bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrahigh energy storage in high-entropy ceramic capacitors with polymorphic relaxor phase
Authors: Zhang Min , Lan Shun , Yang Bing B. , Pan Hao , Liu Yi Q. , Zhang Qing H. , Qi Jun L. , Chen Di , Su Hang , Yi Di , Yang Yue Y. , Wei Rui , Cai Hong D. , Han Hao J. , Gu Lin , Nan Ce-Wen , Lin Yuan-Hua
Published: April 2024

Ultrahigh–power-density multilayer ceramic capacitors (MLCCs) are critical components in electrical and electronic systems. However, the realization of a high energy density combined with a high efficiency is a major challenge for practical applications. We propose a high-entropy design in barium titanate (BaTiO
3
)–based lead-free MLCCs with polymorphic relaxor phase. This strategy effectively minimizes hysteresis loss by lowering the domain-switching barriers and enhances the breakdown strength by the high atomic disorder with lattice distortion and grain refining. Benefiting from the synergistic effects, we achieved a high energy density of 20.8 joules per cubic centimeter with an ultrahigh efficiency of 97.5% in the MLCCs. This approach should be universally applicable to designing high-performance dielectrics for energy storage and other related functionalities.
Closing the loop on thermoset plastic recycling
Authors: Nicholls Bryce T. , Fors Brett P.
Published: April 2024

A bio-based plastic advances recycling
The scientific importance of the lunar environment
Authors: Mandt Kathleen E.
Published: April 2024

Many plans are in preparation to land robotic
missions
on the surface of the Moon, which will pave the way to return humans to the lunar surface and set the stage for an ongoing human presence.
Artemis
is a NASA-led international effort to return humans to the Moon. One of the goals of Artemis is to use innovative technologies to address priority science objectives. At the same time, the European Space Agency (ESA) is exploring designs for a
Moon base
to enable ongoing human activity on the lunar surface. Furthermore,
China
plans to land humans on the Moon by 2030. In situ resource utilization (
ISRU
)—the extraction of useful materials from the Moon itself—will be beneficial for efforts to sustain a human presence. ISRU could provide water that can be used by astronauts or split into hydrogen and oxygen rocket fuel for returning to Earth or moving onward to Mars, along with other vital resources. Although this possibility is exciting, it is critical that we recognize how human and robotic activity will
affect the lunar environment
. Not having a global strategy to characterize lunar volatile materials before their scientific value is lost will substantially degrade the Moon’s scientific potential.
Outpatient treatment with concomitant vaccine-boosted convalescent plasma for patients with immunosuppression and COVID-19
Authors: Ripoll Juan G. , Tulledge-Scheitel Sidna M. , Stephenson Anthony A. , Ford Shane , Pike Marsha L. , Gorman Ellen K. , Hanson Sara N. , Juskewitch Justin E. , Miller Alex J. , Zaremba Solomiia , Ovrom Erik A. , Razonable Raymund R. , Ganesh Ravindra , Hurt Ryan T. , Fischer Erin N. , Derr Amber N. , Eberle Michele R. , Larsen Jennifer J. , Carney Christina M. , Theel Elitza S. , Parikh Sameer A. , Kay Neil E. , Joyner Michael J. , Senefeld Jonathon W.
Published: April 2024

Although severe coronavirus disease 2019 (COVID-19) and hospitalization associated with COVID-19 are generally preventable among healthy vaccine recipients, patients with immunosuppression have poor immunogenic responses to COVID-19 vaccines and remain at high risk of infection with SARS-CoV-2 and hospitalization. In addition, monoclonal antibody therapy is limited by the emergence of novel SARS-CoV-2 variants that have serially escaped neutralization. In this context, there is interest in understanding the clinical benefit associated with COVID-19 convalescent plasma collected from persons who have been both naturally infected with SARS-CoV-2 and vaccinated against SARS-CoV-2 (“vax-plasma”). Thus, we report the clinical outcome of 386 immunocompromised outpatients who were diagnosed with COVID-19 and who received contemporary COVID-19-specific therapeutics (standard-of-care group) and a subgroup who also received concomitant treatment with very high titer COVID-19 convalescent plasma (vax-plasma group) with a specific focus on hospitalization rates. The overall hospitalization rate was 2.2% (5 of 225 patients) in the vax-plasma group and 6.2% (10 of 161 patients) in the standard-of-care group, which corresponded to a relative risk reduction of 65% (
P
= 0.046). Evidence of efficacy in nonvaccinated patients cannot be inferred from these data because 94% (361 of 386 patients) of patients were vaccinated. In vaccinated patients with immunosuppression and COVID-19, the addition of vax-plasma or very high titer COVID-19 convalescent plasma to COVID-19-specific therapies reduced the risk of disease progression leading to hospitalization.

IMPORTANCE

As SARS-CoV-2 evolves, new variants of concern (VOCs) have emerged that evade available anti-spike monoclonal antibodies, particularly among immunosuppressed patients. However, high-titer COVID-19 convalescent plasma continues to be effective against VOCs because of its broad-spectrum immunomodulatory properties. Thus, we report clinical outcomes of 386 immunocompromised outpatients who were treated with COVID-19-specific therapeutics and a subgroup also treated with vaccine-boosted convalescent plasma. We found that the administration of vaccine-boosted convalescent plasma was associated with a significantly decreased incidence of hospitalization among immunocompromised COVID-19 outpatients. Our data add to the contemporary data providing evidence to support the clinical utility of high-titer convalescent plasma as antibody replacement therapy in immunocompromised patients.
Supplemental Material: Identifying and characterizing missing source orogens for syn-orogenic basins based on detrital accessory mineral U-Pb geochronology and trace element geochemistry
Authors: Wang Lijun , Lin Shoufa , Xiao W.J. , al. et
Published: April 2024

Analytical methods and data, sample location map, field photographs and thin section photomicrographs, cathodoluminescence and backscatter electron images, and Concordia and kernel density estimation plots.  
Atypical parathyroid adenoma with severe bone manifestations in early adolescence
Authors: Carvalho Ana Rachel Teixeira Batista , Araújo Paula Hollanda de , Romani Flaviene Alves do Prado , Barra Betânia Bisinoto
Published: April 2024

This is a case of primary hyperparathyroidism in a female teenager with multiple fractures and severe bone manifestations. The histopathology revealed atypical parathyroid adenoma, an exceedingly rare form of hyperparathyroidism; its main differential diagnosis is parathyroid carcinoma, as it shares both clinical and histological characteristics with it, in addition to its still uncertain malignant potential.
Impact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse in integrated healthcare system: difference-in-difference study
Authors: Kurlander Jacob E , Laine Loren , Kim Hyungjin Myra , Roberts Christopher B , Saffar Darcy , Myers Aimee , Holleman Robert , Gao Yuqing , Shank Michelle , Nelson Richard , Forman Jane , Helfrich Christian D , Krein Sarah L , Saini Sameer D , Yang Yu-Xiao
Published: April 2024

Objective

To determine how a large scale, multicomponent, pharmacy based intervention to reduce proton pump inhibitor (PPI) overuse affected prescribing patterns, healthcare utilization, and clinical outcomes.

Design

Difference-in-difference study.

Setting

US Veterans Affairs Healthcare System, in which one regional network implemented the overuse intervention and all 17 others served as controls.

Participants

All individuals receiving primary care from 2009 to 2019.

Intervention

Limits on PPI refills for patients without a documented indication for long term use, voiding of PPI prescriptions not recently filled, facilitated electronic prescribing of H2 receptor antagonists, and education for patients and clinicians.

Main outcome measures

The primary outcome was the percentage of patients who filled a PPI prescription per 6 months. Secondary outcomes included percentage of days PPI gastroprotection was prescribed in patients at high risk for upper gastrointestinal bleeding, percentage of patients who filled either a PPI or H2 receptor antagonist prescription, hospital admission for acid peptic disease in older adults appropriate for PPI gastroprotection, primary care visits for an upper gastrointestinal diagnosis, upper endoscopies, and PPI associated clinical conditions.

Results

The number of patients analyzed per interval ranged from 192 607 to 250 349 in intervention sites and from 3 775 953 to 4 360 868 in control sites, with 26% of patients receiving PPIs before the intervention. The intervention was associated with an absolute reduction of 7.3% (95% confidence interval −7.6% to −7.0%) in patients who filled PPI prescriptions, an absolute reduction of 11.3% (−12.0% to −10.5%) in PPI use among patients appropriate for gastroprotection, and an absolute reduction of 5.72% (−6.08% to −5.36%) in patients who filled a PPI or H2 receptor antagonist prescription. No increases were seen in primary care visits for upper gastrointestinal diagnoses, upper endoscopies, or hospital admissions for acid peptic disease in older patients appropriate for gastroprotection. No clinically significant changes were seen in any PPI associated clinical conditions.

Conclusions

The multicomponent intervention was associated with reduced PPI use overall but also in patients appropriate for gastroprotection, with minimal evidence of either clinical benefits or harms.
Reporting form and content of research priorities identified in knee osteoarthritis clinical practice guidelines: a methodological literature analysis
Authors: Gao Yicheng , Liu Zhihan , Cao Rui , Feng Yuting , Tao Liyuan , Su Chengyuan , Guan Xinmiao , Fang Rui , Deng Yingjie , Xiang Wenyuan , Fei Yutong
Published: April 2024

Objectives

Clinical practice guideline (CPG) developers conduct systematic summaries of research evidence, providing them great capacity and ability to identify research priorities. We systematically analysed the reporting form and content of research priorities in CPGs related to knee osteoarthritis (KOA) to provide a valuable reference for guideline developers and clinicians.

Design

A methodological literature analysis was done and the characteristics of the reporting form and the content of the research priorities identified in KOA CPGs were summarised.

Data sources

Six databases (PubMed, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang and Chinese Biomedical Literature Database) were searched for CPGs published from 1 January 2017 to 4 December 2022. The official websites of 40 authoritative orthopaedic societies, rheumatology societies and guideline development organisations were additionally searched.

Eligibility criteria

We included all KOA CPGs published in English or Chinese from 1 January 2017 that included at least one recommendation for KOA. We excluded duplicate publications, older versions of CPGs as well as guidance documents for guideline development.

Data extraction and synthesis

Reviewers worked in pairs and independently screened and extracted the data. Descriptive statistics were used, and absolute frequencies and proportions of related items were calculated.

Results

187 research priorities reported in 41 KOA CPGs were identified. 24 CPGs reported research priorities, of which 17 (41.5%) presented overall research priorities for the entire guideline rather than for specific recommendations. 110 (58.8%) research priorities were put forward due to lack of evidence. Meanwhile, more than 70% of the research priorities reflected the P (population) and I (intervention) structural elements, with 135 (72.2%) and 146 (78.1%), respectively. More than half of the research priorities (118, 63.8%) revolved around evaluating the efficacy of interventions. Research priorities primarily focused on physical activity (32, 17.3%), physical therapy (30, 16.2%), surgical therapy (27, 14.6%) and pharmacological treatment (26, 14.1%).

Conclusions

Research priorities reported in KOA CPGs mainly focused on evaluating non-pharmacological interventions. There exists considerable room for improvement for a comprehensive and standardised generation and reporting of research priorities in KOA CPGs.
Association of antibiotic duration and all-cause mortality in a prospective study of patients with ventilator-associated pneumonia in a tertiary-level critical care unit in Southern India
Authors: Stanley Nivin Daniel , Jeevan Jonathan Arul , Yadav Bijesh , Gunasekaran Karthik , Pichamuthu Kishore , Chandiraseharan Vignesh Kumar , Sathyendra Sowmya , Hansdak Samuel George , Iyyadurai Ramya
Published: April 2024

Objectives

To estimate all-cause mortality in ventilator-associated pneumonia (VAP) and determine whether antibiotic duration beyond 8 days is associated with reduction in all-cause mortality in patients admitted with VAP in the intensive care unit.

Design

A prospective cohort study of patients diagnosed with VAP based on the National Healthcare Safety Network definition and clinical criteria.

Setting

Single tertiary care hospital in Southern India.

Participants

100 consecutive adult patients diagnosed with VAP were followed up for 28 days postdiagnosis or until discharge.

Outcome measures

The incidence of mortality at 28 days postdiagnosis was measured. Tests for association and predictors of mortality were determined using χ2test and multivariate Cox regression analysis. Secondary outcomes included baseline clinical parameters such as age, underlying comorbidities as well as measuring total length of stay, number of ventilator-free days and antibiotic-free days.

Results

The overall case fatality rate due to VAP was 46%. There was no statistically significant difference in mortality rates between those receiving shorter antibiotic duration (5–8 days) and those on longer therapy. Among those who survived until day 9, the observed risk difference was 15.1% between both groups, with an HR of 1.057 (95% CI 0.26 to 4.28). In 70.4% of isolates, non-fermenting Gram-negative bacilli were identified, of which the most common pathogen isolated wasAcinetobacter baumannii(62%).

Conclusion

In this hospital-based cohort study, there is insufficient evidence to suggest that prolonging antibiotic duration beyond 8 days in patients with VAP improves survival.
Qualitative study on the core competencies of nursing personnel in emergency medical rescue teams at comprehensive hospitals in Chongqing, China
Authors: Deng Jing , Kou Xun , Ma Huijuan , Niu Aifang , Luo Yu
Published: April 2024

Objective

As an integral part of emergency medical rescue teams during public health events, understanding the core competencies that nursing personnel should possess—including theoretical knowledge, practical skills, comprehensive abilities and personal traits—can provide a practical basis for better preparation and targeted training for future emergency rescue works. Thus, this study aims to provide a scientific and applicable reference for perfecting the routine training strategy of nursing personnel assembled by emergency medical rescue teams and improving the overall guarantee ability level of this group.

Design

This is a qualitative study conducted using individual semi-structured interviews. All interviews were recorded and transcribed verbatim for the purpose of thematic analysis and extraction.

Setting

Participants were recruited from February to March 2023, from four comprehensive hospitals in Chongqing China with the highest number of emergency relief works.

Participants

A sample of experts (N=15) with extensive experience in emergency relief works was recruited in Chongqing, China.

Results

60% of the experts held master’s degrees or higher, 73.3% held senior or higher titles, 36.7% had participated in work execution more than five times and 73.3% held leadership positions in their current units and in the execution of emergency relief works. Four main themes and 22 corresponding subthemes were derived for the core competencies required for nursing personnel selected for emergency medical rescue teams in public health events, including theoretical knowledge, practical skills, comprehensive abilities and personal traits.

Conclusions

Our study revealed that through interviews with 15 experts with extensive experience in the public health event, the essential elements of core competencies for nursing personnel assigned to emergency medical rescue teams during the public health event were identified. These can serve as a reference standard for the selection of nursing personnel in public health events, and provide a basis for the cultivation and evaluation of competency for nursing personnel assigned to emergency medical rescue teams in the public health event in China and globally.
Community perceptions, beliefs and factors determining family planning uptake among men and women in Ekiti State, Nigeria: finding from a descriptive exploratory study
Authors: Ibikunle Oluwafunmilayo Oluwadamilola , Ipinnimo Tope Michael , Bakare Caroline Ajoke , Ibirongbe Demilade Olusola , Akinwumi Adebowale Femi , Ibikunle Austine Idowu , Ajidagba Emman Babatunde , Olowoselu Oluwafemi Oreoluwa , Abioye Opeyemi Oladipupo , Alabi Ayodele Kamal , Seluwa Gilbert Ayodele , Alabi Olasunkanmi Omotolani , Filani Oyebanji , Adelekan Babatunde
Published: April 2024

Objectives

To examine family planning through the community’s perception, belief system and cultural impact; in addition to identifying the determining factors for family planning uptake.

Design

A descriptive exploratory study.

Setting

Three communities were selected from three local government areas, each in the three senatorial districts in Ekiti State.

Participants

The study was conducted among young unmarried women in the reproductive age group who were sexually active as well as married men and women in the reproductive age group who are currently living with their partners and were sexually active.

Main outcome measures

Eight focus group discussions were conducted in the community in 2019 with 28 male and 50 female participants. The audio recordings were transcribed, triangulated with notes and analysed using QSR NVivo V.8 software. Community perception, beliefs and perceptions of the utility of family planning, as well as cultural, religious and other factors determining family planning uptake were analysed.

Results

The majority of the participants had the perception that family planning helps married couple only. There were diverse beliefs about family planning and mixed reactions with respect to the impact of culture and religion on family planning uptake. Furthermore, a number of factors were identified in determining family planning uptake—intrapersonal, interpersonal and health system factors.

Conclusion

The study concluded that there are varied reactions to family planning uptake due to varied perception, cultural and religious beliefs and determining factors. It was recommended that more targeted male partner engagement in campaign would boost family planning uptake.
Association between the triglyceride to high-density lipoprotein cholesterol ratio and mortality in Chinese maintenance haemodialysis patients: a retrospective cohort study
Authors: Qi Lemuge , Zhang Aihong , Zhang Yanping , Ren Zhuo , Zhao Chen , Wang Qian , Ren Kaiming , Bai Jiuxu , Cao Ning
Published: April 2024

Objective

To investigate the relationship between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and all-cause and cardiovascular (CV) mortality in Chinese haemodialysis (HD) patients.

Design

Retrospective cohort study.

Setting

Patients from June 2015 to September 2016 and followed through September 2021 were categorised into quartiles according to the follow-up averaged TG/HDL-C ratio. The association between TG/HDL-C and mortality was examined by univariate and multivariate time-varying Cox regression analyses. The C-index was used to assess the predictive accuracy of the Cox regression models.

Participants

A total of 534 maintenance HD patients were enrolled.

Primary and secondary outcome measures

The outcomes were all-cause death and CV mortality.

Results

During the median follow-up of 61 months, 207 patients died, with 94 (45.4%) classified as CV death. After adjusting for confounders, multivariate time-varying Cox regression analysis showed that the quartile 4 group (TG/HDL-C ≥2.64) was associated with decreased all-cause mortality (adjusted HR 0.51, 95% CI 0.33–0.77, p=0.001) and CV mortality (adjusted HR 0.31; 95% CI 0.16 to 0.62; p=0.001) in maintenance HD patients. Model 1 of all-cause mortality achieved a C-index of 0.72 (95% CI 0.68 to 0.75), and model 2 achieved a C-index of 0.77 (95% CI 0.73 to 0.82). The C-index for model 1 in CV mortality was 0.74 (95% CI 0.70 to 0.77), and the C-index for model 2 was 0.80 (95% CI 0.75 to 0.84).

Conclusions

High TG/HDL-C was associated with decreased all-cause and CV mortality in HD patients.
Intersection of gambling with smoking and alcohol use in Great Britain: a cross-sectional survey in October 2022
Authors: Kock Loren , Cox Sharon , Shahab Lion , Roberts Amanda , Sharman Steve , Buss Vera , Brown Jamie
Published: April 2024

Objectives

Gambling is associated with cigarette smoking and alcohol consumption. We explored the intersection of gambling across all risk levels of harm with smoking and alcohol use among adults in Great Britain.

Design

A nationally representative cross-sectional survey in October 2022.

Setting

Great Britain.

Participants

A weighted total of 2398 adults (18+ years).

Outcome measures

We examined the prevalence of past-year gambling and, among those reporting gambling, assessed the associations between the outcome of any risk of harm from gambling (scoring >0 on the Problem Gambling Severity Index) and the binary predictor variables of current cigarette smoking and higher risk alcohol consumption (AUDIT-C score≥4). We also explored data on weekly expenditure on gambling with smoking and alcohol use among those categorised at any-risk of harm from gambling.

Results

Overall, 43.6% (95% CI 41.2% to 45.9%) of adults gambled in the past year. Among these, 7.3% (95% CI 5.3% to 9.3%) were classified at any-risk of harm from gambling, 16.0% (95% CI 13.2% to 18.8%) were currently smoking and 40.8% (95% CI 37.2% to 44.4%) were drinking at increasing and higher risk levels. There were no associations between any risk of harm from gambling and current smoking (OR adjusted=0.80, 95% CI 0.35 to 1.66) or drinking at increasing and higher risk levels (OR adjusted=0.94, 95% CI 0.52 to 1.69), respectively. Analyses using Bayes factors indicated that these data were insensitive to distinguish no effect from a range of associations (OR=95% CI 0.5 to 1.9). The mean weekly spend on gambling was £7.69 (95% CI £5.17 to £10.21) overall, £4.80 (95% CI £4.18 to £5.43) among those classified as at no risk and £45.68 (95% CI £12.07 to £79.29) among those at any risk of harm from gambling.

Conclusions

Pilot data in a population-level survey on smoking and alcohol use yielded similar estimates to other population-level surveys on gambling participation and at-risk gambling. Further data are needed to elucidate the intersections more reliably between gambling, smoking and alcohol use and inform population-level approaches to reduce harm.
Point-of-choice kilocalorie labelling practices in large, out-of-home food businesses: a preobservational versus post observational study of labelling practices following implementation of The Calorie Labelling (Out of Home Sector) (England) Regulations 2021
Authors: Polden Megan , Jones Andrew , Essman Michael , Adams Jean , Bishop Tom , Burgoine Thomas , Donohue Aisling , Sharp Stephen , White Martin , Smith Richard , Robinson Eric
Published: April 2024

Background and objectives

On 6 April 2022, the UK government implemented mandatory kilocalorie (kcal) labelling regulations for food and drink products sold in the out-of-home food sector (OHFS) in England. Previous assessments of kcal labelling practices in the UK OHFS found a low prevalence of voluntary implementation and poor compliance with labelling recommendations. This study aimed to examine changes in labelling practices preimplementation versus post implementation of mandatory labelling regulations in 2022.

Methods

In August–December 2021 (preimplementation) and August–November 2022 (post implementation), large OHFS businesses (250 or more employees) subject to labelling regulations were visited. At two time points, a researcher visited the same 117 food outlets (belonging to 90 unique businesses) across four local authorities in England. Outlets were rated for compliance with government regulations for whether kcal labelling was provided at any or all point of choice, provided for all eligible food and drink items, provided per portion for sharing items, if labelling was clear and legible and if kcal reference information was displayed.

Results

There was a significant increase (21% preimplementation vs 80% post implementation, OR=40.98 (95% CI 8.08 to 207.74), p<0.001) in the proportion of outlets providing any kcal labelling at point-of-choice post implementation. Only 15% of outlets met all labelling compliance criteria post implementation, with a minority of outlets not presenting labelling in a clear (33%) or legible (29%) way.

Conclusion

The number of large businesses in the OHFS providing kcal labelling increased following the implementation of mandatory labelling regulations. However, around one-fifth of eligible outlets sampled were not providing kcal labelling 4–8 months after the regulations came into force, and the majority of businesses only partially complied with government guidance. More effective enforcement may be required to further improve kcal labelling practices in the OHFS in England.

Preregistration

Study protocol and analysis strategy preregistered on Open Science Framework (https://osf.io/pfnm6/).
Conceptual framework for establishing twins prevention and continuous health promotion programme: a qualitative study
Authors: Abtahi Hamidreza , Khoshnam-Rad Niloofar , Gholamzadeh Marsa , Daraie Morteza , Sabouri Fatemeh
Published: April 2024

Background

Twin registries and cohorts face numerous challenges, including significant resource allocation, twins’ recruitment and retention. This study aimed to assess expert feedback on a proposed pragmatic idea for launching a continuous health promotion and prevention programme (HPPP) to establish and maintain twin cohorts.

Design

A qualitative study incorporating an inductive thematic analysis.

Setting

Tehran University of Medical Sciences.

Participants

Researchers with expertise in twin studies participated in our study.

Analysis and design

Expert opinions were gathered through focus group discussions (FGDs). Thematic analysis was employed to analyse the findings and develop a model for designing a comprehensive, long-term health promotion programme using ATLAS.ti software. Additionally, a standardised framework was developed to represent the conceptual model of the twin HPPP.

Results

Eight FGDs were conducted, involving 16 experts. Thematic analysis identified eight themes and seven subthemes that encompassed the critical aspects of a continuous monitoring programme for twin health. Based on these identified themes, a conceptual framework was developed for the implementation of an HPPP tailored for twins.

Conclusion

This study presented the initial endeavour to establish a comprehensive and practical solution in the form of a continuous HPPP designed to tackle the obstacles of twins’ cohorts.
Understanding lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London: a qualitative study protocol
Authors: Murray Aisling , Durrani Faiza , Winstanley Ali , Keiller Eleanor , Taleb Patrisiya Ali , Islam Shahlima , Foka Sevasti , Turri Maria Grazia , Lau Jennifer Y F
Published: April 2024

Introduction

It is important to promote resilience in preadolescence; however, there is limited research on children’s understandings and experiences of resilience. Quantitative approaches may not capture dynamic and context-specific aspects of resilience. Resilience research has historically focused on white, middle-class Western adults and adolescents, creating an evidence gap regarding diverse experiences of resilience in middle childhood which could inform interventions. East London’s Muslim community represents a diverse, growing population. Despite being disproportionately affected by deprivation and racial and cultural discrimination, this population is under-represented in resilience research. Using participatory and arts-based methods, this study aims to explore lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London.

Methods and analysis

We propose a qualitative study, grounded in embodied inquiry, consisting of a participatory workshop with 6–12 children and their parents/carers to explore lived experiences and perceptions of resilience. Participants will be identified and recruited from community settings in East London. Eligible participants will be English-speaking Muslims who identify as being black or South Asian, have a child aged 8–12 years and live in East London. The workshop (approx. 3.5 hours) will take place at an Islamic community centre and will include body mapping with children and a focus group discussion with parents/carers to explore resilience perspectives and meanings. Participants will also complete a demographic survey. Workshop audio recordings will be transcribed verbatim and body maps and other paper-based activities will be photographed. Data will be analysed using systematic visuo-textual analysis which affords equal importance to visual and textual data.

Ethics and dissemination

The Queen Mary Ethics of Research Committee at Queen Mary University of London has approved this study (approval date: 9 October 2023; ref: QME23.0042). The researchers plan to publish the results in peer-reviewed journals and present findings at academic conferences.
Prevalence and associated factors of corneal opacity among adults in Kolladiba town, Northwest Ethiopia: a cross-sectional study
Authors: Worku Endalew Mulugeta , Fekadu Sofonias Addis , Alemie Bersufekad Wubie , Lorato Merkineh Markos
Published: April 2024

Objective

This study aimed to assess the prevalence and associated factors of corneal opacity among adults in Kolladiba town, Northwest Ethiopia.

Methods and analysis

A community-based cross-sectional study was conducted using a systematic random sampling technique. A total of 846 adult individuals were recruited for the study. Ethical approval was obtained from the University of Gondar School of Medicine Ethical Review Committee. A standardised, semistructured questionnaire plus an ocular examination were used to collect the data. The data were entered into Epi Info V.7 and cleaned and analysed using SPSS V.26. Binary and multivariable logistic regression analyses were performed to select candidate variables and identify statistically significant factors. Variables with a p value of less than 0.05 according to the multivariable logistic regression analysis were considered to be statistically significant.

Results and conclusion

The prevalence of corneal opacity among the study participants was 27.2% (95% CI 24.4% to 30.4%). In this study, age 49–60 years (adjusted OR (AOR): 1.90; 95% CI 1.03 to 3.32), age ≥61 years (AOR=2.12; 95% CI 1.17 to 3.87), inability to read and write (AOR=2.65; 95% CI 1.68 to 4.16), middle-income level (AOR=2.12; 95% CI 1.30 to 3.47) and poor income level (AOR=4.96; 95% CI 3.04 to 8.09) were factors that were significantly associated with corneal opacity.

In this study, the prevalence of corneal opacity was considerably high. Being poor and unable to read and write were the primary factors significantly associated with corneal opacity. Hence, concerned stakeholders should strive to reverse the effects of corneal opacity on the quality of life of the study and causal studies should be considered in the future.
Exploring coping strategies among caregivers of children who have survived paediatric cancer in Jordan
Authors: Ismael Noor , Jaber Ala’a , Malkawi Somaya , Al Awady Sherin , Ismael Taleb
Published: April 2024

Objective

To explore the coping strategies of caregivers of children who have survived paediatric cancer in Jordan.

Materials and methods

This study used a cross-sectional survey design and convenient sampling. The sample included 102 caregivers of children who have survived cancer, and outcome measures included the Arabic-translated Brief COPE, and caregiver and child demographic and condition questionnaire. Data analyses included descriptive statistics, analysis of frequencies, Spearman-rank order correlations and linear regression.

Results

Caregivers most frequently used religion coping (mean=6.42, SD=1.85), followed by acceptance (mean=5.95, SD=1.96) and planning (mean=5.05, SD=1.94). The least used coping strategies were humour (mean=2.98, SD=1.24) and behavioural disengagement as coping strategies (mean=3.01, SD=1.42). Having a female child predicted more self-distraction utilisation (β=0.265, p=0.007).

Conclusion

Caregivers of children who have survived cancer in Jordan frequently use passive coping strategies like religion and acceptance coping to overcome daily life stressors. Caregivers might benefit from psychosocial occupational therapy interventions to support their engagement in more active or problem-focused coping strategies.
Effectiveness of double checking to reduce medication administration errors: a systematic review
Authors: Koyama Alain K , Maddox Claire-Sophie Sheridan , Li Ling , Bucknall Tracey , Westbrook Johanna I
Published: April 2024

Background

Double checking medication administration in hospitals is often standard practice, particularly for high-risk drugs, yet its effectiveness in reducing medication administration errors (MAEs) and improving patient outcomes remains unclear. We conducted a systematic review of studies evaluating evidence of the effectiveness of double checking to reduce MAEs.

Methods

Five databases (PubMed, Embase, CINAHL, Ovid@Journals, OpenGrey) were searched for studies evaluating the use and effectiveness of double checking on reducing medication administration errors in a hospital setting. Included studies were required to report any of three outcome measures: an effect estimate such as a risk ratio or risk difference representing the association between double checking and MAEs, or between double checking and patient harm; or a rate representing adherence to the hospital’s double checking policy.

Results

Thirteen studies were identified, including 10 studies using an observational study design, two randomised controlled trials and one randomised trial in a simulated setting. Studies included both paediatric and adult inpatient populations and varied considerably in quality. Among three good quality studies, only one showed a significant association between double checking and a reduction in MAEs, another showed no association, and the third study reported only adherence rates. No studies investigated changes in medication-related harm associated with double checking. Reported double checking adherence rates ranged from 52% to 97% of administrations. Only three studies reported if and how independent and primed double checking were differentiated.

Conclusion

There is insufficient evidence that double versus single checking of medication administration is associated with lower rates of MAEs or reduced harm. Most comparative studies fail to define or investigate the level of adherence to independent double checking, further limiting conclusions regarding effectiveness in error prevention. Higher-quality studies are needed to determine if, and in what context (eg, drug type, setting), double checking produces sufficient benefits in patient safety to warrant the considerable resources required.

NCT42018103436.
Pulmonary hypertension survival and hospitalisations in people living with HIV: a systematic review and meta-analysis
Authors: Youssef Mark , Boutros Salama Marina , Rehman Nadia , Hanna Christina , Waniss Mary Rose , Mbuagbaw Lawrence
Published: April 2024

Introduction

People living with HIV (PLHIV) have a higher risk of developing pulmonary hypertension (PH) with subsequent poorer prognosis. This review aimed to determine the (1) survival outcomes and (2) proportion of emergency department (ED) visits and hospitalisations of PLHIV and PH.

Methods

We conducted a systematic review and meta-analysis of observational studies reporting survival outcomes for PLHIV and PH. Electronic databases (Medline, EMBASE, PubMed, Web of Science, Global Index Medicus and Cochrane Library), trial registries and conference proceedings were searched until 22 July 2023. We pooled similar measures of effect, assessed apriori subgroups and used meta-regression to determine mortality and associated variables.

Results

5248 studies were identified; 28 studies were included with a total of 5459 PLHIV and PH. The mean survival (95% CI) of PLHIV and PH was 37.4 months (29.9 to 44.8). Participants alive at 1, 2 and 3 years were 85.8% (74.1% to 95.0%), 75.2% (61.9% to 86.7%) and 61.9% (51.8% to 71.6%), respectively. ED visits and hospitalisation rates were 73.3% (32.5% to 99.9%) and 71.2% (42.4% to 94.2%), respectively. More severe disease, measured by echocardiogram, was associated with poorer prognosis (β −0.01, 95% CI −0.02 to 0.00, p=0.009). Survival was higher in high-income countries compared with lower-income countries (β 0.50, 95% CI 0.28 to 0.73, p<0.001) and in Europe compared with the America (β 0.56, 95% CI 0.37 to 0.75, p<0.001).

Conclusion

Our study confirms poor prognosis and high healthcare utilisation for PLHIV and PH. Prognosis is associated with country income level, geographic region and PH severity. This highlights the importance of screening in this population.

PROSPERO registration number

CRD42023395023.
Epidemiology of injuries at the 2023 UCI cycling world championships using the International Olympic Consensus: a protocol for a prospective cohort study
Authors: Heron Neil , Bigard Xavier , Elliott Niall , Lunan Emma , Fallon Thomas , Palmer Debbie
Published: April 2024

The sport of cycling consists of several individual sporting disciplines. Indeed, the world governing body for cycling, Union Cycliste Internationale (UCI), oversees the various cycling disciplines, with each of these disciplines having a number of subcategories. While several sports have undertaken prospective injury surveillance studies to understand the risks of their sport, plan event medical support and develop prevention programmes, limited high-quality studies have been undertaken within cycling. Indeed, this is the first prospective study of cycling injuries, particularly when considering the whole sport of cycling together. This current study will therefore aim to describe the incidence, severity, burden and nature of injuries within elite cycling in those athletes participating across 13 championship events at the inaugural World Championships, Glasgow, August 2023. Injury and exposure definitions will be in line with the IOC Consensus for injury surveillance in cycling. Injury incidence will be reported per 1000 athlete match hours or per number of athletes/cyclists and injury severity will be assessed via estimated median or mean days lost to training/competition. Meanwhile injury burden will be assessed via days of absence/1000 athlete match hours (or per number of athletes exposed) and all these results will be compared between male and female cyclists. This paper will also report the most common specific injuries for male and female cyclists (per 1000 hours of participation or per number of athletes exposed). Statistical differences will be tested for incidence or severity measures between sexes and will be compared to other sports.
The big heroine genre: motherhood and the maternal body in postsocialist Chinese television
Authors: Xu Chelsea Wenzhu
Published: April 2024

This article explores the feminist social critique in the ‘big heroine’ drama, a newly emerged genre of television that focuses on empowering yet dramatic stories of urban women in contemporary China. The article theorises the genre as a site of ongoing contestations to inform and critique women’s maternal reality in neoliberal, pronatalist China. The big heroine genre is situated in the postsocialist structure of feeling defined by alienation and precarity, responding to China’s need to stabilise the emerging population crisis and labour shortage. Using a popular instance within the genre,Left Right(2022), as a case study, the article argues that the show validates the legitimacy of women’s anxieties and challenges in maternity and then invites viewers to engage in a multifaceted analysis of the intricate web of structural injustices women experience in pregnancy, childbirth, the postpartum and having a second child. By doing so, it not only resonates with viewers’ yearning for recognition and empathy but also stimulates a broader discourse on new and persisting maternal challenges in pronatalist China. I conclude that the genre’s contradictory and contingent nature mirrors the complexities of the Chinese party-state’s attempt to navigate the ideological instability surrounding maternity and motherhood. The genre is progressive in its alternative imagination of kinship and care networks for women navigating the moral, medical, and cultural dilemmas of the maternal body and motherhood in the moment of the state’s transitioning into a more aggressive form of pronatalism.
No healthcare coverage, big problem: lack of insurance for older population associated with worse emergency general surgery outcomes
Authors: Abdul Rahim Komal , Shaikh Namra Qadeer , Lakhdir Maryam Pyar Ali , Afzal Noreen , Merchant Asma Altaf Hussain , Mahmood Saad bin Zafar , Bakhshi Saqib Kamran , Ali Mushyada , Samad Zainab , Haider Adil H
Published: April 2024

Introduction

Older populations, being a unique subset of patients, have poor outcomes for emergency general surgery (EGS). In regions lacking specialized medical coverage for older patients, disparities in healthcare provision lead to poor clinical outcomes. We aimed to identify factors predicting index admission inpatient mortality from EGS among sexagenarians, septuagenarians, and octogenarians.

Methods

Data of patients aged>60 years with EGS conditions defined by the American Association for the Surgery of Trauma at primary index admission from 2010 to 2019 operated and non-operated at a large South Asian tertiary care hospital were analyzed. The primary outcome was primary index admission inpatient 30-day mortality. Parametric survival regression using Weibull distribution was performed. Factors such as patients’ insurance status and surgical intervention were assessed using adjusted HR and 95% CI with a p-value of <0.05 considered statistically significant.

Results

We included 9551 primary index admissions of patients diagnosed with the nine most common primary EGS conditions. The mean patient age was 69.55±7.59 years. Overall mortality and complication rates were 3.94% and 42.29%, respectively. Primary index admission inpatient mortality was associated with complications including cardiac arrest and septic shock. Multivariable survival analysis showed that insurance status was not associated with mortality (HR 1.13; 95% CI 0.79, 1.61) after adjusting for other variables. The odds of developing complications among self-paid individuals were higher (adjusted OR 1.17; 95% CI 1.02, 1.35).

Conclusion

Lack of healthcare coverage for older adults can result in delayed presentation, leading to increased morbidity. Close attention should be paid to such patients for timely provision of treatment. There is a need to expand primary care access and proper management of comorbidities for overall patient well-being. Government initiatives for expanding insurance coverage for older population can further enhance their healthcare access, mitigating the risk of essential treatments being withheld due to financial limitations.

Level of evidence

III.
Scaling law of real traffic jams under varying travel demand
Authors: Chen Rui , Lin Yuming , Yan Huan , Liu Jiazhen , Liu Yu , Li Yong
Published: April 2024

The escalation of urban traffic congestion has reached a critical extent due to rapid urbanization, capturing considerable attention within urban science and transportation research. Although preceding studies have validated the scale-free distributions in spatio-temporal congestion clusters across cities, the influence of travel demand on that distribution has yet to be explored. Using a unique traffic dataset during the COVID-19 pandemic in Shanghai 2022, we present empirical evidence that travel demand plays a pivotal role in shaping the scaling laws of traffic congestion. We uncover a noteworthy negative linear correlation between the travel demand and the traffic resilience represented by scaling exponents of congestion cluster size and recovery duration. Additionally, we reveal that travel demand broadly dominates the scale of congestion in the form of scaling laws, including the aggregated volume of congestion clusters, the number of congestion clusters, and the number of congested roads. Subsequent micro-level analysis of congestion propagation also unveils that cascade diffusion determines the demand sensitivity of congestion, while other intrinsic components, namely spontaneous generation and dissipation, are rather stable. Our findings of traffic congestion under diverse travel demand can profoundly enrich our understanding of the scale-free nature of traffic congestion and provide insights into internal mechanisms of congestion propagation.
Quantum knot mosaics and bounds of the growth constant
Authors: Choi Dooho , Kim Hyoungjun , Oh Seungsang , Yoo Hyungkee
Published: April 2024

The discovery of the Jones polynomial made an important connection between quantum physics and knot theory. Kauffman and Lomonaco introduced the knot mosaic system to define the quantum knot system for the purpose of representing an actual physical quantum system. This paper is inspired by an open question about the knot mosaic enumeration suggested by them. A knot [Formula: see text]-mosaic is an [Formula: see text] array of 11 mosaic tiles representing a knot diagram by adjoining properly. The total number [Formula: see text] of knot [Formula: see text]-mosaics, which indicates the dimension of the Hilbert space of the quantum knot system, is known to grow in a quadratic exponential rate. Recently, Oh et al. developed the state matrix recursion method producing the exact enumeration of knot mosaics, which uses a recursion formula of state matrices. Furthermore, they showed the existence of the knot mosaic constant [Formula: see text] and found its upper and lower bounds in a series of papers. The latest upper bound was obtained through two new concepts: quasimosaics and cling mosaics. As a sequel to this research program, we adjust the state matrix recursion method to handle cling mosaics inside a quasimosaic, which is called the progressive state matrix recursion method. This method provides recursive matrix-relations producing a sharper bound of the knot mosaic constant: [Formula: see text]