batra Himanshu , Ananthaswamy Neeti , Kilgore Paul B. , Hendrix Emily K. , Hosakote Yashoda M. , Wu Xiaorong , Olano Juan P. , Kayode Adeyemi , Galindo Cristi L. , Banga Simran , Drelich Aleksandra , Tat Vivian , Tseng Chien-Te K. , Chopra Ashok K. , Rao Venigalla B.
Published: July 2022

According to the World Health Organization, COVID-19 may have caused ~15-million deaths across the globe and is still ravaging the world. Another wave of ~100 million infections is predicted in the United States due to the emergence of highly transmissible immune-escaped Omicron variants.
Intestinal Inflammation Reversibly Alters the Microbiota to Drive Susceptibility to Clostridioides difficile Colonization in a Mouse Model of Colitis
Authors: Barron Madeline R. , Sovacool Kelly L. , Abernathy-Close Lisa , Vendrov Kimberly C. , Standke Alexandra K. , Bergin Ingrid L. , Schloss Patrick D. , Young Vincent B.
Published: July 2022

Patients with inflammatory bowel disease (IBD) have an increased risk of developing
C. difficile
infection (CDI), even in the absence of antibiotic treatment. Yet, mechanisms regulating
C. difficile
colonization in IBD patients remain unclear.
An overview of the main messages from key data on young people’s health in the UK
Authors: Hagell Ann , Wortley Lizzie , McKeown Rachael
Published: July 2022

Having access to good data on the health of 10–24 year olds is essential for targeting services and improving health outcomes for this age group. We identify the main UK population level data compendiums that include young people, outline some clear messages those data tell us about the state of youth health and suggest what this means for setting priorities for policy and practice.

Although 10–24 year olds in the UK are generally in good health, the data reveal some trends that suggest the need for more prevention and early intervention during adolescence and early adulthood to protect their health now, their future health and the health of their own families later down the line. Particular concerns include preventable mortality, mental health trends, rates of obesity and the need to promote self-management of long-term conditions arising in the transition to adulthood.
Clinical course and treatment of archipelago keratitis: aHerpesviridaekeratitis subtype
Authors: Guindolet Damien , Gemahling Anna , Rousseau Antoine , Nguyen Kim Pauline , Azar Georges , Martin Gilles C , Cochereau Isabelle , Labetoulle Marc , Gabison Eric E
Published: July 2022

Purpose

Archipelago keratitis (ApK) is a subtype ofHerpesviridaestromal keratitis that consists of subepithelial nummular inflammatory infiltrates arranged in a radial centripetal pattern. This rare and poorly described form is not often recognised early. We report the first large series of ApK, with an analysis of clinical settings at presentation, evolution of the disease with time and a description of factors associated with recurrence.

Methods

The clinical records of 82 patients (83 eyes) with a diagnosis of ApK between 2011 and 2021 in two centres were reviewed.

Results

The median age of the 82 patients at referral was 37±28 years. ApK was unilateral in all but one case. A total of 76% of patients had at least one second diagnostic criteria suggesting a herpetic aetiology. Overall, 44 (53%) eyes exhibited least one recurrence after a median of 12 months. Recurrence was frequently associated with neovascularisation (HR 2.1, 95% CI 1.1 to 3.9; p=0.02) and tapering corticosteroids (HR 3.5, 95% CI 1.8 to 7.1; p<0.01) or valaciclovir use (HR=2.3, 95% CI 1.2 to 4.6; p=0.01). Antiviral treatment was used in all patients, whereas local anti-inflammatory drugs such as corticosteroids and/or ciclosporin were used in 73 (88%) cases.

Conclusion

ApK is aHerpesviridaestromal keratitis that is typically unilateral in presentation and features a high risk of recurrence. Combined treatment with antiviral and anti-inflammatory drugs are usually required over the long term. Topical ciclosporin can be useful as a corticosteroid-sparing treatment.
Prediction of visual impairment in retinitis pigmentosa using deep learning and multimodal fundus images
Authors: Liu Tin Yan Alvin , Ling Carlthan , Hahn Leo , Jones Craig K , Boon Camiel JF , Singh Mandeep S
Published: July 2022

Background

The efficiency of clinical trials for retinitis pigmentosa (RP) treatment is limited by the screening burden and lack of reliable surrogate markers for functional end points. Automated methods to determine visual acuity (VA) may help address these challenges. We aimed to determine if VA could be estimated using confocal scanning laser ophthalmoscopy (cSLO) imaging and deep learning (DL).

Methods

Snellen corrected VA and cSLO imaging were obtained retrospectively. The Johns Hopkins University (JHU) dataset was used for 10-fold cross-validations and internal testing. The Amsterdam University Medical Centers (AUMC) dataset was used for external independent testing. Both datasets had the same exclusion criteria: visually significant media opacities and images not centred on the central macula. The JHU dataset included patients with RP with and without molecular confirmation. The AUMC dataset only included molecularly confirmed patients with RP. Using transfer learning, three versions of the ResNet-152 neural network were trained: infrared (IR), optical coherence tomography (OCT) and combined image (CI).

Results

In internal testing (JHU dataset, 2569 images, 462 eyes, 231 patients), the area under the curve (AUC) for the binary classification task of distinguishing between Snellen VA 20/40 or better and worse than Snellen VA 20/40 was 0.83, 0.87 and 0.85 for IR, OCT and CI, respectively. In external testing (AUMC dataset, 349 images, 166 eyes, 83 patients), the AUC was 0.78, 0.87 and 0.85 for IR, OCT and CI, respectively.

Conclusions

Our algorithm showed robust performance in predicting visual impairment in patients with RP, thus providing proof-of-concept for predicting structure-function correlation based solely on cSLO imaging in patients with RP.
Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials
Authors: Schandelmaier Stefan , Kaushal Alka , Lytvyn Lyubov , Heels-Ansdell Diane , Siemieniuk Reed A C , Agoritsas Thomas , Guyatt Gordon H , Vandvik Per O , Couban Rachel , Mollon Brent , Busse Jason W
Published: July 2022

Objective To determine the efficacy of low intensity pulsed ultrasound (LIPUS) for healing of fracture or osteotomy.

Design Systematic review and meta-analysis.

Data sources Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and trial registries up to November 2016.

Study selection Randomized controlled trials of LIPUS compared with sham device or no device in patients with any kind of fracture or osteotomy.

Review methods Two independent reviewers identified studies, extracted data, and assessed risk of bias. A parallel guideline committee (BMJRapid Recommendation) provided input on the design and interpretation of the systematic review, including selection of outcomes important to patients. The GRADE system was used to assess the quality of evidence.

Results 26 randomized controlled trials with a median sample size of 30 (range 8-501) were included. The most trustworthy evidence came from four trials at low risk of bias that included patients with tibia or clavicle fractures. Compared with control, LIPUS did not reduce time to return to work (percentage difference: 2.7% later with LIPUS, 95% confidence interval 7.7% earlier to 14.3% later; moderate certainty) or the number of subsequent operations (risk ratio 0.80, 95% confidence interval 0.55 to 1.16; moderate certainty). For pain, days to weight bearing, and radiographic healing, effects varied substantially among studies. For all three outcomes, trials at low risk of bias failed to show a benefit with LIPUS, while trials at high risk of bias suggested a benefit (interaction P<0.001). When only trials at low risk of bias trials were considered, LIPUS did not reduce days to weight bearing (4.8% later, 4.0% earlier to 14.4% later; high certainty), pain at four to six weeks (mean difference on 0-100 visual analogue scale: 0.93 lower, 2.51 lower to 0.64 higher; high certainty), and days to radiographic healing (1.7% earlier, 11.2% earlier to 8.8% later; moderate certainty).

Conclusions Based on moderate to high quality evidence from studies in patients with fresh fracture, LIPUS does not improve outcomes important to patients and probably has no effect on radiographic bone healing. The applicability to other types of fracture or osteotomy is open to debate.

Systematic review registration PROSPERO CRD42016050965
mHealth-community health worker telemedicine intervention for surgical site infection diagnosis: a prospective study among women delivering via caesarean section in rural Rwanda
Authors: Nkurunziza Theoneste , Williams Wendy , Kateera Fredrick , Riviello Robert , Niyigena Anne , Miranda Elizabeth , Bikorimana Laban , Nkurunziza Jonathan , Velin Lotta , Goodman Andrea S , Matousek Alex , Klug Stefanie J , Gaju Erick , Hedt-Gauthier Bethany L
Published: July 2022

Background

Surgical site infections (SSIs) cause a significant global public health burden in low and middle-income countries. Most SSIs develop after patient discharge and may go undetected. We assessed the feasibility and diagnostic accuracy of an mHealth-community health worker (CHW) home-based telemedicine intervention to diagnose SSIs in women who delivered via caesarean section in rural Rwanda.

Methods

This prospective cohort study included women who underwent a caesarean section at Kirehe District Hospital between September 2019 and March 2020. At postoperative day 10 (±3 days), a trained CHW visited the woman at home, provided wound care and transmitted a photo of the wound to a remote general practitioner (GP) via WhatsApp. The GP reviewed the photo and made an SSI diagnosis. The next day, the woman returned to the hospital for physical examination by an independent GP, whose SSI diagnosis was considered the gold standard for our analysis. We describe the intervention process indicators and report the sensitivity and specificity of the telemedicine-based diagnosis.

Results

Of 787 women included in the study, 91.4% (n=719) were located at their home by the CHW and all of them (n=719, 100%) accepted the intervention. The full intervention was completed, including receipt of GP telemedicine diagnosis within 1 hour, for 79.0% (n=623). The GPs diagnosed 30 SSIs (4.2%) through telemedicine and 38 SSIs (5.4%) through physical examination. The telemedicine sensitivity was 36.8% and specificity was 97.6%. The negative predictive value was 96.4%.

Conclusions

Implementation of an mHealth-CHW home-based intervention in rural Rwanda and similar settings is feasible. Patients’ acceptance of the intervention was key to its success. The telemedicine-based SSI diagnosis had a high negative predictive value but a low sensitivity. Further studies must explore strategies to improve accuracy, such as accompanying wound images with clinical data or developing algorithms using machine learning.
Effect of home-based interventions on basic activities of daily living for patients who had a stroke: a systematic review with meta-analysis
Authors: Qin Ping , Cai Canxin , Chen Xuan , Wei Xijun
Published: July 2022

Objectives

To investigate the effectiveness of home-based interventions in improving the ability to do basic activities of daily living in patients who had a stroke.

Methods

Randomised controlled trials were searched through MEDLINE, Embase and CINAHL from their inception to 31 December 2021. We included studies involving home-based intervention prescribed by professionals and implemented at patients’ homes. The characteristics of these studies were collected. Risk of bias of individual study was assessed by Physiotherapy Evidence Database scale. Meta-analyses were performed where studies reported comparable interventions and outcomes.

Results

In total, 49 studies were included in the systematic review and 16 studies had sufficient data for meta-analyses. The short-term effect of home-based intervention showed no significant difference when compared with institution-based intervention (standardised mean difference (SMD)=0.24, 95% CI −0.15 to 0.62, I2=0%). No significant difference was found between home-based intervention and usual care for long-term effect (SMD=0.02; 95% CI −0.17 to 0.22; I2=0%). Home-based rehabilitation combined with usual care showed a significant short-term effect on the ability to do basic daily activities, compared with usual care alone (SMD=0.55; 95% CI 0.22 to 0.87; p=0.001; I2=3%).

Conclusion

Home-based rehabilitation with usual care, which varied from no therapy to inpatient or outpatient therapy, may have a short-term effect on the ability to do basic activities of daily living for patients who had a stroke compared with usual care alone. However, the evidence quality is low because of the limited number of studies and participants included in the meta-analysis and the possible publication bias. Future research is needed to investigate the effectiveness of home-based rehabilitation in groups with stratification by stroke severity and time since stroke onset, with elaboration of details of the home-based and the control interventions. Moreover, more high-quality studies are required to prove the cost-effectiveness of newly developed strategies like caregiver-mediated rehabilitation and telerehabilitation.

The primary source of funding

The Medical Research Fund of Guangdong Province (No: A2021041).
Herbal supplements in Jordan: a cross-sectional survey of pharmacists’ perspectives and knowledge
Authors: Jalil Banaz , Naser Abdallah Y , M Prieto Jose , Heinrich Michael
Published: July 2022

Objectives

Pharmacists are ideal partners for engaging with the needs and expectations of patients. They can play a vital role by providing information and supplying herbal medicines. In some community settings, pharmacists are also the main first point of care. This study explored Jordanian community pharmacists’ perspectives and knowledge of herbal medicines available in pharmacies.

Design

A cross-sectional study using an online survey was developed, and it was distributed via social media platforms. The one-way analysis of variance (ANOVA) test was used to compare the mean knowledge scores between different demographic groups. Multiple linear regression analysis was used to identify predictors of herbal medicines knowledge.

Setting

Jordanian community pharmacies.

Participants

401 Jordanian community pharmacists.

Results

Herbal supplements are sold in practically all pharmacies (98.5%). Slimming aids (14.7%), followed by sexual and sports enhancements (14%) and maintaining general health (12.1%) were most requested by Jordanian customers. While supplements for maintaining general health (12%), followed by slimming aids (11.4%) and skin conditions (9.3%) were most recommended by Jordanian pharmacists. 63.1% were not aware of potential herb–drug interactions, 95.6% did not receive complaints from customers about herbal medicines and 41.2% would not report adverse reactions to the national pharmacovigilance services. The mean knowledge score for knowledge of use, regulation, adverse reactions, and drug interactions was 3.7 (SD: 0.7), 3.5 (SD: 0.8), 3.6 (SD: 0.8), and 3.6 (SD: 0.8) (out of 5), respectively. ANOVA test showed that total pharmacists’ knowledge scores significantly differed based on the length of time practising pharmacy (p<0.05).

Conclusion

This study highlights some key concerns relating to recommendations, awareness and reporting of herbal medicines among Jordanian community pharmacists. Pharmacists need enhanced education to provide objective and evidence-based information on the benefits–risks of herbal medicines. Future studies need to be carried out to confirm whether our findings are transferable to other Middle Eastern countries.
A workplace organisational intervention to improve hospital nurses’ and physicians’ mental health: study protocol for the Magnet4Europe wait list cluster randomised controlled trial
Authors: Sermeus Walter , Aiken Linda H , Ball Jane , Bridges Jackie , Bruyneel Luk , Busse Reinhard , De Witte Hans , Dello Simon , Drennan Jonathan , Eriksson Lars E , Griffiths Peter , Kohnen Dorothea , Köppen Julia , Lindqvist Rikard , Maier Claudia Bettina , McHugh Matthew D , McKee Martin , Rafferty Anne Marie , Schaufeli Wilmar B , Sloane Douglas M , Alenius Lisa Smeds , Smith Herbert
Published: July 2022

Introduction

The increasing burden of mental distress reported by healthcare professionals is a matter of serious concern and there is a growing recognition of the role of the workplace in creating this problem. Magnet hospitals, a model shown to attract and retain staff in US research, creates positive work environments that aim to support the well-being of healthcare professionals.

Methods and analysis

Magnet4Europe is a cluster randomised controlled trial, with wait list controls, designed to evaluate the effects of organisational redesign, based on the Magnet model, on nurses’ and physicians’ well-being in general acute care hospitals, using a multicomponent implementation strategy. The study will be conducted in more than 60 general acute care hospitals in Belgium, England, Germany, Ireland, Norway and Sweden. The primary outcome is burnout among nurses and physicians, assessed in longitudinal surveys of nurses and physicians at participating hospitals. Additional data will be collected from them on perceived work environments, patient safety and patient quality of care and will be triangulated with data from medical records, including case mix-adjusted in-hospital mortality. The process of implementation will be evaluated using qualitative data from focus group and key informant interviews.

Ethics and dissemination

This study was approved by the Ethics Committee Research UZ/KU Leuven, Belgium; additionally, ethics approval is obtained in all other participating countries either through a central or decentral authority. Findings will be disseminated at conferences, through peer-reviewed manuscripts and via social media.

Trial registration number

ISRCTN10196901.
Automated multidimensional deep learning platform for referable diabetic retinopathy detection: a multicentre, retrospective study
Authors: Zhang Guihua , Lin Jian-Wei , Wang Ji , Ji Jie , Cen Ling-Ping , Chen Weiqi , Xie Peiwen , Zheng Yi , Xiong Yongqun , Wu Hanfu , Li Dongjie , Ng Tsz Kin , Pang Chi Pui , Zhang Mingzhi
Published: July 2022

Objective

To develop and validate a real-world screening, guideline-based deep learning (DL) system for referable diabetic retinopathy (DR) detection.

Design

This is a multicentre platform development study based on retrospective, cross-sectional data sets. Images were labelled by two-level certificated graders as the ground truth. According to the UK DR screening guideline, a DL model based on colour retinal images with five-dimensional classifiers, namely image quality, retinopathy, maculopathy gradability, maculopathy and photocoagulation, was developed. Referable decisions were generated by integrating the output of all classifiers and reported at the image, eye and patient level. The performance of the DL was compared with DR experts.

Setting

DR screening programmes from three hospitals and the Lifeline Express Diabetic Retinopathy Screening Program in China.

Participants

83 465 images of 39 836 eyes from 21 716 patients were annotated, of which 53 211 images were used as the development set and 30 254 images were used as the external validation set, split based on centre and period.

Main outcomes

Accuracy, F1 score, sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), Cohen’s unweighted κ and Gwet’s AC1 were calculated to evaluate the performance of the DL algorithm.

Results

In the external validation set, the five classifiers achieved an accuracy of 0.915–0.980, F1 score of 0.682–0.966, sensitivity of 0.917–0.978, specificity of 0.907–0.981, AUROC of 0.9639–0.9944 and AUPRC of 0.7504–0.9949. Referable DR at three levels was detected with an accuracy of 0.918–0.967, F1 score of 0.822–0.918, sensitivity of 0.970–0.971, specificity of 0.905–0.967, AUROC of 0.9848–0.9931 and AUPRC of 0.9527–0.9760. With reference to the ground truth, the DL system showed comparable performance (Cohen’s κ: 0.86–0.93; Gwet’s AC1: 0.89–0.94) with three DR experts (Cohen’s κ: 0.89–0.96; Gwet’s AC1: 0.91–0.97) in detecting referable lesions.

Conclusions

The automatic DL system for detection of referable DR based on the UK guideline could achieve high accuracy in multidimensional classifications. It is suitable for large-scale, real-world DR screening.
Self-Harm in Eating Disorders (SHINE): a mixed-methods exploratory study
Authors: Lavis Anna , McNeil Sheryllin , Bould Helen , Winston Anthony , Reid Kalen , Easter Christina L , Pendrous Rosina , Michail Maria
Published: July 2022

Introduction

Self-harm is highly prevalent among young people with eating disorders. However, why a young person may develop and continue to experience both an eating disorder and self-harm is unclear. This study will investigate the frequency, intensity, duration, function, context and processes of self-harm among people aged 16–25 diagnosed with an eating disorder. It will explore participants’ perspectives on the genesis and functions of both their self-harm and eating disorder, as well as their support needs. The study was designed with the input of members of a Young Persons’ Advisory Group, who will be key to study delivery and dissemination.

Methods and analysis

This exploratory study has a sequential mixed-methods explanatory design. Between 70 and 100 young people aged 16–25 with both an eating disorder diagnosis and self-harm thoughts and/or behaviours will be recruited from three NHS Eating Disorder outpatient services in England. Phase 1: a 14-day (six prompts per day) ecological momentary assessment (EMA) of participants’ feelings, thoughts, motivations, behaviours and experiences of self-harm. Phase 2: 20–30 participants from phase 1 will be reapproached to take part in an in-depth qualitative interview on the psychological, emotional and social factors that underlie their self-harm and eating disorder as well as their support needs. EMA data from phase 1 will be analysed using descriptive and multilevel statistics. Qualitative interview data from phase 2 will be analysed using inductive and deductive thematic analysis. Results from both phases will be integrated using a mixed-methods matrix, with each participant’s data from both phases compared alongside comparative analysis of the datasets as a whole.

Ethics and dissemination

The study gained ethical approval from the NHS HRA West Midlands–Black Country Research Ethics Committee (number: 296032). We anticipate disseminating findings to clinical, academic and lived experience audiences, at academic conferences, through peer-reviewed articles, and through various public engagement activities (eg, infographics, podcasts).
How to measure mental pain: a systematic review assessing measures of mental pain
Authors: Charvet Camille , Boutron Isabelle , Morvan Yannick , Le Berre Catherine , Touboul Suzanne , Gaillard Raphaël , Fried Eiko , Chevance Astrid
Published: July 2022

Question

Although mental pain is present in many mental disorders and is a predictor of suicide, it is rarely investigated in research or treated in care. A valid tool to measure it is a necessary first step towards better understanding, predicting and ultimately relieving this pain.

Study selection and analysis

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a systematic review to identify all published standardised measures of mental pain. We used qualitative content analysis to evaluate the similarity of each measure, quantified via Jaccard Index scores ranging from no similarity (0) to full similarity (1). Finally, using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology, we evaluated each measure’s development (assessing 35 features), its content validity (31 features) and if the latter was rated at least adequate, its other psychometric properties.

Findings

We identified 10 self-reported scales of mental pain in 2658 screened studies relying on diverse definitions of this construct. The highest average similarity coefficient for any given measure was 0.24, indicative of weak similarity (individual pairwise coefficients from 0 to 0.5). Little to no information was provided regarding the development and the content validity of all 10 scales. Therefore, their development and content validity were rated ‘inadequate’ or ‘doubtful’.

Conclusions and clinical implications

There is not enough evidence of validity to recommend using one measure over others in research or clinical practice. Heterogeneous use of disparate measures across studies limits comparison and combination of their results in meta-analyses. Development by all stakeholders (especially patients) of a consensual patient-reported measure for mental pain is needed.

PROSPERO registration number

CRD42021242679.
Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial
Authors: Zwaans Juliette J M , Raven Wouter , Rosendaal Arthur V , Van Lieshout Esther M M , Van Woerden Geesje , Patka Peter , Haagsma Juanita A , Rood Pleunie P M
Published: July 2022

Background

Patients with traumatic wounds frequently present to the ED. Literature on whether to treat these wounds sterile or non-sterile is sparse. Non-sterile treatment has the advantage of saving resources and costs, and could be of value in health settings where sterile materials are not readily available. Our objective was to compare the rate of wound infection after suturing traumatic lacerations with non-sterile gloves and dressings versus sterile gloves, dressings and drapes in the ED. We hypothesised that non-sterile gloves and dressings would be non-inferior to sterile gloves, dressings and drapes. The non-inferiority margin was set at 2%.

Methods

A multicentre single-blinded randomised controlled trial testing for non-inferiority of non-sterile gloves and dressings versus sterile gloves, dressings and drapes for suturing of traumatic wounds was performed in 3 EDs in The Netherlands. Adults with uncomplicated wounds were included from July 2012 to December 2016. At the time of treatment, patient and wound characteristics and management were documented. The outcome was wound infection, which was identified during follow-up in the treating ED at 5–14 days postprocedure.

Results

From 2468 eligible patients, 1480 were randomised in a sterile (n=747) or non-sterile (n=733) protocol. Baseline characteristics were similar in both study arms. The observed wound infection rate in the non-sterile group was 5.7% (95% CI 4.0% to 7.5%) vs 6.8% (95% CI 5.1% to 8.8%) in the sterile group. The mean difference of the wound infection rate of the two groups was −1.1% (95% CI −3.7% to 1.5%).

Conclusion

Although recruitment ceased prior to reaching our planned sample size, the findings suggest that there is unlikely to be a large difference between the non-sterile gloves, dressings and sterile gloves, dressings and drapes for suturing of traumatic wounds in the ED.

Trial registration number

NL 34798.078.11, NTR3541.
Transitioning out of work and metabolic syndrome incidence: a longitudinal study among 13 303 older workers from the Lifelines Cohort Study and Biobank
Authors: Runge Katharina , van Zon Sander K. R. , Bültmann Ute , Henkens Kène
Published: July 2022

Background

This study investigates (1) whether different employment transition types (ie, unemployment, work disability, early retirement and regular retirement) are associated with metabolic syndrome (MetS) incidence among older workers (50–64 years) and (2) whether occupational group moderates the association between employment transition type and MetS incidence.

Methods

A sample of 13 303 older Dutch workers from the Lifelines Cohort Study and Biobank was examined using longitudinal data from two comprehensive measurement waves with a mean follow-up time of 3.7 years. MetS components were based on physical measures, blood markers and medication use. Employment transitions were determined using questionnaires. Logistic regression analysis was performed to examine the association between employment transition type and MetS incidence.

Results

Older workers who transitioned from employment to unemployment (adjusted OR 1.39, 95% CI 1.05 to 1.82) or work disability (adjusted OR 1.89, 95% CI 1.15 to 3.10) had a significantly higher MetS incidence than the working control group. No association between early retirement or regular retirement with MetS incidence was found after adjusting for sociodemographic, educational and occupational factors. Occupational group did not moderate the association between employment transition type and MetS incidence.

Conclusion

The results suggest that older workers who transition from employment to unemployment or work disability are at risk for developing MetS. More awareness among occupational physicians and general practitioners about MetS incidence in late working life is needed in general and more specific among older workers who transition into unemployment or work disability.
Non-contrast enhanced silent MR angiography to evaluate hemodynamics and morphology of unruptured intracranial aneurysms: a comparative computational fluid dynamics study
Authors: Lu Yuzhao , Leng Xiaochang , Zou Rong , Chen Qi , Li Wenqiang , Zhou Xiaobing , Tan Song , Huang Xiaofei , Ding Cong , Gong Feixiang , Xiang Jianping , Wang Yang
Published: July 2022

Background

Silent MR angiography (silent MRA) is a new generation of non-contrast enhanced angiography with outstanding advantages in visualizing cerebrovascular lesions and the follow-up after endovascular treatment for intracranial aneurysms (IAs). This study aims to investigate the reliability of silent MRA-based three-dimensional (3D) geometric description and hemodynamic calculation of IAs.

Methods

19 patients with 23 unruptured IAs, who underwent both silent MRA and 3D rotational angiography (3DRA), were included in this study. Computational fluid dynamics simulations were performed on all patient-specific 3D reconstruction images to compare the morphology and hemodynamics of the two different imaging models for IAs.

Results

Silent MRA models had smaller maximum and perpendicular height (mm), aneurysmal surface area (mm2), and aneurysmal volume (mm3) than 3DRA (p<0.05); the differences of the above parameters between the two models were 9.0±6.2%, 7.7±7.4%, 15.9±13.0%, and 21.4±17.5%, respectively. However, correlation analysis of morphological parameters in various dimensions and model comparison showed good overall consistency in geometrical characteristics between the two models. Moderate coherence was observed between models in time-averaged wall shear stress of aneurysm and parent vessel (TAWSS, PAWSS), aneurysm velocity (AV), parent vessel velocity, and oscillatory shear index (OSI). However, strong correlations were observed among normalized aneurysm wall shear stress (NWSS), low shear area (LSA), inflow concentration index (ICI), and normalized aneurysm velocity (NAV).

Conclusion

Both morphological and hemodynamic assessments of IAs for silent MRA are comparable to 3DRA. Additionally, normalized indicators such as NWSS, LSA, ICI, and NAV were better than TAWSS, AV, and OSI in silent MRA-related hemodynamic evaluation.