bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal rate control in dogs with atrial fibrillation—ORCA study—Multicenter prospective observational study: Prognostic impact and predictors of rate control
Authors: Pedro Brigite , Mavropoulou Antonia , Oyama Mark A. , Linney Christopher , Neves João , Dukes‐McEwan Joanna , Fontes‐Sousa Ana P. , Gelzer Anna R.
Published: May 2023

Background

The optimal heart rate (HR) in dogs with atrial fibrillation (AF) is unknown. Impact of HR on survival needs elucidation.

Hypothesis/Objectives

Dogs with a 24 hours Holter‐derived meanHR ≤125 beats per minute (bpm; rate controlled) survive longer than dogs with higher meanHR. We further aimed to determine which variables predict ability to achieving rate control.

Animals

Sixty dogs with AF.

Methods

Holter‐derived meanHR, clinical, echocardiographic, and biomarker variables were analyzed prospectively. Survival was recorded from time of rate control, with all‐cause mortality as primary endpoint. Cox proportional hazards analysis identified variables independently associated with survival; Kaplan‐Meier survival analysis estimated the median survival time of dogs with meanHR ≤125 bpm vs >125 bpm. Logistic regression explored baseline variables associated with inability to achieve rate control.

Results

Structural heart disease was present in 56/60 dogs, 50/60 had congestive heart failure, and 45/60 died. Median time to all‐cause death was 160 days (range, 88‐303 days), dogs with meanHR >125 bpm (n = 27) lived 33 days (95% confidence interval [CI], 15‐141 days), dogs with meanHR ≤125 bpm (n = 33) lived 608 days (95% CI, 155‐880 days; P < .0001). Congenital heart disease and N‐terminal pro‐B‐type natriuretic peptide were independently associated with higher risk of death (P < .01 and <.0001, respectively) whereas meanHR ≤125 bpm decreased the risk of death (P < .001). Increased left atrial size, increased C‐reactive protein concentration and lower blood pressure at admission were associated with failure to achieve rate control.

Conclusions and Clinical Importance

Rate control affects survival; an optimal target meanHR <125 bpm should be sought in dogs with AF. Baseline patient variables can help predict if rate control is achievable.
Effects of calcium supplementation to resuscitation fluids in endurance horses: A randomized, blinded, clinical trial
Authors: Fielding C. Langdon , Deane Emma L. , Major Dustin S. , Mayer Jennifer R. , Love Juliette C. , Peralez Michael S. , Magdesian K. Gary
Published: May 2023

Background

The addition of calcium to resuscitation fluids is a common practice in horses, but studies evaluating the effects of calcium supplementation are limited. In healthy horses, decreases in heart rate and changes in serum electrolyte concentrations have been reported.

Hypothesis

Calcium gluconate administration at a rate of 0.4 mg/kg/min to eliminated endurance horses with metabolic problems will affect heart rate, gastrointestinal sounds, and serum electrolyte concentrations.

Animals

Endurance horses eliminated from the Tevis Cup 100‐mile (160 km) endurance ride for metabolic problems and requiring IV fluid therapy were eligible.

Methods

Sixteen horses were randomly assigned to receive 0.4 mg/kg/min of calcium (23% calcium gluconate solution) over 1 hour diluted in 10 L of a non‐calcium containing isotonic crystalloid (CAL group) or 10 L of a non‐calcium containing isotonic crystalloid (CON group). Staff members administering the fluids were blinded to treatment group. Blood samples were collected and physical examinations performed before and after treatment. Heart rates were recorded every 15 min during fluid administration. Data were compared using 2‐way analysis of variance (ANOVA) with repeated measures for continuous variables and Fisher's exact test for categorical variables.

Results

Calcium was associated with lower heart rates 45 min after starting the infusion (P = .002). Gastrointestinal sounds were less likely to improve in the calcium group compared with the control group (P = .005). An increase in plasma phosphorus concentration (P = .03) was associated with calcium administration.

Conclusions

Intravenous calcium supplementation to endurance horses eliminated from competition after development of metabolic problems may decrease heart rate but impairs improvement in gastrointestinal sounds.
“Recovery” in mental health services, now and then: A poststructuralist examination of the despotic State machine's effects
Authors: Johansson Jim A. , Holmes Dave
Published: May 2023

Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient‐centered approaches. But as we argue in this paper, the recovery‐oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as “recovery” nursing practices became more established, more codified, and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health—including forensic mental health—institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change.
GhbZIP30‐GhCCCH17 module accelerates corm dormancy release by reducing endogenous ABA under cold storage in Gladiolus
Authors: Liang Jia‐hui , Li Jing‐ru , Liu Chang , Pan Wen‐qiang , Wu Wen‐jing , Shi Wen‐jing , Wang Lu‐jia , Yi Ming‐fang , Wu Jian
Published: May 2023

Gladiolus hybridus is one of the most popular flowers worldwide. However, its corm dormancy characteristic largely limits its off‐season production. Long‐term cold treatment (LT), which increases sugar content and reduces abscisic acid (ABA), is an efficient approach to accelerate corm dormancy release (CDR). Here, we identified a GhbZIP30‐GhCCCH17 module that mediates the antagonism between sugars and ABA during CDR. We showed that sugars promoted CDR by reducing ABA levels in Gladiolus. Our data demonstrated that GhbZIP30 transcription factor directly binds the GhCCCH17 zinc finger promoter and activates its transcription, confirmed by yeast one‐hybrid, dual‐luciferase (Dual‐LUC), chromatin immunoprecipitation‐quantitative PCR (ChIP‐qPCR) and electrophoretic mobility shift assay (EMSA). GhCCCH17 is a transcriptional activator, and its nuclear localisation is altered by surcose and cytokinin treatments. Both GhbZIP30 and GhCCCH17 positively respond to LT, sugars, and cytokinin treatments. Silencing GhbZIP30 or GhCCCH17 resulted in delayed CDR by regulating ABA metabolic genes, while their overexpression promoted CDR. Taken together, we propose that the GhbZIP30‐GhCCCH17 module is involved in cold‐ and glucose‐induced CDR by regulating ABA metabolic genes.
Translating nonviolence: Ahimsa, satyagraha, and the civil rights movement
Authors: Slate Nico
Published: May 2023

Recent scholarship has challenged a simplistic transmission model of the diffusion of nonviolence within the American civil rights movement. Yet many historical studies remain focused on the spread of content communicated by experts and, in particular, on the relative degree to which activists adhered to what Gandhi called ahimsa, a term that is often translated as “non‐harm” or “non‐violence,” but which carried a range of meanings for Gandhi and many of his colleagues. This essay, by contrast, focuses on “satyagraha,” a word that literally means “holding firm to the truth,” and that Gandhi popularized out of frustration with the label “passive resistance.” I use a range of historical sources, including audio recordings of civil rights workshops at the Highlander Folk School, to reveal the limitations of an ahimsa‐based conception of the diffusion of nonviolence and to explore an alternative, satyagraha‐based understanding of nonviolent education within the civil rights movement. I argue that the “translation” of satyagraha played a key role in the struggle against American racism, and suggest that future scholarship should explore the centrality of translation to nonviolence as both philosophy and method.
The novel HLA‐B*08 allele, HLA‐B*08:295, identified by next generation sequencing
Authors: Akhmetshina Gulnaz , Ananeva Anastasiia , Andryushkina Anna V. , Shagimardanova Elena I.
Published: May 2023

The novel HLA‐B*08:295 allele was characterized using next generation sequencing technology.
Characterization of the novel HLA‐C*06:02:96 allele by next‐generation sequencing
Authors: Chen Nanying , Zhao Shuoxian , Li Ying , Zhang Wei , Zhu Faming
Published: May 2023

HLA‐C*06:02:96 differs from HLA‐C*06:02:01:01 by one single nucleotide substitution at position 924 C > A.
Genome‐wide characterization of plantCTP:phosphocholine cytidylyltransferases through evolutionary, biochemical, and structural analyses
Authors: Xiao Qiong , Pan Xue , Xu Yang , Singer Stacy D. , Chen Guanqun
Published: May 2023

Phosphatidylcholine has essential functions in many eukaryotic cells, and itsde novobiosynthesis is rate‐limited by cytidine triphosphate:phosphocholine cytidylyltransferase (CCT). Although the biological and biochemical functions of CCT have been reported in mammals and several plants, this key enzyme has yet to be examined at a genome‐wide level. As such, certain fundamental questions remain unanswered, including the evolutionary history, genetic and functional relationships, and structural variations among CCTs in the green lineage. In the current study, in‐depth phylogenetic analysis, as well as the conservation and diversification inCCTgene structure and motif patterns, indicated that CCTs exist broadly in chlorophytes, bryophytes, lycophytes, monilophytes, gymnosperms, early‐diverging angiosperms, monocots, and eudicots, and form eight relatively conserved clades. To further explore the potential function of selection pressure, we conducted extensive selection pressure analysis with a representativeCCTgene,CCT1from the model plantArabidopsis thaliana(AthCCT1), and identified two positive selection sites, L59 and Q156. Site‐directed mutagenesis andin vitroenzyme assays demonstrated that these positively selected sites were indeed important for the activity and substrate affinity of AthCCT1, and subsequent 3D structure analyses explained the potential biochemical mechanism. Taken together, our results unraveled the evolution and diversity of CCTs in the green lineage, as well as their association with the enzyme's biochemical and structural properties, and expanded our understanding of this important enzyme at the genome‐wide level.
THE AIMS OF TYPOLOGIES AND A TYPOLOGY OF METHODS
Authors: Chin Adam J.
Published: May 2023

Typologies like Ian Barbour's have been widely used—and critiqued—in religion‐and‐science. Several alternatives have been proposed by, for example, John Haught, Willem Drees, Mikael Stenmark, and Shoaib Ahmed Malik. However, there has been a surprising deficit in discussion of what we wish typologies to do in religion and science in the first place. In this article, I provide a general analysis of typologies in religion‐and‐science by (1) providing a classification of existing typologies as conclusion‐ or concept‐oriented; (2) showing that typologies are used, or expected to be used, as first‐order categorizations of how religion and science are related and as second‐order classifications of scholars/scholarly works; (3) discussing several aims which we might want typologies to achieve in their second‐order usage; and (4) presenting a new kind of typology focused on the methods used by scholars which achieves those aims in a unique way.
Sample Senior Design Projects of Industrial Engineering Program at Kuwait University
Authors: Ali Allahverdi
Published: May 2023

A senior design course provides engineering students the opportunity to identify, formulate, and solve complex real-world engineering problems. This outcome is one of the seven student outcomes adopted by The Accreditation Board for Engineering and Technology (ABET). Therefore, the senior design course is a part of the curriculum of most of the international engineering programs. Hence, it is also a required course in the curriculum of the Industrial and Management Systems Engineering (IMSE) program of Kuwait University (KU). In the senior design course of IMSE program at KU, students select a company and conduct their project at the company. In this paper, three of these companies are briefly described along with identified problems, proposed solutions, and obtained results. Student evaluation by the company’s representatives is also discussed. It has been shown that the senior design students improved the operations of the selected companies significantly. It has been also observed that the students are enthusiastic by applying the methodologies and tools of Industrial Engineering that they learned in their earlier courses to solve real life problems.
Model for Developing and Assessing Critical Thinking Skills in an Undergraduate Civil Engineering Program
Authors: Alina Zapalska  , Hudson Jackson  , Sharon Zelmanowitz
Published: May 2023

This paper presents a model for developing and assessing critical thinking in an undergraduate program. The 21st Century Bloom’s Taxonomy provides a framework for creating classroom materials that fosters the development and advancement of critical thinking skills. Furthermore, the paper presents an instrument for assessing students’ critical thinking progression and development. The proposed strategy is based on a specifically developed process where students are guided to progress from a lower to a higher level of cognitive thinking level during four years of undergraduate study. Placement of course activities in a specially designed sequence, as well as the use of specifically designed critical thinking instructions and assessment process to achieve desired learning outcomes are vital to deliver an effective critical thinking program. The proposed model for advancement and assessment of critical thinking presented in this paper can be used by other programs that plan to implement effective strategy for critical thinking. An example of the Civil Engineering undergraduate program at the United States Coast Guard Academy is presented to illustrate this effective strategy.
Implementation of Project-Based Learning in System Modelling and Analysis Course
Authors: Ismail Fatimah Sham , Mohd. Subha Nurul Adilla , Sudin Shahdan , Ghazali Nurzal Effiyana , Mohd-Yusof Khairiyah
Published: May 2023

In preparing graduates to cater demands in industry, 21st Century Skills has been embedded in curriculum. To develop the 21st Century Skills among electrical engineering students, Project-Based Learning (PjBL) has been introduced to the electrical engineering students in System Modelling and Analysis Course. Previously, students are given exercises taken from textbooks and other references only. When PjBL is implemented, it contributes to introducing students with real-world problem setting and empowering students’ cognitive abilities. This paper discusses how the real-world problem is developed for the System Modelling and Analysis Course and how PjBL is implemented in the course. Jigsaw was used with the implementation of PjBL to introduce cooperative classrooms and to improve students’ social skills. The real-world problem developed in this PjBL is the ship-to-shore (STS) crane system. The implementation impact was discussed based on students’ reflection and the Course Learning Outcomes (CLOs) achievements. Overall CLOs achievement were above the key performance indicator. In addition, students gave positive feedback on this implementation. In conclusion, PjBL can be implemented to improve self-regulated learning among the students in order to supply them with the 21st Learning Skills.
Exploring Learners’ Experiences in Video-conference Classrooms through theExtended Technology Acceptance Model
Authors: Edwards Bosede Iyiade , Edwards Josephine Opeyemi
Published: May 2023

The forced switch to fully online learning during the pandemic lockdown resulted in the conversion of video-conference platforms into digital classrooms. The emergency situation at the time left no room for necessary research, training and adequate deployment process, thus forcing both learners and instructors to adopt these learning environments as the only solution to learning during those times. After the lockdown seasons were over, several educational institutions have been considering hybrid instructional modes, thereby making these platforms to persist within education. This necessitates the assessment of learners’ perception on learning in these new classrooms. This study aims to inform and inspire the design of inclusive, and sensitive future learning environments and schools where the needs of all types of learners are factored into instructional design and delivery.  An analysis model based on the Technology Acceptance Model (TAM) was deployed in this study which reports on findings from an online survey of 86 respondents consisting of 48 males and 38 females all educated at post-secondary levels. Respondents ages were between 17 and 60 years with a mean age of 30.49 years. Findings show positive learners’ perceptions of video-conference in terms of most constructs, with more neutral and almost negative feedback regarding support for collaboration and instructor presence. No negative perceptions were reported regarding frustration with the technology, and no difference in perception was expressed regarding continuation of virtual learning on video-conference, or return to physical classroom. Platforms were rated by respondents based on factors considered by respondents as important for learning; the highest ratings were assigned based on features including screen sharing, host meeting control capabilities and guest control.
The Diophantine equation f(x)=g(y)$f(x)=g(y)$ for polynomials with simple rational roots
Authors: Hajdu L. , Tijdeman R.
Published: May 2023

In this paper we consider Diophantine equations of the form where has simple rational roots and has rational coefficients. We give strict conditions for the cases where the equation has infinitely many solutions in rationals with a bounded denominator. We give examples illustrating that the given conditions are necessary. It turns out that such equations with infinitely many solutions are strongly related to Prouhet–Tarry–Escott tuples. In the special, but important case when has only simple rational roots as well, we can give a simpler statement. Also we provide an application to equal products with terms belonging to blocks of consecutive integers of bounded length. The latter theorem is related to problems and results of Erdős and Turk, and of Erdős and Graham.
Bayesian estimation for Bell state rotations
Authors: Anastassiou Luke , Ralph Jason F. , Maskell Simon , Kok Pieter
Published: May 2023

This paper explores the effect of three-dimensional rotations on two-qubit Bell states and proposes a Bayesian method for the estimation of the parameters of the rotation. We use a particle filter to estimate the parameters of the rotation from a sequence of Bell state measurements, and we demonstrate that the resultant improvement over the optimal single qubit case approaches the 2 factor that is consistent with the Heisenberg limit. We also demonstrate how the accuracy of the estimation method is a function of the purity of mixed states.
Bayesian detection and tracking of odontocetes in 3-D from their echolocation clicks
Authors: Jang Junsu , Meyer Florian , Snyder Eric R. , Wiggins Sean M. , Baumann-Pickering Simone , Hildebrand John A.
Published: May 2023

Localization and tracking of marine animals can reveal key insights into their behaviors underwater that would otherwise remain unexplored. A promising nonintrusive approach to obtaining location information of marine animals is to process their bioacoustic signals, which are passively recorded using multiple hydrophones. In this paper, a data processing chain that automatically detects and tracks multiple odontocetes (toothed whales) in three dimensions (3-D) from their echolocation clicks recorded with volumetric hydrophone arrays is proposed. First, the time-difference-of-arrival (TDOA) measurements are extracted with a generalized cross-correlation that whitens the received acoustic signals based on the instrument noise statistics. Subsequently, odontocetes are tracked in the TDOA domain using a graph-based multi-target tracking (MTT) method to reject false TDOA measurements and close gaps of missed detections. The resulting TDOA estimates are then used by another graph-based MTT stage that estimates odontocete tracks in 3-D. The tracking capability of the proposed data processing chain is demonstrated on real acoustic data provided by two volumetric hydrophone arrays that recorded echolocation clicks from Cuvier's beaked whales (Ziphius cavirostris). Simulation results show that the presented MTT method using 3-D can outperform an existing approach that relies on manual annotation.
Distortion-product otoacoustic emissions measured using synchronized swept-sines
Authors: Vencovský Václav , Novak Antonin , Klimeš Ondřej , Honzík Petr , Vetešník Aleš
Published: May 2023

Swept-sines provide a tool for fast and high-resolution measurement of evoked otoacoustic emissions. During the measurement, a response to swept-sine(s) is recorded by a probe placed in the ear canal. Otoacoustic emissions can then be extracted by various techniques, e.g., Fourier analysis, the heterodyne method, and the least-square-fitting (LSF) technique. This paper employs a technique originally proposed with exponential swept-sines, which allows for direct emission extraction from the measured intermodulation impulse response. It is shown here that the technique can be used to extract distortion-product otoacoustic emissions (DPOAEs) evoked with two simultaneous swept-sines. For proper extraction of the DPOAE phase, the technique employs previously proposed adjusted formulas for exponential swept-sines generating so-called synchronized swept-sines (SSSs). Here, the SSS technique is verified using responses derived from a numerical solution of a cochlear model and responses measured in human subjects. Although computationally much less demanding, the technique yields comparable results to those obtained by the LSF technique, which has been shown in the literature to be the most noise-robust among the emission extraction methods.
The effect of source backing materials and excitation pulse durations on laser-generated ultrasound waveforms
Authors: Rajagopal Srinath , Allen Thomas , Berendt Martin , Lin Di , Alam Shaif-ul , Richardson David J. , Cox Ben T.
Published: May 2023

In this article, it is shown experimentally that a planar laser-generated ultrasound source with a hard reflective backing will generate higher acoustic pressures than a comparable source with an acoustically matched backing when the stress confinement condition is not met. Furthermore, while the source with an acoustically matched backing will have a broader bandwidth when the laser pulse is short enough to ensure stress confinement, the bandwidths of both source types will converge as the laser pulse duration increases beyond stress confinement. The explanation of the results is supported by numerical simulations.
Observations of the space/time scales of Beaufort sea acoustic duct variability and their impact on transmission loss via the mode interaction parameter
Authors: Kucukosmanoglu Murat , Colosi John A. , Worcester Peter F. , Dzieciuch Matthew A. , Sagen Hanne , Duda Timothy F. , Zhang Weifeng Gordon , Miller Christopher W. , Richards Edward L.
Published: May 2023

The Beaufort duct (BD) is a subsurface sound channel in the western Arctic Ocean formed by cold Pacific Winter Water (PWW) sandwiched between warmer Pacific Summer Water (PSW) and Atlantic Water (AW). Sound waves can be trapped in this duct and travel long distances without experiencing lossy surface/ice interactions. This study analyzes BD vertical and temporal variability using moored oceanographic measurements from two yearlong acoustic transmission experiments (2016–2017 and 2019–2020). The focus is on BD normal mode propagation through observed ocean features, such as eddies and spicy intrusions, where direct numerical simulations and the mode interaction parameter (MIP) are used to quantify ducted mode coupling strength. The observations show strong PSW sound speed variability, weak variability in the PWW, and moderate variability in the AW, with typical time scales from days to weeks. For several hundreds Hertz propagation, the BD modes are relatively stable, except for rare episodes of strong sound speed perturbations. The MIP identifies a resonance condition such that the likelihood of coupling is greatest when there is significant sound speed variability in the horizontal wave number band 1/11<kh<1/5 km−1. MITgcm ocean model results are used to estimate sound speed fluctuations in this resonance regime.
The substrate selectivity of papain-like proteases from human-infecting coronaviruses correlates with innate immune suppression
Authors: Xiong Yuxian , Huang Bin , Yang Ying , Fu Xinming , Fu Ziyang , Xu Huidong , Liu Ming , Cao Dan , Zhang Manman , Yang Haibin , Niu Xiaogang , Yu Cong , Huang Hao
Published: May 2023

Coronaviruses that can infect humans can cause either common colds (HCoV-NL63, HCoV-229E, HCoV-HKU1, and HCoV-OC43) or severe respiratory symptoms (SARS-CoV-2, SARS-CoV, and MERS-CoV). The papain-like proteases (PLPs) of SARS-CoV, SARS-CoV-2, MERS-CoV, and HCoV-NL63 function in viral innate immune evasion and have deubiquitinating (DUB) and deISGylating activities. We identified the PLPs of HCoV-229E, HCoV-HKU1, and HCoV-OC43 and found that their enzymatic properties correlated with their ability to suppress innate immune responses. A conserved noncatalytic aspartic acid residue was critical for both DUB and deISGylating activities, but the PLPs had differing ubiquitin (Ub) chain cleavage selectivities and binding affinities for Ub, K48-linked diUb, and interferon-stimulated gene 15 (ISG15) substrates. The crystal structure of HKU1-PLP2 in complex with Ub revealed binding interfaces that accounted for the unusually high binding affinity between this PLP and Ub. In cellular assays, the PLPs from the severe disease–causing coronaviruses strongly suppressed innate immune IFN-I and NF-κB signaling and stimulated autophagy, whereas the PLPs from the mild disease–causing coronaviruses generally showed weaker effects on immune suppression and autophagy induction. In addition, a PLP from a SARS-CoV-2 variant of concern showed increased suppression of innate immune signaling pathways. Overall, these results demonstrated that the DUB and deISGylating activities and substrate selectivities of these PLPs differentially contribute to viral innate immune evasion and may affect viral pathogenicity.
Prognostic value of echocardiographic parameters in congenital diaphragmatic hernia: a systematic review and meta-analysis
Authors: Pammi Mohan , Kelagere Yashaswini , Koh Sara , Sisson Amy , Hagan Joseph , Kailin Joshua , Fernandes Caraciolo J
Published: May 2023

Background

Prognostication of mortality and decision to offer extracorporeal membrane oxygenation (ECMO) treatment in infants with congenital diaphragmatic hernia (CDH) can inform clinical management.

Objective

To summarise the prognostic value of echocardiography in infants with CDH.

Methods

Electronic databases Ovid MEDLINE, Embase, Scopus, CINAHL, the Cochrane Library and conference proceedings up to July 2022 were searched. Studies evaluating the prognostic performance of echocardiographic parameters in newborn infants were included. Risk of bias and applicability were assessed using the Quality Assessment of Prognostic Studies tool. We used a random-effect model for meta-analysis to compute mean differences (MDs) for continuous outcomes and relative risk (RR) for binary outcomes with 95% CIs. Our primary outcome was mortality; secondary outcomes were need for ECMO, duration of ventilation, length of stay, and need for oxygen and/or inhaled nitric oxide.

Results

Twenty-six studies were included that were of acceptable methodological quality. Increased diameters of the right and left pulmonary arteries at birth (mm), MD 0.95 (95% CI 0.45 and 1.46) and MD 0.79 (95% CI 0.58 to 0.99), respectively) were associated with survival. Left ventricular (LV) dysfunction, RR 2.40, (95% CI 1.98 to 2.91), right ventricular (RV) dysfunction, RR 1.83 (95% CI 1.29 to 2.60) and severe pulmonary hypertension (PH), RR 1.69, (95% CI 1.53 to 1.86) were associated with mortality. Left and RV dysfunctions, RR 3.30 (95% CI 2.19 to 4.98) and RR 2.16 (95% CI 1.85 to 2.52), respectively, significantly predicted decision to offer ECMO treatment. Limitations are lack of consensus on what parameter is optimal and standardisation of echo assessments.

Conclusions

LV and RV dysfunctions, PH and pulmonary artery diameter are useful prognostic factors among patients with CDH.
Systematic scoping review of interventions to prevent and respond to child marriage across Africa: progress, gaps and priorities
Authors: Greene Margaret E , Siddiqi Manahil , Abularrage Tara F
Published: May 2023

Objectives

Despite the high prevalence of child marriage in Africa, little is known about the current state of the evidence on interventions to prevent and respond to child marriage in the region. The objectives of this systematic scoping review are to describe the breadth of existing evidence on child marriage prevention and response interventions, analyze where these interventions have been implemented, and identify research gaps and priorities for moving forward.

Methods

The inclusion criteria incorporated publications that: (1) focused on Africa, (2) described interventions to address child marriage, (3) were published 2000–2021 and (4) were published as peer-reviewed articles or reports in English. We searched seven databases (PubMed, PsychINFO, Embase, Cinahl Plus, Popline, Web of Science and Cochrane Library), hand-searched the websites of 15 organisations and used Google Scholar to identify research published in 2021. Two authors independently screened titles and abstracts followed by full-text reviews and data extraction for included studies.

Results

Our analysis of the 132 intervention studies identified highlights important disparities by intervention type, sub-region, and intervention activities, focus populations and impact. The greatest number of intervention studies focused on Eastern Africa. Health and empowerment approaches were most represented, followed by education and laws and policies. Norms or livelihoods approaches were least represented.

Conclusion

Our review finds few high-quality impact evaluations, most of which assess cash transfer programmes. There is a need to strengthen evaluative evidence on other intervention approaches including empowerment and norms change interventions, in particular. Given the linguistic and cultural diversity of the continent, more country-specific studies and research published in languages other than English are needed, particularly in high-prevalence Middle African countries.
Effect and safety of C7 neurotomy at the intervertebral foramen in patients with chronic poststroke aphasia: a multicentre, randomised, controlled study protocol
Authors: Li Tie , Feng Juntao , Hu Ruiping , Lv Minzhi , Chang Wenshuo , Ma Xingyi , Qi Wenjun , Zhang Ying , Chen Xiuen , Ding Ling , Gu Yudong , Xu Wendong
Published: May 2023

Introduction

Aphasia affects many stroke survivors; therefore, effective treatments are urgently needed. Preliminary clinical findings have suggested an association between contralateral C7–C7 cross nerve transfer and recovery from chronic aphasia. Randomised controlled trials supporting the efficacy of C7 neurotomy (NC7) are lacking. This study will explore the efficacy of NC7 at the intervertebral foramen for improving chronic poststroke aphasia.

Methods and analysis

This study protocol reports a multicentre, randomised, assessor-blinded active-controlled trial. A total of 50 patients with chronic poststroke aphasia for over 1 year and with a aphasia quotient calculated by Western Aphasia Battery Aphasia Quotient (WAB-AQ) score below 93.8 will be recruited. Participants will be randomly assigned to 1 of 2 groups (25 individuals each) to receive NC7 plus intensive speech and language therapy (iSLT), or iSLT alone programme. The primary outcome is the change in Boston Naming Test score from baseline to the first follow-up after NC7 plus 3 weeks of iSLT or iSLT alone. The secondary outcomes include the changes in the WAB-AQ, Communication Activities of Daily Living-3, International Classification of Functioning, Disability and Health (ICF) speech language function, Barthel Index, Stroke Aphasic Depression Questionnaire-hospital version and sensorimotor assessments. The study will also collect functional imaging outcomes of naming and semantic violation tasks through functional MRI and electroencephalogram to evaluate the intervention-induced neuroplasticity.

Ethics and dissemination

This study was approved by the institutional review boards of Huashan Hospital, Fudan University, and all participating institutions. The study findings will be disseminated through peer-reviewed publications and conference presentations.

Trial registration number

ChiCTR2200057180.
Hope in the era of precision oncology: a qualitative study of informal caregivers’ experiences
Authors: Kenny Katherine , Williams Veazey Leah , Broom Alex , Peterie Michelle , Page Alexander , Prainsack Barbara , Wakefield Claire E. , Itchins Malinda , Khasraw Mustafa , Lwin Zarnie
Published: May 2023

Objectives

To explore informal caregivers’ perspectives on precision medicine in cancer care.

Design

Semi-structured interviews with the informal caregivers of people living with cancer and receiving targeted/immunotherapies. Interview transcripts were analysed thematically using a framework approach.

Setting

Recruitment was facilitated by two hospitals and five Australian cancer community groups.

Participants

Informal caregivers (n=28; 16 men, 12 women; aged 18–80) of people living with cancer and receiving targeted/immunotherapies.

Results

Thematic analysis identified three findings, centred largely on the pervasive theme of hope in relation to precision therapies including: (1) precision as a key component of caregivers’ hope; (2) hope as a collective practice between patients, caregivers, clinicians and others, which entailed work and obligation for caregivers; and (3) hope as linked to expectations of further scientific progress, even if there may be no personal, immediate benefit.

Conclusions

Innovation and change in precision oncology are rapidly reconfiguring the parameters of hope for patients and caregivers, creating new and difficult relational moments and experiences in everyday life and in clinical encounters. In the context of a shifting therapeutic landscape, caregivers’ experiences illustrate the need to understand hope as collectively produced, as emotional and moral labour, and as entangled in broader cultural expectations of medical advances. Such understandings may help clinicians as they guide patients and caregivers through the complexities of diagnosis, treatment, emerging evidence and possible futures in the precision era. Developing a better understanding of informal caregivers’ experiences of caring for patients receiving precision therapies is important for improving support to patients and their caregivers.
Holistic mHealth interventions for the promotion of healthy ageing: protocol for a systematic review
Authors: Zheng Shenglin , Edney Sarah Martine , Mair Jacqueline Louise , Kowatsch Tobias , Castro Oscar , Salamanca-Sanabria Alicia , Müller‐Riemenschneider Falk
Published: May 2023

Introduction

Maintaining physical and mental health is essential for healthy ageing. It can be supported by modifying lifestyle factors such as physical activity and diet. Poor mental health, in turn, contributes to the opposing effect. The promotion of healthy ageing may therefore benefit from holistic interventions integrating physical activity, diet and mental health. These interventions can be scaled up to the population level by using mobile technologies. However, systematic evidence regarding the characteristics and effectiveness of such holistic mHealth interventions remains limited. This paper presents a protocol for a systematic review that aims to provide an overview of the current state of the evidence for holistic mHealth interventions, including their characteristics and effects on behavioural and health outcomes in general adult populations .

Methods and analysis

We will conduct a comprehensive search for randomised controlled trials and non-randomised studies of interventions published between January 2011 and April 2022 in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, China National Knowledge Infrastructure and Google Scholar (first 200 records). Eligible studies will be mHealth interventions targeting general adult populations with content on physical activity, diet and mental health. We will extract information on all relevant behavioural and health outcomes, as well as those related to intervention feasibility. Screening and data extraction processes will be carried out independently by two reviewers. Cochrane risk-of-bias tools will be used to assess risk of bias. We will provide a narrative overview of the findings from eligible studies. With sufficient data, a meta-analysis will be conducted.

Ethics and dissemination

Ethical approval is not required because this study is a systematic review based on published data. We intend to publish our findings in a peer-reviewed journal and present the study at international conferences.

PROSPERO registration number

CRD42022315166.
Health and total factor productivity nexus in selected sub-Saharan African countries: quadratic and threshold modelling
Authors: Adegoke Yetunde Oluranti , Mbonigaba Josue , George Gavin
Published: May 2023

Objectives

The sub-Saharan African (SSA) countries have been recording a decline in total factor productivity (TFP) growth, inadequate health funding and poor health outcomes are regarded as problems that might have impeded productivity in the region. This study therefore aligns with Grossman’s theory that better health could be instrumental to productivity growth. In this paper, we establish a predictive TFP model that accommodates the roles of health, which has been omitted in prior studies. To corroborate our findings we examine the threshold relationship between health and TFP.

Methods

The study employs the fixed and random effect model, panel two-stage least squares, static and dynamic panel threshold regression model on a balanced panel data of 25 selected SSA countries from 1995 to 2020 as the estimating technique for the linear relationship and the non-linear relationship between health and TFP.

Results

The result of the analysis reveals a positive relationship between health expenditure and TFP, health expenditure per capita and TFP. Education and other non-health factors, like Information Communication Technology (ICT) and control of corruption equally have significant positive impact on TFP. The result further shows the existence of a threshold relationship between TFP and health at 3.5% level of public health expenditure. We also discover threshold relationship between TFP and some non-health variables like education and ICT at 2.56% and 21%, respectively

Conclusions

More importantly, the study confirms health as a determinant of TFP and also validates the existence of a non-linear relationship between TFP and health. Overall, improvements in health and its proxies have implications for TFP growth in SSA. Therefore, the increase in public health expenditure stipulated in this study should be passed into law for optimal productivity growth rate.
Associations between Insulin Index and dietary insulin load with cardiometabolic phenotype in the AZAR cohort population in north-western Iran: a cross-sectionalstudy
Authors: Faramarzi Elnaz , Somi Mohammad Hossein , Naghibi Irvani Seyed Sina , Pourhashem Nahid , Nourizadeh Amir Mohammad
Published: May 2023

Objectives

Hyperinsulinaemia and insulin resistance are proposed as contributors to the incidence of cardiometabolic phenotypes (CMPs) with unhealthy metabolic status. This study analysed the association between dietary insulin load (DIL) and Dietary Insulin Index (DII) with CMPs in the AZAR cohort population.

Design

This study was a cross-sectional analysis of the AZAR Cohort Study, beginning in 2014 and continuing to this date.

Setting

The AZAR cohort is a part of an Iranian screening programme named the Persian cohort and involves participants living in the Shabestar region, Iran for at least 9 months.

Participants

A total of 15 006 participants agreed to partake in the study. We excluded participants with missing data (n=15), daily energy intake lower than 800 kcal (n=7) or higher than 8000 kcal (n=17), and cancer (n=85). Finally, 14 882 individuals remained.

Primary and secondary outcome measures

The gathered information included the participants' demographic, dietary, anthropometric and physical activity data.

Results

The frequency of DIL and DII significantly decreased from the first to fourth quartiles in metabolically unhealthy participants (p≤0.001). The mean values of DIL and DII were greater in metabolically healthy participants than in unhealthy ones (p<0.001). The results of the unadjusted model showed that the risks of unhealthy phenotypes in the fourth DIL quartile decreased by 0.21 (0.14–0.32) and 0.37 (0.33–0.43), respectively, compared with the first quartile. The same model showed the same risks for DII decreased by 0.18 (0.11–0.28) and 0.39 (0.34–0.45), respectively. The results in both genders were the same as all participants combined.

Conclusions

DII and DIL were correlated with a decreased OR of unhealthy phenotypes. We suggest the reason may be either a lifestyle change in metabolically unhealthy participants or elevated insulin secretion not being as detrimental as previously thought. Further studies can confirm these speculations.
Potentially inappropriate prescribing in hospitalised children: a retrospective, cross-sectional study at a tertiary children’s hospital in China
Authors: Li Siyu , Huang Liang , Zeng Linan , Yu Dan , Jia Zhi-Jun , Cheng Guo , Wang Huiqing , Zhang Lingli
Published: May 2023

Introduction

For improving and optimising drug use in children, we previously developed a tool (including a series of criteria for identifying potentially inappropriate prescribing in children) by literature review and the two-round Delphi technique to prevent inappropriate medication prescriptions at the prescribing stage.

Objective

To assess the prevalence of potentially inappropriate prescription (PIP) among hospitalised children and explore risk factors associated with PIP.

Design

A retrospective cross-sectional study.

Setting

A tertiary children’s hospital in China.

Participants

Hospitalised children with complete medical records who received drug treatment and discharged from 1 January to 31 December 2021.

Outcome measures

We evaluated the medication prescriptions by using a series of previously developed criteria for detecting the prevalence of PIP in hospitalised children and used logistic regression to explore the risk factors (including sex, age, number of drugs, number of comorbidities, days of hospitalisation and admission departments) for PIP in children.

Results

A total of 87 555 medication prescriptions for 16 995 hospitalised children were analysed, and 19 722 PIPs were detected. The prevalence of PIP was 22.53%, and 36.92% of the children had at least one PIP during hospitalisation. The department with the highest prevalence of PIP was the surgical department (OR 9.413; 95% CI 5.521 to 16.046), followed by the paediatric intensive care unit (PICU; OR 8.206; 95% CI 6.643 to 10.137). ‘Inhaled corticosteroids for children with respiratory infections but without chronic respiratory diseases’ was the most frequent PIP. Logistic regression results showed that PIP was more likely to occur in male patients (OR 1.128, 95% CI 1.059 to 1.202) and younger patients (<2 years old; OR 1.974; 95% CI 1.739 to 2.241), and in those with more comorbidities (≥11 types; OR 4.181; 95% CI 3.671 to 4.761), concomitant drugs (≥11 types; OR 22.250; 95% CI 14.468 to 34.223) or longer hospital stay (≥30 days; OR 8.130; 95% CI 6.727 to 9.827).

Conclusions

Medications for long-term hospitalised young children with multiple comorbidities should be minimised and optimised, to avoid PIP, reduce adverse drug reactions and ensure children’s medication safety. The surgery department and PICU had a high prevalence of PIP in the studied hospital and should be the focus of supervision and management in routine prescription review.
Maternal glucose levels and future risk of developing cardiovascular disease: a systematic review and meta-analysis protocol
Authors: Zeng Na , Wen Wendy , Corsi Daniel J , Li Wenshan , Kibret Taddele , Wen Shi Wu
Published: May 2023

Introduction

Hyperglycaemia during pregnancy has been considered as one of the risk factors for cardiovascular diseases (CVDs) among women. Although the evidence regarding the association between gestational diabetes mellitus (GDM) and subsequent CVD has been synthesised, there are no systematic reviews covering the evidence of the association among the non-GDM population. This systematic review and meta-analysis, therefore, aim to fill the gap by summarising existing evidence on the association between maternal glucose levels and the risk of future CVD in pregnant women with or without a diagnosis of GDM.

Methods and analysis

This systematic review protocol was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. Comprehensive literature searches were performed in the following electronic databases: MEDLINE, EMBASE and CINAHL to identify relevant papers from inception to 31 December 2022. All observational studies (case–control studies, cohort studies and cross-sectional studies) will be included. Two reviewers will perform the abstract and full-text screening based on the eligibility criteria through Covidence. The Newcastle-Ottawa Scale will be used to assess the methodological quality of included studies. Statistical heterogeneity will be assessed by using the I2test and Cochrane’s Q test. If the included studies are found to be homogeneous, pooled estimates will be calculated and meta-analysis will be performed using Review Manager 5 (RevMan) software. Random effects will be used to determine weights for meta-analysis, if needed. Pre-specified subgroup analysis and sensitivity analysis will be performed, if needed. The study results will be presented in the sequence of main outcomes, secondary outcomes and important subgroup analysis for each type of glucose level separately.

Ethics and dissemination

Given no original data will be collected, ethics approval is not applicable for this review. The results of this review will be disseminated by publication and conference presentation.

PROSPERO registration number

CRD42022363037.