bluuebunny/crossref_metadata_2025 huggingface dataset:
The psychometric properties of Turkish version of the Modified Paediatric Mini Mental Scale
Authors: Kurt Merve , Savaş Dilan , Tarsuslu Şimşek Tülay , YİŞ Uluç
Published: October 2022

Background

Children with neurological diseases suffer from neurocognitive problems due to both the disease and the treatment processes. Therefore, it is necessary that a battery can be used to determine and track the cognitive function of these children. The aim of this study is to establish the Turkish version of the Modified Paediatric Mini Mental Scale (MPMMS), ensure its cultural adaptation, and test the validity and reliability of the Turkish version of the MPMMS.

Methods

Sixty‐five children with the neurological condition were enrolled in this methodological study. The subjects' age, height, weight, and body mass index were recorded. The MPMMS and the social function subscale of the Paediatric Evaluation of Disability Inventory (PEDI) were used to assess the participants' cognitive function. The construct validity of the questionnaire was determined by the correlation between the MPMMS and the social function subscale of the PEDI. Cronbach's alpha was calculated to determine internal consistency. To determine test–retest reliability, 32 children were assessed 7–14 days after the initial assessment, and the intraclass correlation coefficient (ICC) was calculated.

Results

The mean age of the participants was 9.26 ± 3.87 years. A very strong significant correlation was found between the MPMMS and social function subscale of the PEDI (r = 0.935, p = 0.000). The internal consistency of the MPMMS was excellent (Cronbach's alpha = 0.932).

Conclusions

The Turkish version of the MPMMS has excellent validity and reliability and can be used by professionals in various health care settings to determine children's cognitive abilities.
Gender quotas in the Arab world ‐ 20 years on
Authors: Welborne Bozena C. , Buttorff Gail J.
Published: October 2022

This article aims to survey the state of the literature on gender quotas in the Middle East and North Africa (MENA), explicitly focusing on where it stands in terms of their institutional, political, and societal impact after two decades of implementation. In addition, it considers how MENA scholarship on the topic compares with the global literature and includes insights into how region‐specific work contributes to our understanding of gender quotas as an electoral and legislative institution overall.
Moral friends? The idea of the moral relationship
Authors: Vandieken Jonas
Published: October 2022

What role do human relationships play within the moral domain? There appears to be a lot of agreement that relationships play an important role in and for morality, but certainly not any foundational one. Yet, there has been a recent interest in seeking to explain the foundation of morality in relational terms. According to these relational proposals, the very foundation of impartial morality, and in particular the domain of “what we owe to each other” can be found in the same normative structures that are characteristic of interpersonal relationships and the partial reasons they give rise to. This suggestion has been met with serious criticism, according to which any seeming appeal to a so‐called moral relationship does no work in grounding morality and the obligations that we owe to each other. The present paper intends to challenge this conclusion by arguing that the objections rendered are not decisive, as a result of which we can begin to make sense of the idea that we do share a reason‐giving relationship with each other in the moral sphere. The moral relationship, the paper argues, is one we simply share with each other in virtue of our shared vulnerability to attitudinal injury as rational agents.
Compressive creep buckling of single cell metamaterial at elevated temperatures
Authors: Fitzgerald Kaitlynn M. , Berfield Thomas A. , Torbati‐Sarraf Hamid , Pataky Garrett J.
Published: October 2022

The benefits of tailored lattice topologies are limited in elevated temperature conditions without a clear understanding about the interplay between the metamaterial structure and the creep response of the base material. This study showed that the metamaterial structure causes the lattice compressive creep behavior to differ largely from that of bulk structures of the same base material. Inconel 625 FCCZ lattices and solid round bar specimens were crept in compression at two elevated temperatures and at three stress levels. The solid round bar specimens experienced only small increases in the steady state creep rate with a steady state exponent of 0.35 and 0.63 at 550°C and 650°C. The solid round bar specimens did not exhibit a deformation mechanism change over the temperatures and stress levels tested. The FCCZ lattices exhibited much larger changes in creep rates with changing stress and temperature with a steady state exponent of 18.3 and 20.2 at 550°C and 650°C, respectively. Additionally, the lattice specimens experienced three different failure behaviors with increasing temperature and stress from stable creep, to progressive buckling, and finally rapid collapse.
Moving through liquid territories: A cartographic history of roads in the Danube Delta
Authors: Constantinescu Ștefan , Tănăsescu Mihnea
Published: October 2022

We present an analysis of the Danube Delta (Romania) that is focused on the evolution and use of roads, so as to highlight the primacy of movement in spatialisation and the fluidity of roads themselves. We demonstrate that local inhabitants of the Danube Delta have relied on a network of roads for survival and have in the process fitted themselves to a deltaic space full of affordances that foreign observers have missed. Our objectives are achieved by juxtaposing a cartographic archive spanning from the 19th century up to 2019 with the lived experience of the deltaic space. The maps we uncover and redraw show how the road infrastructure in the Danube Delta has evolved. We explain what has driven this evolution by interpreting the archive in light of long‐term field work (2015–2019). This allows us to re‐characterise the deltaic space as a hybrid of solidity and liquidity, and to show the evolution of the local perspective in relation to traversing this complicated land. This is a completely new historical and cartographic contribution to a severely understudied area, the Danube Delta.
Global seasonal and pandemic patterns in influenza: An application of longitudinal study designs
Authors: Naumova Elena N. , Simpson Ryan B. , Zhou Bingjie , Hartwick Meghan A.
Published: October 2022

The confluence of growing analytic capacities and global surveillance systems for seasonal infections has created new opportunities to further develop statistical methodology and advance the understanding of the global disease dynamics. We developed a framework to characterise the seasonality of infectious diseases for publicly available global health surveillance data. Specifically, we aimed to estimate the seasonal characteristics and their uncertainty using mixed effects models with harmonic components and the δ‐method and develop multi‐panel visualisations to present complex interplay of seasonal peaks across geographic locations. We compiled a set of 2 422 weekly time series of 14 reported outcomes for 173 Member States from the World Health Organization's (WHO) international influenza virological surveillance system, FluNet, from 02 January 1995 through 20 June 2021. We produced an analecta of data visualisations to describe global travelling waves of influenza while addressing issues of data completeness and credibility. Our results offer directions for further improvements in data collection, reporting, analysis and development of statistical methodology and predictive approaches.
Can support by digital technologies stimulate intrapreneurial behaviour? The moderating role of management support for innovation and intrapreneurial self‐efficacy
Authors: Rabl Tanja , Petzsche Valentin , Baum Matthias , Franzke Sonja
Published: October 2022

Drawing on theorising on digital technologies as external enablers of entrepreneurial activities and an interactionist perspective on corporate entrepreneurship, this article examines the relationship between digital technology support and employee intrapreneurial behaviour. We propose that management support for innovation as an organisational characteristic and intrapreneurial self‐efficacy as an individual characteristic moderate this relationship. Findings from a metric conjoint experiment with 1360 decisions nested within 85 employees showed that support by social media, support by collaborative technologies, and support by intelligent decision support systems were significant predictors of employee intrapreneurial behaviour. However, the relative impact of support by these digital technologies varied with different levels of management support for innovation and intrapreneurial self‐efficacy.
Global research status of pathological scar reported over the period 2001–2021: A 20‐year bibliometric analysis
Authors: Li Shiyi , Ding Hongfan , Yang Yi , Yu Boya , Chen Minliang
Published: October 2022

Pathological scar is a classic problem in plastic and reconstructive surgery. Although the researches on pathological scar have been conducted for decades, the way to go to address this thorny problem still remains challenging. To the best of our knowledge, few bibliometric analysis concerning pathological scar have been reported. In this study, we set out to employ bibliometric and visual analysis to offer research status and trends of pathological scar over the period 2001–2021. All publications covering pathological scar during 2001–2021 were retrieved and extracted from the Web of Science database. We applied VOSviewer software to evaluate the keywords and research hotpots, and the online tool (http://bibliometric.com/) was used to carried out the publication trends analysis. A total of 2221 pathological scar‐related articles were identified over the period 2001–2021. China is the country which had the largest volume of publications (819, 36.87%), followed by the United States (416, 18.73%), Japan (144, 6.48%), Korea (142, 6.39%), and England (118, 5.31%). Among the institutions and journals, Shanghai Jiao Tong University (167) and Wound Repair and Regeneration (85) accounted for the most papers related to pathological scar, respectively. Professor Bayat A, who had the most citation frequency (2303), made great contribution in pathological scar field. “Fibroblast”, “expression”, and “proliferation” were identified as the pathological scar research hotspot through analysis of the keywords. In terms of publication, China ranked first all over the world, but the numbers of publication are inconsistent with the citation frequency, ranking first and second, respectively. Shanghai Jiao Tong University and journal Wound Repair and Regeneration stand for the highest level of research in this field to a certain extent. In the early stage, the research focus was mainly on the prevention, treatment, and risk factors for recurrence of pathological scar from cases. In the later stage, the research focus was on the comprehensive management, in which the mechanism research was in‐depth to the molecular and gene level.
Generation rent on the housing treadmill: A study on South Korea's housing allowance programmes and recurring precarity
Authors: Han Seon Hoe , Kim Jisun , Park Nara
Published: October 2022

Given the ongoing economic crisis and the increase in housing prices, many young adults —known as “generation rent”—use a large portion of their wages for rent and cannot buy a house. In South Korea, generation rent in lower income brackets are particularly vulnerable to overlapping precarities as housing inequality worsens. In response, South Korean local governments have offered housing allowance programmes since 2019, but studies on the impact of housing allowance on young adults are scant. This article examines how and to what extent housing allowance for young adults relieves precarity through a grounded theory approach. Eighteen young adults who benefit from the programme participated in in‐depth interviews. Results show that after living independently, participants experienced multidimensional precarity: housing, financial, professional and social support exclusion. To alleviate their precarity, they applied for a housing allowance programme, thereby experiencing changes. Although their precarity was reduced, it was not entirely allayed because of the programme's short duration, which kept them stuck on the “housing treadmill.”
Logical anti‐exceptionalism meets the “logic‐as‐models” approach
Authors: Becker Arenhart Jonas R.
Published: October 2022

Logical anti‐exceptionalism is the view that logic is not special, it is continuous with science. This continuity is typically understood in terms of the use of the abductive method in logical theory choice, with logical knowledge resulting from our choice of the theory best accounting for the data. In this paper, we argue for two related claims: (i) that this understanding of the continuity between logic and science faces considerable challenges; and (ii) that such challenges may be avoided by elaborating the continuity of logic with science in terms of the “logic‐as‐models” approach. More specifically, we defend that logical theories should be seen in the lights of the “models‐as‐epistemic‐tools” approach, an approach to the nature of models in empirical science more closely connected with current scientific practice. The result is a version of logical anti‐exceptionalism opening new perspectives for the philosophical understanding of logic.
Controlling the etch selectivity of silicon using low-RF power HBr reactive ion etching
Authors: Chien Kun-Chieh , Chang Chih-Hao
Published: October 2022

Silicon nanostructures with high aspect-ratio (AR) features have played an important role in many fields. In this study, we report the fabrication of high AR silicon nanostructures using an inductively coupled plasma reactive ion etching (ICP-RIE) process by controlling the voltage bias at the substrate. The results show that by reducing the radio frequency (RF) bias power to 10 W, the etch selectivity of silicon to photoresist can be enhanced up to 36 times. Using the photoresist as a mask, this process can fabricate 300 nm-period one-dimensional (1D) grating structures with a height up to 807 nm, an improvement of 3.75-fold compared with structures fabricated by normal bias power. Furthermore, the analysis of the etch rate shows that the etch rate decreases over time in 1D gratings but remains constant in 2D pillar arrays, which can be attributed to the removal of the sidewall passivation. By including an O2 ICP-RIE step to remove the remaining polymer mask, the highest AR of 2D pillar structures that can be achieved is 8.8. The optical characterization of the fabricated structures demonstrates effective antireflection properties, where the measurements show that the reflectivity can be suppressed from 35% to 0.01% near normal incidence and 35% to 2.4% at 65° incident angle. The demonstrated low-RF power ICP-RIE process can create high AR nanostructures without the need for an inorganic mask and can find applications in integrated circuits, photonics, and functional nanostructures.
Promoting Physical Activity Among Children and Adolescents With Disabilities: The Translation of Policy to Practice Internationally
Authors: Sit Cindy , Aubert Salomé , Carty Catherine , Silva Diego Augusto Santos , López-Gil José Francisco , Asunta Piritta , Palad Yves , Guisihan Roselle , Lee Jeongmin , Arbour Nicitopoulos Kelly P. , Vanderloo Leigh M. , Stanish Heidi , Haegele Justin , Urbański Piotr K. , Pozeriene Jurate , Hutzler Yeshayahu , Ng Kwok
Published: October 2022

Background: Physical inactivity among children and adolescents with disabilities (CAWD) is a global public health issue. Policy efforts to promote physical activity (PA) among CAWD have increased. This study summarizes the international policy trend for promoting PA among CAWD, with behavioral and policy insights specific to CAWD from country/regional indicators from the Active Healthy Kids Global Alliance Matrix on Physical Activity for Children and Adolescents to determine policy translation into practice. Methods: International and national PA policy documents on CAWD were assessed. Data from the Global Matrix Para Report Cards on the behavioral and government indicators from 14 countries or regions (grouped by human development index) were reviewed and compared. Results: Policy instruments began promoting PA for CAWD in 1989 via the Convention on the Rights of the Child. International policy has been advocating PA specifically for CAWD recently. In 2020, the World Health Organization published specific PA guidelines for CAWD. Data from the 14 Para Report Car found 14 grades on the average behavioral indicator and 12 on the government indicator. A gap between the average behavioral indicator (D−) and the government indicator (C+) was found in the Para Report Card data. Conclusions: Although international policies are consistent in their attention to the needs of CAWD, national/regional policies vary. Coverage ranges from nonexistent to embedded in broader inclusion concepts. A gap in policies to promote PA of CAWD is prevalent and is more prominent in countries or regions with a lower human development index ranking.
Supplemental Material: Diagenetic priming of submarine landslides in ooze-rich substrates
Authors: Wu Nan , al. et
Published: October 2022

Supplemental figures and tables. 
Massive pulmonary embolism treated with low-dose thrombolysis on the geriatric ward during the COVID-19 pandemic
Authors: Shepherd Thomas David , Niaz Talha Saad , Yadav Rohini
Published: October 2022

A man in his 70s was admitted to hospital due to a fall, urinary tract infection and delirium. The patient had a ‘do not attempt cardiopulmonary resuscitation’ order in place and a ward-based ceiling of care was agreed. He tested positive for COVID-19 while on a geriatric ward and subsequently developed bilateral pulmonary emboli with haemodynamic instability. The patient had a significant bleeding risk; however, the expected morbidity and mortality risk from the pulmonary emboli was high. A decision was made to give the patient low-dose thrombolysis on the geriatric ward, following which he made a full recovery. Acute thrombolysis is normally performed in emergency department, high dependency unit (HDU) or intensive care unit (ICU) settings; however, this was not possible in this case due to the burden the COVID-19 pandemic had placed on HDU/ICU services and bed capacity. Adaptation of treatment guidelines allowed for emergency life-saving treatment to be delivered to this patient.
Surgical enucleation of radicular cyst in endodontically treated primary mandibular molar
Authors: Bane Sphurti Pramod , Rathi Nilesh Vithaldas , Thosar Nilima Ramdas , Deulkar Pranjali Vilas
Published: October 2022

Radicular cysts are most common odontogenic cysts seen in the orofacial region, but not commonly detected in paediatric cases. This case report describes the accidental detection of radicular cyst and its surgical management in an 8-year-old boy in lower left back region of the jaw. The article also gives an insight about radicular cyst from its aetiology to the various other treatment modalities.
Anti-NMDA receptor encephalitis with initial negative markers: diagnostic and therapeutic challenges of a refractory case with 9-month-long follow-up
Authors: Cascardo Camilla , Ismail Alexander , Fullmer Joseph , Davila Francisco
Published: October 2022

Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a progressively debilitating, frequently fatal disease caused by autoantibodies against the NMDA receptor. Risk of delayed treatment is high due to variable presentations, lack of awareness and potential false negative diagnostic studies. In this case report, a woman in her 20s presented with psychiatric manifestations and rapidly declined. Dyskinetic movements and dysautonomia were observed. Initial cerebrospinal fluid and serum anti-NMDA receptor antibodies were negative. MRI was inconclusive. Electroencephalography demonstrated extreme delta brush. Pelvic CT revealed an adnexal teratoma. She remained refractory to treatment until day 126 when, after two cycles of cyclophosphamide, she started to improve. She participated in rehabilitation with eventual discharge home on day 269. Recognising the variable presentations of anti-NMDA receptor encephalitis is important in avoiding misdiagnosis and delayed treatment. If clinical suspicion remains high despite negative results, repeat testing should be pursued. Clinical response should guide treatment decisions in refractory cases.
Predictors of long-term intraocular pressure control after lens extraction in primary angle closure glaucoma: results from the EAGLE trial
Authors: Mitchell William G , Azuara-Blanco Augusto , Foster Paul J , Halawa Omar , Burr Jennifer , Ramsay Craig R , Cooper David , Cochran Claire , Norrie John , Friedman David , Chang Dolly
Published: October 2022

Background/aims

To assess baseline ocular parameters in the prediction of long-term intraocular pressure (IOP) control after clear lens extraction (CLE) or laser peripheral iridotomy (LPI) in patients with primary angle closure (PAC) disease using data from the Effectiveness of Early Lens Extraction for the treatment of primary angle-closure glaucoma (EAGLE) tria.

Methods

This study is a secondary analysis of EAGLE data where we define the primary outcome of ‘good responders’ as those with IOP<21 mm Hg without requiring additional surgery and ‘optimal responders’ as those who in addition were medication free, at 36-month follow-up. Primary analysis was conducted using a multivariate logistic regression model to assess how randomised interventions and ocular parameters predict treatment response.

Results

A total of 369 patients (182 in CLE arm and 187 in LPI arm) completed the 36-month follow-up examination. After CLE, 90% met our predefined ‘good response’ criterion compared with 67% in the LPI arm, and 66% met ‘optimal response’ criterion compared with 18% in the LPI arm, with significantly longer drops/surgery-free survival time (p<0.05 for all). Patients randomised to CLE (OR=10.1 (6.1 to 16.8)), Chinese (OR=2.3 (1.3 to 3.9)), and those who had not previously used glaucoma drops (OR=2.8 (1.6 to 4.8)) were more likely to maintain long-term optimal IOP response over 36 months.

Conclusion

Patients with primary angle closure glaucoma/PAC are 10 times more likely to maintain drop-free good IOP control with initial CLE surgery than LPI. Non-Chinese ethnicity, higher baseline IOP and using glaucoma drops prior to randomisation are predictors of worse long-term IOP response.
Management of psychiatric and cognitive complications in Parkinson’s disease
Authors: Weintraub Daniel , Aarsland Dag , Biundo Roberta , Dobkin Roseanne , Goldman Jennifer , Lewis, Simon
Published: October 2022

Neuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson’s disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.
Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019
Authors: Bearak Jonathan Marc , Popinchalk Anna , Beavin Cynthia , Ganatra Bela , Moller Ann-Beth , Tunçalp Özge , Alkema Leontine
Published: October 2022

Introduction

Internationally comparable estimates of unintended pregnancy and abortion incidence can illuminate disparities in sexual and reproductive health and autonomy. Country-specific estimates are essential to enable international comparison, and to inform country-level policy and programming.

Methods

We developed a Bayesian model which jointly estimated unintended pregnancy and abortion rates using information on contraceptive needs and use, contraceptive method mix, birth rates, the proportions of births from unintended pregnancies and abortion incidence data. Main outcomes were the estimated rates of unintended pregnancy and abortion for 150 countries and territories, reported for the 5-year period 2015–2019, as annual averages per 1000 women aged 15–49 years.

Results

Estimated unintended pregnancy rates ranged from 11 (80% uncertainty interval: 9 to 13) in Montenegro to 145 (131 to 159) in Uganda per 1000 women aged 15–49 years. Between-country heterogeneity was substantial in all Sustainable Development Goal (SDG) regions, but was greatest in sub-Saharan Africa. Estimated abortion rates ranged from 5 (5 to 6) in Singapore to 80 (55 to 113) in Georgia. Variation between country estimates was similar in all SDG regions except for Europe and Northern America, where estimated abortion rates were generally lower.

Conclusion

The estimates reflect variation in the degree to unintended pregnancy and abortion that are experienced in countries throughout the world. This evidence highlights the importance of investing in access to contraception and comprehensive abortion care, including in regions which may have lower rates of unintended pregnancy or abortion, respectively, as countries may differ substantially from regional averages.
‘The false reporter will get a praise and the one who reported truth will be discouraged’: a qualitative study on intentional data falsification by frontline maternal and newborn healthcare workers in two regions in Ethiopia
Authors: Estifanos Abiy Seifu , Gezahegn Rediet , Keraga Dorka Woldesenbet , Kifle Abiyou , Procureur Fanny , Hill Zelee
Published: October 2022

Introduction

Health Management Information Systems (HMIS) are vital to ensure accountability and for making decisions including for tracking the Sustainable Development Goals. The Ethiopia Health Sector Transformation Plan II includes preventing data falsification as a major strategic initiative and our study aimed to explore the reasons why healthcare providers intentionally falsify maternal and newborn health (MNH) data in two regions of Ethiopia.

Methods

We conducted a qualitative study in two hospitals, four health centres and their associated health posts in Oromia and Amhara regions. We conducted 45 in-depth interviews with health facility managers, quality improvement (QI) focal persons, health information technicians, MNH care providers, Health Extension Workers and QI mentors. Data were collected in local languages and transcribed in English. During analysis we repeatedly read the transcripts, coded them inductively using NVivo V.12, and categorised the codes into themes.

Results

Participants were hesitant to report personal data falsification but many reported that falsification is common and that they had experienced it in other facilities or had been told about it by other health workers. Falsification was mostly inflating the number of services provided (such as deliveries). Decreasing the number of deaths or reclassifying neonatal death into stillbirths was also reported. An overarching theme was that the health system focuses on, and rewards, the number of services provided over any other metric. This focus led to both system and individual level incentives for falsification and disincentives for accurate reporting.

Conclusion

Our finding suggests that to reduce facility level data falsification policy makers might consider disentangling reward and punishments from the performance reports based on the routine HMIS data. Further studies examining the high-level drivers of falsification at regional, national and global levels and effective interventions to address the drivers of data falsification are needed.
A randomised controlled trial of a probiotic and a prebiotic examining metabolic and mental health outcomes in adults with pre-diabetes
Authors: Barthow Christine , Hood Fiona , Crane Julian , Huthwaite Mark , Weatherall Mark , Parry-Strong Amber , Krebs Jeremy
Published: October 2022

Aims

To evaluate the effect of the probioticLactobacillus rhamnosusHN001 and/or cereal enriched with oat-derived beta-glucan (OBG) on metabolic and mental health outcomes when administered to adults with pre-diabetes.

Design

2×2 factorial design randomised, parallel-groups placebo-controlled; double-blinded for probiotic, single-blinded for cereals.

Participants

Community-dwelling adults aged 18–80 years with pre-diabetes: glycated haemoglobin (HbA1c) 41–49 mmol/mol.

Interventions

Capsules containingLactobacillus rhamnosus(HN001) (6×109colony-forming units/day), or placebo capsules; and cereal containing 4 g/day OBG or calorie-matched control cereal, taken daily, for 6 months. Study groups were: (A) HN001 capsules+OBG cereal; (B) HN001 capsules+control cereal; (C) placebo capsules+OBG cereal and (D) placebo capsules+control cereal.

Outcome measures

Primary outcome: HbA1cat 6 months. Secondary outcomes: fasting plasma glucose, fasting insulin, homeostatic model assessment of insulin resistance, fasting lipids, blood pressure, body weight, waist circumference, body mass index and mental well-being.

Results

153 participants were randomised. There was complete HbA1coutcome data available for 129 participants. At 6 months the mean (SD) HbA1cwas 45.9 (4.4) mmol/mol, n=66 for HN001, and 46.7 (4.3) mmol/mol, n=63 for placebo capsules; 46.5 (4.0) mmol/mol, n=67 for OBG and 46.0 (4.6) mmol/mol n=62 for control cereal. The estimated difference between HN001-placebo capsules was −0.83, 95% CI −1.93 to 0.27 mmol/mol, p=0.63, and between OBG-control cereals −0.17, 95% CI −1.28 to 0.94 mmol/mol, p=0.76. There was no significant interaction between treatments p=0.79. There were no differences between groups or significant interactions between treatments for any of the secondary outcomes.

Conclusions

This study found no evidence of clinical benefit from the supplementation with either HN001 and/or cereal containing 4 g OBG on HbA1cand all secondary outcomes relevant to adults with pre-diabetes.

Trial registration number

Australian New Zealand Clincial Trials Registry number ACTRN12617000990325
Does hospital variation in intrapartum-related perinatal mortality among caesarean births reflect differences in quality of care? Cross-sectional study in 21 hospitals in Burkina Faso
Authors: Cavallaro Francesca L , Kabore Charles P , Pearson Rachel , Blackburn Ruth M , Sobhy Soha , Betran Ana Pilar , Ronsmans Carine , Dumont Alexandre
Published: October 2022

Objectives

To examine hospital variation in crude and risk-adjusted rates of intrapartum-related perinatal mortality among caesarean births.

Design

Secondary analysis of data from the DECIDE (DECIsion for caesarean DElivery) cluster randomised trial postintervention phase.

Setting

21 district and regional hospitals in Burkina Faso.

Participants

All 5134 women giving birth by caesarean section in a 6-month period in 2016.

Primary outcome measure

Intrapartum-related perinatal mortality (fresh stillbirth or neonatal death within 24 hours of birth).

Results

Almost 1 in 10 of 5134 women giving birth by caesarean experienced an intrapartum-related perinatal death. Crude mortality rates varied substantially from 21 to 189 per 1000 between hospitals. Variation was markedly reduced after adjusting for case mix differences (the median OR decreased from 1.9 (95% CI 1.5 to 2.5) to 1.3 (95% CI 1.2 to 1.7)). However, higher and more variable adjusted mortality persisted among hospitals performing fewer caesareans per month. Additionally, adjusting for caesarean care components did not further reduce variation (median OR=1.4 (95% CI 1.2 to 1.8)).

Conclusions

There is a high burden of intrapartum-related perinatal deaths among caesarean births in Burkina Faso and sub-Saharan Africa more widely. Variation in adjusted mortality rates indicates likely differences in quality of caesarean care between hospitals, particularly lower volume hospitals. Improving access to and quality of emergency obstetric and newborn care is an important priority for improving survival of babies at birth.

Trial registration number

ISRCTN48510263.
Randomised parallel trial on the effectiveness and cost-effectiveness in screening gait disorder of silent cerebrovascular disease assisted by artificial intelligent system versus clinical doctors (ACCURATE-1): study protocol
Authors: Fei Beini , Zhao Jin , Li Xin , Tang Yanmin , Qin Guoyou , Zhang Wei , Ding Jing , Hu Min , Wang Xin
Published: October 2022

Introduction

Silent cerebrovascular disease (SCD), which is a common disease in the elderly, leads to cognitive decline, gait disorders, depression and urination dysfunction, and increases the risk of cerebrovascular events. Our study aims to compare the accuracy of the diagnosis of SCD-related gait disorders between the intelligent system and the clinician. Our team have developed an intelligent evaluation system for gait. This study will evaluate whether the intelligent system can help doctors make clinical decisions and predictions, which aids the early prevention and treatment of SCD.

Methods and analysis

This study is a multi-centred, prospective, randomised and controlled trial.

SCD subjects aged 60–85 years in Shanghai and Guizhou will be recruited continuously. All subjects will randomly be divided into a doctor with intelligence assistance group or a doctor group, at a 1:1 ratio. The doctor and intelligent assistant group will accept the intelligent system evaluation. The intelligent system obtains gait parameters by an Red-Green-Blue-depth camera and computer vision algorithm. The doctor group will accept the clinicians’ routine treatment procedures. Meanwhile, all subjects will accept the panel’s gait assessment and recognition rating scale as the gold standard. The primary outcome is the sensitivity of the intelligent system and clinicians to screen for gait disorders. The secondary outcomes include the healthcare costs and the incremental cost effectiveness ratio of intelligent systems and clinicians to screen for gait disorders.

Ethics and dissemination

Approval was granted by the Ethics Committee of Zhongshan Hospital affiliated with Fudan University on 26 November 2019. The approval number is B2019-027(2) R. All subjects will sign an informed consent form before enrolment. Serious adverse events will be reported to the main researchers and ethics committees. The subjects’ data will be kept strictly confidential. The results will be disseminated in peer-reviewed journals.

Trial registration number

NCT04457908
Effectiveness and safety of metoclopramide in treatment of intractable hiccup: a protocol of systematic review and meta-analysis
Authors: Wang Die , Zi Changyan , Zhang Baocheng , Wang Baojia , Chen Tao , Wang Long , Gao Yongxiang
Published: October 2022

Introduction

Hiccup is a common disease that not only occurred on adults but also on infants, which can severely do harm to patients’ physical and psychological health. Metoclopramide has been reported to have effects on intractable hiccup. However, there is a limited evidence that describes the efficacy and safety of metoclopramide in the treatment of intractable hiccup. The aim of this article is to obtain evidence on the effectiveness and safety of metoclopramide in treating patients with intractable hiccup.

Methods and analysis

We will search the following databases, including PubMed, Cochrane Library, Embase, Web of Science, CBM, Wan-fang, VIP database, CNKI and MEDLINE from their inception to 11 November 2021. All the randomised controlled trials associated with metoclopramide in treating intractable hiccup will be included. Articles screened, selected and extracted will be performed by two researchers independently. The risk of bias will be assessed by using the Cochrane Collaboration. We will carry out the meta-analysis by using RevMan V.5.4 software.

PROSPERO registration number

CRD42021293000.
Effects of milk protein concentrate supplementation on metabolic parameters, adipocytokines and body composition in obese women under weight-loss diet: study protocol for a randomised controlled trial
Authors: Haidari Fatemeh , Elahikhah Mahsa , Shariful Islam Sheikh Mohammed , Mohammadshahi Majid , Shahbazian Hajieh , Aghamohammadi Vahideh
Published: October 2022

Introduction

Obesity impairs metabolic function and increases the risk of cardiovascular disease and type 2 diabetes mellitus. Evidence suggests that high-protein diets help to increase weight loss and protect against weight gain. Milk protein concentrate (MPC) is a dairy product with a high protein content with a ratio of casein and whey protein similar to skim milk. This trial aims to evaluate the effect of MPC supplementation in obese women under a weight-loss diet.

Methods and analysis

We will conduct a 2-month open-label, parallel-group, randomised controlled trial to determine the effect of MPC supplementation on levels of glycaemic and lipid profile, leptin, adiponectin, appetite, waist circumference, body mass index and body composition in 44 premenopausal obese women on a weight-loss diet.

Ethics and dissemination

This protocol, approved by the Medical Ethics Committee of Ahvaz University of Medical Sciences, is in accordance with the Declaration of Helsinki (approval number: IR.AJUMS.REC.1399.795). The trial results will be published in peer-reviewed journals.

Trial registration number

Iranian Registry of Clinical Trials (IRCT20201223049804N1).
Catalan experience of deadoption of low-value practices in primary care
Authors: Almazán Cari , Caro-Mendivelso Johanna Milena , Mias Montse , Barrionuevo-Rosas Leslie , Moharra Montse , Gagnon Marie-Pierre
Published: October 2022

Reducing ineffective practices is one way to ensure high-quality and efficient healthcare for the population. For this reason, several initiatives have been implemented worldwide to reduce low-value care. This article describes the experience of theEssencialproject, a multifaceted deadoption strategy implemented in the Catalan primary care system. Lessons learnt from this project include the importance of considering the local context in deadoption strategies, providing adequate training and communication material to patients and clinicians and supporting the key role of clinical champions. Given the knowledge gaps regarding the conditions for successful deadoption strategies, the Catalan experience could provide enlightenment on how to implement, evaluate and sustain a large-scale collaborative deadoption strategy in primary healthcare.
Teledermatology to reduce face-to-face appointments in general practice during the COVID-19 pandemic: a quality improvement project
Authors: Jones Keira , Lennon Emer , McCathie Keighley , Millar Angela , Isles Chris , McFadyen Angus , Shearer Heather
Published: October 2022

Teledermatology is an important subspecialty of telemedicine that continues to evolve with advances in telecommunication and mobile phone technology. A 19-week primary care quality improvement project collected baseline data and tested three change ideas, using the Model for Improvement method, with primary and secondary aims: to increase the weekly percentage of remote dermatological consultations with supporting images that were successfully concluded remotely to greater than 80% and to reduce the weekly percentage of dermatological face-to-face consultations to less than 50%. We hypothesised that by improving the quality of patient images and the confidence of reception staff in triaging skin complaints, there would be a decrease in the weekly number of face-to-face dermatological appointments, thereby decreasing the risk of COVID-19 transmission within the practice and community. Two change ideas focused on supporting patients to improve image quality by introducing ‘4 Key Instructions’ and a patient information leaflet (PIL). The third focused on increasing reception staff confidence in triaging skin complaints by introducing a triage pathway guidance tool. A total of 253 dermatological consultations were analysed: 170 of these were telephone consultations with 308 supporting images. Process measures showed clear improvements in the quality of images provided by patients which likely contributed to an increase in completed remote consultation. Our primary outcome measure was achieved. Our secondary outcome measure suggested that in the absence of high-quality images, it might not be possible to reduce dermatological face-to-face consultations much below 50% in primary care. Process measures showed clear improvements in the quality of images provided by patients which likely contributed to the increase in remote consultation. The implications of these findings for the theory of change are discussed.
Validity and reliability of a new incremental step test for people with chronic obstructive pulmonary disease
Authors: Vilarinho Rui , Serra Lúcia , Águas Ana , Alves Carlos , Silva Pedro Matos , Caneiras Cátia , Montes António Mesquita
Published: October 2022

Background

Incremental step tests (IST) can be used to assess exercise capacity in people with chronic obstructive pulmonary disease (COPD). The development of a new step test based on the characteristics of the incremental shuttle walk test (ISWT) is an important study to explore. We aimed to develop a new IST based on the ISWT in people with COPD, and assess its validity (construct validity) and reliability, according to Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) recommendations.

Methods

A cross-sectional study was conducted in participants recruited from hospitals/clinics. During the recruitment, the participants who presented a 6-minute walk test (6MWT) report in the previous month were also identified and the respective data was collected. Subsequently, participants attended two sessions at their homes. IST was conducted on the first visit, along with the 1 min sit-to-stand (1MSTS) test. IST was repeated on a second visit, performed 5–7 days after the first one. Spearman’s correlations were used for construct validity, by comparing the IST with the 6MWT and the 1MSTS. Intraclass correlation coefficient (ICC2,1), SE of measurement (SEM) and minimal detectable change at 95% CI (MDC95) were used for reliability. The learning effect was explored with the Wilcoxon signed-rank test.

Results

50 participants (70.8±7.5 years) were enrolled. IST was significant and moderate correlated with the 6MWT (ρ=0.50, p=0.020), and with the 1MSTS (ρ=0.46, p=0.001). IST presented an ICC2,1=0.96, SEM=10.1 (16.6%) and MDC95=27.9 (45.8%) for the number of steps. There was a statistically significant difference between the two attempts of the IST (p=0.030).

Conclusion

Despite the significant and moderate correlations with the 6MWT and 1MSTS, the inability to full compliance with the COSMIN recommendations does not yet allow the IST to be considered valid in people with COPD. On the other hand, the IST is a reliable test based on its high ICC, but a learning effect and an ‘indeterminate’ measurement error were shown.

Trial registration number

NCT04715659.
Estimating population-based incidence of community-acquired pneumonia and acute otitis media in children and adults in Ontario and British Columbia using health administrative data, 2005–2018: a Canadian Immunisation Research Network (CIRN) study
Authors: Nasreen Sharifa , Wang Jun , Sadarangani Manish , Kwong Jeffrey C , Quach Caroline , Crowcroft Natasha S , Wilson Sarah E , McGeer Allison , Morris Shaun K , Kellner James D , Sander Beate , Kus Julianne V , Hoang Linda , Marra Fawziah , Fadel Shaza A
Published: October 2022

Background

There is a paucity of data on the burden of the full spectrum of community-acquired pneumonia (CAP) and acute otitis media (AOM) from outpatient and inpatient settings across the age spectrum.

Methods

We conducted a population-based retrospective study in Ontario and British Columbia (BC), Canada, to estimate the incidence rate of CAP and AOM in children and adults over a 14-year period using health administrative databases. CAP and AOM cases were identified from outpatient physician consultation and hospitalisation data in both provinces, and from emergency department visit data in Ontario.

Results

During 2005–2018, Ontario had 3 607 124 CAP, 172 290 bacterial CAP, 7814 pneumococcal pneumonia, and 8 026 971 AOM cases. The incidence rate of CAP declined from 3077/100 000 in 2005 to 2604/100 000 in 2010 before increasing to 2843/100 000 in 2018; bacterial CAP incidence rate also declined from 178/100 000 in 2005 to 112/100 000 in 2010 before increasing to 149/100 000 in 2018. The incidence rate of AOM decreased from 4192/100 000 in 2005 to 3178/100 000 in 2018. BC had 970 455 CAP, 317 913 bacterial CAP, 35 287 pneumococcal pneumonia and 2 022 871 AOM cases. The incidence rate of CAP in BC decreased from 2214/100 000 in 2005 to 1964/100 000 in 2010 before increasing to 2176/100 000 in 2018; bacterial CAP incidence rate increased from 442/100 000 in 2005 to 981/100 000 in 2018. The incidence rate of AOM decreased from 3684/100 000 in 2005 to 2398/100 000 in 2018. The incidence rate of bacterial CAP increased with age in older adults (≥65 years) with the highest burden in the oldest cohort aged ≥85 years both before and after 13-valent pneumococcal conjugate vaccine (PCV13) programme in both provinces. Hospitalised pneumococcal pneumonia decreased slightly but non-hospitalised pneumococcal pneumonia increased in BC during PCV13 period. No consistent direct benefit of PCV13 on CAP was observed in the paediatric population.

Conclusions

There is a substantial burden of CAP and AOM in Ontario and BC. Indirect benefits from childhood PCV vaccination and polysaccharide vaccination of older adults have not substantially decreased the burden of pneumococcal pneumonia in older adults.