bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of different thread products for facial rejuvenation: Materials and barb designs
Authors: Cao Lideng , Qiu He , Yu Donglei , Shuo Liu , Wang Hang
Published: March 2023

Background

In recent years, the thread‐lifting technique has become widely used in clinical settings. Several thread products are used in clinical practice, and there are many differences between products in terms of many aspects.

Methods

Six commercial thread products were collected and evaluated. The general structure, microstructure, elastic modulus, and strength were evaluated using microscopies and tensile testing in vitro. Seventy‐two female rats were divided into six groups. Tissue samples were harvested and histologically evaluated at 1st, 4th, 8th, and 12th week using hematoxylin and eosin and Masson's trichrome staining.

Results

There were differences between products in terms of barb shape, microstructure, elasticity, and strength, and that could be attributed to the materials and barb structures. All threads showed good biological safety, and the density of collagen area in the dermis was increased compared to that in the control group.

Conclusions

This study provided an objective evaluation of barbed thread products, which indicated that all products can be used safely with certain effects in different indications.
A CHEMTAX‐derived phytoplankton community structure during 12‐year observations in the Gulf of Naples (LTER‐MC)
Authors: Saggiomo Maria , Bolinesi Francesco , Brunet Christophe , Passarelli Augusto , Margiotta Francesca , Saggiomo Vincenzo , Mangoni Olga
Published: March 2023

The rapid response of phytoplankton communities to environmental changes makes this compartment one of the most important biological variable to consider in dealing with ecology and trophodynamic of coastal areas, especially in relation with ongoing climate changes and increased human pressures. In the last 30 years, the use of chemotaxonomy has improved the capability to detect phytoplankton community composition in terms of chemofunctional groups, especially for small size species requiring specific expertise and techniques, as well as time‐consuming observation with light microscope. In this study, the temporal variability of chemotaxonomic functional groups has been investigated in surface waters of a LTER station in the Gulf of Naples over 12‐year weekly sampling activities (2003–2015). Data reveal increasing trends in the percentage contribution of diatoms, prasinophytes, cryptophytes to the total phytoplankton biomass, while other groups show a decreasing trend. Nevertheless, strong differences in the intervals of periodicity for each chemofunctional group have emerged, both in terms of timescale and strength of periodicity over time, implying that temporal dynamics of groups were not stationary over the time and that they have different relationships with environmental variability. Our results contribute to enrich scientific knowledge on the ecology of this LTER site and underline the importance of chemotaxonomy as a monitoring tool in coastal marine systems.
Microspore‐expressed SCULP1 is required for p‐coumaroylation of sporopollenin, exine integrity, and pollen development in wheat
Authors: Xu Lei , Tang Yimiao , Yang Yanzhi , Wang Dezhou , Wang Haijun , Du Jianmei , Bai Yajun , Su Shichao , Zhao Changping , Li Lei
Published: March 2023

Sporopollenin is one of the most structurally sophisticated and chemically recalcitrant biopolymers. In higher plants, sporopollenin is the dominant component of exine, the outer wall of pollen grains, and contains covalently linked phenolics that protect the male gametes from harsh environments. Although much has been learned about the biosynthesis of sporopollenin precursors in the tapetum, the nutritive cell layer surrounding developing microspores, little is known about how the biopolymer is assembled on the microspore surface.

We identified SCULP1 (SKS clade universal in pollen) as a seed plant conserved clade of the multicopper oxidase family. We showed that SCULP1 in common wheat (Triticum aestivum) is specifically expressed in the microspore when sporopollenin assembly takes place, localized to the developing exine, and binds p‐coumaric acid in vitro.

Through genetic, biochemical, and 3D reconstruction analyses, we demonstrated that SCULP1 is required for p‐coumaroylation of sporopollenin, exine integrity, and pollen viability. Moreover, we found that SCULP1 accumulation is compromised in thermosensitive genic male sterile wheat lines and its expression partially restored exine integrity and male fertility.

These findings identified a key microspore protein in autonomous sporopollenin polymer assembly, thereby laying the foundation for elucidating and engineering sporopollenin biosynthesis.
Understanding Monetary Spillovers in Highly Integrated Regions: The Case of Europe*
Authors: Feldkircher Martin , Schuberth Helene
Published: March 2023

We analyse why conventional monetary policy tightening in the euro area leads to a deterioration of output in Central‐, East and Southeastern Europe (CESEE). Our findings show that negative spillovers mainly arise through a decline in CESEE imports and exports, induced by a decrease in euro area demand. Negative spillovers are amplified through knock‐on effects through third‐countries and cannot be cushioned by favourable exchange rate movements. We also find evidence for a broad‐based retrenchment of cross‐border bank flows to the region. For the CESEE policymaker, our results indicate a limited power of exchange rate policies to buffer foreign, adverse monetary policy shocks.
The Russian Cusanus: S. L. Frank and the Russian reception of Nicholas of Cusa
Authors: Moore Harry James
Published: March 2023

During the intense philosophical and theological renaissance of the Russian Silver Age, the German Cardinal Nicholas of Cusa (1401–1464) received a unique appraisal in the work of Semyon Liudwigovich Frank (1877–1950), hailed by some as ‘the greatest Russian philosopher’. This paper will show that five of Frank's central philosophical arguments can be traced directly to Cusa's writings. Once these key arguments are taken together with Frank's own comments about Cusa, it can be concluded that Frank saw himself as Cusa's modern successor, presenting his ideas in a different intellectual context. In this sense, we can speak of Frank as the ‘Russian Cusanus’. The arguments in question include Cusa's docta ignorantia, our knowledge of being, the recognition of absolute being as ‘non‐other’, the identity of possibility and actuality in the absolute, and finally the coincidentia oppositorum.
Contemporary Concise Review 2022: Sleep
Authors: O'Driscoll Denise M. , Young Alan C.
Published: March 2023

SUMMARY OF KEY POINTS

COVID‐19 and sleep

The COVID‐19 pandemic is associated with an increase in insomnia and impaired sleep quality

Health care workers are particularly susceptible and improved with cognitive behavioural therapy for insomnia (CBT‐I)

Long COVID has significant effects on sleep

OSA impacts on the severity of acute COVID‐19 illness

Obstructive sleep apnoea

Large trials of clinically representative patients confirm the cardiovascular benefits of CPAP treatment in OSA

CPAP may improve long‐term cognitive outcomes in OSA, but further research is needed

Racial disparities in OSA prevalence and mortality risk are becoming evident

Periodic evaluation of OSA risk in pregnancy is important as timing may be key for intervention to prevent or treat cardiovascular risk factors

Insomnia

Comorbid insomnia and obstructive sleep apnoea (COMISA) can frequently co‐exist and the combined negative effects of both may be deleterious, particularly to cardiovascular health

There is evidence for effectiveness with novel orexin receptor antagonists
How to Use Simplified Reproductive Calendar Data from the Demographic and Health Survey
Authors: Boyle Elizabeth Heger , Rotem Nir , King Miriam L.
Published: March 2023

IPUMS Demographic and Health Surveys (IPUMS DHS), through its intuitive website (http://dhs.ipums.org/), eliminate barriers to overtime and cross‐national analyses with the DHS. IPUMS DHS recently released simplified reproductive calendar data. These calendar data are harmonized across samples, distinguish “not in universe” cases from “no” responses, and do not require destringing. Variable names are hot links to important documentation, such as survey‐question text and comparability concerns. Analysts can also select consistently coded variables relating to the woman, her household, and her social and environmental context without merging files.
Targeted estimation of state occupation probabilities for the non‐Markov illness‐death model
Authors: Munch Anders , Breum Marie Skov , Martinussen Torben , Gerds Thomas A.
Published: March 2023

We use semi‐parametric efficiency theory to derive a class of estimators for the state occupation probabilities of the continuous‐time irreversible illness‐death model. We consider both the setting with and without additional baseline information available, where we impose no specific functional form on the intensity functions of the model. We show that any estimator in the class is asymptotically linear under suitable assumptions about the estimators of the intensity functions. In particular, the assumptions are weak enough to allow the use of data‐adaptive methods, which is important for making the identifying assumption of coarsening at random plausible in realistic settings. We suggest a flexible method for estimating the transition intensity functions of the illness‐death model based on penalized Poisson regression. We apply this method to estimate the nuisance parameters of an illness‐death model in a simulation study and a real‐world application.
Metabolic regulation of quiescence in plants
Authors: Considine Michael J. , Foyer Christine H.
Published: March 2023

Quiescence is a crucial survival attribute in which cell division is repressed in a reversible manner. Although quiescence has long been viewed as an inactive state, recent studies have shown that it is an actively monitored process that is influenced by environmental stimuli. Here, we provide a perspective of the quiescent state and discuss how this process is tuned by energy, nutrient and oxygen status, and the pathways that sense and transmit these signals. We not only highlight the governance of canonical regulators and signalling mechanisms that respond to changes in nutrient and energy status, but also consider the central significance of mitochondrial functions and cues as key regulators of nuclear gene expression. Furthermore, we discuss how reactive oxygen species and the associated redox processes, which are intrinsically linked to energy carbohydrate metabolism, also play a key role in the orchestration of quiescence.
Increased radiographic opacity in the region of the gallbladder can be identified in dogs with large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele
Authors: Jang Hyunyoung , Lee Sang‐Kwon , Choi Sooyoung , Choi Hojung , Lee Youngwon , Lee Kija
Published: March 2023

Increased soft‐tissue opacity in the region of the canine gallbladder is incidentally detected on radiographs. We hypothesized that there is a difference in the detection of gallbladder sediment on radiographs depending on the amount or mobility of the sediment. In this retrospective and analytical study, we aimed to assess the ultrasonographic features of gallbladder sediment that were detected radiographically. We also aimed to assess the differences in the detection of increased opacity of the gallbladder between radiographic views. We included 223 dogs that underwent thoracic radiography, abdominal radiography, and gallbladder ultrasonography. Ultrasonographic images of the gallbladder were divided into five groups: group 1, gravity‐dependent sediment occupying < 50% of the gallbladder; group 2, gravity‐dependent sediment occupying ≥50%; group 3, sediment attached to the gallbladder wall; group 4, sludge ball; and group 5, gallbladder mucocele. Dogs showing increased opacity on subjective assessment of any radiographic view were recorded, and the sensitivity of radiographic views for detecting gallbladder sediment was analyzed. Of 168 dogs with gallbladder sediment, 37 had increased opacity on at least one radiographic projection. The frequency was compared as a percentage within each category, and Group 4 was the highest percentage with increased radiographic gallbladder opacity, followed by Groups 2 and 5. The sensitivity for detecting increased opacity was highest in the thoracic ventrodorsal view. Thus, in dogs with increased gallbladder opacity on radiographs, large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele should be considered differential diagnoses. In addition, the thoracic ventrodorsal view is recommended to evaluate gallbladder opacity.
Designing and calibrating an agent‐based platform to evaluate the effect of climate variables on residential water demand
Authors: Moosavi Seyed Farzad , Salehnia Narges , Seifi Ahmad , AsgharpourMasouleh Ahmadreza , Salehnia Nasrin
Published: March 2023

Many Iranian metropolises, including Shiraz, are situated in arid and semi‐arid regions, lacking sufficient renewable water resources. In recent years, climate changes, including drought and rising temperatures, have led to changes in water supply and demand. Given the necessity and importance of urban water supply, this study investigates the impact of different climate scenarios on residential water demand. Many studies, in their models, do not consider the social interactions between household water consumers and the change in their consumption behaviour, which serves as a fundamental drawback. Thus, the present research attempts to propose an agent‐based framework by modelling social interactions via the diffusion process to investigate water consumption behaviour efficiently. The model is calibrated and applied to Shiraz City in Iran, according to the data from 2006 to 2019, and it is used to simulate each scenario for the following years until 2032. The findings show that temperature has a positive and significant effect on residential water consumption; yet, rainfall negatively affects water consumption. The simulation results of these scenarios for temperature increase or decrease and rainfall changes are estimated. In addition, the developed agent‐based platform can be easily calibrated and adjusted based on the data of any other city to simulate water demand estimation under different climatic and even economic scenarios. Urban water managers can benefit from such estimates to plan future infrastructure development and proactive management of seasonal water resources under the growing pressure of potential climate change because construing the sensitivity of seasonal water consumption to climate conditions is essential to respond to variations in demand.
Reviewer Acknowledgements for Journal of Education and Training Studies, Vol. 11, No. 2
Authors: Smith Robert
Published: March 2023

Journal of Education and Training Studies (JETS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JETS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 11, Number 2 Chris Mutseekwa, Bindura University of Science Education, ZimbabweJane Liang, California Department of Education, USAJohn Cowan, Edinburgh Napier University, UKJohn Mark Asio, Gordon College, PhilippinesKendall Hartley, University of Nevada, USANiveen M. Zayed, MENA College of Management, JordanRichard H. Martin, Mercer University, USARichard Penny, University of Washington Bothell, USA Robert SmithEditorial AssistantOn behalf of,The Editorial Board of Journal of Education and Training StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAE-mail 1: jets@redfame.comE-mail 2: jets@redfame.orgURL: http://jets.redfame.com
Research on the Mechanism of Curve Passing for Bogie on a Medium-Low Speed Maglev With Mid-Set Air Spring
Authors: Wang Bo , Luo Shihui , Liu Jing , Ma Weihua , Xu Jie
Published: March 2023

In the research of rail vehicles, mechanism of curve passing is one of the hot spots, which essentially elucidates the conditions of vehicle curve passing and points out the direction for improving vehicle curve passing ability. As one of the new members of rail transportation, the curve passing capability of medium-low speed maglev directly affects its application and promotion in the field of rail transportation. In order to reveal the mechanism of curve passing for medium-low speed maglev, this paper first studies the necessary conditions for the conventional wheelset curve passing based on the mechanism of curve passing for the conventional wheelset. Second, on the basis of comparing the structure and motion relationship of the conventional wheelset, the independent wheelset and the magnetic wheelset (bogie of medium-low speed maglev), the theoretical derivation of the magnetic wheelset curve passing conditions are carried out to obtain its theoretical solution based on the curve passing conditions of the conventional wheelset. Finally, the conditions of curve passing for the magnetic wheelset are verified by dynamic simulation, and the mechanism of curve passing for the medium-low speed maglev bogie is revealed. Through the research, it can be found that: (1) The mechanism of curve passing for the magnetic wheelset is different from that of the traditional wheelset and the independent wheelset. The speed variance and regulating torque are the composite functions of running speed, curve radius, track gauge, superelevation, guiding stiffness and yaw angle of the magnetic wheelset. (2) When the magnetic wheelset passes through the curve, its motion posture switches between “” and “,” while the unilateral magnetic wheel shows a motion which is similar to “hunting.” (3) Ignoring the factors such as structure and irregularity, it can conduct that the curve capacity of the magnetic wheelset could be improved by increasing the curve radius, reducing the speed, curve superelevation and gauge to a certain extent. This study theoretically reveals the mechanism of curve passing for the medium-low speed maglev bogie, which provides a certain reference for the subsequent design of the medium-low speed maglev and the improvement of the medium-low speed maglev curve capacity.
Echocardiography in the detection of lead-related infective endocarditis
Authors: Bečić Tina , Carević Vedran , Perković-Avelini Ružica , Fabijanic Damir
Published: March 2023

.
Ultrasound imaging and guided intervention for the middle cluneal nerve
Authors: Wu Wei-Ting , Hsu Yu-Chun , Mezian Kamal , Ricci Vincenzo , Chang Ke-Vin , Ozcakar Levent
Published: March 2023

.
Expanded geographic distribution and dietary strategies of the earliest Oldowan hominins and
Paranthropus
Authors: Plummer Thomas W. , Oliver James S. , Finestone Emma M. , Ditchfield Peter W. , Bishop Laura C. , Blumenthal Scott A. , Lemorini Cristina , Caricola Isabella , Bailey Shara E. , Herries Andy I. R. , Parkinson Jennifer A. , Whitfield Elizabeth , Hertel Fritz , Kinyanjui Rahab N. , Vincent Thomas H. , Li Youjuan , Louys Julien , Frost Stephen R. , Braun David R. , Reeves Jonathan S. , Early Emily D. G. , Onyango Blasto , Lamela-Lopez Raquel , Forrest Frances L. , He Huaiyu , Lane Timothy P. , Frouin Marine , Nomade Sébastien , Wilson Evan P. , Bartilol Simion K. , Rotich Nelson Kiprono , Potts Richard
Published: March 2023

The oldest Oldowan tool sites, from around 2.6 million years ago, have previously been confined to Ethiopia’s Afar Triangle. We describe sites at Nyayanga, Kenya, dated to 3.032 to 2.581 million years ago and expand this distribution by over 1300 kilometers. Furthermore, we found two hippopotamid butchery sites associated with mosaic vegetation and a C
4
grazer–dominated fauna. Tool flaking proficiency was comparable with that of younger Oldowan assemblages, but pounding activities were more common. Tool use-wear and bone damage indicate plant and animal tissue processing.
Paranthropus
sp. teeth, the first from southwestern Kenya, possessed carbon isotopic values indicative of a diet rich in C
4
foods. We argue that the earliest Oldowan was more widespread than previously known, used to process diverse foods including megafauna, and associated with
Paranthropus
from its onset.
Relatively oxidized fluids fed Earth’s earliest hydrothermal systems
Authors: Trail Dustin , McCollom Thomas M.
Published: March 2023

The properties of high-temperature lithospheric fluids within the early Earth are poorly known, yet many origin-of-life scenarios depend upon their characteristics. These fluids represent a key communication pathway between Earth’s interior and hydrothermal pools. We use zircon chemistry, experiments, and modeling to infer the character of lithospheric fluids approaching 4 billion years. We constrain oxygen fugacity, chlorine content, and temperature, which allow us to model the solubility and transport of metals that are hypothesized to be crucial for the origin of life. We show that these fluids were more oxidized than the terrestrial mantle during this time and that they were interacting with near-surface aqueous systems, possibly subaerial hydrothermal pools, amplifying redox gradients in a location attractive for prebiotic molecular synthesis or sustained microbial activity.
The connectome of an insect brain
Authors: Winding Michael , Pedigo Benjamin D. , Barnes Christopher L. , Patsolic Heather G. , Park Youngser , Kazimiers Tom , Fushiki Akira , Andrade Ingrid V. , Khandelwal Avinash , Valdes-Aleman Javier , Li Feng , Randel Nadine , Barsotti Elizabeth , Correia Ana , Fetter Richard D. , Hartenstein Volker , Priebe Carey E. , Vogelstein Joshua T. , Cardona Albert , Zlatic Marta
Published: March 2023

Brains contain networks of interconnected neurons and so knowing the network architecture is essential for understanding brain function. We therefore mapped the synaptic-resolution connectome of an entire insect brain (Drosophilalarva) with rich behavior, including learning, value computation, and action selection, comprising 3016 neurons and 548,000 synapses. We characterized neuron types, hubs, feedforward and feedback pathways, as well as cross-hemisphere and brain-nerve cord interactions. We found pervasive multisensory and interhemispheric integration, highly recurrent architecture, abundant feedback from descending neurons, and multiple novel circuit motifs. The brain’s most recurrent circuits comprised the input and output neurons of the learning center. Some structural features, including multilayer shortcuts and nested recurrent loops, resembled state-of-the-art deep learning architectures. The identified brain architecture provides a basis for future experimental and theoretical studies of neural circuits.
Enantioselective electrochemical cobalt-catalyzed aryl C–H activation reactions
Authors: von Münchow Tristan , Dana Suman , Xu Yang , Yuan Binbin , Ackermann Lutz
Published: March 2023

Enantioselective redox transformations typically rely on costly transition metals as catalysts and often stoichiometric amounts of chemical redox agents as well. Electrocatalysis represents a more sustainable alternative, in particular through the use of the hydrogen evolution reaction (HER) in place of a chemical oxidant. In this work, we describe strategies for HER-coupled enantioselective aryl carbon-hydrogen bond (C–H) activation reactions using cobalt in place of a precious metal catalyst for the asymmetric oxidation. Thus, highly enantioselective carbon-hydrogen and nitrogen-hydrogen (C–H and N–H) annulations of carboxylic amides were achieved, which gave access to point and axially chiral compounds. Furthermore, the cobalt-mediated electrocatalysis enabled the preparation of various phosphorus (P)–stereogenic compounds by selective desymmetrization through dehydrogenative C–H activation reactions.
Base editing rescue of spinal muscular atrophy in cells and in mice
Authors: Arbab Mandana , Matuszek Zaneta , Kray Kaitlyn M. , Du Ailing , Newby Gregory A. , Blatnik Anton J. , Raguram Aditya , Richter Michelle F. , Zhao Kevin T. , Levy Jonathan M. , Shen Max W. , Arnold W. David , Wang Dan , Xie Jun , Gao Guangping , Burghes Arthur H. M. , Liu David R.
Published: March 2023

Spinal muscular atrophy (SMA), the leading genetic cause of infant mortality, arises from survival motor neuron (SMN) protein insufficiency resulting from
SMN1
loss. Approved therapies circumvent endogenous SMN regulation and require repeated dosing or may wane. We describe genome editing of
SMN2
, an insufficient copy of
SMN1
harboring a C6>T mutation, to permanently restore SMN protein levels and rescue SMA phenotypes. We used nucleases or base editors to modify five
SMN2
regulatory regions. Base editing converted
SMN2
T6>C, restoring SMN protein levels to wild type. Adeno-associated virus serotype 9–mediated base editor delivery in Δ7SMA mice yielded 87% average T6>C conversion, improved motor function, and extended average life span, which was enhanced by one-time base editor and nusinersen coadministration (111 versus 17 days untreated). These findings demonstrate the potential of a one-time base editing treatment for SMA.
Complete Genome Sequence of New
Cronobacter-
Specific Bacteriophage Dev_CS701
Authors: Kajsik Michal , Durovka Peter , Kajsikova Maria , Rusnakova Diana , Szemes Tomas , Drahovska Hana
Published: March 2023

Cronobacter
is a ubiquitous Gram-negative bacterium linked with serious infections. In this report, we describe the characterization of
Cronobacter
phage Dev_CS701, which was isolated from wastewater. Related to phages belonging to the
Straboviridae
family and
Pseudotevenvirus
genus, such as vB_CsaM_IeB, Dev_CS701 contains 257 predicted protein-coding genes and a tRNA gene.
The Effect of Outer Space and Other Environmental Cues on Bacterial Conjugation
Authors: Piscon Bar , Pia Esposito Eliana , Fichtman Boris , Samburski Guy , Efremushkin Lihi , Amselem Shimon , Harel Amnon , Rahav Galia , Zarrilli Raffaele , Gal-Mor Ohad
Published: March 2023

Bacterial conjugation is a highly ubiquitous and promiscuous process, by which a donor bacterium transfers a large portion of genetic material to a recipient cell. This mechanism of horizontal gene transfer plays an important role in bacterial evolution and in the ability of bacteria to acquire resistance to antimicrobial drugs and disinfectants.
Enrichment Culture but Not Metagenomic Sequencing Identified a Highly Prevalent Phage Infecting
Lactiplantibacillus plantarum
in Human Feces
Authors: Zhao Xueyang , Sun Chuqing , Jin Menglu , Chen Jingchao , Xing Lulu , Yan Jin , Wang Hailei , Liu Zhi , Chen Wei-Hua
Published: March 2023

As
Lactiplantibacillus plantarum
(previously known as
Lactobacillus plantarum
) is increasingly used as a probiotic to treat human gut-related diseases, its bacteriophages may pose a certain threat to their further application and should be identified and characterized more often from the human intestine. Here, we isolated and identified the first gut
L. plantarum
phage that is prevalent in a Chinese population.
Large-scale igneous intrusion emplacement as a trigger for fluid seepage on the northern South China Sea margin
Authors: Zhao Fang , Iyer Karthik , Xia Shaohong
Published: March 2023

Widespread mud eruptions have been identified along the northern margin of the South China Sea. However, the ultimate driving force for initiation of the eruptions remains to be discussed. Here, we investigated the discovered hydrothermal vents and the presence of gas/fluid occurring above deep-seated igneous intrusions and volcanic edifices and consider them as a likely trigger. Using a one-dimensional (1D) numerical model, SILLi 1.0, we studied the thermal effect of a 100-m-thick dolerite sill complex emplaced at 1100 °C and 3.8 km depth within the organic-rich Triassic series (∼3.5 wt% total organic carbon). The modeled scenarios also account for variations in sill count and thickness and the effects of erosion. The calculated CH4 produced from contact metamorphism reaches a peak of ∼700 kg/m2/yr shortly after emplacement of the first sill in the complex. When scaled to a sill size of 100 m by 25 km2, i.e., a sill volume of 2500 km3, ∼42−550 Mt of CH4, depending on individual sill thickness, have been produced within 10,000 yr of sill emplacement from sedimentary organic matter in the aureole, with peak generation of ∼17.5 Mt CH4/yr just after emplacement. The newly discovered vents are suggested to have formed as a direct result of sill emplacement and by overpressure generated in the sediments around the sill by hydrothermal fluids and gases liberated during organic matter degradation. Combining data from seismic images with the likely production of carbon gas released from contact metamorphism with igneous intrusions, we suggest that volcanically induced gas release is common along the South China Sea margin. This study supports the important role of magmatism in driving regional-scale gas/fluid seepage. Our findings also suggest that the hydrothermal vents and intrusive magmatic bodies provide postemplacement fluid focusing pathways to shallower strata or the seafloor over long time scales.
Communication of anticancer drug benefits and related uncertainties to patients and clinicians: document analysis of regulated information on prescription drugs in Europe
Authors: Davis Courtney , Wagner Anita K , Salcher-Konrad Maximilian , Scowcroft Henry , Mintzes Barbara , Pokorny Adrian M J , Lew Jianhui , Naci Huseyin
Published: March 2023

Objective

To evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe.

Design

Document content analysis.

Setting

European Medicines Agency.

Participants

Anticancer drugs granted a first marketing authorisation by the European Medicines Agency, 2017-19.

Main outcome measures

Whether written information on a product addressed patients’ commonly asked questions about: who and what the drug is used for; how the drug was studied; types of drug benefit expected; and the extent of weak, uncertain, or missing evidence for drug benefits. Information on drug benefits in written sources for clinicians (summaries of product characteristics), patients (patient information leaflets), and the public (public summaries) was compared with information reported in regulatory assessment documents (European public assessment reports).

Results

29 anticancer drugs that received a first marketing authorisation for 32 separate cancer indications in 2017-19 were included. General information about the drug (including information on approved indications and how the drug works) was frequently reported across regulated information sources aimed at both clinicians and patients. Nearly all summaries of product characteristics communicated full information to clinicians about the number and design of the main studies, the control arm (if any), study sample size, and primary measures of drug benefit. None of the patient information leaflets communicated information to patients about how drugs were studied. 31 (97%) summaries of product characteristics and 25 (78%) public summaries contained information about drug benefits that was accurate and consistent with information in regulatory assessment documents. The presence or absence of evidence that a drug extended survival was reported in 23 (72%) summaries of product characteristics and four (13%) public summaries. None of the patient information leaflets communicated information about the drug benefits that patients might expect based on study findings. Scientific concerns about the reliability of evidence on drug benefits, which were raised by European regulatory assessors for almost all drugs in the study sample, were rarely communicated to clinicians, patients, or the public.

Conclusions

The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
Pharmacological emergency management of agitation in children and young people: protocol for a randomised controlled trial of oral medication (PEAChY-O)
Authors: Bourke Elyssia M , Borland Meredith L , Kochar Amit , George Shane , Shellshear Deborah , Jani Shefali , Perkins Kent , Tham Doris , Gordon Michael Solomon , Klein Kate , Prakash Chidambaram , Lee Katherine , Davidson Andrew , Knott Jonathan C , Craig Simon , Babl Franz E
Published: March 2023

Introduction

Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in emergency departments (EDs) in adults and young people. Despite the increasing number of presentations and significant associated risks to patients, families and caregivers, there is limited evidence to guide the most effective pharmacological management in children and adolescents. The aim of this study is to determine whether a single dose of oral olanzapine is more effective than a dose of oral diazepam at successfully sedating young people with ASBD.

Methods and analysis

This study is a multicentre, open-label, superiority randomised controlled trial. Young people aged between 9 years and 17 years and 364 days presenting to an ED with ASBD who are deemed to require medication for behavioural containment will be recruited to the study. Participants will be randomised in a 1:1 allocation between a single weight-based dose of oral olanzapine and oral diazepam. The primary outcome is the proportion of participants who achieve successful sedation at 1-hour post randomisation without the need for additional sedation. Secondary outcomes will include assessing for adverse events, additional medications provided in the ED, further episodes of ASBD, length of stay in the ED and hospital and satisfaction with management.

Effectiveness will be determined using an intention-to-treat analysis, with medication efficacy determined as part of the secondary outcomes using a per-protocol analysis. The primary outcome of successful sedation at 1 hour will be presented as a percentage within each treatment group, with comparisons presented as a risk difference with its 95% CIs.

Ethics and dissemination

Ethics approval was received from the Royal Children’s Hospital Human Research Ethics Committee (HREC/66478/RCHM-2020). This incorporated a waiver of informed consent for the study. The findings will be disseminated in a peer-reviewed journal and at academic conferences.

Trial registration number

ACTRN12621001236886.
High-flow nasal cannula reduces intubation rate in patients with COVID-19 with acute respiratory failure: a meta-analysis and systematic review
Authors: Li Yang , LI Cong , Chang Wei , Liu Ling
Published: March 2023

Objective

This study aimed to investigate the effect of high-flow nasal cannula therapy (HFNC) versus conventional oxygen therapy (COT) on intubation rate, 28-day intensive care unit (ICU) mortality, 28-day ventilator-free days (VFDs) and ICU length of stay (ICU LOS) in adult patients with acute respiratory failure (ARF) associated with COVID-19.

Design

Systematic review and meta-analysis.

Data sources

PubMed, Web of Science, Cochrane Library and Embase up to June 2022.

Eligibility criteria for selecting studies

Only randomised controlled trials or cohort studies comparing HFNC with COT in patients with COVID-19 were included up to June 2022. Studies conducted on children or pregnant women, and those not published in English were excluded.

Data extraction and synthesis

Two reviewers independently screened the titles, abstracts and full texts. Relevant information was extracted and curated in the tables. The Cochrane Collaboration tool and Newcastle-Ottawa Scale were used to assess the quality of randomised controlled trials or cohort studies. Meta-analysis was conducted using RevMan V.5.4 computer software using a random effects model with a 95% CI. Heterogeneity was assessed using Cochran’s Q test (χ2) and Higgins I2statistics, with subgroup analyses to account for sources of heterogeneity.

Results

Nine studies involving 3370 (1480 received HFNC) were included. HFNC reduced the intubation rate compared with COT (OR 0.44, 95% CI 0.28 to 0.71, p=0.0007), decreased 28-day ICU mortality (OR 0.54, 95% CI 0.30 to 0.97, p=0.04) and improved 28-day VFDs (mean difference (MD) 2.58, 95% CI 1.70 to 3.45, p<0.00001). However, HFNC had no effect on ICU LOS versus COT (MD 0.52, 95% CI −1.01 to 2.06, p=0.50).

Conclusions

Our study indicates that HFNC may reduce intubation rate and 28-day ICU mortality, and improve 28-day VFDs in patients with ARF due to COVID-19 compared with COT. Large-scale randomised controlled trials are necessary to validate our findings.

PROSPERO registration number

CRD42022345713.
Study protocol for economic evaluation of probiotic intervention for prevention of neonatal sepsis in 0–2-month old low-birth weight infants in India: the ProSPoNS trial
Authors: Sinha Anju , Bahuguna Pankaj , Gupta Subodh Sharan , Kuruba Yamini Priyanka , Poluru Ramesh , Mathur Apoorva , Raja Dilip , Raut Abhishek V , Mahajan Kamaleshwar S , Sudhakar Rishikesh , Kulkarni Bharati , Pandey Ravindra Mohan , Arora Narendra K. , Prinja Shankar
Published: March 2023

Introduction

The ProSPoNS trial is a multicentre, double-blind, placebo-controlled trial to evaluate the role of probiotics in prevention of neonatal sepsis. The present protocol describes the data and methodology for the cost utility of the probiotic intervention alongside the controlled trial.

Methods and analysis

A societal perspective will be adopted in the economic evaluation. Direct medical and non-medical costs associated with neonatal sepsis and its treatment would be ascertained in both the intervention and the control arm. Intervention costs will be facilitated through primary data collection and programme budgetary records. Treatment cost for neonatal sepsis and associated conditions will be accessed from Indian national costing database estimating healthcare system costs. A cost–utility design will be employed with outcome as incremental cost per disability-adjusted life year averted. Considering a time-horizon of 6 months, trial estimates will be extrapolated to model the cost and consequences among high-risk neonatal population in India. A discount rate of 3% will be used. Impact of uncertainties present in analysis will be addressed through both deterministic and probabilistic sensitivity analysis.

Ethics and dissemination

Has been obtained from EC of the six participating sites (MGIMS Wardha, KEM Pune, JIPMER Puducherry, AIPH, Bhubaneswar, LHMC New Delhi, SMC Meerut) as well as from the ERC of LSTM, UK. A peer-reviewed article will be published after completion of the study. Findings will be disseminated to the community of the study sites, with academic bodies and policymakers.

Registration

The protocol has been approved by the regulatory authority (Central Drugs Standards Control Organisation; CDSCO) in India (CT-NOC No. CT/NOC/17/2019 dated 1 March 2019). The ProSPoNS trial is registered at the Clinical Trial Registry of India (CTRI). Registered on 16 May 2019.

Trial registration number

CTRI/2019/05/019197; Clinical Trial Registry.
Nurses’ practice of peripherally inserted central catheter maintenance and its influencing factors in Guizhou province, China: a cross-sectional study
Authors: Hu Li , Li Yaling , Li Hong , Ling Wenjing , Zheng Chaoting , Ran Mingfei , Xu Binbin
Published: March 2023

Objectives

The aim of this study was to investigate the level of practice of peripherally inserted central catheter (PICC) maintenance among nurses in Guizhou province, China, and to explore its influencing factors.

Design

Cross-sectional study.

Setting

11 tertiary and 26 secondary hospitals of Guizhou province, China.

Participants

A total of 832 nurses engaged in clinical work of PICC maintenance participated in the present study.

Primary outcome measures

PICC maintenance knowledge questionnaire, PICC maintenance attitude questionnaire and PICC maintenance practice questionnaire were administrated online for measuring participants’ knowledge, attitude and practice of PICC maintenance, respectively.

Results

The mean score of nurses’ practice of PICC maintenance was 79.77±12.13 and 60.8% of participants reported acceptable practices of PICC maintenance. The availability of PICC guidelines (β=0.10, p=0.002), previous training on PICC maintenance (β=0.18, p<0.001) and attitudes toward PICC maintenance (β=0.48, p<0.001) were significant factors predicting nurses’ practices of PICC maintenance. These factors account for 33% of the variance in the practice of PICC maintenance.

Conclusion

Nurses’ practice of PICC maintenance in Guizhou province was unsatisfactory. Their practice was influenced by the availability of PICC guidelines, whether or not they received training and their attitudes toward PICC maintenance. A province-level PICC maintenance alliance is recommended to be established to improve the quality of PICC maintenance in Guizhou, which can develop or update PICC guidelines, and provide training on PICC maintenance regularly for nurses engaging in PICC maintenance.
Vaccine coverage for recommended vaccines among splenectomised patients in Apulia, South Italy: a retrospective cohort study
Authors: Bianchi Francesco Paolo , Stefanizzi Pasquale , Di Lorenzo Antonio , Cuscianna Eustachio , Tafuri Silvio , Germinario Cinzia Annatea
Published: March 2023

Objective

Splenectomised/asplenic patients have a 10–50 fold higher risk than the general population of developing overwhelming postsplenectomy infection. To control this risk, these patients have to receive a specific immunisation schedule, before or in the 2 weeks after the surgical intervention. The study aims to estimate vaccine coverage (VC) for recommended vaccines among splenectomised patients in Apulia (South Italy), and to define the determinants of vaccination uptake in this population.

Design

Retrospective cohort study.

Setting

Apulia, Southern Italy.

Participants

1576 splenectomised patients.

Methods

The Apulian regional archive of hospital discharge forms (SDOs) was used to define the splenectomised Apulian inhabitants. The study period went from 2015 to 2020. The vaccination status forStreptococcus pneumoniae(13-valent conjugate anti-pneumococcal vaccine+PPSV23),Haemophilus influenzaetype b (Hib; one dose),Neisseria meningitidisACYW135 (two doses),Neisseria meningitidisB (two doses) and influenza (at least one dose of influenza vaccine before an influenza season after splenectomy) was assessed via data collected from the Regional Immunisation Database (GIAVA). In order to define a subject as fully immunised, we considered the Centers for Diseases Control and Prevention guidelines to define the optimal immunisation status.

Results

Since 2015, 1576 Apulian inhabitants have undergone splenectomy; the VC for anti-Neisseria meningitidisB vaccine was 30.9%, for anti-Neisseria meningitidisACYW135 was 27.7%, for anti-Streptococcus pneumoniaewas 27.0%, for anti-Hib was 30.1%, and 49.2% received at least one dose of influenza vaccine before an influenza season after splenectomy. None of the patients splenectomised in 2015 and 2016 had received the recommended MenACYW135and PPSV23 booster doses 5 years after completing the basal cycles.

Conclusions

The results of our study highlight low VC values among Apulian splenectomised patients. The task of public health institutions is to implement new strategies aimed at increasing VC in this population, implementing educational measures for patients and families, training for general practitioners and specialists, and ad hoc communication campaigns.
Health literacy education programmes developed for qualified health professionals: a scoping review
Authors: Connell Lauren , Finn Yvonne , Sixsmith Jane
Published: March 2023

Objectives

Both literature and policy have identified the need for health literacy education for qualified health professionals. This study aimed to identify and map health literacy competencies and health literacy related communication skills educational interventions for qualified health professionals. The research questions included: Of the qualified health professional education interventions identified, which are focused on diabetes care? What health literacy competencies and health literacy related communication skills are integrated into each programme? What are the characteristics of each education programme? What were the barriers and facilitators to implementation? What methods are used to evaluate intervention effectiveness, if any?

Design

Scoping review, informed by the Joanna Briggs Institute guidelines.

Data sources

The following databases: OVID; CINAHL; Cochrane; EMBASE; ERIC: PsycInfo; RIAN; Pro-Quest; UpToDate were searched.

Eligibility criteria

Articles were included if the education programme focused on qualified health professionals, in all clinical settings, treating adult patient populations, of all study types.

Data extraction and synthesis

Two authors independently screened titles, abstracts and full text articles that met the inclusion criteria. The third author mediated any discrepancies. The data were extracted and charted in table format.

Results

In total, 53 articles were identified. One article referred to diabetes care. Twenty-six addressed health literacy education, and 27 addressed health literacy related communication. Thirty-five reported using didactic and experiential methods. The majority of studies did not report barriers (N=45) or facilitators (N=52) to implementation of knowledge and skills into practice. Forty-nine studies evaluated the reported education programmes using outcome measures.

Conclusions

This review mapped existing education programmes regarding health literacy and health literacy related communication skills, where programme characteristics were identified to inform future intervention development. An evident gap was identified regarding qualified health professional education in health literacy, specifically in diabetes care.
Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
Authors: Findlay Callum , Fong Wei Chern Gavin , Goldie Simon , Jones Huw
Published: March 2023

Background

Healthcare systems face unprecedented numbers of patients waiting for elective treatments in the wake of the COVID-19 pandemic. Hospitals must urgently optimise patient pathways and build capacity to meet the populations health needs. Criteria-led discharge (CLD) is frequently used to optimise elective care pathways but may hold potential in discharging patients at the end of an acute hospital admission.

Methods

We conducted a quality improvement project to design and introduce a novel inpatient pathway using CLD for patients with severe acute tonsillitis. Our analysis compared the standardisation of treatment, length of stay, discharge time and readmission rate between those treated on the novel pathway compared with standard treatment.

Results

The study population included 137 patients admitted to a tertiary centre with acute tonsillitis. Introduction of the tonsillitis pathway using CLD resulted in a significant reduction in median length of stay from 24 hours to 18 hours. Of those treated on the tonsillitis pathway, 52.2% were discharged prior to midday compared with 29.1% who received standard treatment. No patient discharged using CLD required readmission.

Conclusion

CLD is safe and effective at reducing length of stay in patients requiring acute hospital admission for acute tonsillitis. CLD should be used and evaluated in further novel patient pathways across different areas of medicine to optimise care and build capacity for provision of elective healthcare services. Further research is required to investigate safe and optimal criteria which indicate patients are fit for discharge.