bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in the Distribution of Membrane Lipids during Growth of Thermotoga maritima at Different Temperatures: Indications for the Potential Mechanism of Biosynthesis of Ether-Bound Diabolic Acid (Membrane-Spanning) Lipids
Authors: Sahonero-Canavesi Diana X. , Villanueva Laura , Bale Nicole J. , Bosviel Jade , Koenen Michel , Hopmans Ellen C. , Sinninghe Damsté Jaap S.
Published: November 2021

Membrane-spanning lipids are unique compounds found in most archaeal membranes, but they are also present in specific bacterial groups like the
Thermotogales
. The synthesis and physiological role of membrane-spanning lipids in bacteria represent an evolutionary and biochemical open question that points to the differentiation of the membrane lipid composition.
MbnC Is Not Required for the Formation of the N-Terminal Oxazolone in the Methanobactin from Methylosinus trichosporium OB3b
Authors: Dershwitz Philip , Gu Wenyu , Roche Julien , Kang-Yun Christina S. , Semrau Jeremy D. , Bobik Thomas A. , Fulton Bruce , Zischka Hans , DiSpirito Alan A.
Published: November 2021

A number of environmental and medical applications have been proposed for MBs, including bioremediation of toxic metals and nanoparticle formation, as well as the treatment of copper- and iron-related diseases. However, before MBs can be modified and optimized for any specific application, the biosynthetic pathway for MB production must be defined.
iTRAQ-Based Proteomics Analysis of Human Cytomegalovirus Latency and Reactivation in T98G Cells
Authors: Cheng Shuang , Zhao Fei , Wen Le , Yang Bo , Wang Xian-Zhang , Huang Sheng-Nan , Jiang Xuan , Zeng Wen-Bo , Sun Jin-Yan , Zhang Fu-Kun , Shen Hong-Jie , Fortunato Elizabeth , Luo Min-Hua , Cheng Han
Published: November 2021

Human cytomegalovirus (HCMV) is a highly transmissible betaherpesvirus that has a prevalence of 60% to 90% worldwide. This opportunist pathogen poses a significant threat to newborns and immunosuppressed individuals.
Bacterial Epidemiology and Antimicrobial Resistance Profiles in Children Reported by the ISPED Program in China, 2016 to 2020
Authors: Fu Pan , Xu Hongmei , Jing Chunmei , Deng Jikui , Wang Hongmei , Hua Chunzhen , Chen Yinghu , Chen Xuejun , Zhang Ting , Zhang Hong , Chen Yiping , Yang Jinhong , Lin Aiwei , Wang Shifu , Cao Qing , Wang Xing , Deng Huiling , Cao Sancheng , Hao Jianhua , Gao Wei , Huang Yuanyuan , Yu Hui , Wang Chuanqing
Published: November 2021

AMR, especially that involving multidrug-resistant organisms (MDROs), is recognized as a global threat to human health; AMR renders infections increasingly difficult to treat, constituting an enormous economic burden and producing tremendous negative impacts on patient morbidity and mortality rates. There are many surveillance programs in the world to address AMR profiles and MDRO prevalence in humans.
Diagnostic Performance of Self-Collected Saliva Versus Nasopharyngeal Swab for the Molecular Detection of SARS-CoV-2 in the Clinical Setting
Authors: Uddin Mohammad Khaja Mafij , Shirin Tahmina , Hossain Mohammad Enayet , Alam Ahmed Nawsher , Ami Jenifar Quaiyum , Hasan Rashedul , Miah Mojnu , Shaly Nusrat Jahan , Ahmed Shahriar , Rahman S. M. Mazidur , Rahman Mustafizur , Banu Sayera
Published: November 2021

As the COVID-19 pandemic erupted, the WHO recommended the use of nasopharyngeal or throat swabs for the detection of SARS-CoV-2 etiology of COVID-19. The collection of NPS causes discomfort because of its invasive collection procedure.
Effect of Long-Term and Short-Term Imbalanced Zn Manipulation on Gut Microbiota and Screening for Microbial Markers Sensitive to Zinc Status
Authors: Chen Lingjun , Wang Zhonghang , Wang Peng , Yu Xiaonan , Ding Haoxuan , Wang Zinan , Feng Jie
Published: November 2021

Zn insufficiency is an essential health problem in developing countries. To prevent the occurrence of zinc deficit, zinc fortification and supplementation are widely used.
6-Thioguanine Inhibits Herpes Simplex Virus 1 Infection of Eyes
Authors: Chen Deyan , Liu Ye , Zhang Fang , You Qiao , Ma Wenyuan , Wu Jing , Wu Zhiwei
Published: November 2021

We reported the discovery of 6-TG inhibition of HSV-1 infection and its inhibitory roles in HSK both
in vitro
and
in vivo
. 6-TG was shown to possess at least 10× more potent inhibitory activity against HSV-1 than ACV and GCV and, more importantly, inhibit ACV/GCV-resistant mutant viruses. Animal model studies showed that gel-formulated 6-TG topically applied to eyes locally infected with HSV-1 could significantly inhibit HSV-1 replication, alleviate virus-induced HSK pathogenesis, and improve eye conditions.
Protocol for pragmatic randomised trial: integrating electronic health record-based behavioural economic ‘nudges’ into the electronic health record to reduce preoperative testing for patients undergoing cataract surgery
Authors: Ahmadi Alast , Sorensen Andrea , Villaflores Chad Wes A , Mafi John N , Vangala Sitaram S , Hofer Ira S , Bartlett John D , Cheng Eric M , Duval Victor F , Damberg Cheryl , Elashoff David , Goldstein Noah J , Ladapo Joseph A , Moore James M , Pessegueiro Antonio M , Shu Suzanne B , Skootsky Samuel A , Turner Ashley , Sarkisian Catherine A
Published: November 2021

Introduction

Robust randomised trial data have shown that routine preoperative (pre-op) testing for cataract surgery patients is inappropriate. While guidelines have discouraged testing since 2002, cataract pre-op testing rates have remained unchanged since the 1990s. Given the challenges of reducing low-value care despite strong consensus around the evidence, innovative approaches are needed to promote high-value care. This trial evaluates the impact of an interdisciplinary electronic health record (EHR) intervention that is informed by behavioural economic theory.

Methods and analysis

This pragmatic randomised trial is being conducted at UCLA Health between June 2021 and June 2022 with a 12-month follow-up period. We are randomising all UCLA Health physicians who perform pre-op visits during the study period to one of the three nudge arms or usual care. These three nudge alerts address (1) patient harm, (2) increased out-of-pocket costs for patients and (3) psychological harm to the patients related to pre-op testing. The nudges are triggered when a physician starts to order a pre-op test. We hypothesise that receipt of a nudge will be associated with reduced pre-op testing. The primary outcome will be the change in the percentage of patients undergoing pre-op testing at 12 months. Secondary outcomes will include the percentage of patients undergoing specific categories of pre-op tests (labs, EKGs, chest X-rays (CXRs)), the efficacy of each nudge, same-day surgery cancellations and cost savings.

Ethics and dissemination

The study protocol was approved by the institutional review board of the University of California, Los Angeles as well as a nominated Data Safety Monitoring Board. If successful, we will have created a tool that can be disseminated rapidly to EHR vendors across the nation to reduce inappropriate testing for the most common low-risk surgical procedures in the country.

Trial registration number

ClinicalTrials.gov identifier:NCT04104256.
Which older Brazilians will accept a COVID-19 vaccine? Cross-sectional evidence from the Brazilian Longitudinal Study of Aging (ELSI-Brazil)
Authors: Macinko James , Seixas Brayan V , Mambrini Juliana Vaz de Melo , Lima-Costa M Fernanda
Published: November 2021

Objectives

Vaccine hesitancy may represent a barrier to effective COVID-19 immunisation campaigns. This study assesses individual, disease-specific and contextual factors associated with COVID-19 vaccine acceptance among a nationally representative sample of older Brazilian adults.

Design

Cross-sectional analysis of data from household interviews and a supplementary telephone survey.

Setting

Brazil and its five geographic regions.

Participants

Data are derived from 6584 individuals aged 50 years and over who participated in the second wave of the Brazilian Longitudinal Study of Aging.

Primary and secondary outcome measures

Survey-weighted multinomial logistic regression assesses factors associated with intending, not intending or being uncertain about one’s intention to vaccinate against COVID-19.

Findings

Seventy-one per cent of study participants intend to receive a COVID-19 vaccine once available, while 17% (representative of nearly 9 million people) have no intention to vaccinate, and 12% are still undecided. Besides age, demographic and health-related factors related to COVID-19 severity and complications were not associated with intention to vaccinate. Those who most trusted social media or friends and family for COVID-19 information and those who did not trust any information source were 68% and 78% more likely to refuse vaccination, respectively, as compared with those who trusted official information sources. People who inconsistently used face masks when outside were 3.4 times more likely than consistent face mask users to intend to refuse vaccination. Higher municipal COVID-19 fatality rates were negatively associated with vaccine refusal.

Conclusions

Most national COVID-19 immunisation strategies identify older individuals as among those prioritised for early vaccination, given their increased risk of more severe symptoms and complications of the disease. Because individual, disease-specific, and contextual factors were associated with vaccine acceptance, there is a clear need for multilevel and multichannel information and outreach campaigns to increase COVID-19 vaccine acceptance among vulnerable older populations.
Analysis of multimorbidity networks associated with different factors in Northeast China: a cross-sectional analysis
Authors: Yu Jianxing , Li Yingying , Zheng Zhou , Jia Huanhuan , Cao Peng , Qiangba Yuzhen , Yu Xihe
Published: November 2021

Objectives

This study aimed to identify and study the associations and co-occurrence of multimorbidity, and assessed the associations of diseases with sex, age and hospitalisation duration.

Design

Cross-sectional.

Setting

15 general hospitals in Jilin Province, China.

Participants

A total of 431 295 inpatients were enrolled through a cross-sectional study in Jilin Province, China.

Primary outcome measures

The complex relationships of multimorbidity were presented as weighted networks.

Results

The distributions of the numbers of diseases differed significantly by sex, age and hospitalisation duration (p<0.001). Cerebrovascular diseases (CD), hypertensive diseases (HyD), ischaemic heart diseases (IHD) and other forms of heart disease (OFHD) showed the highest weights in the multimorbidity networks. The connections between different sexes or hospitalisation duration and diseases were similar, while those between different age groups and diseases were different.

Conclusions

CD, HyD, IHD and OFHD were the central points of disease clusters and directly or indirectly related to other diseases or factors. Thus, effective interventions for these diseases should be adopted. Furthermore, different intervention strategies should be developed according to multimorbidity patterns in different age groups.
Cost-effectiveness of custom-made insoles versus usual care in patients with plantar heel pain in primary care: cost-effectiveness analysis of a randomised controlled trial
Authors: Rasenberg Nadine , van Middelkoop Marienke , Bierma-Zeinstra Sita M A , El Alili Mohamed , Bindels Patrick , Bosmans J
Published: November 2021

Objectives

To evaluate the cost-effectiveness of custom-made insoles compared with general practitioner (GP)-led usual care after 26 weeks of follow-up in individuals with plantar heel pain (PHP) from a societal perspective.

Design

Cost-effectiveness analysis of a double-blinded randomised controlled trial.

Setting

General practice in the Netherlands.

Participants

116 participants with PHP for at least 2 weeks, aged 18–65 years and presenting to the GP.

Interventions

Participants were randomised to GP-led usual care (n=46) or referral to a podiatrist for treatment with a custom-made insole (n=70). Participant randomised to a sham insole (n=69) were excluded from this analysis.

Primary and secondary outcomes

Outcomes comprised pain during rest and activity, and quality of life. Costs included healthcare and lost productivity costs. Statistical uncertainty was estimated using bootstrapping and presented using cost-effectiveness acceptability curves.

Results

Participants in the custom-made insole group experienced statistically significant more pain during activity at 26 weeks than participants in the usual care group (overall effect 1.06; 95% CI 0.36 to 1.75). There were no significant differences between groups in other outcomes. Total societal costs in the custom-made insole group were non-significantly higher than in the usual care group (mean difference €376; 95% CI −€1775 to €2038). The intervention with custom-made insoles was dominated by usual care by the GP (ie, more expensive and less effective) for pain during activity and quality of life outcomes. For the outcome pain at rest, the intervention was more expensive and more effective than usual care. However, the maximum probability of cost-effectiveness was only 0.59 at very high ceiling ratios.

Conclusions

These findings show that that custom-made insoles are not cost-effective in comparison with GP-led usual care. Clinicians should be reserved in prescribing custom-made insoles for PHP as a primary intervention.

Trial registration number

NTR5346.
ROBOCOP II (ROBOtic assisted versus conventional open partial nephrectomy) randomised, controlled feasibility trial: clinical trial protocol
Authors: Kowalewski Karl-Friedrich , Sidoti Abate Marie Angela , Neuberger Manuel , Kirchner Marietta , Krisam Regina , Egen Luisa , Haney Caelan Max , Siegel Fabian , Michel Maurice-Stephan , Honeck Patrick , Nuhn Philipp , Westhoff Niklas , Kriegmair Maximilian Christian
Published: November 2021

Introduction

Randomised controlled trials comparing robotic-assisted partial nephrectomy (RAPN) and open PN (OPN) are lacking. Therefore, we aim to report the study protocol and a trial update for a randomised controlled feasibility trial comparing RAPN versus OPN for renal neoplasms.

Methods and analysis

The ROBOtic assisted versus conventional Open Partial nephrectomy II trial is designed as a single-centre, randomised, open-label, feasibility trial. Participation will be offered to patients with renal neoplasms and deemed feasible for both, OPN and RAPN. We aim to enrol 50 patients within 15 months using a 1:1 allocation ratio. The primary endpoint of the trial is feasibility of recruitment and will be successful if one third of eligible patients agree to participate. Secondary endpoints include perioperative results, health-related quality of life, inflammatory response as well as surgical ergonomics of the operating team. If the primary outcome, feasibility of recruitment, is successful, the secondary results of the trial will be used for planning a confirmative phase III trial.

Ethics and dissemination

Ethical approval was obtained from the local institutional review board (Ethik-Kommission II at Heidelberg University: 2020-542N). Results will be made publicly available in peer-reviewed scientific journals and presented at appropriate congresses and social media.

Trial registration number

NCT04534998.
What are healthcare workers’ preferences for hand hygiene interventions? A discrete choice experiment
Authors: Chen Wenlin , Tseng Chung-Li
Published: November 2021

Objectives

To understand the key attributes in designing effective interventions for improving healthcare workers’ (HCWs’) hand hygiene compliance and HCWs’ preference for these attributes.

Design

A discrete choice experiment (DCE) was conducted with five attributes extracted from the framework of Total Quality Management that can be applied in the design of hand hygiene interventions. They were hand hygiene monitoring, open discussion, message framing, resources accessibility and top management involvement. An addition attribute, peer hand hygiene performance, was considered as a contextual factor. Data were analysed by a conditional logit model to evaluate how these attributes impact HCWs’ hand hygiene compliance.

Setting

The DCE was conducted with participants from a university hospital in Taichung.

Participants

HCWs involved in daily patient-care activities (N=387).

Results

To enhance their compliance, HCWs had strong and consistent preferences in having open discussion of hand hygiene problems (β=0.4977,p§amp;lt;0.001), easy access to hand hygiene resources (β=0.5633,p§amp;lt;0.001) and top management involvement (β=0.4779,p§amp;lt;0.001). For hand hygiene monitoring (β=-0.1259,p§amp;lt;0.1), HCWs preferred to be monitored by infection control staff over their department head if their peer hand hygiene performance was low. On the other hand, when the peer performance was high, monitoring by their department head could improve their hand hygiene compliance. Similarly, how educational messages were framed impacted compliance and also depended on the peer hand hygiene performance. When the peer performance was low, HCWs were more likely to increase their compliance in reaction to loss-framed educational messages (β=0.1211,p§amp;lt;0.1). When the peer performance was high, gain-framed messages that focus on the benefit of compliance were more effective in inducing compliance.

Conclusions

Each intervention design has its unique impact on HCWs’ hand hygiene compliant behaviour. The proposed approach can be used to evaluate HCWs’ preference and compliance of an intervention before it is implemented.
Sex ratios and ‘missing women’ among Asian minority and migrant populations in Aotearoa/New Zealand: a retrospective cohort analysis
Authors: Simon-Kumar Rachel , Paynter Janine , Chiang Annie , Chabba Nimisha
Published: November 2021

Objectives

Recent research from the UK, USA, Australia and Canada point to male-favouring sex ratios at birth (SRB) among their Asian minority populations, attributed to son preference and sex-selective abortion within these cultural groups. The present study conducts a similar investigation of SRBs among New Zealand’s Asian minority and migrant populations, who comprise 15% of the population.

Setting and participants

The study focused on Asian populations of New Zealand and comparisons were made with NZ European, Māori, Pacific Island and Middle-Eastern, Latin American and African groups. Secondary data were obtained from the New Zealand historical census series between 1976 and 2013 and a retrospective birth cohort in New Zealand was created using the Stats NZ Integrated Data Infrastructure from 2003 to 2018.

Primary and secondary outcome measures

The primary outcome measure was SRBs and sex ratios between the ages 0 and 5 by ethnicity. A logistic regression was conducted and adjusted for selected variables of interest including visa group, parity, maternal age and deprivation. Finally, associations between family size, ethnicity and family sex composition were examined in a subset of this cohort (families with two or three children).

Results

There was no evidence of ‘missing women’ or gender bias as indicated by a deviation from the biological norm in New Zealand’s Asian population. However, Indian and Chinese families were significantly more likely to have a third child if their first two children were female compared with two male children.

Conclusion

The analyses did not reveal male-favouring sex ratios and any conclusive evidence of sex-selective abortion among Indian and Chinese populations. Based on these data, we conclude that in comparison to other western countries, New Zealand’s Asian migrant populations present as an anomaly. The larger family sizes for Indian and Chinese populations where the first two children were girls suggested potentially ‘soft’ practices of son preference.
Risk of infection and contribution to transmission of SARS-CoV-2 in school staff: a systematic review
Authors: Karki Sudip Jung , Joachim Alexandar , Heinsohn Torben , Lange Berit
Published: November 2021

Objective

To summarise the comparative risk of infection in school staff and their contribution to SARS-CoV-2 transmission.

Design

Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

Data sources

MEDLINE, WHO COVID-19 database and preView were searched on 29 January 2021.

Eligibility criteria

We included studies that reported risk of SARS-CoV-2 infection in school staff or transmission of SARS-CoV-2 in school settings.

Data extraction and synthesis

Data extraction was done in duplicates. Data synthesis was qualitative. We report attack rates and infection risk in school settings for staff and students stratified by control measures taken and infection dynamics at the point of data collection.

Results

Eighteen studies were included. Three studies in low incidence settings showed low attack rates similar for teachers and students. Five studies in medium incidence settings and two studies in high incidence settings showed secondary attack rates up to 16% in school staff.

Seroprevalence studies, two in each low and high incidence settings showed an infection risk of 0%–0.2% and 1.7%–28% for teachers.

The risk of infection for teachers compared with students were similar in one study in low incidence setting, higher in three studies (RR 1.2–4.4) and lower in three studies in medium to high incidence settings. The risk of infection for teachers in a high infection environment is higher in face-to-face than in distance classes when compared with general population groups. The risk of infections as well as risk of hospitalisation both increased for teachers during school openings compared with school closure.

Conclusion

While in low incidence settings there is little evidence for school staff to be at high risk of SARS-CoV-2 infection, in high incidence settings there is an increased risk of SARS-CoV-2 infection in school staff teaching face-to-face compared to staff teaching digitally and general population.

PROSPERO registration number

CRD42021239225.
Characteristics, interventions and outcomes of patients with valvular heart disease hospitalised in China: a cross-sectional study
Authors: Huang Xinghe , Dhruva Sanket S , Yuan Xin , Bai Xueke , Lu Yuan , Yan Xiaofang , Liu Jiamin , Li Wei , Hu Danli , Ji Runqing , Gao Min , Miao Fengyu , Li Jiaying , Ge Jinzhuo , Krumholz Harlan M , Li Jing
Published: November 2021

Objectives

Little is known about contemporary characteristics and management of valvular heart disease (VHD) in China. This study aimed to examine the clinical characteristics, aetiology and type of VHD, interventions and in-hospital outcomes of patients with VHD hospitalised in China.

Methods

We used a two-stage random sampling design to create a nationally representative sample of patients with VHD hospitalised in 2015 in China and included adult patients with mild, moderate or severe VHD. We abstracted data from medical records, including echocardiogram reports, on patient characteristics, aetiology, type and severity of VHD, interventions and in-hospital outcomes. We weighted our findings to estimate nationally representative hospitalisations. We performed multivariable logistic regression analysis to identify factors associated with valve intervention.

Results

In 2015, 38 841 patients with VHD were hospitalised in 188 randomly sampled hospitals, representing 662 384 inpatients with VHD in China. We sampled 9363 patients, mean age 68.7 years (95% CI 42.2 to 95.2) and 46.8% (95% CI 45.8% to 47.8%) male, with an echocardiogram. Degenerative origin was the predominant aetiology overall (33.3%, 95% CI 32.3% to 34.3%), while rheumatic origin was the most frequent aetiology among patients with VHD as the primary diagnosis (37.4%, 95% CI 35.9% to 38.8%). Rheumatic origin was also the most common aetiology among patients with moderate or severe VHD (27.3%, 95% CI 25.6% to 29.0% and 33.6%, 95% CI 31.9% to 35.2%, respectively). The most common VHD was mitral regurgitation (79.1%, 95% CI 78.2% to 79.9%), followed by tricuspid regurgitation (77.4%, 95% CI 76.5% to 78.2%). Among patients with a primary diagnosis of severe VHD who were admitted to facilities capable of valve intervention, 35.6% (95% CI 33.1% to 38.1%) underwent valve intervention during the hospitalisation. The likelihood of intervention decreased significantly among patients with higher operative risk.

Conclusions

Among patients with VHD hospitalised in China, the predominant aetiology was degenerative in origin; among patients with moderate or severe VHD, rheumatic origin was the most common aetiology. Targeted strategies and policies should be promoted to address degenerative VHD. Patients with severe VHD may be undertreated, particularly those with high operative risk.
Evaluation of an early career clinical academic training programme using the CIPP model
Authors: Burke Elaine , Hennessy Martina
Published: November 2021

Objectives

This study describes the successful implementation and outputs of a combined clinical academic training programme for doctors in their first postgraduate year in Ireland, the Academic Internship Track (AIT).

Design

The AIT was evaluated using the Context, Input, Process and Product model. Literature reviews, meetings with key stakeholders, reviews of similar established programmes overseas, a survey of undergraduate medical students, exit survey, scientific outputs and career trajectory monitoring were all implemented in the programme evaluation.

Setting

The AIT represents collaboration amongst all six intern training networks in Ireland.

Results

Key stakeholders indicated support and significant interest in establishing the AIT. The input evaluation informed programme design which incorporates protected time to carry out a research project, a named supervisor, a bursary and access to dedicated study days. Since the programme’s launch in 2017, there has been 100% uptake of posts and 0% attrition. Exiting participants indicate high levels of satisfaction with the programme; 92% reported having benefited from participation. Over 90% intend remaining in Ireland in both the immediate and longer terms. Fifty-seven per cent of participants in the first 3 years of the programme had succeeded in publishing a research article or review paper in a peer-reviewed journal.

Conclusions

Now in its fourth year, AIT remains a highly sought-after programme and is perceived to be beneficial to one’s career. Participants in the programme have contributed significantly to their field of interest despite being in the earliest career stages. The programme has the potential to help retain medical talent in Ireland.
Healthcare utilisation of patients with cholecystolithiasis in primary care: a multipractice comparative analysis
Authors: Thunnissen Floris Martijn , Drager Luuk David , Braak Breg , Drenth Joost P H , van Laarhoven Cornelis J H M , Schers Henk J , de Reuver Philip R
Published: November 2021

Objectives

To examine general practitioners’ (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis.

Design

Retrospective analysis of registry data and a subset of individual medical records.

Setting

Seventeen primary care practices affiliated with the Radboudumc Practice Based Research Network in the Netherlands.

Participants

633 patients with cholecystolithiasis diagnosed between 2012 and 2016.

Primary and secondary outcome measures

The primary outcome of this study was the healthcare utilisation of patients with cholecystolithiasis diagnosed by the GP in terms of referrals to secondary care, laboratory diagnostics, prescribed medication and the prevalence of concomitant abdominal-related diagnoses in a time interval of 3 years before and 3 years after diagnosis of cholecystolithiasis. For secondary outcomes, electronic medical records were studied from seven practices to assess emergency department visits, operation rates and repeat visits for persistent abdominal symptoms. We compared the non-referred group with the referred group.

Results

In 57% of patients, concomitant abdominal-related diagnoses were recorded besides the diagnosis cholecystolithiasis. In-depth analyses of 294 patients showed a referral rate of 79.3% (n=233); 62.9% (n=185) underwent cholecystectomy. After referral, 55.4% (129/233) returned to the GP for persistent abdominal symptoms. Patients returning after referral were more often treated for another abdominal-related diagnosis before cholecystolithiasis was recorded (51.9% vs 28.8%, p<0.001).

Conclusions

The majority of patients in general practice with gallstones are referred and undergo cholecystectomy. Patients with concomitant abdominal-related diagnoses are likely to return to their physician. GPs should inform patients about these outcomes to improve the shared decision-making process before gallbladder surgery.
Preparing social workers to address health inequities emerging during the COVID-19 pandemic by building capacity for health policy: a scoping review protocol
Authors: Ashcroft Rachelle , Lam Simon , Kourgiantakis Toula , Begun Stephanie , Nelson Michelle L A , Adamson Keith , Cadell Susan , Walsh Benjamin , Greenblatt Andrea , Hussain Amina , Sur Deepy , Sirotich Frank , Craig Shelley L
Published: November 2021

Introduction

The COVID-19 pandemic has brought tremendous changes in healthcare delivery and exacerbated a wide range of inequities. Social workers across a broad range of healthcare settings bring an expertise in social, behavioural and mental healthcare needed to help address these health inequities. In addition, social workers integrate policy-directed interventions and solutions in clinical practice, which is a needed perspective for recovery from the COVID-19 pandemic. It remains unclear, however, what the most pressing policy issues are that have emerged during the COVID-19 pandemic. In addition, many social workers in health settings tend to underuse policy in their direct practice. The objectives of this scoping review are to: (1) systematically scope the literature on social work, COVID-19 pandemic and policy; and (2) describe the competencies required by social workers and the social work profession to address the policy issues emerging during the COVID-19 pandemic.

Methods and analysis

The scoping review follows Arksey and O’Malley’s five-stage framework. Identification of literature published between 1 December 2019 and the search date, 31 March 2021, will take place in two stages: (1) title and abstract review, and (2) full-text review. In partnership with a health science librarian, the research team listed keywords related to social work and policy to search databases including Medline, Embase, PsycINFO, CINAHL, Social Services Abstract and Social Work Abstracts. Two graduate-level research assistants will conduct screening and full-text review. Data will then be extracted, charted, analysed and summarised to report on our results and implications on practice, policy and future research.

Ethics and dissemination

Results will help develop a policy practice competence framework to inform how social workers can influence policy. We will share our findings through peer-reviewed publications and conference presentations. This study does not require Research Ethics Board approval as it uses publicly available sources of data.
Efficacy of anti-TNF dosing interval lengthening in adolescents and young adults with inflammatory bowel disease in sustained remission (FREE-study): protocol for a partially randomised patient preference trial
Authors: Bouhuys Marleen , Lexmond Willem S , Dijkstra Gerard , Lobatón Triana , Louis Edouard , van Biervliet Stephanie , Groen Henk , Guardiola Jordi , Rheenen Patrick van
Published: November 2021

Introduction

Anti-tumour necrosis factor (TNF) therapy has greatly improved treatment outcomes in patients with inflammatory bowel disease (IBD), but long-term use is associated with cutaneous reactions, susceptibility to infections and frequent injections or hospital visits. Several non-controlled studies have demonstrated that dose reduction is feasible for a subset of patients, provided that early detection of a disease flare is possible. Here, we aim to compare the effectiveness of interval lengthening with standard dosing in maintaining remission in young patients with IBD.

Methods and analysis

In this international, prospective, non-inferiority, partially randomised patient preference trial, we aim to recruit 148 patients aged 12–25 years with luminal Crohn’s disease or ulcerative colitis in sustained remission (ie, three consecutive in-range faecal calprotectin (FC) results or recently confirmed endoscopic remission). In the interventional arm, the dosing interval will be lengthened from 8 to 12 weeks for infliximab users and from 2 to 3 weeks for adalimumab users. In the control group, standard dosing will be continued. Rapid tests will be performed for FC every 4 weeks and for anti-TNF trough levels every 12 weeks. The primary outcome is the cumulative incidence of out-of-range FC results at 48-week follow-up. Secondary endpoints include time to get out-of-range FC results, cumulative incidence of adverse effects, proportion of patients progressing to loss of response and identification of predictors of successful interval lengthening.

Ethics and dissemination

The protocol has been approved by the Medical Ethics Review Committee of the University Medical Centre Groningen and is pending at the other participating centres. Results will be disseminated in peer-reviewed journals and presented at scientific meetings.

Trial registration number

EudraCT number: 2020-001811-26; ClinicalTrials.gov Identifier:NCT04646187. Protocol version 4, date 17 September 2021.
Why are physical restraints still in use? A qualitative descriptive study from Chinese critical care clinicians’ perspectives
Authors: Cui Nianqi , Qiu Ruolin , Zhang Yuping , Chen Dandan , Zhang Hui , Rao Hongyu , Jin Jingfen
Published: November 2021

Objectives

To understand why critical care clinicians still implement physical restraints, to prevent unplanned extubation and to explore the driving factors influencing the decision-making of physical restraints use.

Design

A qualitative descriptive design was used. The data were collected through one-to-one, semistructured interviews and analysed through the framework of thematic analysis.

Participants and setting

The study was conducted from December 2019 to May 2020 at one general intensive care unit (ICU) and one emergency ICU in a general tertiary hospital with 3200 beds in Hangzhou, China. The sampling strategy was combined maximum variation sampling and criterion sampling.

Results

A total of 14 clinicians participated in the study. The reason why critical care clinicians implemented physical restraints to prevent unplanned extubation was that the tense healthcare climate was caused by family members’ rejection of mismatched expectations. As unplanned extubation was highly likely to create medical disputes, hospitals placed excessive emphasis on unplanned extubation, which resulted in a lack of analysis of the cause of unplanned extubation and strict measures for dealing with unplanned extubation. The shortage of nursing human resources, unsuitable ward environments, intensivists’ attitudes, timely extubation for intensivists, nurse experiences and the patient’s possibility of unplanned extubation all contributed to the decision-making resulting in the use of physical restraints.

Conclusions

Although nurses played a crucial role in the decision-making process of using physical restraints, changing the healthcare climate and the hospital management mode for unplanned extubation are fundamental measures to reduce physical restraints use.
Call to action: empowering patients and families to initiate clinical ethics consultations
Authors: Blackler Liz , Scharf Amy E , Matsoukas Konstantina , Colletti Michelle , Voigt Louis P
Published: November 2021

Clinical ethics consultations exist to support patients, families and clinicians who are facing ethical or moral challenges related to patient care. They provide a forum for open communication, where all stakeholders are encouraged to express their concerns and articulate their viewpoints. Ethics consultations can be requested by patients, caregivers or members of a patient’s clinical or supportive team. Althoughpatientsand by extension their families (especially in cases of decisional incapacity) are the common denominators in most ethics consultations, these constituents are theleastlikely to request them. At many healthcare organisations in the USA, ethics consultations are overwhelmingly requested by physicians and other clinicians. We believe it is vital that healthcare institutions bridge the knowledge gaps and power imbalances over access to ethics consultation services through augmented policies, procedures and infrastructure. With enhanced education and support, patients and families may use ethics consultation to elevate their voices and prioritise their unique characteristics and preferences in the delivery of their healthcare. Empowering patients and families to request ethics consultation can only strengthen the patient/family–clinician relationship, enhance the shared decision-making model of care and ultimately lead to improved patient-centred care.
Impact of anesthetic strategy on outcomes for patients with acute basilar artery occlusion undergoing mechanical thrombectomy
Authors: Li Fengli , Wan Junfang , Song Jiaxing , Yuan Junjie , Kong Weilin , Huang Jiacheng , Luo Weidong , Wu Deping , Li Linyu , Chen Luming , Zhao Chenghao , Chen Jin , Tao Hui , Sang Hongfei , Qiu Zhongming , Zi Wenjie , Yang Qingwu , Chen Xingyu , Li Hong , Peng Feng
Published: November 2021

Background

The best anesthetic management strategy for patients with acute large vessel occlusion treated with mechanical thrombectomy (MT) remains uncertain. Most studies have focused on anterior–circulation stroke caused by large artery occlusion. Nevertheless, limited data are available on the appropriate choice of anesthetic for acute basilar artery occlusion (BAO). We aimed to investigate the effect of anesthetic method on clinical outcomes in patients with BAO undergoing MT.

Methods

Patients undergoing MT for acute BAO in the BASILAR registry (Acute Basilar Artery Occlusion Study) were included. We divided patients into three groups according to the anesthetic technique used during MT: general anesthesia (GA), local anesthesia (LA), and conscious sedation (CS). Propensity score matching was performed to achieve baseline balance.

Results

639 patients were included. GA was used in 257 patients (40.2%), LA was used in 250 patients (39.1%), and CS was used in 132 patients (20.7%). After 1:1 matching, favorable outcome, mortality, and hemorrhagic transformation rates, as well as modified Rankin Scale (mRS) score at 90 days, did not differ between the GA, LA, and CS groups.

Conclusions

The choice of anesthetic strategy, GA, LA, or CS, did not affect the clinical outcomes of patients with acute BAO treated with MT in the BASILAR registry.
Endoluminal flow diverting stents for middle cerebral artery bifurcation aneurysms: multicenter cohort
Authors: Salem Mohamed M , Khorasanizadeh Mirhojjat , Lay Sovann V , Renieri Leonardo , Kuhn Anna L , Sweid Ahmad , Massari Francesco , Moore Justin M , Tjoumakaris Stavropoula I. , Jabbour Pascal , Puri Ajit S , Ogilvy Christopher S , Jankowitz Brian T , Burkhardt Jan-Karl , Kan Peter , Limbucci Nicola , Cognard Christophe , Thomas Ajith J
Published: November 2021

Background

Data regarding the safety and efficacy of flow diverting stents (FDS) in the treatment of middle cerebral artery (MCA) bifurcation aneurysms are scarce and limited to small single center series, with particular concern for increased risk of ischemic complications with jailing one of the M2 branches.

Methods

Prospectively-maintained databases at six North American and European centers were queried for patients harboring MCA bifurcation aneurysms undergoing treatment with FDS (2011–2018). The pertinent clinical and radiographic data were collected and analyzed.

Results

87 patients (median age 60 years, 69% females) harboring 87 aneurysms were included. The majority of aneurysms were unruptured (79%); 75.9% were saccular with a median maximal diameter of 8.5 mm. Radiographic imaging follow-up was available in 88.5% of cases at a median of 16.3 months post-treatment, showing complete occlusion in 59% and near complete occlusion (90–99%) in 18% of aneurysms. The overall rate of ischemic and hemorrhagic complications was 8% and 1.1%, respectively. Symptomatic and permanent complications were encountered in 5.7% and 2.3% of patients respectively, with retreatment pursued in 2.3% of patients. Jailed branch occlusion was detected in 11.5% of cases, with clinical sequelae in 2.3%. Last follow-up modified Rankin Scale of 0–2 was noted in 96.8% of patients. On multivariate analysis, male sex was the only independent predictor of aneurysmal persistence at last follow-up imaging (p=0.019).

Conclusion

FDS treatment for MCA bifurcation aneurysms is feasible, with comparable safety and efficacy profiles to other available endovascular options when utilized in carefully selected aneurysms. Jailing of M2 branches was not associated with a higher risk of post-procedural ischemic complications.
Effect of sub-inhibitory concentrations of cefepime on biofilm formation by Pseudomonas aeruginosa
Authors: Hagras Soheir A.A. , Hosny Alaa El-Dien M.S. , Helmy Omneya M. , Salem-Bekhit Mounir M. , Shakeel Faiyaz , Farrag Hala A.
Published: November 2021

This study investigated the effect of cefepime at sub-minimum inhibitory concentrations (sub-MICs) on in vitro biofilm formation (BF) by clinical isolates of Pseudomonas aeruginosa. The effect of cefepime at sub-MIC levels (½–1/256 MIC) on in vitro BF by six clinical isolates of P. aeruginosa was phenotypically assessed following 24 and 48 h of challenge using the tissue culture plate (TCP) assay. Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to observe the change in expression of three biofilm-related genes, namely, a protease-encoding gene (lasA), fimbrial protein-encoding gene (cupA1), and alginate-encoding gene (algC), in a weak biofilm-producing strain of P. aeruginosa following 24 and 48 h of challenge with sub-MICs of cefepime. The BF morphology in response to cefepime was imaged using scanning electron microscopy (SEM). The TCP assay showed strain-, time-, and concentration-dependent changes in in vitro BF in P. aeruginosa following challenge with sub-MICs of cefepime, with a profound increase in strains with inherently no or weak biofilm-producing ability. RT-PCR revealed time-dependent upregulation in the expression of the investigated genes following challenge with ½ and ¼ MIC levels, as confirmed by SEM. Cefepime at sub-MICs could upregulate the expression of BF-related genes and enhance BF by P. aeruginosa clinical isolates.
Exploring neutrino–nucleus interactions in the GeV regime using MINERvA
Authors: Lu X.-G. , Dar Z. Ahmad , Akbar F. , Andrade D. A. , Ascencio M. V. , Barr G. D. , Bashyal A. , Bellantoni L. , Bercellie A. , Betancourt M. , Bodek A. , Bonilla J. L. , Budd H. , Caceres G. , Cai T. , Carneiro M. F. , da Motta H. , Díaz G. A. , Felix J. , Fields L. , Filkins A. , Fine R. , Gago A. M. , Gallagher H. , Gilligan S. M. , Gran R. , Harris D. A. , Henry S. , Jena D. , Jena S. , Kleykamp J. , Klustová A. , Kordosky M. , Last D. , Lozano A. , Maher E. , Manly S. , Mann W. A. , Mauger C. , McFarland K. S. , McGowan A. M. , Messerly B. , Miller J. , Morfín J. G. , Naples D. , Nelson J. K. , Nguyen C. , Olivier A. , Paolone V. , Perdue G. N. , Plows K.-J. , Ramírez M. A. , Ransome R. D. , Ray H. , Rodrigues P. A. , Ruterbories D. , Schellman H. , Salinas C. J. Solano , Su H. , Sultana M. , Syrotenko V. S. , Valencia E. , Waldron A. V. , Wark D. , Weber A. , Yang K. , Zazueta L. ,   (The MINERνA Collaboration)
Published: November 2021

With the advance of particle accelerator and detector technologies, the neutrino physics landscape is rapidly expanding. As neutrino oscillation experiments enter the intensity and precision frontiers, neutrino–nucleus interaction measurements are providing crucial input. MINERvA is an experiment at Fermilab dedicated to the study of neutrino–nucleus interactions in the regime of incident neutrino energies from one to few GeV. The experiment recorded neutrino and antineutrino scattering data with the NuMI beamline from 2009 to 2019 using the Low-Energy and Medium-Energy beams that peak at 3GeV and 6GeV, respectively. This article reviews the broad spectrum of interesting nuclear and particle physics that MINERvA investigations have illuminated. The newfound, detailed knowledge of neutrino interactions with nuclear targets thereby obtained is proving essential to continued progress in the neutrino physics sector.
About this title - Carbon Cycle and Ecosystem Response to the Jenkyns Event in the Early Toarcian (Jurassic)
Authors: Reolid M. , Duarte L. V. , Mattioli E. , Ruebsam W.
Published: November 2021

The Toarcian Oceanic Anoxic Event, also known as the Jenkyns Event, was a hyperthermal episode which occurred during the early Toarcian (c. 183 Ma; Early Jurassic) and resulted in numerous collateral effects including global warming, enhanced weathering, sea-level change, carbonate crisis, marine anoxia–dysoxia, and a second-order mass extinction. This volume presents the last advances for understanding early Toarcian environmental changes through different disciplines: biostratigraphy, micropalaeontology, palaeontology, ichnology, palaeoecology, sedimentology, integrated stratigraphy, inorganic, organic and isotopic geochemistry, and cyclostratigraphy. The study of this abrupt climate change is critical for predicting future global changes, and for understanding the complex biogeochemical interactions through time between geosphere, atmosphere, hydrosphere and biosphere.
A ReRAM Memory Compiler for Monolithic 3D Integrated Circuits in a Carbon Nanotube Process
Authors: Lee Edward , Kim Daehyun , Kim Jinwoo , Lim Sung Kyu , Mukhopadhyay Saibal
Published: November 2021

We present a ReRAM memory compiler for monolithic 3D (M3D) integrated circuits (IC). We develop ReRAM architectures for M3D ICs using 1T-1R bit cells and single and multiple tiers of transistors for access and peripheral circuits. The compiler includes an automated flow for generation of subarrays of different dimensions and larger arrays of a target capacity by integrating multiple subarrays. The compiler is demonstrated using an M3D process design kit (PDK) based on a Carbon Nanotube Transistor technology. The PDK includes multiple layers of transistors and back-end-of-the-line integrated ReRAM. Simulations show the compiled ReRAM macros with multiple tiers of transistors reduces footprint and improves performance over the macros with single-tier transistors. The compiler creates layout views that are exported into library exchange format or graphic data system for full-array assembly and schematic/symbol views to extract per-bit read/write energy and read latency. Comparison of the proposed M3D subarray architectures with baseline 2D subarrays, generated with a custom-designed set of bit cells and peripherals, demonstrate up to 48% area reduction and 13% latency improvement.