bluuebunny/crossref_metadata_2025 huggingface dataset:
Litter addition as a tool for restoring hydrological processes and controlling erosion in riparian forests disturbed by fine sediment deposition
Authors: Felix Rodrigo Weber , Dias André Tavares Corrêa , Bevilacqua Maria Silvina , da Silva Maria Paula Façanha , Bozelli Reinaldo Luiz , de Barros Marcos Paulo Figueiredo
Published: March 2023

Riverscape aggradation due to the deposition of fine particles above natural forest litter can change the soil, sediment, and water properties, damage riparian vegetation, and reduce environmental integrity, especially in headwater streams. Litter addition techniques that enhance surface roughness and permeability can decrease the interference of fine particles on the ecosystem, representing a low‐tech alternative to recover disturbed riparian areas. We aimed to evaluate run‐off, percolation, storage coefficients, run‐off volume, and sediment yield using a rainfall simulator and the mitigation potential provided by the addition of forest litter to limnological variables—turbidity, total suspended solids (TSS), electrical conductivity, pH, nitrogen—which are indicators of integrity that can reflect streams' aggradation. Fifteen soil samples from a disturbed area (silt and clay deposits aboveground), five from an undisturbed area (sandy soil), and superficial forest litter were obtained from riparian areas adjacent to two small streams in Carajás National Forest, Brazil. The addition of litter showed great potential to mitigate erosive processes and to reestablish hydrological processes in the disturbed soil. The run‐off volume and sediment yield were 2–4 times lower in litter addition treatments compared to non‐litter addition. Litter addition also improved run‐off water quality, especially turbidity and TSS, which were 12–16 times and 3–13 times lower, respectively. The experimental addition of litter has shown encouraging results to be applied in situ as a sustainable, low‐cost, and simplified nature‐based solution to contribute to the restoration of degraded riparian forests and reduce in‐stream silt and clay aggradation.
Readmission is experienced as inevitable among older adults receiving homecare: A qualitative interview study
Authors: Elkjær Mette , Gram Bibi , Mogensen Christian Backer , Brabrand Mikkel , Primdahl Jette
Published: March 2023

Background

Older adults receiving homecare have an increased risk of readmission. The transition from hospital to home can be experienced as unsafe, and older adults describe themselves as vulnerable during the post‐discharge period. Thus, the objective was to explore the experiences of unplanned readmissions among older adults who receive homecare.

Methods

We conducted qualitative individual semi‐structured interviews with older adults, 65 years or above, receiving homecare and being readmitted to an emergency department (ED) between August and October 2020. Data were analysed by systematic text condensation as described by Malterud.

Findings

We included 12 adults aged 67–95 years, seven were male, and eight lived alone. The analysis derived three themes: (1) Responsibility and security at home, (2) the role of family, friends and homecare and (3) the importance of trust. The older adults felt that the hospital strived for too‐early discharge, as they still did not feel well. They worried about how to manage their daily life. Active involvement of their family increased their sense of security, but those living alone described feeling anxious being at home by themselves after discharge. Although older adults did not wish to go to the hospital, inadequate treatment at home and the feeling of responsibility for their illness made them feel insecure. They expressed that earlier negative experiences affected their trust in the system and their inclination to ask for help.

Conclusions

The older adults were discharged from the hospital despite feeling ill. They described inadequate competencies from healthcare professionals in the home as a contributing factor to their readmission. The readmission increased a sense of security. Support from the family in the process was essential and provided a sense of security, whereas older adults living alone experienced feelings of insecurity in the home environment.
A neglected history: The political figure of the Colombian migrant in Venezuela
Authors: De Corso Giuseppe
Published: March 2023

The aim of this article is to examine migration between Venezuela and Colombia by taking the long view and thus filling a gap in the literature. Building on Thomas Nail’s 2015 book, The Figure of the Migrant, the focus of the analysis is on regimes of social motion and the essentially political figure of the migrant. The article moves on to a more detailed empirical examination, analysing various topics such as the socio‐occupational insertion of migrants along with their demographic and economic impact, with some final thoughts about reverse migration. By offering an historical description of the process, the aim is to explore the multiple aspects of migration that manifest along this particular border.
Reduction of wrinkles: From a computational hypothesis to a clinical, instrumental, and biological proof
Authors: Santoprete Roberto , Hourblin Virginie , Foucher Aude , Dufour Olivia , Bernard Dominique , Domanov Yegor , Querleux Bernard , Potter Anne
Published: March 2023

Background

Facial wrinkles are clear markers of the aging process, being chronological, photo‐induced, or reflecting repetitive facial expressions. The aim of this study is to provide new insights into the biophysical and biological mechanisms involved in the formation, prevention, or elimination of the expression wrinkles.

Materials and methods

We use a computational model to get a better understanding of the wrinkle mechanical behavior and evolution after skin softening and suggesting a possible antiaging mechanism. Then, we provide a clinical demonstration of the anti‐wrinkle effect of a long‐term application of a 20% glycerol in a moisturizer formula (GBM) versus its vehicle on crow's feet. Skin hydration, elasticity, and wrinkles visibility were evaluated by a combination of clinical and instrumental in vivo data, inverse finite element analysis, and proteomic data.

Results

The computational model shows a predominantly compressive stress beneath the wrinkle and its significant decrease by the softening of stratum corneum. The associated clinical study confirmed a significant increase of skin hydration and elasticity as well as a decrease of wrinkle visibility after 2 and 4 months as application for both formulas; this effect being stronger for GBM. A softening effect on stratum corneum and dermis was also observed for the GBM. Furthermore, proteomic data revealed an effect of upregulation of four proteins associated with desquamation, cell‐glycan extracellular interactions, and protein glycation/oxidation, functions related to the tissue mechanics and adhesion.

Conclusions

We provide an in vivo demonstration of the anti‐ageing benefit of glycerol at high dose (20%) reflected by a cumulative skin surface softening effect. The use of high moisturizing potent formulations should bring additional performance to other conventional moisturizing formulations.
Pfizer‐BioNTech vaccine induces the production of cross‐reactive antibodies against Trypanosoma cruzi proteins: A preliminary study
Authors: López‐Monteon Aracely , Balderas‐Caballero Areli Eunice , Domínguez‐Guillén Jorge Alberto , Romero‐Ramírez Héctor , Baltierra‐Uribe Shantal Lizbeth , Ramos‐Ligonio Angel
Published: March 2023

Objective

To evaluate the presence of cross‐reactivity by anti‐severe acute respiratory syndrome coronavirus 2 antibodies induced by the Pfizer‐BioNTech vaccine against Trypanosoma cruzi proteins in a screening test.

Methods

Forty‐three serum samples were obtained from personnel at the Hospital General Naval de Alta Especialidad in Mexico City who received one or two doses of the vaccine and were tested for T. cruzi infection using four tests: two ‘in house’ enzyme‐linked immunosorbent assays (ELISAs), a commercial ELISA diagnostic kit and an immunoblot test.

Results

IgG antibodies against the T. cruzi proteins were present in the serum of unvaccinated subjects and subjects who had received one or two doses of the vaccine. The positivity of the samples against T. cruzi was ruled out by means of a Western Blot assay, where all samples were negative for T. cruzi.

Conclusion

The data suggest that people convalescing from coronavirus disease 2019 and those who received the Pfizer‐BioNTech vaccine exhibit cross‐reactive antibodies against T. cruzi antigens in ELISA assays.
Successful autologous hematopoietic stem cell transplants using Salmonella positive products collected from asymptomatic donors
Authors: Phou Samantha , Perez‐Alvarez Ingrid , Morgan Margie , Contreras Deisy A. , Ben‐Aderet Michael , Gaddam Emily , Paquette Ronald , Vescio Robert , Pepkowitz Samuel H. , Gibb David R. , Zabner Rachel , Klapper Ellen B.
Published: March 2023

Background

Bacterial contamination of hematopoietic stem cell (HSC) products is most commonly due to normal skin flora. Salmonella in HSC products is rare, and to our knowledge safe administration of an autologous HSC product containing Salmonella has not been reported.

Study Design and Methods

We describe two patients undergoing autologous HSC transplant: peripheral blood HSC collection was performed by leukapheresis, and samples were cultured according to standard institutional protocol. Subsequent microorganism identification was performed using MALDI‐TOF (Bruker Biotyper). Strain‐relatedness was investigated by infrared spectroscopy using the IR Biotyper (Bruker).

Results

The patients were asymptomatic throughout the collection process; however, HSC products collected on two consecutive days from each patient were positive for Salmonella. Isolates from both cultures were further characterized as Salmonella enterica serovar Dublin by the local public health department. Antibiotic susceptibility testing revealed different sensitivity patterns for the two strains. IR Biotyper demonstrated significant discriminatory power among the clinically significant Salmonella enterica subspecies, serogroups B, C1, and D. The patient strains were similar as both belonged to Group D Salmonella enterica serovar Dublin but were not identical. The Salmonella positive autologous HSC products were infused to both patients following administration of empiric antibiotic therapy. Both patients successfully engrafted and did well.

Conclusion

Salmonella is rarely seen in cellular therapy products and positivity may be the result of asymptomatic bacteremia at the time of collection. We present two instances of autologous HSC products containing Salmonella that were infused, along with prophylactic antimicrobial therapy without significant adverse clinical effects.
Autophagy ameliorates Pseudomonas aeruginosa‐infected diabetic wounds by regulating the toll‐like receptor 4/myeloid differentiation factor 88 pathway
Authors: Ji Xiaoyan , Jin Peng , Yu Pei , Wang Penghua
Published: March 2023

Diabetic foot ulcers (DFUs) are among the most common complications in patients with diabetes and a leading cause of lower extremity amputation. DFUs are exacerbated by prolonged bacterial infection; therefore, there is an urgent need for effective treatments to alleviate the burden associated with this condition. Although autophagy plays a unique role in pathogen phagocytosis and inflammation, its role in diabetic foot infections (DFIs) remains unclear. Pseudomonas aeruginosa (PA) is the most frequently isolated gram‐negative bacterium from DFUs. Here, we evaluated the role of autophagy in ameliorating PA infection in wounds in a diabetic rat model and a bone marrow‐derived macrophage (BMDM) hyperglycemia model. Both models were pretreated with or without rapamycin (RAPA) and then infected with or without PA. Pretreatment of rats with RAPA significantly enhanced PA phagocytosis, suppressed wound inflammation, reduced the M1:M2 macrophage ratio, and improved wound healing. In vitro investigation of the underlying mechanisms revealed that enhanced autophagy resulted in decreased macrophage secretion of inflammatory factors such as TNF‐α, IL‐6, and IL‐1β but increased that of IL‐10 in response to PA infection. Additionally, RAPA treatment significantly enhanced autophagy in macrophages by increasing LC3 and beclin‐1 levels, which led to altered macrophage function. Furthermore, RAPA blocked the PA‐induced TLR4/MyD88 pathway to regulate macrophage polarisation and inflammatory cytokine production, which was validated by RNA interference and use of the autophagy inhibitor 3‐methyladenine (3‐MA). These findings suggest enhancing autophagy as a novel therapeutic strategy against PA infection to ultimately improve diabetic wound healing.
Attitudes of patients with renal disease on xenotransplantation: A systematic review
Authors: DeLaura Isabel , Anwar Imran J. , Ladowski Joseph , Patino Alejandra , Cantrell Sarah , Sanoff Scott
Published: March 2023

Background

Recent years have seen major advancements in xenotransplantation: the first pig‐to‐human heart transplant, the development of a brain‐dead recipient model for kidney xenotransplantation, and the registration of the first xenokidney clinical trial. The attitudes of patients with kidney disease or transplants on xenotransplantation and an assessment of their reservations and considerations regarding the technology are crucial to successful clinical translation and eventual widespread implementation.

Methods

This systematic review was registered through PROSPERO (CRD42022344581) prior to initiation of the study and reported using the Preferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA) guidelines. We included studies that evaluated attitudes towards and willingness to undergo xenotransplantation in patients with end‐stage renal disease (ESRD), including those who had already undergone transplantation. MEDLINE (via Ovid), Embase (via Elsevier), and Web of Science (via Clarivate) were searched from database inception to July 15, 2022 by an experienced medical librarian for studies on xenotransplantation and attitudes. Abstracts and full text were screened using Covidence software and data items regarding study methodology, patient demographics, and attitudes regarding xenotransplantation were extracted using Microsoft Excel. Risk of bias assessments were performed using the Critical Appraisal Skills Programmed and National Institute of Health study quality assessment tools.

Results

Of 1992 studies identified, 14 studies met the inclusion criteria. These studies were conducted across eight countries, four in the United States, for a total of 3114 patients on the kidney waitlist or with a kidney transplant. All patients were over 17 years old and 58% were male. Acceptance of a xenotransplant was assessed using surveys in 12 studies. Sixty‐three percent (n= 1354) of kidney patients reported that they would accept a xenotransplant with function comparable to that of an allotransplant. Acceptance of xenografts with inferior function to allografts (15%) or as bridge organs (35%) to allotransplantation was lower. Specific concerns expressed by patients included graft function, infection, social stigma, and animal rights. Subgroup analyses showed higher acceptance in already transplanted compared to waitlist patients and white compared to Black Americans.

Conclusion

An understanding of patient attitudes and reservations is key to the successful execution of the first xenotransplantation clinical trials. This study compiles important factors to consider, such as patient concerns, attitudes regarding practical clinical scenarios for the use of xenotransplantation, and the impact of demographic factors on acceptance of this emerging technology.
Constitutive Behavior of Titanium Alloy With Dual-Phase Microstructures: Experiments and Modeling
Authors: Zhang Yujie , Li Ming , Jiang Kun , Wang Hongyu , Qu Ping , Wang Hongtao , Zhu Linli
Published: March 2023

The complex composition, size, and distribution of microstructures of titanium (Ti) alloy affect the mechanical properties of titanium alloy and its application in aerospace, ocean technology, and bioengineering. In this paper, the microstructural components and mechanical behavior of Ti80 are first investigated experimentally. According to the experimental observations of the dual-phased microstructures, a mechanism and microstructure-based constitutive model of Ti80 is established to study the quantitative relationship between mechanical behavior and equiaxed αp + lamellar αs + β microstructures of titanium alloys. And the influence of dislocation evolution and accumulation on the strengthening and work-hardening of materials is also explored in detail, especially the contribution of dislocation pile-up zone at the phase boundary between α phase and β phase on the strengthening of materials. Numerical results show that the proposed model can describe the constitutive behavior of Ti80 very well, including yield stress and strain hardening. And various strengthening mechanisms originated from the grain boundaries, phase boundaries of β transformation structure and β precipitation are analyzed. The proposed model is further applied to predict the constitutive behaviors of the titanium alloy with different sizes and various volume fractions of microstructure.
Method for extracting the intrinsic diffusion coefficient from grain boundary diffusion depth profile
Authors: Lian Songyou , Fourie Antonie J. , Wang Jiangyong , Swart Hendrik C. , Terblans Jacobus Johannes
Published: March 2023

Numerical research is done on grain boundary diffusion of Cu-Ni bilayer thin films. Together, the composition-dependent interdiffusion coefficient and the position of the grain boundary are considered. Fick’s second law provides a quantitative assessment of the effects of grain size, volume, grain boundary diffusion coefficient, diffusion temperature, and time on the depth profile. Regarding the situation where the plateau values of the Ni concentration in the Cu layer and the Cu concentration in the Ni layer are almost the same for the case where the Ni intrinsic diffusion coefficient is significantly bigger than that for Cu, a detailed explanation is provided. We may produce a profile that is like the direct volume diffusion profile with a relative inaccuracy of 7.53% by using a method that is provided to eliminate the impacts of grain boundaries and grain size on the grain boundary diffusion profile. For most of the circumstances covered in this study, the technique is effective. The transformation of the grain boundary diffusion profile yields a composition-dependent interdiffusion coefficient, and the calculation’s outcome is consistent with the theoretical conclusion drawn from the Darken equation. Thin films of Cu (150 nm)/Ni (150 nm)/SiOx/Si (100 nm) were produced as examples, and Auger electron spectroscopy was used to determine the respective depth profiles. The calculated diffusion parameters, namely, the pre-exponential factor and the activation energy, are well within the bounds of the available data.
Proposal that interpretation of field emission current–voltage characteristics should be treated as a specialized form of electrical engineering
Authors: Forbes Richard G.
Published: March 2023

This article proposes that we should think differently about predicting and interpreting measured field electron emission (FE) current–voltage [Im(Vm)] characteristics. It is commonly assumed that Im(Vm) data interpretation is a problem in emission physics and related electrostatics. Many experimentalists then apply the Fowler–Nordheim plot methodology, developed in 1929. However, with modern emitting materials, this 90-year-old interpretation methodology often fails (maybe in nearly 50% of cases) and yields spurious values for characterization parameters, particularly field enhancement factors. This has generated an unreliable literature. Hence, validity checks on experimental Im(Vm) data are nearly always needed before use. A new check, supplementing existing checks, is described. Twelve different “system complications” that, acting singly or in combinations, can cause validity-check failure are identified. A top-level path forward from this unsatisfactory situation is proposed. The term “field electron emission system (FE system)” is defined to include all aspects of an experimental system that affect the measured Im(Vm) characteristics. The analysis of FE systems should now be regarded as a specialized form of electronic/electrical engineering, provisionally called “FE Systems Engineering.” In this approach, the Im(Vm) relationship is split as follows: (a) the current is expressed as a function Im(FC) of the local surface-field magnitude FC at some defined emitter surface location “C,” and (b) the relationship between FC and measured voltage Vm is expressed and determined separately. Determining Im(FC) is mostly a problem in emission physics. Determining the relationship FC(Vm) depends on system electrostatics and (for systems failing a validity check) on the other aspects of FE Systems Engineering, in particular, electrical-circuit modeling. The scope of FE Systems Engineering and some related research implications and problems are outlined.
Inversion in an uncertain ocean using Gaussian processes
Authors: Michalopoulou Zoi-Heleni , Gerstoft Peter
Published: March 2023

Gaussian processes (GPs) can capture correlation of the acoustic field at different depths in the ocean. This feature is exploited in this work for pre-processing acoustic data before these are employed for source localization and environmental inversion using matched field inversion (MFI) in an underwater waveguide. Via the application of GPs, the data are denoised and interpolated, generating densely populated acoustic fields at virtual arrays, which are then used as data in MFI. Replicas are also computed at the virtual receivers at which field predictions are made. The correlations among field measurements at distinct spatial points are manifested through the selection of kernel functions. These rely on hyperparameters, that are estimated through a maximum likelihood process for optimal denoising and interpolation. The approach, employing Gaussian and Matérn kernels, is tested on synthetic and real data with both an exhaustive search and genetic algorithms and is found to be superior to conventional beamformer MFI. It is also shown that the Matérn kernel, providing more degrees of freedom because of an increased number of hyperparameters, is preferable over the frequently used Gaussian kernel.
A Framework for the Standardization of Game Analysis in Ice Hockey
Authors: Staunton Craig A. , Björklund Glenn
Published: March 2023

Background: Compared with other major global team sports such as football or basketball, ice hockey has received considerably less attention in sport-science research. However, the research focus on ice hockey performance is growing rapidly. Unfortunately, despite the growing interest in ice hockey, among the little research that has been conducted there are inconsistencies in terminology and methodology in the study of physiology and performance during games. The need for systematic and standardized reporting of study methodology is vital, as a lack of methodological detail or methodological inconsistencies make it impossible to replicate published studies, and alterations in the methodologies used can influence the measured demands imposed on players. Accordingly, this prohibits the ability of coaches to generate game-replicating training programs, decreasing the application of research findings to practice. In addition, a lack of methodological detail or methodological inconsistencies can result in incorrect conclusions being made from research. Purpose: In this invited commentary, we aim to increase awareness regarding the current standard of methodological reporting in ice hockey game-analysis research. In addition, we have developed a framework for the standardization of game analysis in ice hockey in order to allow for greater replication in future research and to increase the application of published findings to practice. Conclusions: We implore researchers in the field to consult the Ice Hockey Game Analysis Research Methodological Reporting Checklist in order to adopt a detailed reporting standard of methodologies in future work to help improve the applicability of research outcomes.
Systematic Review of the Coach–Athlete Relationship From the Coaches’ Perspective
Authors: McShan Keith , Moore E. Whitney G.
Published: March 2023

The purpose of this study was to systematically review the variables associated with the coach–athlete relationship (CAR) from the coaches’ perspective. Three databases were searched; 57 studies published between January 2000 and May 2021 met the inclusion criteria. Correlates (n = 35) were grouped into three categories: coach variables, athlete variables, and coaching behaviors. Variables positively associated with the coaches’ perspective of the CAR included coaching satisfaction, the teaching of life skills, and engaging in need-supportive behaviors. Negative correlates included coaching burnout, athletes’ avoidant attachment style, and coaches’ controlling behaviors. Aside from coach satisfaction, many of the relationships mentioned came from only one or two studies; therefore, replication studies are needed examining CAR from the coaches’ perspective. In conclusion, the better coaches report CAR to be, the more they also report fostering a caring and autonomy-supportive environment, teaching life skills, and being satisfied with their coaching experience.
Was
Coccidioides
a Pre-Columbian Hitchhiker to Southcentral Washington?
Authors: Engelthaler David M. , Chatters James C. , Casadevall Arturo
Published: March 2023

Coccidioides immitis
, a pathogenic environmental fungus that causes Valley fever (coccidioidomycosis) primarily in the American Southwest and parts of Central and South America, has emerged over the past 12 years in the Columbia River Basin region, near the confluence with the Yakima River, in southcentral Washington state, USA. An initial autochthonous Washington human case was found in 2010, stemming from a wound derived from soil contamination during an all-terrain vehicle crash.
Lipidomics and Comparative Metabolite Excretion Analysis of Methanogenic Archaea Reveal Organism-Specific Adaptations to Varying Temperatures and Substrate Concentrations
Authors: Taubner Ruth-Sophie , Baumann Lydia M. F. , Steiner Michael , Pfeifer Kevin , Reischl Barbara , Korynt Kordian , Bauersachs Thorsten , Mähnert Barbara , Clifford Elisabeth L. , Peckmann Jörn , Schuster Bernhard , Birgel Daniel , Rittmann Simon K.-M. R.
Published: March 2023

Biological methane production by methanogenic archaea has been well studied for biotechnological purposes. This study reveals that methanogenic archaea actively modulate their lipid inventory and proteinogenic amino acid excretion pattern in response to environmental changes and the possible utilization of methanogenic archaea as microbial cell factories for the targeted production of lipids and amino acids.
Supplemental Material: Laurentide Ice Sheet persistence during Pleistocene interglacials
Authors: LeBlanc Danielle E. , al. et
Published: March 2023

Additional information about materials and methods, forward modeling simulations, and data tables. 
Ten-year survival of children with trisomy 13 or trisomy 18: a multi-registry European cohort study
Authors: Glinianaia Svetlana V , Rankin Judith , Tan Joachim , Loane Maria , Garne Ester , Cavero-Carbonell Clara , de Walle Hermien E K , Gatt Miriam , Gissler Mika , Klungsøyr Kari , Lelong Natalie , Neville Amanda , Pierini Anna , Tucker David F , Urhoj Stine Kjaer , Wellesley Diana Gay , Morris Joan K
Published: March 2023

Objective

To investigate the survival to 10 years of age of children with trisomy 13 (T13) and children with trisomy 18 (T18), born 1995–2014.

Design

Population-based cohort study that linked mortality data to data on children born with T13 or T18, including translocations and mosaicisms, from 13 member registries of EUROCAT, a European network for the surveillance of congenital anomalies.

Setting

13 regions in nine Western European countries.

Patients

252 live births with T13 and 602 with T18.

Main outcome measures

Survival at 1 week, 4 weeks and 1, 5 and 10 years of age estimated by random-effects meta-analyses of registry-specific Kaplan-Meier survival estimates.

Results

Survival estimates of children with T13 were 34% (95% CI 26% to 46%), 17% (95% CI 11% to 29%) and 11% (95% CI 6% to 18%) at 4 weeks, 1 and 10 years, respectively. The corresponding survival estimates were 38% (95% CI 31% to 45%), 13% (95% CI 10% to 17%) and 8% (95% CI 5% to 13%) for children with T18. The 10-year survival conditional on surviving to 4 weeks was 32% (95% CI 23% to 41%) and 21% (95% CI 15% to 28%) for children with T13 and T18, respectively.

Conclusions

This multi-registry European study found that despite extremely high neonatal mortality in children with T13 and T18, 32% and 21%, respectively, of those who survived to 4 weeks were likely to survive to age 10 years. These reliable survival estimates are useful to inform counselling of parents after prenatal diagnosis.
Targeting patient recovery priorities in degenerative cervical myelopathy: design and rationale for the RECEDE-Myelopathy trial—study protocol
Authors: Davies Benjamin , Mowforth Oliver D , Yordanov Stefan , Alvarez-Berdugo Daniel , Bond Simon , Nodale Marianna , Kareclas Paula , Whitehead Lynne , Bishop Jon , Chandran Siddharthan , Lamb Sarah , Bacon Mark , Papadopoulos Marios C , Starkey Michelle , Sadler Iwan , Smith Lara , Kalsi-Ryan Sukhvinder , Carpenter Adrian , Trivedi Rikin A , Wilby Martin , Choi David , Wilkinson Ian B , Fehlings Michael G , Hutchinson Peter John , Kotter Mark R N
Published: March 2023

Introduction

Degenerative cervical myelopathy (DCM) is a common and disabling condition of symptomatic cervical spinal cord compression secondary to degenerative changes in spinal structures leading to a mechanical stress injury of the spinal cord. RECEDE-Myelopathy aims to test the disease-modulating activity of the phosphodiesterase 3/phosphodiesterase 4 inhibitor Ibudilast as an adjuvant to surgical decompression in DCM.

Methods and analysis

RECEDE-Myelopathy is a multicentre, double-blind, randomised, placebo-controlled trial. Participants will be randomised to receive either 60–100 mg Ibudilast or placebo starting within 10 weeks prior to surgery and continuing for 24 weeks after surgery for a maximum of 34 weeks. Adults with DCM, who have a modified Japanese Orthopaedic Association (mJOA) score 8–14 inclusive and are scheduled for their first decompressive surgery are eligible for inclusion. The coprimary endpoints are pain measured on a visual analogue scale and physical function measured by the mJOA score at 6 months after surgery. Clinical assessments will be undertaken preoperatively, postoperatively and 3, 6 and 12 months after surgery. We hypothesise that adjuvant therapy with Ibudilast leads to a meaningful and additional improvement in either pain or function, as compared with standard routine care.

Study design

Clinical trial protocol V.2.2 October 2020.

Ethics and dissemination

Ethical approval has been obtained from HRA—Wales.The results will be presented at an international and national scientific conferences and in a peer-reviewed journals.

Trial registration number

ISRCTN Number:ISRCTN16682024.
Efficacy and safety of GLP-1 receptor agonists versus SGLT-2 inhibitors in overweight/obese patients with or without diabetes mellitus: a systematic review and network meta-analysis
Authors: Ma Hong , Lin Yu-Hao , Dai Li-Zhen , Lin Chen-Shi , Huang Yanling , Liu Shu-Yuan
Published: March 2023

Objective

To compare the efficacy and safety between and within glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2is) in overweight or obese adults with or without diabetes mellitus.

Methods

PubMed, ISI Web of Science, Embase and Cochrane Central Register of Controlled Trials database were comprehensively searched to identify randomised controlled trials (RCTs) of effects of GLP-1RAs and SGLT-2is in overweight or obese participants from inception to 16 January 2022. The efficacy outcomes were the changes of body weight, glucose level and blood pressure. The safety outcomes were serious adverse events and discontinuation due to adverse events. The mean differences, ORs, 95% credible intervals (95% CI), the surface under the cumulative ranking were evaluated for each outcome by network meta-analysis.

Results

Sixty-one RCTs were included in our analysis. Both GLP-1RAs and SGLT-2is conferred greater extents in body weight reduction, achieving at least 5% wt loss, HbA1c and fasting plasma glucose decrease compared with placebo. GLP-1RAs was superior to SGLT-2is in HbA1c reduction (MD: −0.39%, 95% CI −0.70 to −0.08). GLP-1RAs had high risk of adverse events, while SGLT-2is were relatively safe. Based on intraclass comparison, semaglutide 2.4 mg was among the most effective interventions in losing body weight (MD: −11.51 kg, 95% CI −12.83 to −10.21), decreasing HbA1c (MD: −1.49%, 95% CI −2.07 to −0.92) and fasting plasma glucose (MD: −2.15 mmol/L, 95% CI −2.83 to −1.59), reducing systolic blood pressure (MD: −4.89 mm Hg, 95% CI −6.04 to −3.71) and diastolic blood pressure (MD: −1.59 mm Hg, 95% CI −2.37 to −0.86) with moderate certainty evidences, while it was associated with high risk of adverse events.

Conclusions

Semaglutide 2.4 mg showed the greatest effects on losing body weight, controlling glycaemic level and reducing blood pressure while it was associated with high risk of adverse events.

PROSPERO registration number

CRD42021258103.
Transcranial direct current stimulation combined with bodyweight support–tai chi footwork for motor function of stroke survivors: a study protocol of randomised controlled trial
Authors: Lai Ming-hui , Xu Hai-chen , Huang Meng-cui , Lu Yan , Yang Kun , Jiang Li-ming , Yu Xiao-ming
Published: March 2023

Introduction

Our previous studies have proposed the bodyweight support–t’ai chi (BWS-TC) footwork training for stroke survivors with severe motor dysfunction and fear of falling, and have proven its positive effects for motor function. Transcranial direct current stimulation (tDCS) provides a non-invasive and safe way to modulate neuronal activity and provoke neuroplastic changes and to improve the motor function of stroke survivors. However, it is unclear whether the integration of BWS-TC and tDCS has synergistic effects on improving motor function of the stroke survivors.

Methods and analysis

This study will be an assessor-blinded randomised controlled trial involving 12-week intervention and 6-month follow-up. One hundred and thirty-five individuals with stroke will be randomly divided in a ratio of 1:1:1 into three groups. Control group A, control group B and intervention group C will receive tDCS and conventional rehabilitation programmes (CRPs), BWS-TC and CRP, tDCS-BWS-TC and CRP for 12 weeks, respectively. The primary outcome measures will include the efficacy (Fugl-Meyer Assessment), acceptability and safety of these interventions. The secondary outcome measures will include balance ability (ie, limits of stability and modified clinical test of sensory integration), walking function, brain structure and function, risk of falling, Barthel Index and 36-Item Short Form Survey. All outcomes will be assessed at baseline, 6 and 12 weeks during intervention, and 1, 3 and 6 months during the follow-up period. Two-way analysis of variance with repeated measures will be applied to examine the main effects of the group and the time factor and group–time interaction effects for all outcome measures.

Ethics and dissemination

Ethics approval was obtained from the ethics committee of the Shanghai Seventh People’s Hospital (2021-7th-HIRB-017). The results of the study will be published in a peer-reviewed journal and presented at scientific conferences.

Trial registration number

ChiCTR2200059329.
Improving family functioning and reducing violence in the home in North Kivu, Democratic Republic of Congo: a pilot cluster-randomised controlled trial of Safe at Home
Authors: Falb Kathryn L , Asghar Khudejha , Blackwell Alexandra , Baseme Simon , Nyanguba Martin , Roth Danielle , Hategekimana Jean de Dieu
Published: March 2023

Objective

To test the effectiveness of the Safe at Home programme which was developed to improve family well-being and prevent multiple forms of violence in the home.

Design

Waitlisted pilot cluster randomised controlled trial.

Setting

North Kivu, Democratic Republic of Congo.

Participants

202 heterosexual couples.

Intervention

The Safe at Home programme.

Primary and secondary outcome measures

The primary outcome was family functioning, with secondary outcomes of past-3 month co-occurring violence, intimate partner violence (IPV) and harsh discipline. Pathway mechanisms assessed included attitudes related to acceptance of harsh discipline, gender equitable attitudes, positive parenting skills and power sharing within the couple.

Results

No significant improvements in family functioning were documented for women (β=1.49; 95% CI: −2.75 to 5.74; p=0.49) and men (β=1.09; 95% CI: −3.13 to 4.74; p=0.69). However, women in Safe at Home reported a OR=0.15 (p=0.000), OR=0.23 (p=0.001) and OR=0.29 (p=0.013) change in co-occurring IPV and harsh discipline; physical/sexual/emotional IPV by their partner and use of physical and/or emotional harsh discipline against their child, respectively, as compared with women in the waitlisted group. Men participating in Safe at Home reported a OR=0.23 (p=0.005) change in perpetration of co-occurring violence, OR=0.26 (p=0.003) change in any form of IPV perpetration and OR=0.56 (p=0.19) change in use of harsh discipline against their child as compared with the waitlist arm. Positive changes were also noted in pathway variables around attitudes, skills and behaviours within couples.

Conclusion

This pilot trial demonstrated the Safe at Home programme to be highly effective in preventing multiple forms of violence in the home and improving equitable attitudes and skills in couples. Future research should assess longitudinal impact and implementation at scale.

Trial registration number

NCT04163549.
Characterising the burden of chronic kidney disease among people with type 2 diabetes in England: a cohort study using the Clinical Practice Research Datalink
Authors: Cook Sarah , Schmedt Niklas , Broughton Julie , Kalra Philip A , Tomlinson Laurie A , Quint Jennifer K
Published: March 2023

Objectives

To describe prevalence of chronic kidney disease (CKD), demographic and clinical characteristics, treatment patterns and rates of cardiovascular and renal complications for patients with type 2 diabetes (T2D) treated in routine clinical care.

Design

Repeat cross-sectional study (6 monthly cross-sections) and cohort study from 1 January 2017 to 31 December 2019.

Setting

Primary care data from English practices contributing to the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics and Office for National Statistics mortality data.

Participants

Patients with T2D aged >18 years, at least one year of registration data.

Primary and secondary outcomes

Primary outcome was prevalence of CKD defined as chronic kidney disease epidemiology collaboration (CKD-EPI) estimated glomerular filtration rate <60 mL/min/1.73 m2, and/or urinary albumin creatinine ratio ≥3 mg/mmol in the past 24 months. Secondary outcomes were prescriptions of medications of interest and clinical and demographic characteristics in the past 3 months.

In the cohort study rates of renal and cardiovascular complications, all-cause mortality and hospitalisations over the study period were compared among those with and without CKD.

Results

There were 574 190 eligible patients with T2D as of 1 January 2017 and 664 296 as of 31 December 2019. Estimated prevalence of CKD across the study period was stable at approximately 30%. Medication use was stable over time in people with CKD and T2D, with low use of steroidal mineralocorticoid receptor antagonists (approximately 4.5% across all time points) and a low use but steady increase in use of sodium-glucose co-transporter-2 inhibitors (from 2.6% to 6.2%). Rates of all complications were higher in those with CKD at the start of the study period, with increasing rates, with increased severity of CKD, heart failure and albuminuria.

Conclusions

The burden of CKD in patients with T2D is high and associated with substantially increased rates of complications particularly in those with comorbid heart failure.
Towards exploring current challenges and future opportunities relating to the prehospital triage of patients with traumatic brain injury: a mixed-methods study protocol
Authors: Alqurashi Naif , Alotaibi Ahmed , Bell Steve , Lecky Fiona , Body Richard
Published: March 2023

Introduction

Traumatic brain injury (TBI) is a major global health burden that results in disability and loss of health. Identifying those patients who require specialist neuroscience care can be challenging due to the low accuracy of existing prehospital trauma triage tools. Despite the widespread use of decision aids to ‘rule out’ TBI in hospitals, they are not widely used in the prehospital environment. We aim to provide a snapshot of current prehospital practices in the UK, and to explore facilitators and challenges that may be encountered when adopting new tools for decision support.

Methods and analysis

A mixed-methods study will be conducted using a convergent design approach. In the first phase, we will conduct a national survey of current practice in which every participating ambulance service in the UK will receive an online questionnaire, and only one response is required. In the second phase, semistructured interviews will be conducted to explore the perceptions of ambulance service personnel regarding the implementation of new triage methods that may enhance triage decisions. The survey questions and the interview topic guide were piloted and externally reviewed. Quantitative data will be summarised using descriptive statistics; qualitative data will be analysed thematically.

Ethics and dissemination

This study has been approved by the Health Research Authority (REC reference 22/HRA/2035). Our findings may inform the design of future care pathways and research as well as identify challenges and opportunities for future development of prehospital triage tools for patients with suspected TBI. Our findings will be published in peer-reviewed journals, relevant national and international conferences, and will be included in a PhD thesis.
Qualitative interview study exploring the early identification and referral of patients with suspected head and neck cancer by community pharmacists in England
Authors: Sturrock Andrew , Bissett Susan M , Carrozzo Marco , Lish Rachel , Howe Debora , Mountain Sue , Nugent Michael , O’Hara James , Preshaw Philip M , Todd Adam , Wilkes Scott
Published: March 2023

Objective

To explore pharmacists’ perceptions of, and attitudes towards, the early identification and referral of patients with signs and symptoms indicating potential diagnosis of head and neck cancer (HNC) in community pharmacy settings.

Design

Qualitative methodology, using constant comparative analysis to undertake an iterative series of semistructured interviews. Framework analysis facilitated the identification of salient themes.

Setting

Community pharmacies in Northern England.

Participants

17 community pharmacists.

Results

Four salient and inter-related categories emerged: (1) Opportunity and access, indicating frequent consultations with patients presenting with potential HNC symptoms and the accessible nature of community pharmacists; (2) Knowledge gap, indicating knowledge of key referral criteria, but limited experience and expertise in undertaking more holistic patient assessments to inform clinical decision making; (3) Referral pathways and workloads; indicating good working relationships with general medical practices, but limited collaboration with dental services, and a desire to engage with formal referral pathways, but current practices based entirely on signposting resulting in a potential lack of safety-netting, no auditable trail, feedback mechanism or integration into the multidisciplinary team; (4) Utilisation of clinical decision support tools; indicating that no participants were aware the Head and Neck Cancer Risk Calculator (HaNC-RC V2) for HNC but were positive towards the use of such tools to improve decision making. HaNC-RC V2 was seen as a potential tool to facilitate a more holistic approach to assessing patient’s symptoms, acting as a prompt to further explore a patient’s presentation, requiring further investigation in this context.

Conclusions

Community pharmacies offer access to patients and high-risk populations that could support HNC awareness initiatives, earlier identification and referral. However, further work to develop a sustainable and cost-effective approach to integrating pharmacists into cancer referral pathways is needed, alongside appropriate training for pharmacists to successfully deliver optimum patient care.
Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys
Authors: McCormick Ian , Kim Min J , Hydara Abba , Olaniyan Segun I , Jobe Modou , Badjie Omar , Sanyang Nyakassi M B , Jarju Gibril , Njai Modou , Sankareh Alhagie , Bastawrous Andrew , Allen Luke , Mactaggart Islay , Burton Matthew J , Ramke Jacqueline
Published: March 2023

Objective

Monitoring health outcomes disaggregated by socioeconomic position (SEP) is crucial to ensure no one is left behind in efforts to achieve universal health coverage. In eye health planning, rapid population surveys are most commonly implemented; these need an SEP measure that is feasible to collect within the constraints of a streamlined examination protocol. We aimed to assess whether each of four SEP measures identified inequality—an underserved group or socioeconomic gradient—in key eye health outcomes.

Design

Population-based cross-sectional survey.

Participants

A subset of 4020 adults 50 years and older from a nationally representative sample of 9188 adults aged 35 years and older in The Gambia.

Outcome measures

Blindness (presenting visual acuity (PVA) <3/60), any vision impairment (VI) (PVA <6/12), cataract surgical coverage (CSC) and effective cataract surgical coverage (eCSC) at two operable cataract thresholds (<6/12 and <6/60) analysed by one objective asset-based measure (EquityTool) and three subjective measures of relative SEP (a self-reported economic ladder question and self-reported household food adequacy and income sufficiency).

Results

Subjective household food adequacy and income sufficiency demonstrated a socioeconomic gradient (queuing pattern) in point estimates of any VI and CSC and eCSC at both operable cataract thresholds. Any VI, CSC <6/60 and eCSC <6/60 were worse among people who reported inadequate household food compared with those with just adequate food. Any VI and CSC <6/60 were worse among people who reported not enough household income compared with those with just enough income. Neither the subjective economic ladder question nor the objective asset-wealth measure demonstrated any socioeconomic gradient or pattern of inequality in any of the eye health outcomes.

Conclusion

We recommend pilot-testing self-reported food adequacy and income sufficiency as SEP variables in vision and eye health surveys in other locations, including assessing the acceptability, reliability and repeatability of each question.