bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of daily 3‐s maximum voluntary isometric, concentric, or eccentric contraction on elbow flexor strength
Authors: Sato Shigeru , Yoshida Riku , Murakoshi Fu , Sasaki Yuto , Yahata Kaoru , Nosaka Kazunori , Nakamura Masatoshi
Published: February 2022

The present study compared a 3‐s isometric maximal voluntary contraction (MVC), concentric MVC and eccentric MVC of the elbow flexors performed daily for 5 days a week for 4 weeks for changes in muscle strength and thickness. Young sedentary individuals were assigned to one of three training groups (n = 13 per group) that performed either 3‐s isometric, concentric, or eccentric MVC once a day for 20 days, or to a control group (n = 10) that had measurements without training. The participants in the isometric group performed isometric MVC at 55° (0.96 rad) elbow flexion, and those in the concentric or eccentric group performed concentric MVC or eccentric MVC between 10° (0.17 rad) and 100° (1.75 rad) elbow flexion at 30°/s (0.52 rad/s) on an isokinetic dynamometer. MVC isometric torque at 20° (0.35 rad), 55° (0.96 rad), and 90° (1.57 rad) elbow flexion, MVC concentric and eccentric torque at 30°/s (0.52 rad/s) and 180°/s (3.14 rad/s), and muscle thickness (MT) of biceps brachii and brachialis were measured before and several days after the 20th exercise session. The control group did not show any changes. The eccentric group showed increases (p < 0.01) in isometric (three angle average: 10.2 ± 6.4%), concentric (two velocity average: 12.8 ± 9.6%), and eccentric MVC torque (12.2 ± 7.8%). An increase (p < 0.05) was limited for isometric MVC torque (6.3 ± 6.0%) in the concentric group, and for eccentric MVC torque (7.2 ± 4.4%) in the isometric group. No significant changes in MT were evident for all groups. Performing one 3‐s MVC a day increased muscle strength, but eccentric MVC produced more potent effects than isometric or concentric MVC.
The failure mode of a mechanically loaded equine medial femoral condyle analog with a void and the impact of lag and neutral screw placement
Authors: Moreno Caitlin R. , Santschi Elizabeth M. , Younkin Jarrod T. , Larson Robert L. , Litsky Alan S.
Published: February 2022

Objective

To determine the failure method of simulated equine medial femoral condyle (MFC) subchondral bone defects under compression and the influence of screw placement on failure resistance.

Study Design

In vitro study.

Sample Population

Composite disks (CD) simulating the moduli of yearling bone in the MFC.

Methods

Four CD conditions were tested, all with a 12.7 mm void (n = 6 per condition): intact (no void), void only, void with a 4.5 mm screw placed in neutral fashion, and void with a 4.5 mm screw placed in lag fashion. Composite disks of each condition were tested under monotonic compression to 6000 N and cyclic compression to 10 000 cycles. Observable failure, load at first observable failure, and displacement at peak 2000 N load were compared among conditions.

Results

Specimens failed by cracking at the superior aspect of the void or the screw exit hole. After monotonic loading, cracks were observed 6/6 CD with a void, 6/6 CD with a void/lag screw, and 5/6 CD with a void/neutral screw. After cyclical testing, cracks were noted only on the superior aspect of 6/6 CD with a void and 3/6 CD with a void/lag screw. Displacement at peak load was 0.06 mm (intact), 0.32 mm (void), 0.24 mm (void/lag screw), and 0.11 mm (void/neutral screw).

Conclusion

Model MFC voids failed by superior cracking that was resisted by lag and neutral screw placement.

Clinical Significance

Neutral screws may be an acceptable treatment for subchondral lucencies in the MFC.
Diarrhoeal pathogenesis in Salmonella infection may result from an imbalance in intestinal epithelial differentiation through reduced Notch signalling
Authors: Quach Andrew , Jayaratne Rashini R. , Lee Beom Jae , Ibeawuchi Stella‐Rita , Lim Eileen , Das Soumita , Barrett Kim E.
Published: February 2022

Infections with non‐typhoidal Salmonella spp. represent the most burdensome foodborne illnesses worldwide, yet despite their prevalence, the mechanism through which Salmonella elicits diarrhoea is not entirely known. Intestinal ion transporters play important roles in fluid and electrolyte homeostasis in the intestine. We have previously shown that infection with Salmonella caused decreased colonic expression of the chloride/bicarbonate exchanger SLC26A3 (down‐regulated in adenoma; DRA) in a mouse model. In this study, we focused on the mechanism of DRA downregulation during Salmonella infection, by using murine epithelial enteroid‐derived monolayers (EDMs). The decrease in DRA expression caused by infection was recapitulated in EDMs and accompanied by increased expression of Atonal Homolog 1 (ATOH1), the goblet cell marker Muc2 and the enteroendocrine cell marker ChgA. This suggested biased epithelial differentiation towards the secretory, rather than absorptive phenotype. In addition, the downstream Notch effector, Notch intracellular domain (NICD) and Hes1 were decreased following Salmonella infection. The relevance of Notch signalling was further investigated using a γ‐secretase inhibitor, which recapitulated the downregulation in Hes1 and DRA as well as upregulation in ATOH1 and Muc2 seen following infection. Our findings suggest that Salmonella infection may result in a shift from absorptive to secretory cell types through Notch inhibition, which explains why there is a decreased capacity for absorption and ultimately the accumulation of diarrhoeal fluid. Our work also shows the value of EDMs as a model to investigate mechanisms that might be targeted for therapy of diarrhoea caused by Salmonella infection.

Key points

Salmonella is a leading foodborne pathogen known to cause high‐chloride‐content diarrhoea.

Salmonella infection of murine enteroid‐derived monolayers decreased DRA expression.

Salmonella infection resulted in upregulation of the secretory epithelial marker ATOH1, the goblet cell marker Muc2 and the enteroendocrine cell marker ChgA.

Downregulation of DRA may result from infection‐induced Notch inhibition, as reflected by decreased expression of Notch intracellular domain and Hes1, as well as from decreased HNF1α signalling.

The imbalance in intestinal epithelial differentiation favouring secretory over absorptive cell types is a possible mechanism by which Salmonella elicits diarrhoea and may be relevant therapeutically.
Importancia del estado de flujos de efectivo para la gestión financiera sostenible
Authors: Correa García Jaime Andrés , Correa Mejía Diego Andrés
Published: February 2022

El propósito de este artículo es evidenciar las prácticas de presentación del Estado de Flujos de Efectivo (EFE) y los aportes que brinda para la gestión financiera sostenible. Este trabajo se fundamenta en la alta aplicación que tienen los flujos de caja en las finanzas corporativas y en el creciente interés por el EFE a raíz de la reciente implementación de las Normas Internacionales de Información Financiera (NIIF) en Colombia. Apoyados en una muestra de 14.979 empresas, se exponen ocho escenarios de interpretación y análisis basados en el EFE y el Flujo de Caja Libre (FCL) para su aplicación empresarial. En este estudio se aplicó un análisis correlacional multivariado a través del método Biplot que arrojó como resultado que las empresas que generan utilidades netas positivas no necesariamente cuentan con flujos de caja que les permita atender sus acreencias financieras y dividendos. Este trabajo aporta a la literatura académica sobre el estado de flujos de efectivo y sienta las bases para trabajos futuros una vez se consoliden estas nuevas normas en Colombia.
Protective Masks Utilizing Nonendangered Components
Authors: Griffin Linsey , Yu Minji , Cloet Alison , Arnold Susan , Carlson Neil , Hillmyer Marc , Ou Qisheng , Pei Chenxing , Cao Qingfeng , Pui David , Franklin Rhonda , Durfee William
Published: February 2022

At the beginning of the COVID-19 pandemic when traditional N95 respirators were in short supply in the United States, there was a need for alternative products that did not rely on traditional avenues of sourcing and manufacturing. The purpose of this research was to develop and test alternatives to N95 respirators that could be produced locally without specialized materials and processes. Through an interdisciplinary team of experts, new mask designs that use repurposed filtration media and commercially available components were developed and tested for filtration and fit against current N95 standards. Filtration efficiency test results showed that the filtration media can be used for high-quality facemasks and quantitative fit testing demonstrated that the new mask designs could be viable alternatives to traditional N95 facemasks when those masks are in short supply. Manufacturing viability was tested utilizing a workforce to create 6000 masks over 10 days. The ability to quickly produce masks at scale using a workforce without specialized skills demonstrated the feasibility of the mask designs and manufacturing approach to address shortages of critical healthcare equipment, mitigate risk for healthcare and essential workers, and minimize the transmission and spread of disease.
Sport Management Faculty Members’ Mentorship of Student-Athletes
Authors: Warner Stacy M. , Stokowski Sarah , Fridley Alison , Kim Kibaek
Published: February 2022

When compared with other disciplines, sport management educators are more likely to encounter student-athletes in their classrooms. While faculty mentoring is a key to student success for all, better understanding of this mentoring dynamic between sport management faculty and student-athletes is important to advancing pedagogical knowledge within the discipline. And perhaps, even more importantly, it can aid in creating a pathway for faculty advocacy and dispelling stigmas related to student-athletes. Consequently, the Mentor Role Instrument was used to determine if faculty mentorship of student-athletes differs by function type (RQ1) and if this was impacted by gender or faculty appointment (RQ2). An online survey of 88 sport management educators indicated that a significant difference was found, F(8, 783) = 44.16; p < .001, among mentoring function type. Friendship and Acceptance were the most prevalent mentoring functions, while Protection was the least frequent. Results did not indicate that gender or faculty appointment impacted faculty mentorship styles toward student-athletes.
Comprehensive mapping of NICU developmental care nursing interventions and related sensitive outcome indicators: a scoping review protocol
Authors: Héon Marjolaine , Aita Marilyn , Lavallée Andréane , De Clifford-Faugère Gwenaëlle , Laporte Geneviève , Boisvert Annie , Feeley Nancy
Published: February 2022

Introduction

Neurodevelopmental outcomes of preterm infant are still a contemporary concern. To counter the detrimental effects resulting from the hospitalisation in the neonatal intensive care unit (NICU), developmental care (DC) interventions have emerged as a philosophy of care aimed at protecting and enhancing preterm infant’s development and promoting parental outcomes. In the past two decades, many authors have suggested DC models, core measures, practice guidelines and standards of care but outlined different groupings of interventions rather than specific interventions that can be used in NICU clinical practice. Moreover, as these DC interventions are mostly implemented by neonatal nurses, it would be strategic and valuable to identify specific outcome indicators to make visible the contribution of NICU nurses to DC.

Objectives

The overarching objective of this review is to identify the nature, range, and extent of the literature regarding DC nursing interventions for preterm infants in the NICU. The secondary twofold objectives are to highlight interventions that fall into identified categories of DC interventions and suggest nursing-sensitive outcome indicators related to DC interventions in the NICU.

Inclusion criteria

Papers reporting on or discussing a DC nursing intervention during NICU hospitalisation will be included.

Methods and analysis

The Joanna Briggs Institute’s methodology for scoping reviews will be followed. CINAHL, MEDLINE, Embase, PubMed, Web of Science, Scopus, ProQuest and PsycInfo databases from 2009 to the present will be searched. Any type of paper, published in English or French, will be considered. Study selection and data extraction will be conducted by pairs of two review authors independently. A qualitative content analysis will be conducted.

Ethics and dissemination

No Institutional Review Board ethical approbation is needed. Results of this review will be presented in scientific meetings and published in refereed papers.
Exercise improves sleep quality in older adults: a protocol for a systematic review and meta-analysis
Authors: Zhang Wei , Liu Yi , Yu Jing , Li Dongze , Jia Yu , Zhang Qin , Gao Yongli , Wan Zhi , Wei Wei
Published: February 2022

Introduction

Sleep disturbance is a common problem among the elderly and is associated with physical and mental health. Exercise has been reported as an alternative therapeutic strategy for people with sleep disturbances. However, this topic has not been systematically reviewed for older adults. This study was conducted to provide a protocol to systematically evaluate the effects of exercise on sleep quality in the elderly.

Methods and analysis

An electronic search of the PubMed, Embase and Cochrane Library databases will be performed with no language restrictions, and data extraction will be performed by two independent reviewers. The reviewers will discuss and resolve any differences, and a third reviewer will be consulted in cases of uncertainty. Randomised controlled trials will be selected. The primary outcome will be an objective measurement of sleep quality (eg, polysomnography). The secondary outcomes will be self-reported sleep quality (using the Pittsburgh Sleep Quality Index scale), and adverse events (such as falls and fractures). RevMan V.5.3.5 and Stata V.16.0 software will be used for meta-analysis. If the heterogeneity tests show slight or no statistical heterogeneity, the fixed effects model will be used; in other cases, the random effect model will be used for data synthesis.

Ethics and dissemination

The protocol does not require ethical approval. The findings will be disseminated in peer-reviewed publications and journals.

PROSPERO registration number

CRD42021287980.
Association of sudden sensorineural hearing loss with asthma: a longitudinal follow-up study using a national sample cohort
Authors: Choi Hyo Geun , Min Chanyang , Lee Chang Ho , Kim So Young
Published: February 2022

Objective

To investigate the risk of sudden sensorineural hearing loss (SSNHL) in asthma patients.

Design

A longitudinal follow-up study using a retrospective cohort

Setting

The 2002–2013 Korean National Health Insurance Service-Health Screening Cohort

Participants and interventions

The ≥40 years old Korean population were enrolled. The asthma patients were 1:1 matched with the control group for age, sex, income and region of residence.

Main outcome measure

The occurrence of SSNHL was followed in both asthma and control groups. The stratified Cox proportional hazard model was used. Age, sex, income and region of residence were stratified, and Charlson Comorbidity Index scores, obesity, smoking, alcohol consumption and atopic dermatitis histories were adjusted. Subgroup analysis was performed according to age, sex, obesity, smoking and alcohol consumption.

Results

The results showed that 1.0% (877/90 564) of the asthma group and 0.8% (706/90,564) of the control group exhibited SSNHL (p<0.001). The asthma group demonstrated a higher HR for SSNHL than the control group (adjusted HR 1.23, 95% CI 1.11 to 1.36, p<0.001). According to age and sex, the female subgroup showed elevated HRs for SSNHL in asthma patients. Both the non-smoker and current smoker groups demonstrated higher HRs for SSNHL in asthma patients than in controls. According to alcohol consumption or obesity, the <1 time a week alcohol consumption group and normal weight and severe obesity groups showed higher HRs for SSNHL in asthma patients than in the controls.

Conclusions

Adult asthma patients had a higher risk of SSNHL than the control participants matched for demographic and socioeconomic factors.
Incidence of neuromyelitis optica spectrum disorders in China: a large cohort study using claim data
Authors: Wu Yiqun , Yang Mo , Gao Pei , Wang Zijing , Wu Junhui , Wang Jiating , Xu Quangang , Zhou Huanfen , Wu Tao , Wu Weiping , Wei Shihui , Hu Yong-Hua
Published: February 2022

Objectives

Population-based studies estimating the incidence of neuromyelitis optica spectrum disorders (NMOSDs) in Asia are limited, and the relationship between latitude and incidence has been scarcely investigated. We aimed to estimate the incidence of NMOSDs in Chinese adults and explore their relationship to latitude.

Design

Cohort study based on data from the Urban Employee Basic Medical Insurance in China.

Participants

177 million people were followed from 2016 to 2017 in 20 provinces.

Primary outcome measures

The incidence rate was estimated by Poisson distribution and reported as age-adjusted and sex-adjusted rates using the standard population.

Results

There were 1313 incident NMOSD cases, with an overall incidence of 0.41 (95% CIs: 0.39 to 0.43) per 100 000 person-years. The incidence in females was higher, with a female-to-male IRR of 4.52. The incidence increased with age, peaking at 55–64 years in females and 65–74 years in males and then decreasing thereafter. The female-to-male IRRs were higher in those <55 years. The association between latitude and incidence was not statistically significant.

Conclusions

The incidence of NMOSD in Chinese adults was 0.41 per 100 000 person-years. There is no latitude gradient observed. Sex and age influence the risk of NMOSD, suggesting the role of genetic, hormonal and other related factors in the pathophysiology.
Collecting genetic samples and linked mental health data from adolescents in schools: protocol coproduction and a mixed-methods pilot of feasibility and acceptability
Authors: Warne Naomi , Rook Sarah , Bevan Jones Rhys , Brown Rachel , Bates Lesley , Hopkins-Jones Lucinda , Evans Alexandra , Hall Jeremy , Langley Kate , Thapar Anita , Walters James , Murphy Simon , Moore Graham , Rice Frances , Collishaw Stephan
Published: February 2022

Objectives

To coproduce a school-based protocol and examine acceptability and feasibility of collecting saliva samples for genetic studies from secondary/high school students for the purpose of mental health research.

Design

Protocol coproduction and mixed-methods feasibility pilot.

Setting

Secondary schools in Wales, UK.

Participants

Students aged 11–13 years.

Primary and secondary outcome measures

Coproduced research protocol including an interactive science workshop delivered in schools; school, parental and student recruitment rates; adherence to protocol and adverse events; ability to extract and genotype saliva samples; student enjoyment of the science workshop and qualitative analysis of teacher focus groups on acceptability and feasibility.

Results

Five secondary schools participated in the coproduction phase, and three of these took part in the research study (eligible sample n=868 students). Four further schools were subsequently approached, but none participated. Parental opt-in consent was received from 98 parents (11.3% eligible sample), three parents (0.3%) actively refused and responses were not received for 767 (88.4%) parents. We obtained saliva samples plus consent for data linkage for 79 students. Only one sample was of insufficient quality to be genotyped. The science workshop received positive feedback from students. Feedback from teachers showed that undertaking research like this in schools is viewed as acceptable in principle, potentially feasible, but that there are important procedural barriers to be overcome. Key recommendations include establishing close working relationships between the research team and school classroom staff, together with improved methods for communicating with and engaging parents.

Conclusions

There are major challenges to undertaking large-scale genetic mental health research in secondary schools. Such research may be acceptable in principle, and in practice DNA collected from saliva in classrooms is of sufficient quality. However, key challenges that must be overcome include ensuring representative recruitment of schools and sufficient parental engagement where opt-in parental consent is required.
Associations between sensitisation to allergens and allergic diseases: a hospital-based case–control study in China
Authors: Zhang Wei , Xie Biao , Liu Meina , Wang Yupeng
Published: February 2022

Objectives

To assess the associations of sensitisation to common allergens with atopic dermatitis, allergic rhinitis and allergic asthma in adults.

Design

Case–control study.

Setting

Data were collected from the First Affiliated Hospital of Harbin Medical University in Harbin, China.

Participants

Cases were 5111 patients with physician-diagnosed atopic dermatitis (n=2631), allergic asthma (n=1320) and allergic rhinitis (n=1160) recruited from the department of allergy from March 2009 to December 2017. Controls were 2576 healthy adults who underwent physical examination at the same hospital during the same period.

Main outcome measures

Specific IgE levels to 16 common food, indoor and outdoor allergens were assessed in all participants. Adjusted ORs and 95% CIs for the association between allergen sensitisation and allergic diseases were estimated using multivariate logistic regression.

Results

The prevalence of allergen sensitisation was higher in patients with atopic dermatitis (indoor=17.14%, outdoor=12.85%, food=21.44%), allergic rhinitis (indoor=23.18%, outdoor=26.81%, food=8.94%) and allergic asthma (indoor=24.65%, outdoor=16.46%, food=14.31%) compared with controls (indoor=11.03%, outdoor=6.84%, food=5.83%). After adjustment for potential confounding variables, there was a dose–response relevance between the levels of allergen-specific IgE and allergic diseases (p trend <0.0001). The number of allergens to which a patient was sensitised increased the risk of allergic diseases (atopic dermatitis: highest adjusted OR=4.28, 95% CI 2.57 to 7.11; allergic rhinitis: highest adjusted OR=13.00, 95% CI 3.76 to 45.00; allergic asthma: OR=2.37, 95% CI 1.67 to 3.37).

Conclusion

There was a dose–response relevance between levels of allergen-specific IgE and allergic diseases’ prevalence, and multiple sensitisations increased the risk of allergic diseases. This study provides evidence for the prophylaxis of allergic diseases.
FTACMT study protocol: a multicentre, double-blind, randomised, placebo-controlled trial of faecal microbiota transplantation for autism spectrum disorder
Authors: Chen Ye , Xueying Zhang , Jiaqu Cui , Qiyi Chen , Huanlong Qin , Ning Li , Yasong Du , Xiaoxin Zhao , Rong Yang , Jubao Lu , Xiaoqiong Lv , Chunlian Ma , Yu Wang , Shidong Chen , Guifang Kuang , Dongmei Zhao , Shuanfeng Fang , Xujing Zhang , Binrang Yang , Yanxia Wang , Ling Li , Song Yuan , Xiang Zhou , Beihua Zhang , Lin Jiang , Hong Ji
Published: February 2022

Introduction

Autism spectrum disorder (ASD) is a complicated diffuse developmental disorder that commonly involves gastrointestinal distress and dysbacteriosis. Emerging lines of evidence have shown faecal microbiota transplantation (FMT) to be a potential therapeutic strategy for improving the clinical outcomes of patients with ASD by re-establishing their intestinal microflora. We are undertaking the first-ever multicentre, double-blind, randomised controlled trial of FMT for the treatment of children with both ASD and gastrointestinal symptoms and will assess the feasibility and efficacy outcomes of this strategy.

Methods

In total, 318 children with both ASD and gastrointestinal symptoms will be enrolled (from 15 hospitals in China) to receive either FMT intervention (n=212) or a placebo (control, n=106). Children aged 3–6 years will take two capsules two times a day, and those older than 6 years will take three capsules two times a day. Each patient will receive four treatment courses, with each 12-day course being repeated every month. Outcomes will be evaluated at baseline, throughout the period of intervention, and at subsequent follow-ups for 2 months. The primary trial objective is to investigate the remodelling effect of FMT on the intestinal microflora in patients with ASD. The secondary objective focuses on the clinical efficacy and safety of FMT, including its improvement of the clinical response and metabonomics.

Ethics and dissemination

Ethical approval was obtained from the hospital Ethics Committee of each Faecal Transfer for ASD China Multicenter Trial Working Group. The ongoing FMT clinical trial is intended to support the approval of the new technology and its administration. The results of this trial will provide high-quality evidence to inform the future clinical application of this new therapy.

Trial registration number

ChiCTR2100043906; Pre-results.
Prospective open-label non-inferiority randomised controlled trial comparing letrozole and mifepristone pretreatment in medical management of first trimester missed miscarriage: study protocol
Authors: Du Libei , Li Raymond Hang Wun , Gemzell-Danielsson Kristina , Du Yan Hong , Zhang Li , Diao Wei Yu , Ho Pak Chung
Published: February 2022

Introduction

Medical treatment is a less invasive alternative to surgical management of missed miscarriage. Studies have shown that pretreatment with mifepristone can increase the complete abortion rate in management of first-trimester missed miscarriage compared with misoprostol alone. Two studies have also shown that pretreatment with letrozole could increase the efficacy compared with misoprostol alone. So far, there is no trial comparing letrozole and mifepristone pretreatment for missed miscarriage. We designed this randomised controlled trial to test the hypothesis that for first-trimester missed miscarriage, letrozole pretreatment is non-inferior to mifepristone pretreatment followed by misoprostol in terms of complete abortion rate.

Methods and analysis

This is a prospective open-label non-inferiority randomised controlled trial conducted in a single centre. In total, 294 women diagnosed with first-trimester missed miscarriage opting for medical treatment is recruited with informed consent. They are randomly assigned to receive mifepristone or letrozole pretreatment. In the mifepristone group, each woman takes 200 mg mifepristone orally followed 24–48 hours later by 800 µg misoprostol vaginally. In the letrozole group, each woman takes 10 mg letrozole orally per day for 3 days, followed by 800 µg misoprostol vaginally on the third day of letrozole administration. Follow-up is conducted on days 15 and 42 after misoprostol administration. The primary outcome is the overall complete abortion rate. Secondary outcomes include side effects and complications during the study period. Data will be analysed with both intention-to-treat and per protocol approaches. A p<0.05 will be considered as indicating statistical significance.

Ethics and dissemination

Ethics approval has been obtained from the Institutional Review Board of the University of Hong Kong-Shenzhen Hospital with approval number: (2020)166. Findings will be disseminated in a peer-reviewed journal and in national and/or international meetings to guide future practice.

Trial registration number

ChiCTR2000041480.
Implementation and dissemination of home and community-based interventions for informal caregivers of people living with dementia: a systematic scoping review protocol
Authors: Zhu Eden Meng , Buljac-Samardžić Martina , Ahaus Kees , Sevdalis Nick , Huijsman Robbert
Published: February 2022

Introduction

Ageing in place, supported by formal home and community services and informal caregivers, is the most used long-term care option for people with dementia (PwD). Informal caregivers are inundated by their caregiving responsibilities and resultantly suffer consequences. Despite the multitude of clinical effectiveness studies on interventions that support informal caregivers, there is a paucity of information regarding their implementation process. This scoping review aims to identify the implementation strategies, implementation outcomes, and barriers and facilitators that impede or support the dissemination and uptake of interventions that support informal caregivers of PwD at home.

Methods and analysis

This protocol is guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Protocols, and the scoping review will follow the systematic steps of the PRISMA-Extension for Scoping Reviews guideline. The search strategy will include publications produced from inception to 8 March 2021 and will be conducted in the search engines Embase, Medline (Ovid), Web of Science and Cochrane Central Register of Controlled Trials (Wiley), followed by a three-stage approach. First, title and abstracts will be screened by two independent reviewers. Second, full-text articles will also be screened by both reviewers and, in case of disagreement, by a third reviewer. The first two stages are based on a set of inclusion and exclusion criteria. Reference lists of the final included studies will also be checked for relevant articles. Data from the final included studies will be extracted and synthesised using the Expert Recommendations for Implementing Change compilation and Proctor’s implementation outcomes to ensure homogenous and standardised reporting of implementation information.

Ethics and dissemination

The review findings will be published in a peer-reviewed journal and disseminated at geriatric and implementation conferences to inform researchers, health service planners and practice professionals with an overview of the existing literature to guide them in the effective implementation of caregiver-focused interventions in dementia support.
Development of support material for health professionals who are implementing Shared Decision-making in breast cancer screening: validation using the Delphi technique
Authors: Hernández-Leal María José , Codern-Bové Núria , Pérez-Lacasta María José , Cardona Angels , Vidal-Lancis Carmen , Carles-Lavila Misericòrdia
Published: February 2022

Background

The Literature is no report support material on Shared Decision-making applied to breast cancer screening that is intended for Spanish health professionals. The researcher created both a handbook and a guide for this topic using an adaption of the Three-talk model.

Objective

A Delphi method will be used to reach an agreement among experts on the contents and design of a manual and guide, designed by the research team, and to be used by health professionals in the application of SDM in breast cancer screening.

Design

A qualitative study. The content and design of the handbook and the guide was discussed by 20 experts. The Delphi techniques was in an online mode between July and October 2020 and researchers used Google forms in three rounds with open and closed questions. The criterion established for consensus was a coefficient of concordance (Cc) above 75, for questions using a Likert scale of 1–6—in which 1 meant ‘completely disagree’ and 6 ‘completely agree’—with a cut-off point equal to or higher than 4.

Results

Participants considered the Three-talk model suitable for the screening context. The handbook sections and level of detail were considered satisfactory (Cc=90). The summary provided by the clinical practice guide was considered necessary (Cc=75), as it was the self-assessment tool for professionals (Cc=85). Content was added: addressing the limitations of the SDM model; extending the number of sample dialogues for health professionals; providing supplementary resources on using Patient Decisions aids and adding references on communication skills.

Conclusions and applications

The first handbook and clinical practice guide providing unique SDM support material for health professionals have been developed. The handbook and guide are useful and innovative as supporting material for health professionals, but training strategies for SDM and a piloting plan for the use of materials are requested, in order to facilitate its implementation.
Variation in coded frailty syndromes in secondary care administrative data: an international retrospective exploratory study
Authors: Soong John T Y , Ng Sheryl Hui-Xian , Tan Kyle Xin Quan , Gammall Jurgita , Hopper Adrian
Published: February 2022

Objectives

Challenges with manual methodologies to identify frailty, have led to enthusiasm for utilising large-scale administrative data, particularly standardised diagnostic codes. However, concerns have been raised regarding coding reliability and variability. We aimed to quantify variation in coding frailty syndromes within standardised diagnostic code fields of an international dataset.

Setting

Pooled data from 37 hospitals in 10 countries from 2010 to 2014.

Participants

Patients ≥75 years with admission of >24 hours (N=1 404 671 patient episodes).

Primary and secondary outcome measures

Frailty syndrome groups were coded in all standardised diagnostic fields by creation of a binary flag if the relevant diagnosis was present in the 12 months leading to index admission. Volume and percentages of coded frailty syndrome groups by age, gender, year and country were tabulated, and trend analysis provided in line charts. Descriptive statistics including mean, range, and coefficient of variation (CV) were calculated. Relationship to in-hospital mortality, hospital readmission and length of stay were visualised as bar charts.

Results

The top four contributors were UK, US, Norway and Australia, which accounted for 75.4% of the volume of admissions. There were 553 595 (39.4%) patient episodes with at least one frailty syndrome group coded. The two most frequently coded frailty syndrome groups were ‘Falls and Fractures’ (N=3 36 087; 23.9%) and ‘Delirium and Dementia’ (N=221 072; 15.7%), with the lowest CV. Trend analysis revealed some coding instability over the frailty syndrome groups from 2010 to 2014. The four countries with the lowest CV for coded frailty syndrome groups were Belgium, Australia, USA and UK. There was up to twofold, fourfold and twofold variation difference for outcomes of length of stay, 30-day readmission and inpatient mortality, respectively, across the countries.

Conclusions

Variation in coding frequency for frailty syndromes in standardised diagnostic fields are quantified and described. Recommendations are made to account for this variation when producing risk prediction models.
Challenges and solutions to providing surgery in Sierra Leone hospitals: a qualitative analysis of surgical provider perspectives
Authors: Wilson Spencer , Bah Mohamed M , George Peter , Caulker Augustus , Holmer Hampus , Leather Andrew JM , Kamara Thaim B
Published: February 2022

Objective

This study aimed to use qualitative interviews with surgical providers to explore challenges and solutions to providing surgical and anaesthesia care in Sierra Leone’s hospitals.

Design

Data were collected through anonymous, semistructured interviews. We used a qualitative framework approach to analyse interview data and determine themes relating to challenges that were reported.

Setting

A purposive sample of 12 hospitals was selected throughout Sierra Leone to include district and referral hospitals of varying ownership (private, non-governmental organisation and government).

Participants

The most senior surgical provider available during each hospital site visit participated in a semistructured interview. A total of 12 interviews were conducted.

Results

Providers described both challenges and solutions relating to the following categories: equipment and supplies, access to services, human resources, infrastructure, management and patient factors. These challenges were found to affect surgical care in hospitals by delaying surgical care, decreasing operative capacity and decreasing quality of care. Providers identified not only the root causes of these challenges, but also the varied workarounds and solutions they employ to overcome them.

Conclusion

Surgical providers can offer important insights into challenges affecting surgical services in hospitals. Despite working in challenging environments with limited resources, providers have developed innovative solutions to improve surgical and anaesthesia care in hospitals in Sierra Leone. Qualitative research has an important role to play in improving understanding of the challenges facing surgeons in low-income countries.
Impact of surgical management of primary tumors in stage IV breast cancer patients: a retrospective observational study based on SEER database
Authors: Xie Ning , Hu Xiaobo , Tang Yu , Tian Can , He Ying , Hu Zhe-Yu , Hu Chongyu , Wang Xiao , Liu Xiangyan , Liu Liping , Xiao Huawu , Peng Wei , Zhou Haoyu , Ouyang Quchang
Published: February 2022

Objectives

Although primary tumour surgery could prolong survival for patients with stage IV breast cancer, how to select candidates for primary tumour surgery is still a challenging problem for medical oncologists.

Design

This study is a retrospective database study.

Setting and participants

In this study, we aimed at evaluating the primary site surgery effect and select the beneficial subgroups. 13 618 patients with stage IV breast cancer, diagnosed between 2010 and 2015, were collected from SEER*Stat database.

Interventions

Based on the local surgery at primary tumour site, patients were categorised into three groups: primary tumour surgery performed group, recommended for primary tumour surgery but refused (RBR) group and surgery not recommended (NR) group.

Primary and secondary outcome measures

All-cause survival and breast cancer-specific survival (BCSS).

Results

Univariate Cox regression analyses showed that, compared with surgery group, patients in non-surgery (RBR and NR) groups tend to be older, T4, N0/NX, triple-negative and visceral metastatic. For both all-cause survival and BCSS, non-surgery, advanced T stage, triple-negative BC (TNBC) and visceral metastases were significant risk factors. Primary tumour surgery showed benefits for both all-cause survival (HR=0.44, 95% CI=0.39–0.49, p<0.0001) and BCSS (HR=0.43, 95% CI=0.38–0.49, p<0.0001). However, after propensity score matching, primary tumour surgery failed to demonstrate significant benefits for TNBC (HR=0.96, 95% CI=0.60–1.53, p=0.851) and patients with visceral metastases (HR=0.90, 95% CI=0.60–1.36, p=0.62).

Conclusion

Surgery was associated with prolonged survival in stage IV breast cancers, but not in patients with TNBC and visceral metastases.
HPV vaccine awareness, knowledge and information sources among youth in Switzerland: a mixed methods study
Authors: Schwendener Corina L , Kiener Laura M , Jafflin Kristen , Rouached Sarah , Juillerat Anna , Meier Vincent , Schärli Maurer Susanna , Muggli Franco , Gültekin Nejla , Baumann Aron , Debergh Marlyse , Gruillot Catherine , Huber Benedikt , Merten Sonja , Buhl Andrea , Deml Michael J. , Tarr Philip E.
Published: February 2022

Objectives

We aimed to provide a detailed characterisation of human papillomavirus (HPV) vaccine awareness, knowledge and information sources in the HPV vaccine decision-making process of youth, both male and female, in Switzerland.

Design

With a mixed-method study design, we conducted quantitative questionnaires and qualitative interviews, which lasted 20–45 min.

Setting and participants

We recruited participants, 15–26 years of age, in physicians’ offices, in a local sexual health clinic, and during military enlistment. We administered quantitative questionnaires to 997 youth participants (585 male, 412 female) and conducted qualitative interviews with 31 youth (17 male, 14 female).

Primary and secondary outcome measures

We assessed HPV vaccine awareness, knowledge, information sources and vaccination status.

Results

In the study’s quantitative component, 108 (20%) male and 262 (65%) female participants had received ≥1 dose of HPV vaccine. 697 (70%) participants were knowledgeable about the HPV vaccine. Females were more likely to be knowledgeable than males (342/412 (83%) vs 355/585 (61%); p<0.01). Younger participants in the sample compared with older participants were more likely to be aware of HPV vaccine (135/148 (91%) vs 695/849 (82%); p<0.01). The three most mentioned information sources were school health programmes (442 (53%)), healthcare providers (190 (23%)) and participants’ social networks (163 (20%)). Overall, 554/710 (78%) participants had a female-gendered perception of HPV vaccine, a finding which was further supported and explained by qualitative data.

Conclusions

Despite a male HPV vaccine recommendation being made >4 years prior to the data collection, HPV vaccine knowledge was higher among females than males, and a female-gendered perception of HPV vaccine remains prevalent. Internet and social media were minor HPV vaccine information sources. Study findings demonstrate that HPV knowledge matters for HPV vaccine uptake and suggest that we should improve HPV information quality and access for youth, particularly by tailoring knowledge campaigns to young men.
Living experiences of patients with advanced cancer with low socioeconomic status: protocol for a systematic review of qualitative evidence
Authors: An Zifen , Meng Xianmei , Fang Pei , Yu Huidan , Yu Liping
Published: February 2022

Introduction

The number of patients with advanced cancer is rapidly increasing, and the disease burden among those with low socioeconomic status (SES) has accordingly become a global concern. Low SES can adversely impact patients with advanced cancer. The purpose of this systematic review is to shed light on the life experiences of patients with advanced cancer with low SES to help provide targeted and effective strategies to improve their quality of life.

Methods and analysis

We will include the following English databases: Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PubMed, MEDLINE, Embase, Web of Science, Joanna Briggs Institute (JBI) Database of Systematic Reviews, PsycINFO and OpenGrey, and the following Chinese databases: China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals and Wanfang Data Knowledge Service Platform. A comprehensive search of qualitative studies on the experiences of patients with advanced cancer with low SES will be conducted from the above databases, with no age limit. Quality assessments of the studies will be independently performed by two reviewers using the JBI Critical Assessment Checklist, and any disagreements will be resolved through a discussion with a third reviewer. Relevant data will be extracted using the JBI standardised data extraction tools. The JBI meta-aggregation tool will be used to compare, analyse and summarise the original results. The reliability and credibility of the overall quality of the studies included will be evaluated using the JBI ConQual approach.

Ethics and dissemination

This study is based on existing public literature and therefore does not require a formal ethics review. The results of the study may be presented in peer-reviewed international journals and presented at scientific conferences.

PROSPERO registration number

CRD42021250423.
Prevalence and incidence of antibodies against SARS-CoV-2 among primary healthcare providers in Belgium during 1 year of the COVID-19 epidemic: prospective cohort study protocol
Authors: Adriaenssens Niels , Scholtes Beatrice , Bruyndonckx Robin , Verbakel Jan Y , De Sutter An , Heytens Stefan , Van den Bruel Ann , Desombere Isabelle , Van Damme Pierre , Goossens Herman , Buret Laëtitia , Duysburgh Els , Coenen Samuel
Published: February 2022

Introduction

National SARS-CoV-2 seroprevalence data provide essential information about population exposure to the virus and help predict the future course of the epidemic. Early cohort studies have suggested declines in levels of antibodies in individuals associated with, for example, illness severity, age and comorbidities. This protocol focuses on the seroprevalence among primary healthcare providers (PHCPs) in Belgium. PHCPs manage the vast majority of (COVID-19) patients and therefore play an essential role in the efficient organisation of healthcare. Currently, evidence is lacking on (1) how many PHCPs get infected with SARS-CoV-2 in Belgium, (2) the rate at which this happens, (3) their clinical spectrum, (4) their risk factors, (5) the effectiveness of the measures to prevent infection and (6) the accuracy of the serology-based point-of-care test (POCT) in a primary care setting.

Methods and analysis

This study will be set up as a prospective cohort study. General practitioners (GPs) and other PHCPs (working in a GP practice) will be recruited via professional networks and professional media outlets to register online to participate. Registered GPs and other PHCPs will be asked at each testing point (n=9) to perform a capillary blood sample antibody POCT targeting IgM and IgG against the receptor-binding domain of SARS-CoV-2 and complete an online questionnaire. The primary outcomes are the prevalence and incidence of antibodies against SARS-CoV-2 in PHCPs during a 12-month follow-up period. Secondary outcomes include the longevity of antibodies against SARS-CoV-2.

Ethics and dissemination

Ethical approval has been granted by the ethics committee of the University Hospital of Antwerp/University of Antwerp (Belgian registration number: 3002020000237). Alongside journal publications, dissemination activities include the publication of monthly reports to be shared with the participants and the general population through the publicly available website of the Belgian health authorities (Sciensano).

Trial registration number

NCT04779424.
Scandinavian Olecranon Research in the Elderly (SCORE): protocol for a non-inferiority, randomised, controlled, multicentre trial comparing operative and conservative treatment of olecranon fractures in the elderly
Authors: Rantalaiho Ida , Laaksonen Inari , Launonen Antti P , Luokkala Toni , Flinkkilä Tapio , Salmela Mikko , Adolfsson L , Olsen Bo , Isotalo Kari , Ryösä Anssi , Äärimaa Ville
Published: February 2022

Introduction

The incidence of olecranon fractures is growing in the elderly population. The traditional operative approach is giving way among the elderly to conservative treatment, which seems to provide a comparable functional outcome with a lower complication burden. However, there is still a lack of reliable evidence to support this shift.

The objective of this trial is to investigate whether conservative treatment of displaced olecranon fractures in patients aged 75 or older yields comparable results to those of operative treatment in terms of pain and daily function.

Methods and analysis

Scandinavian Olecranon Research in the Elderly (SCORE) is a randomised, controlled, multicentre, non-inferiority trial. Eligible patients will be randomised to either conservative or operative treatment. The sample size will be 68 patients and allocation done at a 1:1 ratio (34 patients per group). The randomisation is stratified according to the participating hospital and patient’s sex. Both groups will receive the same postoperative physiotherapy and pain management. The primary outcome is Disabilities of the Arm, Shoulder and Hand at 1-year follow-up. Secondary outcomes are pain and satisfaction measured on visual analogue scales, Patient Reported Elbow Evaluation, range of motion of the elbow and extension strength of the elbow compared with the unaffected arm. Radiographs will be taken at each follow-up. Primary analysis of the results will be conducted on an intention-to-treat basis.

Ethics and dissemination

The study protocol for this clinical trial has been approved by the Ethics Committee of the Hospital District of Southwest Finland and will be submitted for approval to the Regional Ethics Committees in Linköping, Sweden and Copenhagen, Denmark. Every recruiting centre will apply local research approvals. The results of this study will be submitted for publication in peer-reviewed journals.

Trial registration number

NCT04401462.

Protocol version

This is the second protocol version dated on 16 April 2020.