bluuebunny/crossref_metadata_2025 huggingface dataset:
Active Circulation of Corynebacterium ulcerans among Nonhuman Primates
Authors: Thomas Archana , Slifka Ariel M. , Hendrickson Sara M. , Amanna Ian J. , Slifka Mark K.
Published: July 2022

C. ulcerans
represents an emerging zoonotic agent of diphtheria, but little is known about its transmission or maintenance among animal reservoirs. In these studies, we identified diphtheria outbreaks among both outdoor- and indoor-housed rhesus macaques and isolated a toxigenic strain of
C. ulcerans
from a recently infected animal.
Human Air-Liquid-Interface Organotypic Airway Cultures Express Significantly More ACE2 Receptor Protein and Are More Susceptible to HCoV-NL63 Infection than Monolayer Cultures of Primary Respiratory Epithelial Cells
Authors: Castillo Gino , Mora-Díaz Juan Carlos , Nelli Rahul K. , Giménez-Lirola Luis G.
Published: July 2022

HCoV-NL63 is widespread globally, accounting for a significant number of respiratory infections in children and adults. HCoV-NL63 gains entrance into respiratory epithelial cells via the ACE2 receptor, the same cell receptor used by severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2.
Revisiting the 1899 earthquake series using integrative geophysical analysis in Yakutat Bay, Alaska, USA
Authors: Walton Maureen A.L. , Gulick Sean P.S. , Haeussler Peter J.
Published: July 2022

A series of large earthquakes in 1899 affected southeastern Alaska near Yakutat and Disenchantment Bays. The largest of the series, a MW 8.2 event on 10 September 1899, generated an ~12-m-high tsunami and as much as 14.4 m of coseismic uplift in Yakutat Bay, the largest coseismic uplift ever measured. Several complex fault systems in the area are associated with the Yakutat terrane collision with North America and the termination of the Fairweather strike-slip system, but because faults local to Yakutat Bay have been incompletely or poorly mapped, it is unclear which fault system(s) ruptured during the 10 September 1899 event. Using marine geophysical data collected in August 2012, we provide an improved tectonic framework for the Yakutat area, which advances our understanding of earthquake hazards. We combined 153 line km of 2012 high-resolution multichannel seismic (MCS) reflection data with compressed high-intensity radar pulse (Chirp) profiles, basin-scale MCS data, 2018 seafloor bathymetry, published geodetic models and thermochronology data, and previous measurements of coseismic uplift to better constrain fault geometry and subsurface structure in the Yakutat Bay area. We did not observe any active or concealed faults crossing Yakutat Bay in our high-resolution data, requiring faults to be located entirely onshore or nearshore. We interpreted onshore faults east of Yakutat Bay to be associated with the transpressional termination of the Fairweather fault system, forming a series of splay faults that exhibit a horsetail geometry. Thrust and reverse faults on the west side of the bay are related to Yakutat terrane underthrusting and collision with North America. Our results include an updated fault map, structural model of Yakutat Bay, and quantitative assessment of uncertainties for legacy geologic coseismic uplift measurements. Additionally, our results indicate the 10 September 1899 rupture was possibly related to stress loading from the earlier Yakutat terrane underthrusting event of 4 September 1899, with the majority of 10 September coseismic slip occurring on the Esker Creek system on the northwest side of Yakutat Bay. Limited (~2 m) coseismic or postseismic slip associated with the 1899 events occurred on faults located east of Yakutat Bay.
Upper-plate structure and tsunamigenic faults near the Kodiak Islands, Alaska, USA
Authors: Ramos Marlon D. , Liberty Lee M. , Haeussler Peter J. , Humphreys Robert
Published: July 2022

The Kodiak Islands lie near the southern terminus of the 1964 Great Alaska earthquake rupture area and within the Kodiak subduction zone segment. Both local and trans-Pacific tsunamis were generated during this devastating megathrust event, but the local tsunami source region and the causative faults are poorly understood. We provide an updated view of the tsunami and earthquake hazard for the Kodiak Islands region through tsunami modeling and geophysical data analysis. Using seismic and bathymetric data, we characterize a regionally extensive seafloor lineament related to the Kodiak shelf fault zone, with focused uplift along a 50-km-long portion of the newly named Ugak fault as the most likely source of the local Kodiak Islands tsunami in 1964. We present evidence of Holocene motion along the Albatross Banks fault zone, but we suggest that this fault did not produce a tsunami in 1964. We relate major structural boundaries to active forearc splay faults, where tectonic uplift is collocated with gravity lineations. Differences in interseismic locking, seismicity rates, and potential field signatures argue for different stress conditions at depth near presumed segment boundaries. We find that the Kodiak segment boundaries have a clear geophysical expression and are linked to upper-plate structure and splay faulting. The tsunamigenic fault hazard is higher for the Kodiak shelf fault zone when compared to the nearby Albatross Banks fault zone, suggesting short wave travel paths and little tsunami warning time for nearby communities.
Gender equity in health research publishing in Africa
Authors: Baobeid Anwaar , Faghani-Hamadani Tara , Sauer Sara , Boum Yap , Hedt-Gauthier Bethany L , Neufeld Nicholas , Odhiambo Jackline , Volmink Jimmy , Shuchman Miriam , Di Ruggiero Erica , Condo Jeanine U
Published: July 2022

Introduction

Women researchers find it more difficult to publish in academic journals than men, an inequity that affects women’s careers and was exacerbated during the pandemic, particularly for women in low-income and middle-income countries. We measured publishing by sub-Saharan African (SSA) women in prestigious authorship positions (first or last author, or single author) during the time frame 2014–2016. We also examined policies and practices at journals publishing high rates of women scientists from sub-Saharan Africa, to identify potential structural enablers affecting these women in publishing.

Methods

The study used Namsor V.2, an application programming interface, to conduct a secondary analysis of a bibliometric database. We also analysed policies and practices of ten journals with the highest number of SSA women publishing in first authorship positions.

Results

Based on regional analyses, the greatest magnitude of authorship inequity is in papers from sub-Saharan Africa, where men comprised 61% of first authors, 65% of last authors and 66% of single authors. Women from South Africa and Nigeria had greater success in publishing than those from other SSA countries, though women represented at least 20% of last authors in 25 SSA countries. The journals that published the most SSA women as prominent authors are journals based in SSA. Journals with overwhelmingly male leadership are also among those publishing the highest number of SSA women.

Conclusion

Women scholars in SSA face substantial gender inequities in publishing in prestigious authorship positions in academic journals, though there is a cadre of women research leaders across the region. Journals in SSA are important for local women scholars and the inequities SSA women researchers face are not necessarily attributable to gender discrepancy in journals’ editorial leadership.
Flexible Work: Opportunity and Challenge (FLOC) for individual, social and economic sustainability. Protocol for a prospective cohort study of non-standard employment and flexible work arrangements in Sweden
Authors: Svensson Sven , Hallman David M , Mathiassen SvendErik , Heiden Marina , Fagerström Arne , Mutiganda Jean Claude , Bergström Gunnar
Published: July 2022

Introduction

Flexibility in working life, including non-standard employment (NSE) and flexible work arrangements (FWAs), offers the organisation a better ability to adapt to changing conditions while also posing considerable challenges for organisations as well as workers. The aim of the Flexible Work: Opportunity and Challenge (FLOC) study is to investigate associations between NSE and FWA on the one hand, and individual, social and economic sustainability on the other.

Methods and analysis

This prospective open cohort study targets approximately 8000 workers 18–65 years old in 8–10 public and private organisations in Sweden. We will use a comprehensive battery of measurement methods addressing financial performance, physical and psychosocial exposures, and physical and mental health, both at the organisational and the individual level. Methods include valid survey questionnaires and register data, and, in subpopulations, technical measurements, interviews and diaries. Main exposures are type of employment and type of work arrangement. Main outcomes are indicators of social and economic sustainability and, at the individual level, health and well-being. Data, collected over 54 months at approximately 18-month intervals, will be analysed using multivariate methods considering main effects as well as potential effect modifiers. The analyses will take into account that respondents are nested in organisations, divisions and/or have specific managers.

Ethics and dissemination

FLOC is approved by the Swedish Ethical Review Authority (decision numbers 2019–06220, 2020–06094 and 2021–02725). Data will be published in peer-reviewed journals and presented at international conferences, and researchers will assist the organisations in improving policies and routines for employment and organisation of work.
Interactions of ST-elevation myocardial infarction, age, and sex and the risk of major adverse cardiovascular events among Chinese adults: a secondary analysis of a single-centre prospective cohort
Authors: Wang Cuiping , Zhou Lin , Liang Yi , Liu Peijing , Yuan Wei
Published: July 2022

Objectives

This study aimed to evaluate the interactions of ST-elevation myocardial infarction (STEMI), ageing and sex with respect to the incidence of major adverse cardiovascular events (MACE) among Chinese adults.

Design

Secondary analysis of a single-centre prospective cohort.

Setting

Patients who were admitted to cardiology clinics of the Affiliated Hospital of Jiangsu University due to acute myocardial infarction (MI) from June 2017 to November 2019 were eligible for inclusion in the study. This research only examined in-hospital cases.

Participants

Patients aged <18 years or confirmed dead within 24 hours from admission were excluded. A total of 843 adults were included in the analysis.

Primary and secondary outcome measures

MACE was defined as any occurrence of cardiovascular mortality, MI recurrence, cardiogenic shock or heart failure. The relative excess risk due to interaction (RERI), attributable proportion (AP) and the synergy index were computed to quantify the interactions. Men without STEMI and adults without STEMI aged <60 years were the reference groups when examining the risk of MACE.

Results

The female participants with STEMI showed a statistically higher risk of MACE compared with the male participants without STEMI (relative risk (RR): 2.713, CI: 1.350 to 5.426, p=0.005). A 3.327 times higher risk of MACE was detected in the older adults with STEMI (aged ≥60 years) compared with the adults without STEMI aged <60 years (RR: 3.327, CI: 1.414 to 8.955, p=0.01). Older female patients also had an increased risk of MACE (RR: 3.033, CI: 1.432 to 6.777, p=0.005). A positive additive interaction was detected between STEMI and age (RERI: 1.917, CI: 0.196 to 3.637; AP: 0.576, CI: 0.174 to 0.979). STEMI and sex also indicated an additive interaction (AP: 0.459, CI: 0.018 to 0.899).

Conclusion

In this Chinese population with MI, the risk of MACE was increased by about 2.7 times in women with STEMI compared with men without STEMI. MACE incidence increased by about 3.3 times in older patients with STEMI compared with younger patients without STEMI. STEMI and age, and STEMI and sex, may have a positive additive interaction.
Socioeconomic environment and survival in patients after ST-segment elevation myocardial infarction (STEMI): a longitudinal study for the City of Vienna
Authors: Spitzer Sonja , di Lego Vanessa , Kuhn Michael , Roth Christian , Berger Rudolf
Published: July 2022

Objectives

This study investigates the relationship between socioeconomic environment (SEE) and survival after ST-segment elevation myocardial infarction (STEMI) separately for women and men in the City of Vienna, Austria.

Design

Hospital-based observational data of STEMI patients are linked with district-level information on SEE and the mortality register, enabling survival analyses with a 19-year follow-up (2000–2018).

Setting

The analysis is set at the main tertiary care hospital of the City of Vienna. On weekends, it is the only hospital in charge of treating STEMIs and thus provides representative data for the Viennese population.

Participants

The study comprises a total of 1481 patients with STEMI, including women and men aged 24–94 years.

Primary and secondary outcome measures

Primary outcome measures are age at STEMI and age at death. We further distinguish between deaths from coronary artery disease (CAD), deaths from acute coronary syndrome (ACS), and other causes of death. SEE is proxied via mean individual gross income from employment in each municipal district.

Results

Results are based on Kaplan-Meier survival probability estimates, Cox proportional hazard regressions and competing risk models, always using age as the time scale. Descriptive findings suggest a socioeconomic gradient in the age at death after STEMI. This finding is, however, not supported by the regression results. Female patients with STEMI have better survival outcomes, but only for deaths related to CAD (HR: 0.668, 95% CIs 0.452 to 0.985) and other causes of deaths (HR: 0.627, 95% CIs 0.444 to 0.884), and not for deaths from the more acute ACS.

Conclusions

Additional research is necessary to further disentangle the interaction between SEE and age at STEMI, as our findings suggest that individuals from poorer districts have STEMI at younger ages, which indicates vulnerability in regard to health conditions in these neighbourhoods.
Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017)
Authors: Low Andrea , Gummerson Elizabeth , Schwitters Amee , Bonifacio Rogerio , Teferi Mekleet , Mutenda Nicholus , Ayton Sarah , Juma James , Ahpoe Claudia , Ginindza Choice , Patel Hetal , Biraro Samuel , Sachathep Karam , Hakim Avi J , Barradas Danielle , Hassani Ahmed Saadani , Kirungi Willford , Jackson Keisha , Goeke Leah , Philips Neena , Mulenga Lloyd , Ward Jennifer , Hong Steven , Rutherford George , Findley Sally
Published: July 2022

Objective

To assess the potential bidirectional relationship between food insecurity and HIV infection in sub-Saharan Africa.

Design

Nationally representative HIV impact assessment household-based surveys.

Setting

Zambia, Eswatini, Lesotho, Uganda and Tanzania and Namibia.

Participants

112 955 survey participants aged 15–59 years with HIV and recency test results.

Measures

Recent HIV infection (within 6 months) classified using the HIV-1 limited antigen avidity assay, in participants with an unsuppressed viral load (>1000 copies/mL) and no detectable antiretrovirals; severe food insecurity (SFI) defined as having no food in the house ≥three times in the past month.

Results

Overall, 10.3% of participants lived in households reporting SFI. SFI was most common in urban, woman-headed households, and in people with chronic HIV infection. Among women, SFI was associated with a twofold increase in risk of recent HIV infection (adjusted relative risk (aRR) 2.08, 95% CI 1.09 to 3.97). SFI was also associated with transactional sex (aRR 1.28, 95% CI 1.17 to 1.41), a history of forced sex (aRR 1.36, 95% CI 1.11 to 1.66) and condom-less sex with a partner of unknown or positive HIV status (aRR 1.08, 95% CI 1.02 to 1.14) in all women, and intergenerational sex (partner ≥10 years older) in women aged 15–24 years (aRR 1.23, 95% CI 1.03 to 1.46). Recent receipt of food support was protective against HIV acquisition (aRR 0.36, 95% CI 0.14 to 0.88).

Conclusion

SFI increased risk for HIV acquisition in women by twofold. Heightened food insecurity during climactic extremes could imperil HIV epidemic control, and food support to women with SFI during these events could reduce HIV transmission.
How the Suboxone Education Programme presented as a solution to risks in the Canadian opioid crisis: a critical discourse analysis
Authors: Sud Abhimanyu , Strang Matthew , Buchman Daniel Z , Spithoff Sheryl , Upshur Ross E G , Webster Fiona , Grundy Quinn
Published: July 2022

Objectives

Pharmaceutical industry involvement in medical education, research and clinical practice can lead to conflicts of interest. Within this context, this study examined how the ‘Suboxone Education Programme’, developed and delivered by a pharmaceutical company as part of a federally regulated risk management program, was presented as a solution to various kinds of risks relating to opioid use in public documents from medical institutions across Canada.

Setting

These documents were issued during the Canadian opioid crisis, a time when the involvement of industry in health policy was being widely questioned given industry’s role in driving the overprescribing of opioid analgesics and contributing to population-level harms.

Design

A critical discourse analysis of 69 documents collected between July 2020 and May 2021 referencing the Suboxone Education Program spanning 13 years (2007–2021) from medical, nursing and pharmacy institutions sourced from every Canadian province and territory. Discursive themes were identified through iterative and duplicate analyses using a semistructured data extraction instrument.

Results

Documents characterised the Programme as addressing iatrogenic risks from overprescribing opioid analgesics, environmental risks from a toxic street drug supply and pharmacological risks relating to the dominant therapeutic alternative of methadone. The programme was identified as being able to address these risks by providing mechanisms to surveil healthcare professionals and to facilitate the prescribing of Suboxone. Medical institutions legitimised the Suboxone Education Programme by lending their regulatory, epidemiological and professional authority.

Conclusions

Addressing risk is considered as a central, moral responsibility of contemporary healthcare services. In this case, moral imperatives to address opioid crisis-related risks overrode other ethical concerns regarding conflicts of interest between industry and public welfare. Failing to address these conflicts potentially imperils efforts of mitigating population health harms by propagating an important driving force of the opioid crisis.
Effect of Zhan Zhuang Qigong on upper limb static tremor and aerobic exercise capacity in patients with mild-to-moderate Parkinson’s disease: study protocol for a randomised controlled trial
Authors: Zhang Linlin , Liu Xihua , Xi Xiaoming , Chen Yuxiao , Wang Qing , Qu Xinjie , Cao Haihao , Wang Limin , Sun Wenyu , Chen Guoming , Liu Huifen , Jiang Xiaoyu , Su Hang , Jiang Jiahui , Bi Hongyan
Published: July 2022

Introduction

Currently, the first choice for the clinical treatment of static tremor in Parkinson’s disease (PD) is drug therapy, however side effects are common. In recent years, the effects of physical therapy on PD has become a serious research focus. Studies have indicated that aerobic and resistance exercises alleviate PD movement disorders and improve aerobic capacity, but the effects of Qigong on PD static tremor and aerobic capacity remain unknown.

Methods and analysis

Objective

To observe the effects of Zhan Zhuang Qigong on upper limb static tremor and aerobic capacity in patients with PD, we established a rigorous randomised, parallel-controlled, assignment hidden, evaluator-blinded protocol.

Methods

Seventy-two patients with PD, at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, were recruited and randomly divided into a control (n=36) and experimental group (n=36). The intervention group received conventional medicine plus Zhan Zhuang Qigong exercises five times a week at 30 min each time, over an 8-week period. The long-term effects of Zhan Zhuang Qigong on PD was investigated after the intervention. Phyphox APP, CRST, CPET, UPDRS(II, III) were used to evaluate tremor, aerobic capacity, and motor function in groups.

Discussion

We are investigating the effects of Zhan Zhuang Qigong on upper limb static tremor and aerobic capacity in patients with PD. If positive are identified, they will add a new research direction and evidence for the clinical exploration of exercise therapy for PD.

Ethics and dissemination

This study was approved by the Ethics Committee of Shandong University of Traditional Chinese Medicine (Approval Number: 2021–025-KY). The Committee will be informed of any changes to the trial protocol, such as intervention intensity, outcome indicators and data collection. Study results will be presented as a paper at an international conference or in a journal.

Trial registration number

ChiCTR2100053529.
Effects and utility of an online forward triage tool during the SARS-CoV-2 pandemic: a mixed method study and patient perspectives, Switzerland
Authors: Michel Janet , Mettler Annette , Stuber Raphael , Müller Martin , Ricklin Meret E , Jent Philipp , Hautz Wolf E , Sauter Thomas C
Published: July 2022

Objective

To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 online forward triage tool (OFTT) in a pandemic context.

Design

A mixed method sequential explanatory study was employed. Quantitative data of all OFTT users, between 2 March 2020 and 12 May 2020, were collected. Second, qualitative data were collected through key informant interviews (n=19) to explain the quantitative findings, explore tool utility, user experience and elicit recommendations.

Setting

The working group e-emergency medicine at the emergency department developed an OFTT, which was made available online.

Participants

Participants included all users above the age of 18 that used the OFTT between 2 March 2020 and 12 May 2020.

Intervention

An OFTT that displayed the current test recommendations of the Federal Office of Public Health on whether someone needed testing for COVID-19 or not. No diagnosis was provided.

Results

In the study period, 6272 users consulted our OFTT; 40.2% (1626/4049) would have contacted a healthcare provider had the tool not existed. 560 participants consented to a follow-up survey and provided a valid email address. 31.4% (176/560) participants returned a complete follow-up questionnaire. 84.7% (149/176) followed the recommendations given. 41.5% (73/176) reported that their fear was allayed after using the tool. Qualitatively, seven overarching themes emerged namely (1) accessibility of tool, (2) user-friendliness of tool, (3) utility of tool as an information source, (4) utility of tool in allaying fear and anxiety, (5) utility of tool in medical decision-making (6) utility of tool in reducing the potential for onward transmissions and (7) utility of tool in reducing health system burden.

Conclusion

Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden but can also serve as an information source, reduce anxiety and fear, reduce potential for cross infections and facilitate medical decision-making.
Use of a 2-year continuing professional development programme to change Japanese physicians’ attitudes to learning primary care: a qualitative study
Authors: Seki Masayasu , Fujinuma Yasuki , Matsushima Masato , Joki Tatsuhiro , Okonogi Hideo , Miura Yasuhiko , Ohno Iwao , Hiramoto Jun
Published: July 2022

Objective

To evaluate changes in the learning attitudes of primary care physicians.

Design

Qualitative study through one focus group interview with the programme’s participants. Analysis of the focus group content using the Steps for Coding and Theorization method.

Setting

Japan.

Participants

Eight primary care physicians who completed a 2-year continuing professional development (CPD) programme using a problem-based learning (PBL) approach, focused on acquiring the skills needed to practise as primary care physicians in the community.

Results

Participants described positive changes in their attitudes and behaviours as a result of the training programme. These changes were grouped into three main themes: ‘changes in learning methods regarding medical practice’, ‘encounters with diverse perspectives and values, and confidence gained from those encounters’, and ‘showing one’s attitude towards learning and its influence on others’. The experienced practitioners participating in this study reported that the programme helped them apply their skills more broadly; for example, searching the literature for psychosocial aspects of practice and engaging more comfortably with diverse perspectives. They reported the positive impact of their learning on their coworkers.

Conclusion

A 2-year CPD programme using PBL can influence primary care physicians’ attitudes and learning-related behaviours. Further research is needed to determine which specific aspects of the programme are the most effective and whether the changes in attitudes and behaviours described affect patient care.
Cognitive functioning and work-related outcomes of non-central nervous system cancer survivors: protocol for a systematic review with meta-analysis
Authors: Oliveira Ana F , Fernandes Sofia , Reis Juliana D , Torres Ana , Santos Isabel M , Von Ah Diane
Published: July 2022

Introduction

In recent years, growing attention has been given to the study of the impact of cancer-related cognitive impairment (CRCI) in working non-central nervous system (CNS) cancer survivors. Available literature has shown that working cancer survivors identify cognitive problems at work as very problematic and worrisome. Some reviews have discussed the association between CRCI and work-related outcomes; however, none to date have investigated this association through comprehensive systematic review with meta-analysis. Hence, this work will comprehensively summarise existing evidence from quantitative studies assessing the relationship between CRCI and work-related outcomes of adult non-CNS cancer survivors at working age.

Methods and analysis

The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Electronic searches in the databases Web of Science, Scopus, PubMed, ProQuest, PsycINFO and CINAHL, complemented by a manual search of other relevant articles, will be performed from 2000 onwards to identify relevant publications. Two independent reviewers will assess studies for inclusion and extract data from each article using a standardised form. Studies eligible for inclusion must be quantitative, contain adult non-CNS cancer survivors with CRCI, and a measure of cognitive functioning and work-related outcomes. To assess risk of bias, the Joanna Briggs Institute Critical Appraisal Tool Studies checklists will be independently used by the two researchers. Synthesis of the included articles will be conducted using a narrative method and through meta-analysis. Meta-analysis will be reported via correlation for the association between CRCI and work-related outcomes. The cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system.

Ethics and dissemination

Ethics approval is not required since individual patient data will not be collected. The findings will be published in a peer-review indexed journal, presented at scientific meetings and included in a chapter of a Doctoral thesis.

PROSPERO registration number

CRD42020165458.
Snapshot of health-related behaviours in adults living with disabilities 1 year into the COVID-19 pandemic: a cross-sectional survey study
Authors: Hussain Syeda F , Heinze Nikki , Castle Claire L , Godier-McBard Lauren R , Kempapidis Theofilos , Gomes Renata S M
Published: July 2022

Objectives

This survey aimed to assess the status of a range of health-related behaviours 1 year after the coronavirus outbreak was declared a pandemic in adults living with disabilities comparative with those with no disabilities.

Design

This cross-sectional study reports findings from an online survey conducted in March 2021. Mann-Whitney U and Χ2 tests were used to compare a range of health behaviours including time spent self-isolating, smoking, alcohol consumption, exercise frequency and diet in adults with and without disabilities.

Setting

A convenience sample of UK adults was recruited through the researchers’ personal and professional networks including UK-based sight loss sector charities, social media platforms and professional forums.

Participants

A total of 123 UK participants completed the survey.

Outcome measures

COVID-19 diagnosis, time spent self-isolating, alcohol consumption frequency, exercise frequency, change in smoking habit and eating habits.

Results

No significant differences were found in alcohol consumption, smoking, water intake, breakfast, or fruit and vegetable intake. There were statistically significant differences in the time spent self-isolating (U=2061, p=0.001), exercise frequency (U=1171.5, p=0.005) and the amount of food eaten (χ2 (2)=9.60, p=0.008, Cramer’s V=0.281). Although the majority in both groups reported exercising three to four times per week and eating what they should, those with disabilities were more likely to eat less than they should, not exercise at all and to have been self-isolating for over 6 months than participants with no disabilities.

Conclusions

The data in this study present some key differences between the two groups, with those living with disabilities being more likely to report that they had been self-isolating for prolonged periods of time, not exercising at all, and not eating as much as they should . This raises concerns for the health and well-being of individuals with disabilities.
Improving compliance with appropriateness of testing for heparin-induced thrombocytopaenia: a quality improvement report
Authors: Mericliler Meric , Kazakova Vera , Nicolas Diala , Acharya Utkarsh H , Jaber Bertrand L
Published: July 2022

Heparin-induced thrombocytopaenia (HIT) is a serious complication of heparin therapy. Evidence-based guidelines recommend the use of the 4Ts scoring system to calculate pretest probability of HIT. However, this scoring system is often underused, and inappropriate testing can lead to increased morbidity, medical costs and length of hospital stay. We identified that inappropriate testing for HIT was common at our institution and implemented structured multicomponent educational interventions to evaluate the impact of education on the appropriateness of HIT testing. The educational interventions led to a significantly increased rate of appropriateness of HIT testing (69% vs 35%; p=0.001). In addition, the 4Ts score documentation rate significantly improved following the intervention (52% vs 17%; p=0.001). The rates of discontinuation of heparin products and initiation of alternative anticoagulation increased, although not statistically significantly. Educational interventions can improve compliance with evidence-based guidelines on appropriateness of testing for HIT.
Early detection and treatment of acute illness in medical patients with novel software: a prospective quality improvement initiative
Authors: Burns Jonathan , Williams Dave , Mlinaritsch Danielle , Koechlin Maryna , Canning Trena , Neitzel Andrew
Published: July 2022

Objective

An ageing population and rising healthcare costs place healthcare systems at risk of failure. Our goal was to develop a technology that would identify illness early, initiate action and therein improve patient care, outcomes and save healthcare resources.

Design

This was a prospective interventional quality improvement study.

Setting

A 40 bed medical floor in a 300 bed Canadian tertiary care regional referral hospital.

Participants

General ward patients randomly assigned to control or treatment groups. There was no cross-over or loss to follow-up.

Intervention

We designed an algorithm and software programme capable of detecting the sentinel change in a deteriorating patient’s clinical condition and once detected direct early investigation and care. Study duration was 1 year.

Main outcome measures

Primary outcome was patient transfer from the general medical ward to the intensive care unit (ICU). The secondary outcome was the time needed to (1) order investigations (2) contact senior medical staff and (3) senior medical staff intervention.

Results

We identified a decrease in the transfer of patients from the medical ward to the ICU. Over the course of the study including 273 patients (110 in the control group and 163 in the treatment group), transfers dropped from 14 to 3 with a relative risk reduction of 85.54% (95% CI 84.96 to 86.1), a number needed to treat of 9.19 (95% CI 9.01 to 9.36) and a absolute risk reduction of 10.89% (95% CI 10.7 to 11.1). We also found a statistically significant reduction in the time required to order investigations (p=0.049), contact senior medical staff (p=0.040) and senior medical staff intervention (p=0.045).

Conclusion

A novel algorithm and software in the hands of nursing staff identified acute illness with adequate sensitivity and specificity to dramatically reduce ICU transfers and time to clinical intervention on a medical ward.
Verification and validation of the anti-PD-L1 antibody, Clone 22C3on a laboratory-developed test
Authors: Brennan Shane , O'Neill Julie , Kennedy Susan
Published: July 2022

Aims

The first aim of this study is to compare and validate the performance of the programmed death receptor ligand 1 (PD-L1) IHC 22C3 pharmDx assay kit processed via Dako Omnis platform with the Dako Autostainer Link 48. The second aim is to examine the concordance of scoring by pathologists using the same immunohistochemistry (IHC) assay on the Dako Omnis platform and the Dako Autostainer Link 48.

Methods

Fourty-seven formalin-fixed, paraffin-embedded tissue blocks of head and neck squamous cell carcinoma tumour were stained with the PD-L1 IHC 22C3 pharmDx assay kit processed via the Dako Autostainer Link 48 and the Dako Omnis platform. Combined positive score (CPS) was ascribed by two scoring pathologists, with discordant cases provided with an agreed score.

Results

First, identical staining patterns were identified. Second, high agreement of PD-L1 scores when a CPS cut-off of 1 was implemented illustrated an overall agreement of 94%, positive agreement of 100% and negative agreement of 88%. Finally, results highlight an intraexaminer concordance of 89% and interexaminer concordance of 85% and 92%.

Conclusions

In conclusion, we propose to open for discussion the deconstruction of the current practice of a compulsory companion diagnostic test (CDT) for a particular PD-L1 immunohistochemical assay. The implementation of laboratory developed tests as an alternative to the CDT poses as a novel and readily available method to surmount limitations posed to pathology laboratories.
IdyllaEGFRassay on extracted DNA: advantages, limits and place in molecular screening according to the latest guidelines for non-small-cell lung cancer (NSCLC) patients
Authors: Khalifa Emmanuel , Chapusot Caroline , Tournier Benjamin , Sentis Julie , Marion Estelle , Remond Alicia , Aubry Manon , Pioche Célia , Bergeron Anthony , Primois Charlotte , Blanchard Larry , Millière Alice , Boucheix Marlène , Léger Yannick , Bairrao Marine , Brouste Véronique , Martin Laurent , Soubeyran Isabelle
Published: July 2022

Aims

Idylla epidermal growth factor receptor (EGFR) is a fast and fully automated mutation assay that is easy to implement. However, under the Biocartis-recommended technical conditions, tissue sections are directly introduced into the cartridge, at the risk of exhausting the tumour sample. In this study, we evaluate the performance of IdyllaEGFRon extracted DNA and discuss its place within the global non-small-cell lung cancer (NSCLC) screening strategy.

Methods

577 comparative tests between IdyllaEGFRon extracted DNA and next-generation sequencing (NGS) were performed across two centres.

Results

Preanalytical thresholds were established (20% tumour cell content, 50 ng DNA input) and challenged prospectively in routine practice. 16.8% of samples referred for screening were considered non eligible for IdyllaEGFRtesting. Due to discordant by design cases, IdyllaEGFRsensitivity was 86.9% for currently actionableEGFRmutations. IdyllaEGFRspecificity was 100% in first-line screening. NGS was always feasible on the same DNA.

Conclusion

IdyllaEGFRon extracted DNA is feasible and enables tumour material to be saved compared with tissue section use. It is not necessary to replace the analytical thresholds of the Biocartis algorithm. Due to both the limits of the mutational repertoire and the high increase of targetable genes in NSCLC, the use of IdyllaEGFRshould be restricted to clinical emergency situations accompanied by NGS.
Of not passing: homelessness, addiction, mental health and care during COVID-19
Authors: Lenhard Johannes , Margetts Megan , Meng Eana
Published: July 2022

People experiencing homelessness in the UK were unconditionally offered housing (and support) from the beginning of the first lockdown in March 2020. For many, that meant ‘(re)entering’ the support system and having a chance to ‘move on’ to longer-term housing. This beneficial effect of some of the policy reactions to the pandemic on people experiencing homelessness was unexpected. On the flip side, however, particularly for people struggling with drug use and mental health issues, adequate support was not available for long periods of time; support was either suspended temporarily or people were excluded from institutional support for not adhering to, for instance, lockdown rules. Similarly, digital support alternatives—modelled on increasingly widespread telemedicine—did often not work specifically for people struggling with complex needs or women experiencing homelessness. This research paper reports detailed evidence of what we observed as continued and catalysed exclusions based on interviews and ethnographic observations with both people experiencing homelessness and service providers from the beginning of the COVID-19 pandemic. Referring to our insights and learnings from three locally and temporally overlapping research projects between May 2020 and April 2021, we also propose changes to redesign future (health)care provision to prevent such impasses—which extend beyond lockdown situations to general conditional housing and support.
Spontaneous clearance of asymptomatic anogenital and pharyngeal Neisseria gonorrhoeae: a secondary analysis from the NABOGO trial
Authors: Teker Buhari , de Vries Henry , Heijman Titia , van Dam Alje , Schim van der Loeff Maarten , Jongen Vita Willemijn
Published: July 2022

Introduction

Spontaneous clearance of asymptomatic Neisseria gonorrhoeae (NG) does occur, but data are scarce. We aimed to assess spontaneous clearance among patients with asymptomatic anal, pharyngeal, vaginal and urethral NG infections who participated in the New AntiBiotic treatment Options for uncomplicated GOnorrhoea (NABOGO) trial. In addition, we assessed the determinants associated with spontaneous clearance.

Methods

The NABOGO trial (Trial registration number: NCT03294395) was a randomised controlled, double-blind, single-centre trial assessing non-inferiority of ertapenem, gentamicin and fosfomycin to ceftriaxone for treatment of uncomplicated gonorrhoea. For asymptomatic NABOGO participants, we collected pre-enrolment and enrolment visit samples before trial medication was given. Spontaneous clearance was defined as a positive pre-enrolment nucleic acid amplification test (NAAT) result, followed by a negative NAAT at enrolment. We compared the median time between pre-enrolment and enrolment visits for patients who cleared spontaneously and for those who did not. Determinants of spontaneous clearance were assessed using logistic regression.

Results

Thirty-two of 221 (14.5%) anal NG infections cleared spontaneously, 17 of 91 (18.7%) pharyngeal, 3 of 13 (23.1%) vaginal and 9 of 28 (32.1%) urethral NG infections. The median time between the pre-enrolment and enrolment visit was longer for patients who cleared their pharyngeal infection spontaneously compared with those who did not (median 8 days (IQR=7–11) vs 6 days (IQR=4–8), p=0.012); no determinants of clearance at other sites were identified. Overall, patients with more days between the pre-enrolment and enrolment visit were more likely to clear spontaneously (adjusted OR=1.06 per additional day, 95% CI 1.01 to 1.12). No association between location of NG infection and spontaneous clearance was found.

Conclusions

A significant proportion of asymptomatic patients cleared their NG infections spontaneously. Given these results, treatment of all NG infections after a one-time NAAT may be excessive, and more research on the natural history of NG is needed to improve antibiotic stewardship.
Quantifying regional patterns of collapse in British Columbia Central Coast chum salmon (Oncorhynchus keta) populations since 1960
Authors: Atlas W.I. , Wilson K.L. , Whitney C.K. , Moody J.E. , Service C.N. , Reid M. , Sloat M.R.
Published: July 2022

In recent decades, chum salmon ( Oncorhynchus keta) on the Central and North Coasts of British Columbia have experienced increasing variability and declining abundance. Chum are targeted by mixed-stock commercial fisheries despite declining trends and limited stock assessment to clarify conservation and fishery tradeoffs. We analyzed trends in chum salmon run sizes to 25 watersheds in the Central Coast region, to support co-governance of fisheries under newly ratified Fisheries Resources Reconciliation Agreement. Central Coast chum have declined by ∼90% since 1960, and only three populations did not undergo an evident decline. Bella Coola enhanced chum had an increasing trend but have experienced 29-fold variation in run sizes since 2005. Recently, Bella Coola enhanced chum comprised over 50% of Central Coast chum abundance and the contribution of this stock to overall abundance has more than tripled (from 13.8%) since enhancement began. Given concerns about the long-term health of chum salmon stocks and the social–ecological systems they support, commercial fisheries were closed on the Central Coast in 2021. If current trends continue, fishery opportunities may remain limited.
Effect of high-intensity interval training and high-intensity resistance training on irisin and fibroblast growth factor 21 in men with overweight and obesity
Authors: Haghighi Amir Hossein , Hajinia Morteza , Askari Roya , Abbasian Sadegh , Goldfied Gary
Published: July 2022

Adipose tissue browning is a physiological process that increases energy expenditure and may combat against obesity and its related risk factors. Fibroblast growth factor 21 (FGF21) and irisin, hormones affected by exercise that also affect adipose tissue browning, have not been widely studied with regard to exercise type and duration. This study compared the effect of high-intensity interval training (HIIT) and high-intensity resistance training (HIRT) on irisin and FGF21 in men living with overweight and obesity. After completing a training program three times weekly for 8 weeks, participants’ serum levels of irisin and FGF21 were significantly increased in the HIIT and HIRT groups compared with the control group ( p < 0.05). Additionally, body fat percentage and body weight in both training groups were significantly reduced in comparison with the control group ( p < 0.05). Thus, HIIT and HIRT programs may be used as a feasible modality to promote favourable changes in body composition and irisin and FGF21, factors critical for browning white adipose tissue in men living with overweight and obesity.
Approximating compact objects in bootstrapped Newtonian gravity: use of the canonical potential
Authors: Casadio Roberto , Kuntz Iberê , Micu Octavian
Published: July 2022

We consider compact objects in a classical and non-relativistic generalisation of Newtonian gravity, dubbed bootstrapped Newtonian theory, which includes higher-order derivative interaction terms of the kind generically present in the strong-field regime of gravity. By means of a field redefinition, the original bootstrapped Newtonian action is written in a canonical Newtonian form with non-linear source terms. Exact analytic solutions remain unattainable, but we show that perturbative solutions of the canonical theory can be efficiently used to derive approximate descriptions of compact objects. In particular, using the canonical potential, we can more directly and generally show that the Arnowitt–Deser–Misner mass differs from the (Newtonian) proper mass due to the non-linear couplings in the theory. A few examples of sources with different density profiles are explicitly reanalysed in this framework.
Positronium microwave spectroscopy using Ramsey interferometry
Authors: Babij T. J. , Cassidy D. B.
Published: July 2022

We describe an experimental arrangement suitable for performing microwave spectroscopy measurements of the positronium (Ps) $$n=2$$

n
=
2

fine structure using Ramsey interferometry. Simulations are presented concerning the production of energetic $$2\,^3S_1$$

2

3

S
1

Ps atoms from a Xe gas cell, and their subsequent interactions with a pair of waveguides in which coherent microwave radiation fields are applied. We conclude that for realistic experimental parameters, optimized using a Monte Carlo simulation, a gas cell length of 10 cm with a gas pressure of 0.5 Pa and a positron beam energy of 40 eV, count rates on the order of 50 Hz should be possible.

Graphical abstract
Characterization of Gaussian quantum Markov semigroups
Authors: Poletti Damiano
Published: July 2022

We give a characterization of QMSs on the Bosonic Fock Space [Formula: see text] whose predual preserves the set of gaussian states. We show they can be obtained via certain generalized GKLS generators and they satisfy an explicit formula for their action on Weyl operators.
Study of the effect of thermal radiation on singularities in presence of viscous holographic Ricci dark energy and modified Chaplygin gas
Authors: Sultana Sanjeeda , Chakraborty Gargee , Chattopadhyay Surajit
Published: July 2022

This work reports the effect of thermal radiation on singularities in the presence of holographic Ricci dark energy (HRDE) with generalized IR cut-off. The Eckart approach has been considered to initiate the study. The density of HRDE, which is a just particular cases of general Nojiri–Odintsov (NO) HDE [S. Nojiri and S. D. Odintsov, Unifying phantom inflation with late-time acceleration: Scalar phantom-non-phantom transition model and generalized holographic dark energy, Gen. Relativ. Gravit.  38(8) (2006) 1285–1304], in non-interacting and non-viscous case has been reconstructed and it is found that with the passage of cosmic time t, it is decreasing. The Equation of State (EoS) parameter of HRDE in non-interacting and viscous scenario, the EoS parameter of modified Chaplygin gas (MCG) in a non-interacting and non-viscous scenario and the EoS parameter of MCG in an interacting and non-viscous scenario have been reconstructed and studied. There is a chance of Type I, Type II, Type III, Type IV and [Formula: see text]-singularities for the conditions we obtained. For the effect of thermal radiation of inhomogeneous viscous fluid in an interacting scenario, there is a scope of avoidance of Big-Rip Singularity.