bluuebunny/crossref_metadata_2025 huggingface dataset:
Shifting from ependyma to choroid plexus epithelium and the changing expressions of aquaporin‐1 and aquaporin‐4
Authors: Mack Andreas F. , Bihlmaier Ronja , Deffner Felix
Published: November 2023

The cells of the choroid plexus (CP) epithelium are specialized ependymal cells (ECs) but have distinct properties. The CP cells and ECs form single‐cell sheets contiguous to each other at a transitional zone. The CP is underlined by a basal lamina and has barrier properties, whereas the ECs do not. The basal lamina of the CP is continuous with the glia limitans superficialis and, consequently, the CP stroma is continuous with the meninges along entering blood vessels. The CP has previously been reported to express aquaporin‐1 (AQP1) mostly apically, and ECs show mostly basolateral aquaporin‐4 (AQP4) expression. Recent evidence in various systems has shown that in changing conditions the expression and distribution of AQP4 can be modified, involving phosphorylation and calmodulin‐triggered translocation. Studies on the human CP revealed that AQP4 is also expressed in some CP cells, which is likely to be increased during ageing based on mouse data. Moreover, subependymal astrocytic processes in the ependyma–CP transition, forming a glial plate around blood vessels and facing the CP stroma, were strongly positive for AQP4. We propose that the increased AQP4 expression might be a compensatory mechanism for the observed reduction in CSF production in the ageing human brain. The high AQP4 density in the transition zone might facilitate the transport of water into and out of the CP stroma and serve as a drainage and clearing pathway for metabolites in the CNS.

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A Review of Kinematic Theories and Practices Compiled for Biomechanics Students and Researchers
Authors: Erdman Arthur , Lehman Malachi
Published: November 2023

The topic of kinematics is fundamental to engineering and has a significant bearing on clinical evaluations of human movement. For those studying biomechanics, this topic is often overlooked in importance. The degree to which kinematic fundamentals are included in Biomedical engineering (BmE) curriculums is not consistent across programs and often foundational understandings are gained only after reading literature if a research or development project requires that knowledge. The purpose of this paper is to present the important theories and methods of kinematic analysis and synthesis that should be in the “toolbox” of students of biomechanics. Each topic is briefly presented accompanied by an example or two. Deeper learning of each topic is left to the reader, with the help of some sample references to begin that journey.
An In Silico Model for Predicting the Efficacy of Edge-to-Edge Repair for Mitral Regurgitation
Authors: Ooida Junichi , Kiyohara Naoki , Noguchi Hironaga , Oguchi Yuichiro , Nagane Kohei , Sakaguchi Takuya , Aoyama Gakuto , Shige Fumimasa , Chapman James V. , Asami Masahiko , Kofoed Klaus Fuglsang , Pham Michael Huy Cuong , Suzuki Koshiro
Published: November 2023

In recent years, transcatheter edge-to-edge repair (TEER) has been widely adopted as an effective treatment for mitral regurgitation (MR). The aim of this study is to develop a personalized in silico model to predict the effect of edge-to-edge repair in advance to the procedure for each individual patient. For this purpose, we propose a combination of a valve deformation model for computing the mitral valve (MV) orifice area (MVOA) and a lumped parameter model for the hemodynamics, specifically mitral regurgitation volume (RVol). Although we cannot obtain detailed information on the three-dimensional flow field near the mitral valve, we can rapidly simulate the important medical parameters for the clinical decision support. In the present method, we construct the patient-specific pre-operative models by using the parameter optimization and then simulate the postoperative state by applying the additional clipping condition. The computed preclip MVOAs show good agreement with the clinical measurements, and the correlation coefficient takes 0.998. In addition, the MR grade in terms of RVol also has good correlation with the grade by ground truth MVOA. Finally, we try to investigate the applicability for the predicting the postclip state. The simulated valve shapes clearly show the well-known double orifice and the improvement of the MVOA, compared with the preclip state. Similarly, we confirmed the improved reverse flow and MR grade in terms of RVol. A total computational time is approximately 8 h by using general-purpose PC. These results obviously indicate that the present in silico model has good capability for the assessment of edge-to-edge repair.
Sensitivity Analysis of Upper Limb Musculoskeletal Models During Isometric and Isokinetic Tasks
Authors: Diaz Maximillian T. , Harley Joel B. , Nichols Jennifer A.
Published: November 2023

Sensitivity coefficients are used to understand how errors in subject-specific musculoskeletal model parameters influence model predictions. Previous sensitivity studies in the lower limb calculated sensitivity using perturbations that do not fully represent the diversity of the population. Hence, the present study performs sensitivity analysis in the upper limb using a large synthetic dataset to capture greater physiological diversity. The large dataset (n = 401 synthetic subjects) was created by adjusting maximum isometric force, optimal fiber length, pennation angle, and bone mass to induce atrophy, hypertrophy, osteoporosis, and osteopetrosis in two upper limb musculoskeletal models. Simulations of three isometric and two isokinetic upper limb tasks were performed using each synthetic subject to predict muscle activations. Sensitivity coefficients were calculated using three different methods (two point, linear regression, and sensitivity functions) to understand how changes in Hill-type parameters influenced predicted muscle activations. The sensitivity coefficient methods were then compared by evaluating how well the coefficients accounted for measurement uncertainty. This was done by using the sensitivity coefficients to predict the range of muscle activations given known errors in measuring musculoskeletal parameters from medical imaging. Sensitivity functions were found to best account for measurement uncertainty. Simulated muscle activations were most sensitive to optimal fiber length and maximum isometric force during upper limb tasks. Importantly, the level of sensitivity was muscle and task dependent. These findings provide a foundation for how large synthetic datasets can be applied to capture physiologically diverse populations and understand how model parameters influence predictions.
A Model for Competency-Based Grading and Its Effect on Student Outcomes in a Biomechanics Course
Authors: Fischer Kenneth J. , Fischer Christopher J.
Published: November 2023

Competency-based grading (CBG) can take different forms in different subject areas. We present a method for implementing CBG in a biomechanics course with nine primary learning objectives. Competency in each learning objective is measured by the student's ability to correctly answer knowledge questions and solve analytical problems in the field of biomechanics. The primary goal of implementing CBG was to provide more opportunities for lower-performing students to learn the material and to demonstrate that learning. To determine the efficacy of CBG to improve student learning, the primary measure was course grade distribution before and after implementation of CBG. The course grade distribution data indicated that CBG has primarily helped midperforming students to improve their grades. Because of the limitations of course grades as a measure of learning, we also performed analysis of student performance on successive attempts which indicated initial and secondary attempts are best, with student success declining on subsequent attempts. Anecdotally, many students improved performance, and thus their grade, on the (optional) final exam attempts. Limitations of the study include the limited course offerings with CBG (three), and that effects of COVID-19 may be confounding CBG data. Also, the approach places nearly all the grade on quizzes or exams. However, the approach could be modified to include homework grades, projects, and the like. Overall, the student learning in this course and implementation appears to be only positively affected, so this approach appears to have benefits in a biomechanics course.
Cryogenic Air Supply Feasibility for a Confined Space: Underground Refuge Alternative Case Study
Authors: Yan Lincan , Yantek Dave S. , DeGennaro Cory R. , Srednicki Justin R. , Lambie Brandin , Carr Jacob
Published: November 2023

A breathable air source is required for a confined space such as an underground refuge alternative (RA) when it is occupied. To minimize the risk of suffocation, federal regulations require that mechanisms be provided and procedures be included so that, within the refuge alternative, the oxygen concentration is maintained at levels between 18.5% and 23% for 96 h. The regulation also requires that, during use of the RA, the concentration of carbon dioxide should not exceed 1%, and the concentration of carbon monoxide should not exceed 25 ppm. The National Institute for Occupational Safety and Health (NIOSH) evaluated the cryogenic air supply's ability to provide breathable air for a refuge alternative. A propane smoker was used to simulate human breathing by burning propane gas which will consume O2 and generate CO2 and H2O. The rate of propane burned at the smoker was controlled to represent the O2 consumption rate for the breathing of a certain number of people. Two 96-h tests were conducted in a sealed shipping container, which was used as a surrogate for a refuge alternative. While burning propane gas to simulate human oxygen consumption, cryogenic air was provided to the shipping container to determine if the cryogenic air supply would keep the O2 level above 18.5% and CO2 level below 1% inside the shipping container as required by the federal regulations pertaining to refuge alternatives. Both of the 96-h tests simulated the breathing of 21 persons. The first test used the oxygen consumption rate (1.32 cu ft of pure oxygen per hour per person) specified in federal regulations, while the second test used the oxygen consumption rate specified by (Bernard et al. 2018, “Estimation of Metabolic Heat Input for Refuge Alternative Thermal Testing and Simulation,” Min. Eng., 70(8), pp. 50–54) (0.67 cu ft of pure oxygen per hour per person). The test data shows that during both 96-h tests, the oxygen level was maintained within a 21–23% range, and the CO2 level was maintained below 1% (0.2–0.45%). The information in this paper could be useful when applying a cryogenic air supply as a breathable air source for an underground refuge alternative or other confined space.
Design, Development and Validation of a Smart Cochlear Three-Dimensional-Printed Model to Train ENT Surgeons
Authors: Dauterman Michala , Jeyakumar Anita , Gautam Ishwor , Mahajan Alisha , Khanna Sahana , Mahajan Ajay
Published: November 2023

This paper presents a platform for self-learning cochlear insertion using computer vision in a three-dimensional surrogate model. Self-learning and practice experiences often improve the confidence associated with eventual real-world trials by novice medical trainees. This helps the trainees practice electrode insertion to minimize the effect of suboptimal electrode placement such as incomplete electrode insertion, electrode kinking, and electrode tip fold-over. Although existing mastoid fitting templates improve insertion trajectories, extensive training is still required. Current methods that use cadavers, virtual training, or physical models from reconstruction images are not good enough for training purposes. The model presented here simulates the dimensions, texture, and feel of inserting the electrode into the cochlea. Currently, the temporal bone is not included, hence it is not meant for practicing drilling and other procedures to access the cochlear. The insertion process is observed in real-time using a camera and a Graphical User Interface that not only shows the video feed, but also provides depth, trajectory, and speed measurements. In a trial conducted for medical trainees, there was an overall improvement in all four metrics after they were trained on the hardware/software. There was a 14.20% improvement in insertion depth, 44.24% reduction in insertion speed, 52.90% reduction in back-outs, and a 64.89% reduction in kinks/fold-overs. The advantage of this model is that medical trainees can use it as many times as they like, as the whole setup is easy, economical, and reusable.
Influence of Noncondensable Gas–Dust Mixture on Direct Contact Condensation of Steam at Atmospheric Pressure
Authors: Berti Luca , Pesetti Alessio , Raucci Michele , Giambartolomei Guglielmo , Aquaro Donato
Published: November 2023

At the Department of Civil and Industrial Engineering (DICI) of the University of Pisa, an experimental research program, funded by International Thermonuclear Experimental Reactor (ITER) Organization, concerning steam direct condensation in a flux containing also noncondensable gas and dust, was carried out. This mixture of fluids and dust is injected into the ITER pressure suppression tanks during a loss of coolant accident (LOCA) in the Vacuum Vessel. The aim of the research program is to determine the steam condensation efficiency in such conditions. Experimental tests were performed injecting this mixture in a tank partially filled with water. Alumina was used to simulate the actual dust present in the ITER Vacuum Vessel. Mass flow rates, temperature, and pressure of the different fluids involved were recorded during the tests. The steam condensation into the subcooled water pool at a temperature ranging between 318 and 369 K was investigated to determine the condensation regimes occurring during the mixture injection. The values of the fraction of the energy absorbed by water, dust, and metallic structures of the heat losses and of the average heat transfer coefficient were determined considering pure steam, steam-dust and steam-air–dust injection. The average heat transfer coefficient, determined calculating the steam jet surfaces by means of image elaboration, was compared with empirical correlations.
Evaluating LaB6 (310) nanotip as an ultrafast electron emitter
Authors: Bhorade Onkar , Deconihout Bernard , Blum Ivan , Houard Jonathan , Vella Angela
Published: November 2023

The crystallographic dependence of electron emission properties from LaB6 single-crystal tips and its importance has been highlighted in several experimental and theoretical studies. Here, we report on the cold field electron emission from LaB6 nanotips in the ⟨310⟩ orientation under static (DC) and laser-assisted conditions for possible use as an ultrafast electron emitter. By changing the voltage and laser intensity, we observe different emission regimes such as the photo-field emission and the multiphoton photoemission. The field electron microscopy patterns change under ultrafast laser illumination and correspond to the region of a high laser field. The emission properties of LaB6 nanotips in the ⟨310⟩ orientation are compared with those of the ⟨100⟩ orientation.
The Seated Trunk Control Test: Investigation of Reliability and Known-Groups Validity Using Individuals Post-Anterior Cruciate Ligament Reconstruction
Authors: Pollen Travis R. , Roe Chelsey , Johnson Darren L. , Silfies Sheri P. , Noehren Brian
Published: November 2023

Context: Decreased trunk neuromuscular control is a risk factor for both upper- and lower-extremity injuries, yet there are few reliable and valid clinical tests to identify deficits. Objective: The purpose of this study was to determine the reliability and known-groups validity of a novel clinical test, the seated trunk control test (STCT). Design: Cross-sectional reliability and known-groups validity study. Setting: Laboratory. Participants: 89 unique participants: 34 were 3 months postoperative anterior cruciate ligament reconstruction (ACLR) and 55 healthy controls. Methods: For the STCT, participants sat on a balance board with their eyes closed for three 30-second trials while investigators counted balance errors. Intraclass correlations (ICCs) were used to assess interrater reliability (N = 20) and test–retest reliability (N = 40). To assess known-groups validity, independent t tests were used to compare STCT errors at 3 months post-ACLR with healthy matched controls (N = 34/group). Area under a receiver operating characteristic curve identified an optimal cutoff for distinguishing between groups. Results: The STCT had perfect interrater reliability (ICC2,3 = 1.00) and good test–retest reliability (ICC3,3 = .79; 95% confidence interval = .61–.89). The ACLR group made significantly more errors on the STCT (mean [SD] = 15.5 [5.4]) than controls (mean [SD] = 8.2 [4.1]; P < .001, Cohen d = 1.52). The STCT’s ability to distinguish between groups was excellent (area under a ROC curve = 0.86). A cutoff of 12 errors maximized sensitivity (76%) and specificity (85%). Conclusions: The STCT is reliable between raters and across days. It also has excellent ability to distinguish between individuals with a recent ACLR and healthy matched controls, which provides initial evidence to suggest that the STCT may be clinically useful for identifying deficits in trunk neuromuscular control.
GaMF1.39’s antibiotic efficacy and its enhanced antitubercular activity in combination with clofazimine, Telacebec, ND-011992, or TBAJ-876
Authors: Ragunathan Priya , Shuyi Ng Pearly , Singh Samsher , Poh Wee Han , Litty Dennis , Kalia Nitin Pal , Larsson Simon , Harikishore Amaravadhi , Rice Scott A. , Ingham Philip W. , Müller Volker , Moraski Garrett , Miller Marvin J. , Dick Thomas , Pethe Kevin , Grüber Gerhard
Published: November 2023

The
Mycobacterium tuberculosis
(
Mtb
) F-ATP synthase generates most of the biological energy currency ATP. Previously, we identified the mycobacterium-specific loop of the F-ATP synthase subunit γ as a new anti-tuberculosis target and discovered the novel diaminopyrimidine GaMF1, whose potency was improved by structure-activity relationship studies leading to the analog GaMF1.39. Here, we report that GaMF1.39 depletes cellular ATP formation by targeting the mycobacterial F-ATP synthase without affecting proton coupling or oxygen consumption. The antimycobacterial compound is bactericidal and potent against
Mtb
in macrophages without inducing phenotypic changes in biofilm formation, planktonic bacteria, or being toxic to zebrafish larvae. Combining GaMF1.39 with the NADH dehydrogenase inhibitor clofazimine, the cyt-

bcc:aa
3

inhibitor Telacebec, or the F-ATP synthase inhibitor TBAJ-876 showed enhanced whole ATP synthesis inhibition and anti-tuberculosis activity. These results suggest that GaMF1.39 may add value to a compound combination targeting oxidative phosphorylation for tuberculosis treatment.

IMPORTANCE

New drugs are needed to combat multidrug-resistant tuberculosis. The electron transport chain (ETC) maintains the electrochemical potential across the cytoplasmic membrane and allows the production of ATP, the energy currency of any living cell. The mycobacterial engine F-ATP synthase catalyzes the formation of ATP and has come into focus as an attractive and rich drug target. Recent deep insights into these mycobacterial F
1
F
O
-ATP synthase elements opened the door for a renaissance of structure-based target identification and inhibitor design. In this study, we present the GaMF1.39 antimycobacterial compound, targeting the rotary subunit γ of the biological engine. The compound is bactericidal, inhibits infection
ex vivo
, and displays enhanced anti-tuberculosis activity in combination with ETC inhibitors, which promises new strategies to shorten tuberculosis chemotherapy.
Occult bowel cancer presenting as Morvan syndrome
Authors: Alagoda Shyama , Wimalaratna Sunil , Herath Tharuka Milinda
Published: November 2023

A man in his mid-60s presented with a 3-month history of progressive muscle twitching, agitation, cognitive impairment, insomnia, hyperhidrosis and lower limb pain. He had fasciculations, myokymia, myoclonus, exaggerated startle response and significant postural hypotension. Electrophysiological studies showed evidence of peripheral nerve hyperexcitability with neuromyotonia. Contactin-associated protein-like 2 antibodies (CASPR2) were strongly positive. A diagnosis of Morvan syndrome was made. CT of the chest, abdomen and pelvis was undertaken to identify any occult malignancy, and a large bowel carcinoma in situ was identified and resected. His central nervous system and autonomic symptoms significantly improved following surgery, but neuromyotonia persisted, and this was treated with intravenous immunoglobulins and steroids. Early detection of bowel cancer in this patient enabled curative treatment.
Mycobacterium tuberculosisinfectious monoarthritis in a paediatric patient
Authors: Ruland Jeffrey R , Schwartz Joshua M , Bachmann Keith R , Lather Leigh Ann
Published: November 2023

Mycobacterium tuberculosisis uncommon in the USA, and when it is diagnosed, it is usually in adult patients with identifiable risk factors presenting with pulmonary manifestations of the disease. Paediatric tuberculosis is rare, and a minority of those cases can present with isolated extrapulmonary infection. When the musculoskeletal system is involved, there are often no constitutional symptoms, and it can resemble other infectious and inflammatory processes. Diagnosis is challenging, and delay leads to irreversible destructive osteoarticular changes. A prompt diagnosis requires a high index of suspicion. This report presents a case of successfully diagnosed paediatricM. tuberculosismonoarthritis of the knee to highlight these challenges.
Postoperative stellate ganglion block to reduce myocardial injury after laparoscopic radical resection for colorectal cancer: protocol for a randomised trial
Authors: Hu Zhouting , Li Wangyu , Zhao Guoqing , Liang Chen , Li Kai
Published: November 2023

Introduction

Stellate ganglion block (SGB) is usually used in the department of algiatry. But preoperative SGB may reduce adverse cardiovascular events in high-risk patients, although evidence remains sparse. Therefore, we aim to determine whether a single-shot postoperative SGB can reduce the incidence of myocardial injury after non-cardiac surgery (MINS) and improve recovery in patients undergoing laparoscopic radical resection for colorectal cancer.

Methods and analysis

This is an investigator-initiated, single-centre, randomised, two-arm clinical trial enrolling patients aged over 45 years and scheduled for elective laparoscopic radical colorectal surgery with at least one risk factor for MINS. A total of 950 eligible patients will be randomised into a routine or block groups. The primary outcome is the incidence of MINS. The secondary outcomes include the Visual Analogue Scale of pain during rest and movement, the incidence of delirium, quality of recovery (QOR) assessed by QOR-15, and sleep quality assessed by Richards Campbell Sleep Questionnaire. Tertiary outcomes include time to first flatus, gastrointestinal complications such as anastomotic leak or ileus, length of hospital stay, collapse incidence of severe cardiovascular and cerebrovascular complications of myocardial infarction, cardiac arrest, ischaemic or haemorrhagic stroke, and all-cause mortality within 30 days after the operation.

Ethics and dissemination

The protocol was approved by Medical Ethics Committee of the China-Japan Union Hospital, Jilin University (Approval number: 2021081018) prior to recruitment. The study will be performed according to the guidelines of the Declaration of Helsinki. The findings of this study will be published and presented through various scientific forums.

Trial registration number

ChiCTR2200055319.
Experience of an NIHR Clinical Lectureship (medical/dental) and the determining factors for a clinical academic career post lectureship: a mixed-method evaluation
Authors: Stevenson Chris James , Harris-Joseph Helen , Harper Lorraine , Hewison Jenny , Mulvey Matthew R , Heuvelman Hein , McVicker Clare , Razalan Maria Magdalena , Knowles Emma , Ebanks Brad , Lee Kieran , Fenton James , Thompson Peter , Cotterill Lisa Ann
Published: November 2023

Objectives

The objective of this study is to investigate early-to-late postdoctoral clinical academic progression and the experiences of NIHR Clinical Lectureship (CL) fellows, considering enablers and barriers to success, and identifying the factors associated with immediate progression to a clinical academic role following completion of the award.

Setting

Datasets of CL awardees across the UK.

Participants

For semistructured interviews, n=40 CL awardees that had finished their award within the previous 5 years. For quantitative analysis, n=1226 completed or currently active CL awardees.

Outcome measures

The responses from the semistructured interviews to the defined questions on experiences during the award, postaward progression, and enablers and barriers to academic progression. Other primary outcome measures were quantitative data on first destinations postaward, demographic data, and whether an awardee had previously held an NIHR Academic Clinical Fellowship (ACF) or was a recipient of the Academy of Medical Sciences (AMS) Starter Grant.

Results

CL awardees identified numerous benefits to the award, with the majority achieving their aims. Most awardees progressed to a clinical academic role; however, some returned to a clinical only position, citing concerns around the time pressure associated with balancing clinical and academic responsibilities, and the competition to attain further postdoctoral awards. The region of the award partnership, year of award end and success in applying for an AMS Starter Grant were associated with progression to a clinical academic role. Gender, holding an ACF and having a craft or non-craft specialty had no independent statistical association with clinical academic progression.

Conclusions

The CL is a valued element of the Integrated Academic Pathway. By addressing issues around later postdoctoral progression opportunities, responding to challenges experienced by CLs, and by understanding the factors identified in this study associated with clinical academic progression, it should be possible to increase the proportion of CLs that become fully independent clinical academic research leaders.

Participants

1226 NIHR CLs active or completed on the award between 2006 and 2020.
Measuring under-5 mortality and fertility through mobile phone surveys: an assessment of selection bias in 34 low-income and middle-income countries
Authors: Sánchez-Páez David A , Masquelier Bruno , Menashe-Oren Ashira , Baruwa Ololade Julius , Reniers Georges
Published: November 2023

Objectives

This study aims to assess sample selection bias in mobile phone survey estimates of fertility and under-5 mortality.

Design

With data from the Demographic and Health Surveys, we use logistic regressions to identify sociodemographic correlates of mobile phone ownership and access, and Poisson regressions to estimate the association between mobile phone ownership (or access) and fertility and under-5 mortality estimates. We evaluate the potential reasons why estimates by mobile phone ownership differ using a set of behavioural characteristics.

Setting

34 low-income and middle-income countries, mostly in sub-Saharan Africa.

Participants

534 536 women between the ages of 15 and 49.

Outcome measures

Under-5 mortality rate (U5MR) and total fertility rate (TFR).

Results

Mobile phone ownership ranges from 23.6% in Burundi to 96.7% in Armenia. The median TFR ratio and U5MR ratio between the non-owners and the owners of a mobile phone are 1.48 and 1.29, respectively. Fertility and mortality rates would be biased downwards if estimates are only based on women who own or have access to mobile phones. Estimates of U5MR can be adjusted through poststratification using age, educational level, area of residence, wealth and marital status as weights. However, estimates of TFR remain biased even after adjusting for these covariates. This difference is associated with behavioural factors (eg, contraceptive use) that are not captured by the poststratification variables, but for which there are also differences between mobile phone owners and non-owners.

Conclusions

Mobile phone surveys need to collect data on sociodemographic background characteristics to be able to weight and adjust mortality estimates ex post facto. Fertility estimates from mobile phone surveys will be biased unless further research uncovers the mechanisms driving the bias.
Digital health interventions to improve adherence to oral antipsychotics among patients with schizophrenia: a scoping review
Authors: Wu Tao , Xiao Xu , Yan Shirui , Fang Yuanyuan , Wang Min , Zu Fengying , Zhang Yanhong , Qian Ruilian
Published: November 2023

Objectives

To assess the current evidence on the potential of digital health interventions (DHIs) to improve adherence to oral antipsychotics among patients with schizophrenia by assessing the methodologies, feasibility and effectiveness of DHIs as well as the perceptions of relevant stakeholders.

Design

The scoping review was conducted based on the methodologies outlined by Levacet aland reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Data sources

PubMed, Embase, Web of Science, Scopus, CINAHL, PsycINFO and the Cochrane Library were searched in August 2023 to identify relevant publications from the previous decade.

Eligibility criteria

Studies published in English focused on improving medication adherence among adult patients with schizophrenia or schizoaffective disorder via DHIs were selected. Protocols, editorials, comments, perspectives, reviews, correspondence and conference abstracts were excluded.

Data extraction and synthesis

The extracted data included general information about the study, framework, participants, features and strategies of DHIs, measurement tools for adherence used, and main findings.

Results

In total, 64 studies were included in the qualitative synthesis. Features used in DHIs to improve medication adherence included phone calls, text messages, mobile apps, sensors, web-based platforms and electronic devices. Strategies included medication reminders and monitoring, providing medication-related information and suggestions, other illness management suggestions and individual support. Texting and mobile apps were commonly used as medication reminders and monitoring methods. Additionally, the use of sensors combined with other digital technologies has garnered significant attention. All the interventions were considered acceptable and feasible, and several were assessed in pilot trials. Preliminary findings suggest that DHIs could enhance medication adherence in patients with schizophrenia. However, further validation of their effectiveness is required.

Conclusion

DHIs are a promising approach to enhancing medication adherence among patients with schizophrenia. Future interventions should be interactive, focusing on user preference, experience and privacy.
Patterns, prevalence and risk factors of intimate partner violence and its association with mental health status during COVID-19: a cross-sectional study on early married female adolescents in Khulna district, Bangladesh
Authors: Nishat Jannatul Ferdous , Khan Umme Salma , Shovo Taufiq-E-Ahmed , Ahammed Benojir , Rahman Mohammad Mizanur , Hossain Md Tanvir
Published: November 2023

Objectives

This study was designed to identify the patterns, prevalence and risk factors of intimate partner violence (IPV) against female adolescents and its association with mental health problems.

Design

Cross-sectional survey.

Settings

DumuriaUpazila(subdistrict) under the Khulna district of Bangladesh.

Participants

A total of 304 participants were selected purposively based on some specifications: they must be female adolescents, residents of DumuriaUpazilaand married during the COVID-19 pandemic when under 18 years of age.

Outcome measures

By administering a semi-structured interview schedule, data were collected regarding IPV using 12 five-point Likert scale items; a higher score from the summation reflects frequent violence.

Results

The findings suggest that the prevalence of physical, sexual and emotional IPV among the 304 participants, who had an average age of 17.1 years (SD=1.42), was 89.5%, 87.8% and 93.7%, respectively, whereas 12.2% of the participants experienced severe physical IPV, 9.9% experienced severe sexual IPV and 10.5% experienced severe emotional IPV. Stepwise regression models identified age at marriage (p=0.001), number of miscarriages (p=0.005), education of spouse (p=0.001), income of spouse (p=0.016), age gap between spouses (p=0.008), marital adjustment (p<0.001) and subjective happiness (p<0.001) as significant risk factors. Hierarchical regression, however, indicated that age at marriage (p<0.001), age gap between spouses (p<0.001), marital adjustment (p<0.001) and subjective happiness (p<0.001) had negative associations with IPV, while the number of miscarriages (p<0.001) had a positive relationship. Pearson’s correlation showed that IPV was significantly associated with depression, anxiety and stress.

Conclusion

During the COVID-19 pandemic, an increase in IPV and mental health problems among early married adolescents was documented. To reduce physical and mental harm and to assure their well-being, preventive and rehabilitative measures should be devised.
Cohort profile: the United Kingdom Childhood Cancer Study (UKCCS) – a UK-wide population-based study examining the health of cancer survivors
Authors: Roman Eve , Kane Eleanor , Smith Alexandra , Howell Debra , Sheridan Rebecca , Simpson Jill , Bonaventure Audrey , Kinsey Sally
Published: November 2023

Purpose

The United Kingdom Childhood Cancer Study’s (UKCCS’s) matched cohort was established to examine the longer term morbidity and mortality of individuals previously diagnosed with cancer before 15 years of age, comparing future healthcare patterns in 5-year cancer survivors to baseline activity seen in age- and sex-matched individuals from the general population.

Participants

Predicated on a national childhood cancer case-control study conducted in the early 1990s (4430 cases, 9753 controls) in England, Scotland and Wales, the case population comprises 3125 cancer survivors (>5 years), and the control population 7156 age- and sex-matched individuals from the general population who did not have cancer as a child. Participants are now being followed up via linkage to national administrative healthcare databases (deaths, cancers and secondary care hospital activity).

Findings to date

Enabling the creation of cohorts with minimal selection bias and loss to follow-up, the original case-control study registered all newly diagnosed cases of childhood cancer and their corresponding controls, regardless of their family’s participation. Early findings based on the registered case population found marked survival variations with age and sex across subtypes and differences with deprivation among acute lymphoblastic leukaemia (ALL) survivors. More recently, comparing the health-activity patterns of the case and control populations revealed that survivors of childhood ALL experienced excess outpatient and inpatient activity across their teenage/young adult years. Adding to increased risks of cancer and death and involving most clinical specialties, excesses were not related to routine follow-up monitoring and showed no signs of diminishing over time.

Future plans

With annual linkage updates, the UKCCS’s maturing population-based matched cohorts provide the foundation for tracking the health of individuals through their lifetime. Comparing the experience of childhood cancer survivors to that of unaffected general-population counterparts, this will include examining subsequent morbidity and mortality, secondary care hospital activity and the impact of deprivation on longer term outcomes.
Can online and app-based interventions be used by people with diabetes to reduce diabetes distress? A protocol for a scoping review
Authors: Andersen Christina Maar , Mathiesen Anne Sophie , Pouwer François , Mouritsen Julie Drotner , Mathiasen Kim , Rothmann Mette Juel
Published: November 2023

Introduction

Diabetes distress has been defined as "the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes". Diabetes distress affects 20%–25% of individuals living with diabetes and can have negative effects on both diabetes regulation and quality of life. For people living with diabetes distress, innovative tools/interventions such as online or app-based interventions may potentially alleviate diabetes distress in a cost-effective way. The specific research questions of this scoping review are: (1) what are the effects of online or app-based interventions on diabetes distress for adults with type 1 or type 2 diabetes, and (2) what are the characteristics of these interventions (eg, type of intervention, duration, frequency, mode of delivery, underlying theories and working mechanisms)?

Methods and analysis

A scoping review will be conducted, using the methodological framework of Arksey and O’Malley along with Levacet al. Eligible studies are: studies of adults ≥18 years old with type 1 or 2 diabetes using an online or app-based intervention and assessing diabetes distress as the primary or secondary outcome. Five databases (Medline, EMBASE, CINAHL, PsycINFO and Scopus) will be searched and is limited to articles written in English, Danish, Norwegian, Swedish or Dutch. Two reviewers will independently screen potentially eligible studies in Covidence, select studies, and together chart data, collate, summarise, and report the results. We will adhere to the Preferred reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR).

Ethics and dissemination

The scoping review has been exempt from full ethical review by the Regional Committees on Health Research Ethics for Southern Denmark (case number: S-20232000-88). The results of the review will be published in a peer-reviewed journal and presented at relevant conferences and workshops with relevant stakeholders.
Perspectives of informal caregivers who support people following hip fracture surgery: a qualitative study embedded within the HIP HELPER feasibility trial
Authors: Welsh Allie , Hanson Sarah , Pfeiffer Klaus , Khoury Reema , Clark Allan , Ashford Polly-Anna , Hopewell Sally , Logan Pip , Crotty Maria , Costa Matthew , Lamb Sallie , Smith Toby , HIP HELPER Study Collaborators
Published: November 2023

Objectives

This study aims to illuminate the perspectives of informal caregivers who support people following hip fracture surgery.

Design

A qualitative study embedded within a now completed multicentre, feasibility randomised controlled trial (HIP HELPER).

Setting

Five English National Health Service hospitals.

Participants

We interviewed 20 participants (10 informal caregivers and 10 people with hip fracture), following hip fracture surgery. This included one male and nine females who experienced a hip fracture; and seven male and three female informal caregivers. The median age was 72.5 years (range: 65–96 years), 71.0 years (range: 43–81 years) for people with hip fracture and informal caregivers, respectively.

Methods

Semistructured, virtual interviews were undertaken between November 2021 and March 2022, with caregiver dyads (person with hip fracture and their informal caregiver). Data were analysed thematically.

Findings

We identified two main themes: expectations of the informal caregiver role and reality of being an informal caregiver; and subthemes: expectations of care and services; responsibility and advocacy; profile of people with hip fracture; decision to be a caregiver; transition from hospital to home.

Conclusion

Findings suggest informal caregivers do not feel empowered to advocate for a person’s recovery or navigate the care system, leading to increased and unnecessary stress, anxiety and frustration when supporting the person with hip fracture. We suggest that a tailored information giving on the recovery pathway, which is responsive to the caregiving population (ie, considering the needs of male, younger and more active informal caregivers and people with hip fracture) would smooth the transition from hospital to home.

Trial registration number

ISRCTN13270387.Cite Now
Sinus node dysfunction and stroke risk: a systematic review and meta-analysis
Authors: Dong Haoyu , Chen Hao , Hidru Tesfaldet Habtemariam , Xia Yunlong , Yang Xiaolei
Published: November 2023

Objectives

The role of cardiac arrhythmia in ischaemic stroke is widely studied, but the size of the stroke risk in patients with sinus node dysfunction (SND) with and without atrial fibrillation (AF) is unclear. This systematic review and meta-analysis aimed to compare the risk of stroke and its associated factors in patients with SND with and without AF.

Design

A systematic review and meta-analysis was conducted based on the Grading of Recommendations, Assessment, Development and Evaluation approach.

Data sources

PubMed, EMBASE and Cochrane Database were searched until December 2022.

Eligibility criteria for selecting studies

Studies that investigate stroke in patients with SND diagnosed with or without AF/atrial flutter.

Data extraction and synthesis

Two independent authors screened studies for inclusion and extracted data. Literature quality assessment was performed using the Newcastle-Ottawa Scale and the Cochrane Collaboration Tool. The overall risk of stroke was estimated using the random-effects model. The generic inverse variance method was used to calculate the pooled estimates of stroke-associated factors. We performed a sensitivity analysis using a fixed-effects model.

Results

Of the 929 records retrieved, 6 papers (106 163 patients) met the inclusion criteria. The average yearly stroke incidence in patients with SND was 1.542% (95% CI: 1.334% to 1.749%). The stroke incidence was similar between the isolated SND (1.587%; 95% CI: 1.510% to 1.664%) and non-isolated (SND+AF) (1.660%; 95% CI: 0.705% to 2.615%) groups. AF (HR, 95% CI: 1.53 (1.01 to 2.33)), stroke/transient ischaemia attack/other thrombotic events (HR, 95% CI: 2.54 (1.14 to 5.69)), hypertension (HR, 95% CI: 1.51 (1.11 to 2.07)) and heart failure (HR, 95% CI: 1.41 (1.01 to 1.97)) were associated with stroke in the SND population.

Conclusion

Our findings suggest that patients with SND carry a similar risk of stroke to those with combined SND and AF. Future studies are needed to investigate whether interventions targeting stroke prevention, such as anticoagulation therapy, can help to prevent stroke in patients with SND.

PROSPERO registration number

CRD42023408436.
Trends in the prevalence and economic burden of hypertension and its socioeconomic disparities in rural southwestern China: two repeated cross-sectional studies
Authors: Fan Luming , Liu Lan , Zhao Yi , Mo Yi , Li Jinbo , Cai Le
Published: November 2023

Objectives

This study aimed to analyse trends in the prevalence and economic burden of hypertension and its socioeconomic disparities in rural southwestern China.

Design

Two repeated cross-sectional studies were conducted to collect interview and health examination data among individuals aged ≥35 years in rural Yunnan Province, China.

Setting

Three rural areas of Yunnan, China.

Participants

We invited 8187 consenting participants in 2010–2011 and 7572 consenting participants in 2020–2021 to undergo interviews and health examinations.

Results

The standardised prevalence of hypertension significantly increased from 26.1% in 2011 to 40.4% in 2021 (p<0.01), and the per capita direct, indirect and disease economic burdens increased from US$1323, US$46 and US$1369 to US$2196, US$49 and US$2244, respectively. In addition to the indirect economic burden, the direct and disease economic burdens increased significantly. The prevalence of hypertension was higher in illiterate population, among participants with low annual household income per capita, and participants with good access to medical services than in their counterparts who had good education, high annual household income per capita and poor access to medical services (all p<0.05). Moreover, the prevalence of hypertension showed a downward trend with improvement in socioeconomic position (SEP) (p<0.05). The per capita direct and disease economic burdens increased most in participants with low SEP, but the per capita indirect economic burden increased most in participants with upper-middle SEP.

Conclusions

The prevalence and economic burden of hypertension have visibly accelerated in rural Yunnan Province over the 10 years studied, and socioeconomic disparities have been found in the prevalence and economic burden of hypertension. These findings highlight that socioeconomic differentials should be tailored to address the timing of effective interventions for hypertension prevention and control and reduce the economic burden of hypertension in rural southwestern China.
Lost in translation: how can education about dementia be effectively integrated into medical school contexts? A realist synthesis
Authors: Tullo Ellen , Wakeling Luisa , Pearse Rachel , Kheng Khoo Tien , Teodorczuk Andrew
Published: November 2023

Objectives

The prevalence of dementia in both community and hospital settings requires a clinical workforce that is skilled in diagnosis and management of the condition to competently care for patients. Though evidence of successful educational interventions about dementia exists, effective translation into medical school curricula is the exception rather than the norm.

Design

We adopted a realist synthesis approach following Realist And MEta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines to answer the following questions: (1) what are the barriers to integrating effective interventions about dementia into medical school curricula and (2) where they are successfully delivered, what are the contextual factors that allow for this enactment?

Data sources

We searched PubMed, Embase, CINAHL and PsycINFO using the MesH termsSchools, Medical; Students, Medical; Education, MedicalANDNeurocognitive disordersor the closest possible set of terms within each database.

Eligibility criteria

Undergraduate or graduate entry medical school programme, teaching and learning focussing on dementia, evaluating student outcomes (satisfaction, knowledge, skills, attitudes or behaviours), interventions described clearly enough to classify teaching method, any research design (quantitative and qualitative), English language.

Data extraction and synthesis

We used a shared spreadsheet to enter key information about eligible studies and the reasons for excluding studies that did not fit eligibility criteria. We extracted descriptive data about the nature of educational interventions and narrative information as to barriers and facilitators to implementing those interventions.

Results

Our initial literature search identified 16 relevant papers for review. Systematic extraction of data informed the development of an initial programme theory (IPT) structured around four contextual barriers: ‘culture’, ‘concern for patient welfare’, ‘student attitudes’ and ‘logistics’ with associated facilitatory mechanisms embed medical education about dementia.

Conclusions

We outline the process of generating our IPT, including overlap with Cultural Historical Activity Theory. We outline our intention to refine our programme theory through ongoing review of the evidence base and collaboration with stakeholders, with the aim of finalising a model for successful integration of dementia education.