bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatitis B virus infection and factors associated with its acquisition among adults in a Lake Victoria HIV hyperendemic fishing community in Kyotera district, Uganda: a cross-sectional observation
Authors: Ssuuna Charles , Ssempijja Victor , Kalibbala Sarah , Serwadda David , Yeh Ping Teresa , Wawer Maria , Gray Ronald , Chang Larry , Kagaayi Joseph , Reynolds Steven
Published: April 2022

Objective

To investigate hepatitis B virus (HBV) prevalence and factors associated with viral acquisition in a HIV-hyperendemic fishing community, we tested sera for anti-hepatitis B core (HBc) and hepatitis B surface antigen (HBsAg).

Design

Observational cross-sectional study.

Setting

Large fishing village on Lake Victoria, one of the HIV-hyperendemic Rakai Community Cohort Study (RCCS) sites (HIV prevalence ~40%).

Participants

Sample of 460 RCCS participants aged 15–49 years from survey conducted from 5 December 2016 to 13 February 2017. These proportionately included HIV-negative, HIV-positive antiretroviral therapy (ART)-naïve and HIV positive on ART participants.

Results

Of the 460 participants, 49.6% (95% CI 45.0% to 54.1%) had evidence of prior HBV infection and 3.7% (95% CI 2.3% to 5.9%) were either acutely or chronically infected. HBV risk increased with age, number of lifetime sex partners and HIV seropositivity. HBV risk decreased with HIV ART use among HIV-positive participants. Prevalence of prior HBV infection was 17.1% in participants aged 15–19 years, 43.2%, 55.3% and 70.1% in participants aged 20–39, 30–39 and 40–49 years, respectively (p<0.001). Additionally, the prevalence of prior HBV infection was 23.8% in participants with 0–1 lifetime sex partners, 43.2% and 54.8% in participants with 2–3 lifetime sex partners and 4+ lifetime sex partners, respectively (p<0.001).

Conclusions

Findings from this fishing community suggest the need to provide HBV vaccination to adults at risk of sexual transmission who have not been previously immunised.
Patient-reported experiences and views on the Cytosponge test: a mixed-methods analysis from the BEST3 trial
Authors: Maroni Roberta , Barnes Jessica , Offman Judith , Scheibl Fiona , Smith Samuel G , Debiram-Beecham Irene , Waller Jo , Sasieni Peter , Fitzgerald Rebecca C , Rubin Greg ,   BEST3 Consortium, Walter Fiona M
Published: April 2022

Objectives

The BEST3 trial demonstrated the efficacy and safety of the Cytosponge-trefoil factor 3, a cell collection device coupled with the biomarker trefoil factor 3, as a tool for detecting Barrett’s oesophagus, a precursor of oesophageal adenocarcinoma (OAC), in primary care. In this nested study, our aim was to understand patient experiences.

Design

Mixed-methods using questionnaires (including Inventory to Assess Patient Satisfaction, Spielberger State-Trait Anxiety Inventory-6 and two-item perceived risk) and interviews.

Outcome measures

Participant satisfaction, anxiety and perceived risk of developing OAC.

Setting

General practices in England.

Participants

Patients with acid reflux enrolled in the intervention arm of the BEST3 trial and attending the Cytosponge appointment (N=1750).

Results

1488 patients successfully swallowing the Cytosponge completed the follow-up questionnaires, while 30 were interviewed, including some with an unsuccessful swallow.

Overall, participants were satisfied with the Cytosponge test. Several items showed positive ratings, in particular convenience and accessibility, staff’s interpersonal skills and perceived technical competence. The most discomfort was reported during the Cytosponge removal, with more than 60% of participants experiencing gagging. Nevertheless, about 80% were willing to have the procedure again or to recommend it to friends; this was true even for participants experiencing discomfort, as confirmed in the interviews.

Median anxiety scores were below the predefined level of clinically significant anxiety and slightly decreased between baseline and follow-up (p < 0.001). Interviews revealed concerns around the ability to swallow, participating in a clinical trial, and waiting for test results.

The perceived risk of OAC increased following the Cytosponge appointment (p<0.001). Moreover, interviews suggested that some participants had trouble conceptualising risk and did not understand the relationships between test results, gastro-oesophageal reflux and risk of Barrett’s oesophagus and OAC.

Conclusions

When delivered during a trial in primary care, the Cytosponge is well accepted and causes little anxiety.

Trial registration number

ISRCTN68382401.
Undifferentiated-predominant mixed-type early gastric cancer is more aggressive than pure undifferentiated type: a systematic review and meta-analysis
Authors: Yang Peng , Zheng Xiang-Dong , Wang Jun-Mei , Geng Wen-Bin , Wang Xiaoyong
Published: April 2022

Background

Studies have shown that differentiated-predominant mixed-type early gastric cancer (EGC) is more aggressive than pure differentiated-type EGC. However, the biological behaviour of undifferentiated-predominant mixed-type (MU) EGC and pure undifferentiated-type (PU) EGC are controversial. This study was conducted to compare the biological behaviour of MU EGC and PU EGC.

Methods

A systematic review and meta-analysis of observational studies was conducted using literature published through PubMed and Embase from inception to 9 November 2021. Inclusion criteria were: (1) a direct or indirect comparison of MU and PU; (2) patients with EGC; (3) a specified outcome of lymph node metastasis (LNM), lymphovascular invasion, submucosal invasion and/or ulcer findings; and (4) the primary lesion was obtained. The literature search, data extraction and quality assessment were performed by two independent reviewers. The meta-analysis was conducted with a random-effect model using the Mantel-Haenszel method.

Results

Twelve publications with 5644 patients were included. Patients with MU EGC had significantly higher risk of LNM (OR 2.28; 95% CI 1.72 to 3.03) and submucosal invasion (OR 2.19; 95% CI 1.90 to 2.52) compared with patients with PU EGC. No difference was found between patients with MU and PU EGC with respect to lymphovascular invasion risk (OR 1.81; 95% CI 0.84 to 3.87). After stratifying the data according to depth of tumour invasion, a significantly higher risk for LNM was associated with intramucosal MU EGC (OR 2.56; 95% CI 1.66 to 3.95) and submucosal MU EGC (OR 2.63; 95% CI 2.06 to 3.06). Submucosal MU EGC also had a significantly higher risk of lymphovascular invasion (OR 2.40; 95% CI 1.79 to 3.21) compared with submucosal PU EGC.

Discussion

Patients with MU EGC had an increased risk of submucosal invasion and LNM compared with patients with PU EGC . MU patients with submucosal EGC also had an increased lymphovascular invasion risk compared with PU patients. Therefore, attention should be focused on the clinical management of patients with MU EGC.
Effect of acute aerobic exercise before immunotherapy and chemotherapy infusion in patients with metastatic non-small-cell lung cancer: protocol for the ERICA feasibility trial
Authors: Gouez Manon , Pérol Olivia , Pérol Maurice , Caux Christophe , Ménétrier-Caux Christine , Villard Marine , Walzer Thierry , Delrieu Lidia , Saintigny Pierre , Marijnen Philippe , Pialoux Vincent , Fervers Béatrice
Published: April 2022

Introduction

Patients with metastatic non-small cell lung cancer (mNSCLC) suffer from numerous symptoms linked to disease and treatment which may further impair the patient’s overall condition. In addition to its benefits on quality of life and fatigue, physical exercise may improve treatment response, notably due to its known effects on the immune system. The ERICA study is designed to assess the feasibility of a supervised acute physical exercise therapy realised immediately prior immune-chemotherapy infusion in patients with mNSCLC. Secondary objectives will examine the effects of acute exercise combined with an unsupervised home-walking programme on clinical, physical, psychosocial and biological parameters.

Methods and analysis

ERICA is a prospective, monocentric, randomised controlled, open-label feasibility study conducted at the Centre Léon Bérard Comprehensive Cancer Center (France). Thirty patients newly diagnosed with mNSCLC will be randomised (2:1 ratio) to the ‘exercise’ or the ‘control’ group. At baseline and during the last treatment cycle, participants in both groups will receive Physical Activity recommendations, and two nutritional assessments. In the exercise group, participants will receive a 3-month programme consisting of a supervised acute physical exercise session prior to immune-chemotherapy infusion, and an unsupervised home-based walking programme with an activity tracker. The acute exercise consists of 35 min interval training at submaximal intensity scheduled to terminate 15 min prior to infusion. Clinical, physical, biological and psychosocial parameters will be assessed at baseline, 3 and 6 months after inclusion. Biological measures will include immune, inflammatory, metabolic, oxidative stress biomarkers and molecular profiling.

Ethics and dissemination

The study protocol was approved by the French ethics committee (Comité de protection des personnes Ile de France II, N°ID-RCB 20.09.04.65226, 8 December 2020). The study is registered on ClinicalTrials.gov (NCT number:NCT04676009) and is at the pre-results stage. All participants will sign an informed consent form. The findings will be disseminated in peer-reviewed journals and academic conferences.
Participatory mental health interventions in low-income and middle-income countries: a realist review protocol
Authors: Heap Cheyann J , Jennings Hannah Maria , Mathias Kaaren , Gaire Himal , Gumbonzvanda Farirai , Gumbonzvanda Nyaradzayi , Gupta Garima , Jain Sumeet , Maharjan Bidya , Maharjan Rakchhya , Maharjan Sujen Man , Mahat Pashupati , Pillai Pooja , Webber Martin , Wright Jerome , Burgess Rochelle
Published: April 2022

Introduction

The launch of the Movement for Global Mental Health brought long-standing calls for improved mental health interventions in low-and middle-income countries (LMICs) to centre stage. Within the movement, the participation of communities and people with lived experience of mental health problems is argued as essential to successful interventions. However, there remains a lack of conceptual clarity around ‘participation’ in mental health interventions with the specific elements of participation rarely articulated. Our review responds to this gap by exploring how ‘participation’ is applied, what it means and what key mechanisms contribute to change in participatory interventions for mental health in LMICs.

Methods and analysis

A realist review methodology will be used to identify the different contexts that trigger mechanisms of change, and the resulting outcomes related to the development and implementation of participatory mental health interventions, that is: what makes participation work in mental health interventions in LMICs and why? We augment our search with primary data collection in communities who are the targets of global mental health initiatives to inform the production of a programme theory on participation for mental health in LMICs.

Ethics and dissemination

Ethical approval for focus group discussions (FGDs) was obtained in each country involved. FGDs will be conducted in line with WHO safety guidance during the COVID-19 crisis. The full review will be published in an academic journal, with further papers providing an in-depth analysis on community perspectives on participation in mental health. The project findings will also be shared on a website, in webinars and an online workshop.
Diagnostic yield of massively parallel sequencing in patients with chronic kidney disease of unknown etiology: rationale and design of a national prospective cohort study
Authors: de Haan Amber , Eijgelsheim Mark , Vogt Liffert , van der Zwaag Bert , van Eerde Albertien M , Knoers Nine V A M , de Borst Martin H
Published: April 2022

Introduction

Chronic kidney disease (CKD) can be caused by a variety of systemic or primary renal diseases. The cause of CKD remains unexplained in approximately 20% of patients. Retrospective studies indicate that massively parallel sequencing (MPS)-based gene panel testing may lead to a genetic diagnosis in 12%–56% of patients with unexplained CKD, depending on patient profile. The diagnostic yield of MPS-based testing in a routine healthcare setting is unclear. Therefore, the primary aim of the VARIETY (Validation of algoRithms and IdEnTification of genes in Young patients with unexplained CKD) study is to prospectively address the diagnostic yield of MPS-based gene panel testing in patients with unexplained CKD and an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 before the age of 50 years in clinical practice.

Methods and analysis

The VARIETY study is an ongoing, prospective, nationwide observational cohort study to investigate the diagnostic yield of MPS-based testing in patients with unexplained CKD in a routine healthcare setting in the Netherlands. Patients are recruited from outpatient clinics in hospitals across the Netherlands. At least 282 patients will be included to meet the primary aim. Secondary analyses include subgroup analyses according to age and eGFR at first presentation, family history, and the presence of extrarenal symptoms.

Ethics and dissemination

Ethical approval for the study has been obtained from the institutional review board of the University Medical Center Groningen. Study findings should inform physicians and policymakers towards optimal implementation of MPS-based diagnostic testing in patients with unexplained CKD.
Association between antenatal corticosteroids use and perinatal mortality among preterm singletons and twins in Mwanza, Tanzania: an observational study
Authors: Mwita Stanley , Kamala Benjamin Anathory , Konje Eveline , Ambrose Emmanuela Eusebio , Izina Angelina , Chibwe Elieza , Kongola Gilbert , Dewey Deborah
Published: April 2022

Objectives

To examine the association between antenatal corticosteroids (ACS) use and perinatal mortality in singletons and twins delivered before 35 weeks of gestation.

Design

Secondary analysis of data from an observational prospective chart review study that investigated if exposure to ACS was associated with lower rates of perinatal mortality in preterm infants.

Setting

This study was conducted in four hospitals located in Mwanza region, Tanzania.

Participants

The study population included all preterm singletons and twins delivered at these hospitals between 24 weeks 0 days and 34 weeks 6 days of gestation from July 2019 to February 2020.

Outcome measures

The primary outcome was perinatal mortality; the secondary outcome was respiratory distress syndrome (RDS).

Results

The study included 844 singletons and 210 twin infants. Three hundred and fourteen singletons (37.2%) and 52 twins (24.8%) were exposed to at least one dose of ACS. Adjusted multivariate analyses revealed that among singletons’ exposure to ACS was significantly associated with a lower likelihood of perinatal mortality, adjusted relative risk (aRR) 0.30 (95% CI 0.22 to 0.40) and RDS, aRR 0.92 (95% CI 0.87 to 0.97). In twin infants, exposure to ACS was associated with a reduced risk of RDS only, aRR 0.87 (95% CI 0.78 to 0.98).

Conclusion

The use of ACS between 24 weeks 0 days and 34 weeks 6 days of gestation in both singletons and twins in low-resource settings is associated with positive infant outcomes. No adverse effects were noted. Further research that examines the benefits of ACS for twin infants is needed.
Gender-based salary differences in academic medicine: a retrospective review of data from six public medical centers in the Western USA
Authors: Miller Hayley , Seckel Elizabeth , White Chrislyn L , Sanchez Diana , Rubesova Erika , Mueller Claudia , Bianco Katherine
Published: April 2022

Objectives

We assessed the effect of gender, rank and research productivity on compensation for faculty at academic medical centres.

Design

A web-based retrospective review of salary for professors in 2016.

Setting

Faculty from six state-run, publicly funded academic medical centres in the Western USA.

Participants

799 faculty members, 225 assistant (51% women), 200 associate (40% women) and 374 full professors (32% women) from general surgery (26% women), obstetrics and gynaecology (70% women) and radiology (34% women).

Methods

Archived online faculty profiles were reviewed for gender, rank and compensation (total, baseline and supplemental). Total compensation was defined as baseline compensation plus supplemental income. Baseline compensation was defined as base salary minus reductions due to participation in the voluntary Employee Reduction in Time and phased retirement programmes. Supplemental income was defined as additional salary for clinical care and research (eg, grants). Elsevier’s Scopus was used to collect data on h-index, a measure of research productivity. Linear regression models were estimated to determine the relationship between these factors and salary.

Results

Total compensation was significantly higher for men across all professorial ranks in both general surgery (R2=0.159,F(4,299)=14.123,p<0.01) and obstetrics and gynaecology (R2=0.068,F(4,174)=3.172,p<0.05). Women faculty members within these departments earned almost US$75 000 less than their men colleagues. The disparity in salary originates from gaps in supplemental income, as baseline compensation was not significantly different between men and women. No significant gender difference in total compensation for radiology was found (R2=0.01,F(4,266)=0.591,n.s.). Higher h-index was associated with higher baseline compensation across all departments as well as with supplemental income for general surgery. Higher h-index was related to lower supplemental income for radiology and was not related to supplemental income for obstetrics and gynaecology.

Conclusions

Further investigations should focus on discrepancies in supplemental income, which may preferentially benefit men.
Early exercise in blunt chest wall trauma: protocol for a mixed-methods, multicentre, parallel randomised controlled trial (ELECT2 trial)
Authors: Battle Ceri , Charnock Amy , Davies Sara , Davies Susan , Dawson Thomas , Driscoll Timothy , Evans Phillip A , Fitzsimmons Deborah , Harris Shaun , Jones Kate , Lecky Fiona Elizabeth , O'Neill Claire , Prosser Joanne , Toghill Hannah , Watkins Alan , Hutchings Hayley Anne
Published: April 2022

Introduction

Chronic pain and disability are now well-recognised long-term complications of blunt chest wall trauma. Limited research exists regarding therapeutic interventions that can be used to address these complications. A recent feasibility study was completed testing the methods of a definitive trial. This protocol describes the proposed definitive trial, the aim of which is to investigate the impact of an early exercise programme on chronic pain and disability in patients with blunt chest wall trauma.

Methods/analysis

This mixed-methods, multicentre, parallel randomised controlled trial will run in four hospitals in Wales and one in England over 12-month recruitment period. Patients will be randomised to either the control group (routine physiotherapy input) or the intervention group (routine physiotherapy input plus a simple exercise programme completed individually by the patient). Baseline measurements including completion of two surveys (Brief Pain Inventory and EuroQol 5-dimensions, 5-Levels) will be obtained on initial assessment. These measures and a client services receipt inventory will be repeated at 3-month postinjury. Analysis of outcomes will focus on rate and severity of chronic pain and disability, cost-effectiveness and acceptability of the programme by patients and clinicians. Qualitative feedback regarding acceptability will be obtained through patient and clinician focus groups.

Ethics/dissemination

London Riverside Research Ethics Committee (Reference number: 21/LO/0782) and the Health Research Authority granted approval for the trial in December 2021. Patient recruitment will commence in February 2022. Planned dissemination is through publication in a peer-reviewed Emergency Medicine Journal, presentation at appropriate conferences and to stakeholders at professional meetings.

Trial registration number

ISRCTN65829737; Pre-results.
Improving the quality and content of discharge summaries on acute medicine wards: a quality improvement project
Authors: Scarfield Phoebe , Shepherd Thomas David , Stapleton Caitriona , Starks Alexandra , Benn Ellen , Khalid Sara , Dayment Bryony , Moate Alex , Mohamed Sandra , Lee Jasmine
Published: April 2022

Discharge summaries are important medical documents that summarise a patient’s hospital admission. The Royal College of Physicians provides standardised guidance on the content of discharge summaries, given their important role as a handover document to general practitioners (GPs). Our project started in June 2020 on an acute medical ward, where significant variation had been noted in the quality and content of discharge summaries. A multidisciplinary team (MDT) was formed including doctors, nurses and hospital/community pharmacists, as well as a patient representative, to ensure active patient co-design. The problem was scoped by asking GPs to provide feedback via surveys and process mapping. Our aim was to increase the compliance of discharge summaries with 10 core criteria from a baseline of 55% to 95% by June 2021. Change ideas were developed by the MDT and were tested using plan–do–study–act (PDSA) cycles that included additional pharmacy support, a discharge summary template and individualised feedback. The project reached its goal of 95% compliance in January 2021, 5 months ahead of the target date, and this improvement has been sustained since. The project expanded to a second acute medical unit ward in May 2021. The expanded project reached its goal of 90% compliance within 6 weeks and maintained sustained improvement with further PDSA cycles. A standard operating procedure has been created to help embed the changes on these wards. Our future aims are to redesign and improve the current electronic system and to help spread positive changes throughout the Trust.
Overlapping cortical malformations in patients with pathogenic variants inGRIN1andGRIN2B
Authors: Brock Stefanie , Laquerriere Annie , Marguet Florent , Myers Scott J , Hongjie Yuan , Baralle Diana , Vanderhasselt Tim , Stouffs Katrien , Keymolen Kathelijn , Kim Sukhan , Allen James , Shaulsky Gil , Chelly Jamel , Marcorelle Pascale , Aziza Jacqueline , Villard Laurent , Sacaze Elise , de Wit Marie C Y , Wilke Martina , Mancini Grazia Maria Simonetta , Hehr Ute , Lim Derek , Mansour Sahar , Traynelis Stephen F , Beneteau Claire , Denis-Musquer Marie , Jansen Anna C , Fry Andrew E , Bahi-Buisson Nadia
Published: April 2022

Background

Malformations of cortical development (MCDs) have been reported in a subset of patients with pathogenic heterozygous variants inGRIN1orGRIN2B, genes which encode for subunits of the N-methyl-D-aspartate receptor (NMDAR). The aim of this study was to further define the phenotypic spectrum of NMDAR-related MCDs.

Methods

We report the clinical, radiological and molecular features of 7 new patients and review data on 18 previously reported individuals with NMDAR-related MCDs. Neuropathological findings for two individuals with heterozygous variants inGRIN1are presented. We report the clinical and neuropathological features of one additional individual with homozygous pathogenic variants inGRIN1.

Results

Heterozygous variants inGRIN1andGRIN2Bwere associated with overlapping severe clinical and imaging features, including global developmental delay, epilepsy, diffuse dysgyria, dysmorphic basal ganglia and hippocampi. Neuropathological examination in two fetuses with heterozygousGRIN1variants suggests that proliferation as well as radial and tangential neuronal migration are impaired. In addition, we show that neuronal migration is also impaired by homozygousGRIN1variants in an individual with microcephaly with simplified gyral pattern.

Conclusion

These findings expand our understanding of the clinical and imaging features of the ‘NMDARopathy’ spectrum and contribute to our understanding of the likely underlying pathogenic mechanisms leading to MCD in these patients.
Identifying the psychosocial predictors of ultraviolet exposure to the face in patients with xeroderma pigmentosum: a study of the behavioural factors affecting clinical outcomes in this genetic disease
Authors: Sarkany Robert , Norton Sam , Canfield Martha , Morgan Myfanwy , Foster Lesley , Sainsbury Kirby , Araujo-Soares Vera , Wulf Hans Christian , Weinman John , Walburn Jessica
Published: April 2022

Background

For patients with xeroderma pigmentosum (XP), the main means of preventing skin and eye cancers is extreme protection against ultraviolet radiation (UVR), particularly for the face. We have recently developed a methodology for objectively measuring photoprotection behaviour (‘UVR dose to facial skin’) and have found that the degree of photoprotection varies greatly between patients with XP. We have previously identified factors affecting photoprotection behaviour in XP using a subjective measure of photoprotection. Here, we have used this objective methodology to identify the factors which determine photoprotection behaviour in XP.

Methods

We studied 29 psychological, social, demographic and clinical variables in 36 patients with XP. We have previously objectively measured UVR protection (by measuring the dose of UVR reaching the skin of the face over a 3-week period) in these patients. Here, we use linear mixed-effects model analysis to identify the factors which lead to the differences in degree of photoprotection observed in these patients.

Results

Psychosocial factors accounted for as much of the interindividual variation in photoprotection behaviour (29%) as demographic and clinical factors (24%). Psychosocial factors significantly associated with worse UVR protection included: automaticity of the behaviours, and a group of beliefs and perceptions about XP and photoprotection known to associate with poor treatment adherence in other diseases.

Conclusions

We have identified factors contributing to poor photoprotection in XP. Identifying these potentially reversible psychosocial features has enabled us to design an intervention to improve photoprotection in patients with XP, aiming to prevent skin and eye cancers in these patients.
Contemporary antiplatelet therapy for secondary stroke prevention: a narrative review of current literature and guidelines
Authors: Shah Jay , Liu Shimeng , Yu Wengui
Published: April 2022

Antiplatelet therapy is one of the mainstays for secondary stroke prevention. This narrative review aimed to highlight the current evidence and recommendations of antiplatelet therapy for stroke prevention.

We conducted advanced literature search for antiplatelet therapy. Landmark studies and randomised controlled trials evaluating antiplatelet therapy for secondary stroke prevention are reviewed. Results from Cochrane systematic review, pooled data analysis and meta-analysis are discussed.

Single-antiplatelet therapy (SAPT) with aspirin, aspirin/extended-release dipyridamole or clopidogrel reduces the risk of recurrent ischaemic stroke in patients with non-cardioembolic ischaemic stroke or transient ischaemic attack (TIA). Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel or ticagrelor for 21–30 days is more effective than SAPT in patients with minor acute noncardioembolic ischaemic stroke or high-risk TIA. Prolonged use of DAPT is associated with higher risk of haemorrhage without reduction in stroke recurrence than SAPT. Compared with placebo, aspirin reduces the relative risk of recurrent stroke by approximately 22%. Aspirin/dipyridamole and cilostazol are superior to aspirin but associated with significant side effects. Cilostazol or ticagrelor might be more effective than aspirin or clopidogrel in patients with intracranial stenosis.

SAPT is indicated for secondary stroke prevention in patients with non-cardioembolic ischaemic stroke or TIA. DAPT with aspirin and clopidogrel or ticagrelor for 21–30 days followed by SAPT is recommended for patients with minor acute noncardioembolic stroke or high-risk TIA. Selection of appropriate antiplatelet therapy should also be based on compliance, drug tolerance or resistance.
Indobufen versus aspirin in acute ischaemic stroke (INSURE): rationale and design of a multicentre randomised trial
Authors: Pan Yuesong , Meng Xia , Chen Weiqi , Jing Jing , Lin Jinxi , Jiang Yong , Johnston S Claiborne , Bath Philip M , Dong Qiang , Xu An-Ding , Li Hao , Wang Yongjun
Published: April 2022

Background

Indobufen can reversibly inhibit platelet aggregation and showed to be effective in the treatment of ischaemic heart and peripheral vascular diseases. However, it is unclear whether indobufen is an alternative antiplatelet agent for treatment of patients with ischaemic stroke.

Aim

To test whether indobufen is non-inferior to aspirin in reducing the risk of new stroke at 3 months in patients with moderate to severe ischaemic stroke.

Design

The Indobufen vs Aspirin in Acute Ischaemic Stroke (INSURE) is a randomised, double-blind, double-dummy, positive drug control, non-inferior multicentre clinical trial conducted in 200 hospitals in China. Participants will be randomised at a 1:1 ratio to receive either 100 mg indofufen two times daily or 100 mg aspirin once daily within 72 hours of the onset of symptoms from day 1 to 3 months.

Study outcomes

The primary efficacy outcome is a new stroke (ischaemic or haemorrhagic) within 3 months and the primary safety outcome is a severe or moderate bleeding event within 3 months.

Discussion

The INSURE trial will evaluate whether indobufen is non-inferior to aspirin in reducing the risk of new stroke at 3 months in patients with moderate to severe ischaemic stroke.

Trial registration number

NCT03871517.
Main factors affecting nutrient and water use efficiencies in spring canola in North America: a review of literature and analysis
Authors: Liyanage Dilumi W. K. , Bandara Manjula S. , Konschuh Michele N.
Published: April 2022

Improving nutrient and water use efficiencies by optimizing field management practices are important strategies to increase economic and environmental sustainability of canola production in North America. The objective of this study was to review recent research publications and quantitatively assess the impact of field management practices on the efficiency of water and selected macronutrients [nitrogen (N) and sulfur (S)] in canola and to identify the most effective cultural practices for improved efficiencies. The results showed that, overall, the addition of N and S inputs in studies across North America increased yield but had a negative impact on nitrogen use efficiency (NUE) and sulfur use efficiency (SUE) compared with corresponding controls. Split-applied N in spring can improve NUE, but these improvements are mostly dependent on the soil moisture content. SUE is improved when N is supplied to complement the S application. Sulfate forms of S are more readily available and should be applied early in the season, whereas elemental S must be applied in the fall to improve SUE. Maintenance of adequate soil moisture conditions during the reproductive phase of the canola crop improves water use efficiency (WUE). Supplementary irrigation improves SUE, but most canola crops are grown under rain-fed conditions in North America. Maintaining tall stubble until spring and then incorporating it with N improved WUE in canola. In summary, our analyses suggest that further research is required on the integration of canola genotypes with improved nutrient and water use efficiencies and effective management.
Validation of circular dichroic spectroscopy of synthetic oligonucleotide PS2.M for $${\hbox {K}}^{+}$$ concentration measurements
Authors: Bruni Luca , Manghi Massimo , De Sanctis Paola , Zucchini Cinzia , Croci Simonetta
Published: April 2022

The single-stranded synthetic oligonucleotide PS2.M is known to provide a basis for developing sensors since it tends to fold into structures called G-quadruplexes (G4) having characteristic topology and orientation with probabilities that depend on the chemical environment. The presence and concentration of cation species are among the key factors that determine the outcome of such a process. PS2.M and other aptamers have been used in several applications in conjunction with various probes, such as hemin, at the cost of increased technical complexity and applicability limitations. We instead validated the application limits of Circular Dichroic spectroscopy (CD) as only measurement method to assay PS2.M as $${\hbox {K}}^{+}$$

K

+

sensor in a variety of solutions having different chemical complexity. The tested solutions range from simple $$\hbox {NaCl}$$
NaCl
and $$\hbox {KCl}$$
KCl
solutions to chemically complex solutions like DMEM—Dulbecco’s Modified Eagle Medium—which is widely used in a biological laboratory. PS2.M was also evaluated in solutions of $${\hbox {KHCO}}_{3}$$

KHCO
3

and D-ribose (K:D-rib), an antioxidant potassium compound, to compare its response to the simple $$\hbox {KCl}$$
KCl
solution case. Our findings show that, within specific concentration applicability ranges, CD spectra can estimate the $${\hbox {K}}^{+}$$

K

+

concentration in the examined water solutions even at high $${\hbox {Na}}{+}$$

Na
+

concentrations with respect to $${\hbox {K}}^{+}$$

K

+

and in the presence of antioxidant molecules.
Demographic Change, Economic Growth, and Old-Age Economic Security: Asia and the World
Authors: MASON ANDREW , LEE SANG-HYOP , PARK DONGHYUN
Published: April 2022

Asia is aging, although there is significant heterogeneity across subregions and economies. Population aging poses two strategic challenges for the region: sustaining economic growth and delivering old-age economic security. In this paper, we leverage the lifecycle perspective—that individuals’ consumption and labor income differ at each age—and the National Transfer Accounts database to construct and analyze key economic indicators. Our analysis confirms that demographic change will challenge the region’s future growth and increase the cost of funding the consumption of the elderly. We also find that it will have a substantial impact on the public finances of some Asian economies.
Exhibition of Noise-Aided Stochastic Resonance by Discontinuity Detectors in Smartphone Images
Authors: Dhillon Deepak , Chouhan Rajlaxmi
Published: April 2022

The use of smartphone cameras for capturing photographs has seen an exponential growth in the last decade. The noise present in these photographs significantly deviates from the popular Independently Identically Distributed (i.i.d.) Additive White Gaussian Noise (AWGN) noise, and thus the conclusions drawn from simulated-AWGN cannot be directly applied to the smartphone’s true noise. This paper is the first reporting of the exhibition of Stochastic Resonance (SR) or noise-induced threshold-crossing in three genres of discontinuity detectors used in image processing — corner detector, line detector, and edge detector for real-world smartphone images. For the images under investigation, the performance of these detectors is quantified w.r.t. parameters representing intrinsic noise. Observations suggest that all these detectors inherently exhibit the phenomenon of SR due to the fundamental assistance offered by controlled amount of noise in crossing detector thresholds. The manifestations of SR — constant parameter value with varying noise and varying parameter value with constant noise — are demonstrated to exhibit SR in each of the three detectors.
GENDER BIAS, INSTITUTIONAL PREDICAMENTS AND INNOVATIVENESS OF FEMALE CEOS IN CHINA
Authors: WANG JUNMIN , REILLY CAROLINE VIRGINIA , FATEMA KANIZ
Published: April 2022

The benefits of female leaders in economic organizations increasingly are being reported. A large body of empirical studies focuses on the differences between female and male leaders regarding their personality characteristics, social skills and leadership styles. The existing literature pays insufficient attention to the institutional, cultural and organizational contexts that predetermine the mechanisms of shaping the leadership-performance linkage. By analyzing a national sample of Chinese private companies, we offer evidence for female CEOs’ heightened innovativeness compared to male CEOs. We suggest that organizational bias in selecting leadership and discrimination practices compel female CEOs to develop and utilize innovative capacities. A firm’s institutional environment moderates the positive role of female CEOs on firm innovativeness. The positive effects of female CEOs in promoting firm innovativeness are more potent in regions with lower GDP levels and less government support, where discriminations against women are more pervasive and deep-seated.
An Energy Efficient Health Monitoring Approach with Wireless Body Area Networks
Authors: Jain Seemandhar , Jain Prarthi , Upadhyay Prabhat K. , Moualeu Jules M. , Srivastava Abhishek
Published: April 2022

Wireless Body Area Networks (WBANs) comprise a network of sensors subcutaneously implanted or placed near the body surface and facilitate continuous monitoring of health parameters of a patient. Research endeavours involving WBAN are directed towards effective transmission of detected parameters to a Local Processing Unit (LPU, usually a mobile device) and analysis of the parameters at the LPU or a back-end cloud. An important concern in WBAN is the lightweight nature of WBAN nodes and the need to conserve their energy. This is especially true for subcutaneously implanted nodes that cannot be recharged or regularly replaced. Work in energy conservation is mostly aimed at optimising the routing of signals to minimise energy expended. In this article, a simple yet innovative approach to energy conservation and detection of alarming health status is proposed. Energy conservation is ensured through a two-tier approach wherein the first tier eliminates “uninteresting” health parameter readings at the site of a sensing node and prevents these from being transmitted across the WBAN to the LPU. The second tier of assessment includes a proposed anomaly detection model at the LPU that is capable of identifying anomalies from streaming health parameter readings and indicates an adverse medical condition. In addition to being able to handle streaming data, the model works within the resource-constrained environments of an LPU and eliminates the need of transmitting the data to a back-end cloud, ensuring further energy savings. The anomaly detection capability of the model is validated using data available from the critical care units of hospitals and is shown to be superior to other anomaly detection techniques.
QCSP on Reflexive Tournaments
Authors: Larose Benoît , Martin Barnaby , Marković Petar , Paulusma Daniël , Smith Siani , Živný Stanislav
Published: April 2022

We give a complexity dichotomy for the Quantified Constraint Satisfaction Problem

\( \mathrm{QCSP}(\mathrm{H}) \)

when

\( \mathrm{H} \)

is a reflexive tournament. It is well known that reflexive tournaments can be split into a sequence of strongly connected components

\( \mathrm{H}_1,\ldots ,\mathrm{H}_n \)

so that there exists an edge from every vertex of

\( \mathrm{H}_i \)

to every vertex of

\( \mathrm{H}_j \)

if and only if

\( i\lt j \)

. We prove that if

\( \mathrm{H} \)

has both its initial and final strongly connected component (possibly equal) of size 1, then

\( \mathrm{QCSP}(\mathrm{H}) \)

is in

\( \mathsf {NL} \)

and otherwise

\( \mathrm{QCSP}(\mathrm{H}) \)

is

\( \mathsf {NP} \)

-hard.
Friendscope: Exploring In-the-Moment Experience Sharing on Camera Glasses via a Shared Camera
Authors: Nicholas Molly Jane , Smith Brian A. , Vaish Rajan
Published: April 2022

We introduce Friendscope, an instant, in-the-moment experience sharing system for lightweight commercial camera glasses. Friendscope explores a new concept called a shared camera. This concept allows a wearer to share control of their camera with a remote friend, making it possible for both people to capture photos/videos from the camera in the moment. Through a user study with 48 participants, we found that users felt connected to each other, describing the shared camera as a more intimate form of livestreaming. Moreover, even privacy-sensitive users were able to retain their sense of privacy and control with the shared camera. Friendscope's different shared camera configurations give wearers ultimate control over who they share the camera with and what photos/videos they share. We conclude with design implications for future experience sharing systems.
Situating Public Speaking: The Politics and Poetics of the Digital Islamic Sermons in Bangladesh
Authors: Rifat Mohammad Rashidujjaman , Amin Mohammad Ruhul , Ahmed Syed Ishtiaque
Published: April 2022

Research on public speaking has recently made fair progress within the CSCW scholarship that mostly focuses on training speakers to gain popularity. Core to this research is the idea of a universal set of skills that makes a public speech successful in terms of popularity. However, a strand of research has also shown skepticism to this simplistic conceptualization of the speaking context. We join this discussion by presenting a mix of qualitative and quantitative analyses of Islamic preaching videos on YouTube. These videos are created from Islamic sermons -- a form of Islamic religious public speaking in Bangladesh. By exploring the topics of discussion by the preachers and by analyzing the performances of the preachers during the sermons, we demonstrate how those are situated in their social, political, and religious context. Based on our findings, we discuss how the public speaking scholarship of CSCW and related fields could benefit from studying such public speeches in non-secular contexts of the Global South. Further, we discuss how the role of such religious sermons could contribute to the development discourse within CSCW.
Surfacing Equity Issues in Large Computing Courses with Peer-Ranked, Demographically-Labeled Student Feedback
Authors: Xie Benjamin , Oleson Alannah , Everson Jayne , Ko Amy J.
Published: April 2022

As computing courses become larger, students of minoritized groups continue to disproportionately face challenges that hinder their academic and professional success (e.g. implicit bias, microaggressions, lack of resources, assumptions of preparatory privilege). This can impact career aspirations and sense of belonging in computing communities. Instructors have the power to make immediate changes to support more equitable learning, but they are often unaware of students' challenges. To help both instructors and students understand the inequities in their classes, we developed StudentAmp, an interactive system that uses student feedback and self-reported demographic information (e.g. gender, ethnicity, disability, educational background) to show challenges and how they affect students differently. To help instructors make sense of feedback, StudentAmp ranks challenges by student-perceived disruptiveness. We conducted formative evaluations with five large college computing courses (150 - 750 students) being taught remotely during the COVID-19 pandemic. We found that students shared challenges beyond the scope of the course, perceived sharing information about who they were as useful but potentially dangerous, and that teaching teams were able to use this information to consider the positionality of students sharing challenges. Our findings relate to a central design tension of supporting equity by sharing contextualized information about students while also ensuring their privacy and well-being.
"I Just Can't Help But Smile Sometimes": Collaborative Self-Management of Depression
Authors: Burgess Eleanor R. , Reddy Madhu C. , Mohr David C.
Published: April 2022

Depression is a challenging condition that requires individuals to manage their moods and emotions over time. Within CSCW, there has been an interest in understanding how individuals seek and share support on social media and in online communities. However, less attention has been paid to how collaboration as an aspect of self-management of depression unfolds in people's daily lives. In this paper, we explore the collaborative self-management work of 28 individuals managing depression who live in the United States. Data collection included remote semi-structured interviews with an associated cognitive mapping exercise. Our findings describe who participants turn to for day-to-day collaborative support, how collaborative activities are enacted (across both mood-focused and preventative support practices), and where these often technology-mediated interactions occur across text, phone, video, and picture-based channels. We discuss collaborative self-management in the depression support context, including key characteristics: agency, reciprocity, time, and interaction. We also present a four-step model of how the process occurs over time (awareness, planning, interaction, and reflection). We conclude by discussing how technology ecosystems support individuals' collaborative self-management.
A Speech-Based Model for Tracking the Progression of Activities in Extreme Action Teamwork
Authors: Jagannath Swathi , Kamireddi Neha , Zellner Katherine Ann , Burd Randall S. , Marsic Ivan , Sarcevic Aleksandra
Published: April 2022

Designing computerized approaches to support complex teamwork requires an understanding of how activity-related information is relayed among team members. In this paper, we focus on verbal communication and describe a speech-based model that we developed for tracking activity progression during time-critical teamwork. We situated our study in the emergency medical domain of trauma resuscitation and transcribed speech from 104 audio recordings of actual resuscitations. Using the transcripts, we first studied the nature of speech during 34 clinically relevant activities. From this analysis, we identified 11 communicative events across three different stages of activity performance-before, during, and after. For each activity, we created sequential ordering of the communicative events using the concept of narrative schemas. The final speech-based model emerged by extracting and aggregating generalized aspects of the 34 schemas. We evaluated the model performance by using 17 new transcripts and found that the model reliably recognized an activity stage in 98% of activity-related conversation instances. We conclude by discussing these results, their implications for designing computerized approaches that support complex teamwork, and their generalizability to other safety-critical domains.