bluuebunny/crossref_metadata_2025 huggingface dataset:
Demonstration of a silicon gated field emitter array based low frequency Colpitts oscillator at 400 °C
Authors: Bhattacharya Ranajoy , Hay Robert , Cannon Mason , Karaulac Nedeljko , Rughoobur Girish , Akinwande Akintunde Ibitayo , Browning Jim
Published: January 2023

Silicon gated field emitter arrays have been used as a vacuum transistor to demonstrate a 152 kHz Colpitts oscillator. The transfer and output characteristics of the 1000 × 1000 silicon arrays were measured using a collector placed ≈ 1 mm away with a gate voltage up to 40 V and a collector voltage up to 200 V. The data were used to establish an LTspice transistor model based on a field emission tip model and a collector current model that fit the characteristics. Then, the LTspice model was used to design a low frequency Colpitts oscillator. Furthermore, experiments were carried out to successfully demonstrate the oscillation. Oscillation frequency was 152 kHz with a peak to peak voltage of 25 V for a tip to ground series resistance value of 10 kΩ at 50 V on the gate and 210 V on the collector. Further, the oscillator was also tested at 50, 100, 200, 300, and 400 °C. It was observed that frequency shifts for each temperature which is due to the change in the overall capacitance of the test setup. This type of device could be used as a temperature sensor in harsh environments.
Resistance Band Exercise: An Effective Strategy to Reverse Cardiometabolic Disorders in Women With Osteosarcopenic Obesity
Authors: Banitalebi Ebrahim , Banitalebi Elahe , Ghahfarokhi Majid Mardaniyan , Rahimi Mostafa , Laher Ismail , Davison Kade
Published: January 2023

We designed to evaluate the effects of resistance elastic band exercises (REBEs) on cardiometabolic/obesity-related biomarkers in older females with osteosarcopenic obesity. Sixty-three patients (aged 65–80 years) with osteosarcopenic obesity and a body mass index exceeding 30 kg/m2 were enrolled in the study. The participants were randomly assigned to either an experimental group (REBE, n = 32) or a usual care group (n = 31). The experimental group completed a 12-week REBE program, three times a week and 60 min per session. There were decreases in lipid accumulation product (p = .033), visceral adipose index (p = .001), triglyceride-glucose-body mass index (p = .034), and atherogenic index of plasma (p = .028) in the experimental group compared with the usual care group. Our findings highlight the importance of an REBE program in improving combined cardiometabolic/obesity-related indices in older women with osteosarcopenic obesity. The incorporation of an REBE program may benefit individuals who are unable to tolerate or participate in more strenuous exercise programs.
Does Sedentary Behavior Predict Motor Competence in Young Children?
Authors: Chagas Daniel das Virgens , Hesketh Kylie , Downing Katherine , Mohebbi Mohammadreza , Barnett Lisa M.
Published: January 2023

Background: Understanding how or whether sedentary behavior affects motor competence in young children is important considering that children spend a lot of time sedentary. The aim of this study was to examine whether sedentary behavior predicts motor competence in young children. Methods: A longitudinal study with a total of 372 children aged 3.5 years at baseline and 5 years at follow-up was conducted. Objectively measured activity patterns (i.e., using accelerometers) were conducted in a subsample with 188 children. Sedentary behavior was assessed both objectively and subjectively (parent-reported screen time). Locomotor and object control skill scores were determined using the Test of Gross Motor Development—Second Edition. A multivariable analysis was executed adjusting for potential confounders (such as age, sex, time spent in moderate- to vigorous-intensity physical activity, monitor wear time, body mass index z scores, and maternal education). Results: Sedentary behavior at either time point was not significantly associated with either locomotor or object control skills after adjusting for potential confounders. Discussion: Our results did not support the assumption that sedentary behavior affects motor competence in young children. Regardless, given the lack of consistency in the evidence base, we recommend to parents, educators, and health professionals that sedentary activities should be kept within government recommendations due to potential negative effects on child development.
Eyedrop-based macromolecular ophthalmic drug delivery for ocular fundus disease treatment
Authors: Shen Jingjing , Gao Huiqin , Chen Linfu , Jiang Yutong , Li Shu , Chao Yu , Liu Nanhui , Wang Yufei , Wei Ting , Liu Yan , Li Jipeng , Chen Muchao , Zhu Jiafei , Liang Juan , Zhou Xiaoyu , Zhang Xiaofeng , Gu Ping , Chen Qian , Liu Zhuang
Published: January 2023

Therapeutic antibodies are extensively used to treat fundus diseases by intravitreal injection, as eyedrop formulation has been rather challenging due to the presence of ocular barriers. Here, an innovative penetrating carrier was developed for antibody delivery in eyedrop formulations. We found that fluorocarbon-modified chitosan (FCS) would self-assemble with proteins to form nanocomplexes, which could effectively pass across the complicated ocular structure to reach the posterior eye segments in both mice and rabbits. In a choroidal melanoma–bearing mouse model, eyedrops containing FCS/anti-PDL1 could induce stronger antitumor immune responses than those triggered by intravenous injection of anti-PDL1. Moreover, in choroidal neovascularization–bearing mouse and rabbit models, FCS/anti-VEGFA eyedrops effectively inhibited vascular proliferation, achieving comparable therapeutic responses to those observed with intravitreal injection of anti-VEGFA. Our work presents an effective delivery carrier to treat fundus diseases using eyedrop of therapeutic proteins, which may enable at-home treatment of many eye diseases with great patient compliance.
Femtosecond-resolved imaging of a single-particle phase transition in energy-filtered ultrafast electron microscopy
Authors: Kim Ye-Jin , Nho Hak-Won , Ji Shaozheng , Lee Hyejin , Ko Hyunhyub , Weissenrieder Jonas , Kwon Oh-Hoon
Published: January 2023

Using an energy filter in transmission electron microscopy has enabled elemental mapping at the atomic scale and improved the precision of structural determination by gating inelastic and elastic imaging electrons, respectively. Here, we use an energy filter in ultrafast electron microscopy to enhance the temporal resolution toward the domain of atomic motion. Visualizing transient structures with femtosecond temporal precision was achieved by selecting imaging electrons in a narrow energy distribution from dense chirped photoelectron packets with broad longitudinal momentum distributions and thus typically exhibiting picosecond durations. In this study, the heterogeneous ultrafast phase transitions of vanadium dioxide (VO
2
) nanoparticles, a representative strongly correlated system, were filmed and attributed to the emergence of a transient, low-symmetry metallic phase caused by different local strains. Our approach enables electron microscopy to access the time scale of elementary nuclear motion to visualize the onset of the structural dynamics of matter at the nanoscale.
Single-cell dissection of cellular and molecular features underlying human cervical squamous cell carcinoma initiation and progression
Authors: Liu Chao , Zhang Min , Yan Xinlong , Ni Yanli , Gong Yandong , Wang Cong , Zhang Xiaoling , Wan Lingfei , Yang Hui , Ge Chen , Li Yunqiao , Zou Wenxue , Huang Rui , Li Xiaohui , Sun Bing , Liu Bing , Yue Jinbo , Yu Jinming
Published: January 2023

Cervical squamous cell carcinoma (CESC) is a prototypical human cancer with well-characterized pathological stages of initiation and progression. However, high-resolution knowledge of the transcriptional programs underlying each stage of CESC is lacking, and important questions remain. We performed single-cell RNA sequencing of 76,911 individual cells from 13 samples of human cervical tissues at various stages of malignancy, illuminating the transcriptional tumorigenic trajectory of cervical epithelial cells and revealing key factors involved in CESC initiation and progression. In addition, we found significant correlations between the abundance of specific myeloid, lymphoid, and endothelial cell populations and the progression of CESC, which were also associated with patients’ prognosis. Last, we demonstrated the tumor-promoting function of matrix cancer–associated fibroblasts via the NRG1-ERBB3 pathway in CESC. This study provides a valuable resource and deeper insights into CESC initiation and progression, which is helpful in refining CESC diagnosis and for the design of optimal treatment strategies.
Displaying and delivering viral membrane antigens via WW domain–activated extracellular vesicles
Authors: Choi Sengjin , Yang Zhiping , Wang Qiyu , Qiao Zhi , Sun Maoyun , Wiggins Joshua , Xiang Shi-Hua , Lu Quan
Published: January 2023

Membrane proteins expressed on the surface of enveloped viruses are conformational antigens readily recognized by B cells of the immune system. An effective vaccine would require the synthesis and delivery of these native conformational antigens in lipid membranes that preserve specific epitope structures. We have created an extracellular vesicle–based technology that allows viral membrane antigens to be selectively recruited onto the surface of WW domain–activated extracellular vesicles (WAEVs). Budding of WAEVs requires secretory carrier-associated membrane protein 3, which through its proline-proline-alanine-tyrosine motif interacts with WW domains to recruit fused viral membrane antigens onto WAEVs. Immunization with influenza and HIV viral membrane proteins displayed on WAEVs elicits production of virus-specific neutralizing antibodies and, in the case of influenza antigens, protects mice from the lethal viral infection. WAEVs thus represent a versatile platform for presenting and delivering membrane antigens as vaccines against influenza, HIV, and potentially many other viral pathogens.
Slab damage and the pulsating retreat of the Ionian-Apennines subduction
Authors: Carminati Eugenio , Chiarabba Claudio
Published: January 2023

Episodes of slow and fast plate subduction, slab rollback, and backarc opening are widely documented; e.g., in the central Mediterranean region. Pervasive damage by fluids is emerging as a possible weakening mechanism that could lead to slab segmentation and breakoff. We show that low-velocity anomalies within the Ionian slab present in along-dip seismic tomography profiles are traces of past damaging events generated by water penetration into the oceanic lithosphere when it was at the trench. We propose that the stepwise evolution of the central Mediterranean over the past 21 m.y. has been governed by strength changes of the Ionian slab induced by damage. More generally, we speculate that the cyclicity of such a process in space and time in the different circum-Mediterranean subduction events may have led to the present shape of the Mediterranean basin.
Sagittal sinus thrombosis with subarachnoid haemorrhage in a patient with COVID-19 infection
Authors: Murali Nikhil , Marrinan Elizabeth , Biyanwila Chemindra , Hussein Senussi
Published: January 2023

A man in his late 50s was admitted with a 10-day history of right frontotemporal headache, left arm and leg weakness, and a sudden decline in visual acuity in the right eye. The patient had recent exposure to COVID-19 infection and tested positive for the same on admission. A CT scan of the head done on arrival demonstrated a subarachnoid haemorrhage in the right central sulcus with an underlying superior sagittal sinus thrombosis. No other known risk factors for central venous sinus thrombosis could be identified. The patient had a normal level of consciousness on admission clinically; however, he was in severe pain. A collective decision was made to administer anticoagulants to the patient with heparin after carefully deliberating the risk-to-benefit ratio of a superior sagittal thrombus with an associated subarachnoid haemorrhage. Our patient recovered and was discharged after 2 weeks on warfarin. We present this case to highlight the potential risks of hypercoagulable and neurotropic complications of COVID-19 infections, with special emphasis on cerebral venous thrombosis.
KRAS G12D mutation in Brunner gland adenoma
Authors: Ortega Mahatma , Sparks Jessica , Lichy Jack , Nava Victor E
Published: January 2023

Brunner gland lesions (BGLs) encompass benign proliferations of the homonymous glands and have been designated as hyperplasia, adenoma (BGA), hamartoma or nodule. In general terms, lesions larger than 0.5 cm are considered true neoplasia with unknown malignant potential and unclear pathogenesis. Genetic alterations have seldom been reported in BGL, and include SMAD4/DPC4 and LRIG1, but not KRAS (Kirsten rat sarcoma viral oncogene homologue) to the best of our knowledge.

We present the case of a man in his 60s, evaluated for iron deficiency anaemia harbouring a 1.5 cm BGA found by duodenoscopy. Immunohistochemistry failed to reveal microsatellite instability, and next-generation sequencing revealed a KRAS G12D point mutation.
Capacity building at points of entry during COVID-19 pandemic: harmonising training curriculum for Economic Community of West African States
Authors: Usman Aishat Bukola , Lokossou Virgil Kuassi , Sawadogo Kiswendsida , Ward Sarah , Umeokonkwo Chukwuma David , Sawadogo Bernard , Hanlon Chelsea , Kayita Godfrey , Balogun Muhammad Shakir , Antara Simon , Merrill Rebecca , Nguku Patrick M , Issiaka Sombie , JC Aïssi Melchior Athanase
Published: January 2023

This paper describes the process for developing, validating and disseminating through a train-the-trainer (TOT) event a standardised curriculum for public health capacity building for points of entry (POE) staff across the 15-member state Economic Community of West African States (ECOWAS) that reflects both international standards and national guidelines.

A five-phase process was used in developing the curriculum: phase (1) assessment of existing materials developed by the US Centers for Disease Control and Prevention (CDC), Africa CDC and the West African Economic and Monetary Union, (2) design of retained and new, harmonised content, (3) validation by the national leadership to produce final content, (4) implementation of the harmonised curriculum during a regional TOT, and (5) evaluation of the curriculum.

Of the nine modules assessed in English and French, the technical team agreed to retain six harmonised modules providing materials for 10 days of intensive training. Following the TOT, most participants (n=28/30, 93.3%) indicated that the International Health Regulations and emergency management modules were relevant to their work and 96.7% (n=29/30) reported that the training should be cascaded to POE staff in their countries.

The ECOWAS harmonised POE curriculum provides a set of training materials and expectations for national port health and POE staff to use across the region. This initiative contributes to reducing the effort required by countries to identify emergency preparedness and response capacity-building tools for border health systems in the Member States in a highly connected region.
Anxiety and depression among people with type 2 diabetes visiting diabetes clinics of Pokhara Metropolitan, Nepal: a cross-sectional study
Authors: Paudel Shishir , Khanal Shankar Prasad , Gautam Sujan , Chalise Anisha , Koirala Tara Nath , Marahatta Sujan Babu
Published: January 2023

Objectives

To estimate the prevalence of anxiety and depression and identify the associated factors among people with type 2 diabetes mellitus (T2DM) visiting diabetes clinics of Pokhara Metropolitan, Nepal.

Design

Cross-sectional study.

Setting

Three diabetes clinics in Pokhara Metropolitan, Nepal, from May to July 2021.

Participants

283 people with T2DM visiting selected diabetes centres of Pokhara Metropolitan.

Outcome measures

Anxiety and depression were the outcome measures. Face-to-face interviews were conducted using a structured questionnaire comprising information related to participants’ sociodemographic profile and several factors along with Hospital Anxiety and Depression-Anxiety subscale and Patient Health Questionnaire-9 to assess the levels of anxiety and depression, respectively. Pearson’s Χ2tests and binary logistic regression were performed to examine association between dependent and independent variables at 5% level of significance.

Results

The prevalence of anxiety and depression was 31.4% (95% CI 26.2% to 37.5%) and 36.4% (95% CI 30.8% to 42.0%), respectively. Anxiety was found to be associated with a lower level of perceived social support (adjusted OR (AOR) 2.442, 95% CI 1.020 to 5.845), multiple complications (AOR 2.758, 95% CI 1.015 to 7.334) and comorbidities (AOR 2.110, 95% CI 1.004 to 4.436), severe COVID-19 fear (AOR 2.343, 95% CI 1.123 to 4.887) and sleep dissatisfaction (AOR 1.912, 95% CI 1.073 to 3.047). Economical dependency (AOR 1.890, 95% CI 1.026 to 3.482), no insurance (AOR 2.973, 95% CI 1.134 to 7.093), lower perceived social support (AOR 2.883, 95% CI 1.158 to 7.181), multiple complications (AOR 2.308, 95% CI 1.585 to 6.422) and comorbidities (AOR 2.575, 95% CI 1.180 to 5.617), severe COVID-19 fear (AOR 2.117, 95% CI 1.009 to 4.573), alcohol use (AOR 2.401, 95% CI 1.199 to 4.806) and sleep dissatisfaction (AOR 1.995, 95% CI 1.093 to 3.644) were found to be associated with depression.

Conclusion

This study showed high prevalence levels of anxiety and depression among people with T2DM. Strengthening social support and focusing on people with diabetes suffering from comorbidity and complications could help to reduce their risk of mental health problems.
Relationship between intersectionality and cancer inequalities: a scoping review protocol
Authors: Estupiñán Fdez de Mesa Mar , Marcu Afrodita , Ream Emma , Whitaker Katriina L
Published: January 2023

Introduction

Persistent inequalities in cancer care and cancer outcomes exist within and between countries. However, the evidence pertaining to the root causes driving cancer inequalities is mixed. This may be explained by the inadequate attention paid to experiences of patients with cancer living at the intersection of multiple social categories (eg, social class, ethnicity). This is supported by the intersectionality framework. This framework offers an alternative lens through which to analyse and understand how these interlocking systems of oppression uniquely shape the experiences of patients with cancer and drive inequalities. In this protocol, we outline a scoping review that will systematically map what is known about the relationship between intersectionality and inequalities in care experience and cancer outcomes of patients with cancer; and to determine how the intersectionality framework has been applied in studies across the cancer care pathway and across countries.

Methods and analysis

This study will be guided by Arksey and O’Malley’s, and Levacet al’s frameworks for scoping reviews. We will identify and map the evidence on cancer inequalities and intersectionality from 1989 to present date. Electronic databases (EMBASE, PsychINFO, CINAHL, Medline, Web of Science, ProQuest) and a systematic search strategy using a combination of keywords and Boolean operators AND/OR will be used to identify relevant studies. Screening of eligible papers and data extraction will be conducted by two independent reviewers, and disagreements resolved by discussion with the research team. We will use an iterative process to data charting using a piloted form. Findings will be collated into a narrative report.

Ethics and dissemination

Ethical approval is not required since data used are from publicly available secondary sources. Findings will be disseminated through peer-reviewed journals, conferences and stakeholder meetings. Further, findings will inform the next phases of a multistage research project aimed at understanding inequalities among patients with breast cancer.
Effects of intradialytic inspiratory muscle training at different intensities on diaphragm thickness and functional capacity: clinical trial protocol in patients undergoing haemodialysis
Authors: Teixeira Marcelo de S , Ferrari Filipe , Dipp Thiago , Carvalho Gabriel , Bitencourt Eduarda da S , Saffi Marco , Stein Ricardo
Published: January 2023

Introduction

Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) commonly present with a sedentary behaviour and reduced functional capacity, factors that can compromise their prognosis. Intradialytic inspiratory muscle training (IMT) can increase respiratory muscle strength and, consequently, improve functional capacity, besides being easy to apply, cheap and performed in a supervised setting. However, few studies show the effects of this type of training applied at different intensities in this population. This study aims to compare the effects of IMT at different intensities in adults with ESRD undergoing HD.

Methods and analysis

A randomised, double-blind, sham-controlled trial will be conducted on 36 subjects randomly allocated into three groups: IMT at intensities of 30% or 50% of maximal inspiratory pressure (intervention groups), or 10% of maximal inspiratory pressure (sham-IMT). All the interventions will be supervised and performed three times per week, for 12 weeks, totalling 36 sessions. The primary outcomes are the 6-minute walk test, diaphragm thickness and the response of VO2peak post-intervention. Respiratory muscle strength, 24-hour ambulatory blood pressure measurement and the Kidney Disease Quality of Life 36-item short form survey will be evaluated as secondary outcomes.

Ethics and dissemination

This study has been approved by the Research Ethics Committee of the Hospital de Clínicas de Porto Alegre (ID: 2020-0458). The results of this study will be disseminated by conference presentations and peer-reviewed journal.

Trial registration number

NCT04660383.
Disseminated varicella zoster virus infection following live attenuated herpes zoster vaccine: descriptive analysis of reports to Australia’s spontaneous vaccine pharmacovigilance system, 2016–2020
Authors: Li-Kim-Moy Jean , Phillips Anastasia , Morgan Adelaide , Glover Catherine , Jayasinghe Sanjay , Hull Brynley P , Dey Aditi , Beard Frank H , Hickie Megan , Macartney Kristine
Published: January 2023

Objectives

To examine the reported incidence and features of disseminated varicella zoster virus (VZV) infection following live attenuated herpes zoster vaccine live (ZVL: Zostavax, Merck) in immunocompromised people in Australia.

Design and setting

ZVL was funded in 2016 in Australia for people aged 70 years, with a catch-up programme for those 71–79 years. From 2016 to 2020, three deaths due to disseminated vaccine-strain VZV infection occurred following inadvertent ZVL administration in individuals with varying levels of immunocompromise. This descriptive study examined 4 years of national surveillance data reported to the Therapeutic Goods Administration’s Adverse Event Monitoring System (AEMS). Denominator data for rates were from doses recorded in the Australian Immunisation Register.

Participants

Individuals vaccinated between 1 November 2016 and 31 December 2020 who experienced adverse event(s) following immunisation (AEFI) after ZVL recorded in the AEMS.

Primary and secondary outcome measures

Rates and outcomes of confirmed (Oka strain positive) or probable disseminated VZV infection, and inadvertent administration of ZVL in immunocompromised individuals.

Results

854 AEFI were reported from 1 089 966 doses of ZVL administered (78.4 per 100 000 doses). Of those, 14 were classified as confirmed (n=6, 0.55 per 100 000) or probable (n=8) disseminated VZV infection. The confirmed cases were all hospitalised, and most (5/6) were immunocompromised; three cases died. Thirty-seven individuals were reported as vaccinated despite a contraindication due to immunocompromise (3.4 per 100 000), with 12/37 (32%) hospitalised.

Conclusions

Disseminated VZV is potentially life-threatening and occurs mostly in those with severe immunocompromise. Inadvertent administration of ZVL to immunocompromised individuals has occurred despite initial provider guidance and education. Multiple additional strategies to assist providers to identify contraindications have been implemented to prevent adverse outcomes.
Barriers and facilitators to return to work following cardiovascular disease: a systematic review and meta-synthesis of qualitative research
Authors: Andersen Emma Borre , Kristiansen Maria , Bernt Jørgensen Sidsel Marie
Published: January 2023

Objectives

Return to work is a key rehabilitation goal, however, people recovering from cardiovascular disease (CVD) often struggle with returning to work. The aim of this study was to conduct a systematic review and meta-synthesis of the existing qualitative evidence on barriers and facilitators to return to work experienced by people with CVD.

Methods

A systematic literature search was conducted in PubMed, Embase, Web of Science, PsycINFO, Scopus and CINAHL in August 2022. The reference lists of the included articles were searched. The Critical Appraisal Skills Programme was used for quality appraisal and a meta-synthesis was employed.

Findings

This review includes 15 studies of overall high methodological quality. Barriers covered four themes: physical limitations, psychological and relational factors, the working context and support within health and social care systems. Facilitators were related to five themes: return to normality, enhancing well-being, financial concerns, the working context and support within health and social care systems.

Conclusion

Our findings highlight that return to work following CVD is a complex process influenced by individual factors, as well as work-related factors, factors in the health and social care systems and social security policies and regulations. To improve return to work, this review illustrates a need for individualised, multidisciplinary and coordinated vocational rehabilitation programmes that accommodate potential barriers to re-employment. Similarly, this review highlights how vocational rehabilitation programmes should ensure individualised information and support early in the rehabilitation process, as well as the importance of engaging relevant stakeholders, such as employers, in making individualised return-to-work plans.
Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial
Authors: Smith Toby , Khoury Reema , Ashford Polly-Anna , Hanson Sarah , Welsh Allie , Clark Allan B , Dures Emma , Adams Jo
Published: January 2023

Introduction

Chronic musculoskeletal (bone, joint or muscle) pain is disabling. People with it frequently have difficulties in managing everyday activities. Individuals may rely on family members or friends to support them. These people are known as informal caregivers. No interventions have previously addressed the health needs of people with chronic musculoskeletal pain and their caregivers. In response, the JOINT SUPPORT programme was developed. In this study, we will assess the feasibility and acceptability of conducting a pragmatic, multicentre, randomised controlled trial (RCT) to test the clinical and cost-effectiveness of the JOINT SUPPORT programme to support these individuals.

Methods and analysis

This will be a mixed-methods feasibility RCT. We will recruit 80 patients with chronic musculoskeletal pain with their informal caregivers. Patients will be randomised to usual National Health Service (NHS) careORusual NHS care plus a caregiver–patient dyad training programme (JOINT SUPPORT). This programme comprises of five, 1-hour, group-based sessions for patients and caregivers, delivered by trained physiotherapists or occupational therapists. It includes developing skills in: understanding pain, pacing, graded activity, fear avoidance and goal-setting, understanding benefits of physical activity and skills in medication management. This will be re-enforced with a workbook. After the group-based sessions, patients and caregivers will be supported through three telephone sessions with a therapist. Data collected at baseline and 3 months will include: screening logs, intervention logs, fidelity checklists and clinical outcomes on quality of life, physical and emotional outcomes, adverse events and resource use. Qualitative research with 24 patient–caregiver dyads and 12 healthcare professionals will explore the acceptability of trial processes. Stop–go criteria will inform the progression to a full trial.

Ethics and dissemination

Ethical approval was obtained on 22 February 2022 (National Research Ethics Committee Number: 22/NW/0015). Results will be reported at conferences, peer-review publications and across social media channels.

Trial registration number

ISRCTN78169443.
How effectively has a Just Culture been adopted? A qualitative study to analyse the attitudes and behaviours of clinicians and managers to clinical incident management within an NHS Hospital Trust and identify enablers and barriers to achieving a Just Culture
Authors: Tasker Adam , Jones Julia , Brake Simon
Published: January 2023

Objectives

Just Culture aims to improve patient safety by examining the organisational and individual factors that contribute to adverse events, enabling corrective action so that errors are not repeated. This qualitative study aims to: (1) analyse whether the attitudes and behaviours of clinicians and managers are aligned with a Just Culture; (2) identify barriers and enablers to an organisation adopting a Just Culture.

Methodology

This qualitative study used interviews and observation of Trust meetings to elicit the attitudes and behaviours of staff. Semistructured interviews were conducted with 13 doctors of all grades, 5 medical students and 2 managers. Five meetings that reviewed clinical incidents and mortality were observed. This was done in a single Hospital Trust in the Midlands, England. Data were thematically analysed using directed and inductive approaches.

Results

There is evidence of a fair incident management process within the Trust; however, there was no agreed vision of a Just Culture and the majority of the staff were unfamiliar with the term. Negative perspectives relating to clinical incidents and their management persist among staff with many having insecurities regarding being the subject of an investigation and doubts about whether they drive improvement.

Conclusion

This paper examines the significance of these findings and provides recommendations which may have application within other healthcare organisations. Major recommendations include (1) Just Culture: define an agreed vision of what Just Culture means to the Trust; (2) investigations: introduce incident management familiarisation training; (3) Learning Culture: increase face-to-face communication of outcomes of investigations and incident review; (4) investigators: establish an incident investigation team to improve the timeliness and consistency of investigations and the communication and implementation of outcomes.
Routine measurement of patient experience
Authors: Benson Tim , Benson Alex
Published: January 2023

Patient experience is a key pillar of healthcare quality. We describe a framework of three short generic measures covering Patient Experience, Result Satisfaction and Service Integration. The Result Satisfaction measure is described for the first time.

These measures capture twelve aspects of patient experience covering the relationship between patients and clinicians (Patient Experience), the immediate results of the consultation or treatment as perceived by patients (Result Satisfaction) and collaboration between different healthcare services and silos (Service Integration). Each measure has four items.

These measures are compared with three national measures: the Friends and Family Test and the General Practice Patient Survey used in England, and HCAHPS used in US hospitals. The expected benefits of national measures are not being achieved and we need to think again about how best to tailor health services to meet patients’ expectations.

The three measures described (Patient Experience, Result Satisfaction and Service Integration) are generic, short and have low reading ages. They share common forms and scoring schemes, which mean that they can be used individually or in combination at all levels of a healthcare provider.
JAG consensus statements for training and certification in colonoscopy
Authors: Siau Keith , Pelitari Stavroula , Green Susi , McKaig Brian , Rajendran Arun , Feeney Mark , Thoufeeq Mo , Anderson John , Ravindran Vathsan , Hagan Paul , Cripps Neil , Beales Ian L P , Church Karen , Church Nicholas I , Ratcliffe Elizabeth , Din Said , Pullan Rupert D , Powell Sharon , Regan Catherine , Ngu Wee Sing , Wood Eleanor , Mills Sarah , Hawkes Neil , Dunckley Paul , Iacucci Marietta , Thomas-Gibson Siwan , Wells Christopher , Murugananthan Aravinth
Published: January 2023

Introduction

In the UK, endoscopy certification is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update and develop standards and recommendations for colonoscopy training and certification.

Methods

Under the oversight of the Joint Advisory Group (JAG), a modified Delphi process was conducted between 2019 and 2020 with multisociety expert representation. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on colonoscopy training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer reviewed by JAG and relevant stakeholders for incorporation into the updated colonoscopy certification pathway.

Results

In total, 45 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (20), assessment of competence (8) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (1) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, unassisted caecal intubation rate >90%, rectal retroversion >90%, polyp detection rate >15%+, polyp retrieval rate >90%, patient comfort <10% with moderate–severe discomfort); (2) minimum procedure count 280+; (3) performing 15+ procedures over the preceding 3 months; (4) attendance of the JAG Basic Skills in Colonoscopy course; (5) terminal ileal intubation rates of 60%+ in inflammatory bowel disease; (6) satisfying requirements for formative direct observation of procedure skills (DOPS) and direct observation of polypectomy skills (Size, Morphology, Site, Access (SMSA) level 2); (7) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool; (8) successful performance in summative DOPS.

Conclusion

The UK standards for training and certification in colonoscopy have been updated, culminating in a single-stage certification process with emphasis on polypectomy competency (SMSA Level 2+). These standards are intended to support training, improve standards of colonoscopy and polypectomy, and provide support to the newly independent practitioner.
Rationale and design of a randomised double-blind 2×2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischaemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis (INSPIRES)
Authors: Gao Ying , Pan Yuesong , Han Shangrong , Chen Weiqi , Jing Jing , Wang Chunjuan , Yang Yingying , Wang Tingting , Meng Xia , Zhao Xingquan , Liu Liping , Li Hao , Johnston S Claiborne , Amarenco Pierre , Bath Philip M , Wang Yongjun , Wang Yilong
Published: January 2023

Background

It remains unclear if intensive antiplatelet and statin treatments begun within 24–72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe.

Methods

The Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis (INSPIRES) trial is a randomised, double-blind, placebo-controlled, multicentre and 2×2 factorial trial. 6100 individuals between the ages of 35 and 80 who have experienced a mild ischaemic stroke or high-risk transient ischaemic attack (TIA) within the previous 72 hours that is attributed to ≥50% atherosclerotic stenosis of a major intracranial or extracranial artery or multiple infarctions of atherosclerotic origin will be enrolled in the trial. Eligible subjects will be randomised 1:1:1:1 to one of four groups: (1) intensive antiplatelet therapy (combined clopidogrel and aspirin for days 1–21, then aspirin placebo and clopidogrel for days 22–90) plus immediate intensive statin therapy(atorvastatin at a dose of 80 mg daily for the first 21 days, then 40 mg daily for days 22–90); (2) intensive antiplatelet therapy plus delayed intensive statin therapy (atorvastatin placebo for days 1–3, followed by 40 mg per day of atorvastatin for days 4–90); (3) standard antiplatelet therapy (combination of clopidogrel placebo with aspirin for 90 days) plus immediate intensive statin therapy and (4) standard antiplatelet therapy plus delayed intensive statin therapy. The primary efficacy endpoint is any new stroke (ischaemic or haemorrhagic) within 90 days after randomisation. The primary safety endpoint is moderate to severe bleeding at 90 days.

Conclusion

The INSPIRES trial will assess the efficacy and safety of intensive antiplatelet therapy and immediate intensive statin therapy begun within 72 hours of onset in decreasing the recurrent stroke at 90 days in patients with acute mild ischaemic stroke or high-risk TIA of intracranial or extracranial atherosclerosis origin.

Trial registration number

NCT03635749.
Empirical Evaluation of Predictive Models
Authors: Flach Peter
Published: January 2023

I give a brief overview of my recent keynote at the 2022 European Conference on Information Retrieval that was held in Stavanger, Norway. I pay particular attention to some basic questions involving the F-score that appear to lead to confusion. I also settle a question raised at the conference by reconstructing an account from Van Rijsbergen's classic text
Information Retrieval.
Report on the 1st Early Career Researchers' Roundtable for Information Access Research (ECRs4IR 2022) at CHIIR 2022
Authors: Trippas Johanne , Maxwel David , Alqatan Abdulaziz , Boom Miriam , Chavula Catherine , Crescenzi Anita , Ibáñez Luis-Daniel , Meyer Selina , Ortloff Anna-Marie , Palani Srishti , Patel Dolinkumar , Thode Wiebke , Xing Zhaopeng
Published: January 2023

The
First Early Career Researchers Roundtable for Information Access Research Workshop
, in conjunction with the
Seventh ACM Conference on Human Information Interaction and Retrieval (CHIIR)
2022, looked into the future of research, collaborations, and self-development to ask the following.
Where are the opportunities for researchers in a (post-)pandemic environment, especially for Early Career Researchers (ECRs)? What do we need to do to get there? Which practical implementations can the broader CHIIR community support?

The workshop started with an invited talk. Instead of conventional paper presentations, the attendees discussed the lessons learned from working in a pandemic. This report, co-authored by the workshop's organisers and its participants, summarises the discussion.

This report aims to provide the broader CHIIR community with feedback on the workshop and foster ideas
raised by ECRs to support ECRs.
Two primary outcomes are
(i)
ECRs are often enthusiastic about taking on roles within a community, but formal validation and recognition are needed for their efforts and
(ii)
that the role of a conference needs to be reevaluated optimising the benefits of attending the event.

Date:
14 March 2022.

Website:
https://sites.google.com/view/ecrs4ir/home.
Report on the 1st Workshop on Audio Collection Human Interaction (AudioCHI 2022) at CHIIR 2022
Authors: Jones Gareth J. F. , Eskevich Maria , Carterette Ben , Correia Joana , Jones Rosie , Karlgren Jussi , Soboroff Ian
Published: January 2023

This is a report from the AudioCHI 2022 workshop which was organised in conjunction with the CHIIR conference in March 2022. The workshop was organised to bring together researchers in spoken content retrieval with expertise on human computer interaction in information access to examine opportunities and challenges for advancing technologies for search and interaction with spoken content. The workshop was originally planned to be a full day event, but due to pandemic-imposed travelling constraints, it was instead held as a virtual half day event to accommodate time zone differences for participants.

Date:
14 March, 2022.

Website:
https://speechretrievalworkshop.github.io/.
Report on the 2nd Workshop on Reducing Online Misinformation through Credible Information Retrieval (ROMCIR 2022) at ECIR 2022
Authors: Petrocchi Marinella , Viviani Marco
Published: January 2023

The 2022 Workshop on Reducing Online Misinformation through Credible Information Retrieval (ROMCIR 2022), at its Second Edition as part of the Satellite Events of the 44th European Conference on Information Retrieval (ECIR 2022), was concerned with providing users with access to genuine information, to mitigate the information disorder phenomenon characterizing the current online environment. This problem is very broad, as it concerns distinct information objects (e.g., Web pages, online accounts, social media posts, etc.) on different platforms, and several domains and purposes (e.g., detecting fake news, retrieving genuine health-related information, reducing propaganda and hate-speech, etc.). In this context, all those approaches that can serve, from multiple perspectives, to tackle the genuine information access problem, found their place. In particular, this year articles have been submitted that addressed the problem of preventing access to health misinformation and assessing the genuineness of multi-modal information.

Date:
10 April, 2022.

Website:
https://romcir2022.disco.unimib.it/.
Enhancing Scene Text Recognition with Visual Context Information
Authors: Sabir Ahmed
Published: January 2023

This thesis addresses the problem of improving text spotting systems, which aim to detect and recognize text in unrestricted images (e.g., a street sign, an advertisement, a bus destination, etc.). The goal is to improve the performance of off-the-shelf vision systems by exploiting the semantic information derived from the image itself. The rationale is that knowing the content of the image or the visual context can help to decide which words are the correct candidate words. For example, the fact that an image shows a coffee shop makes it more likely that a word on a signboard reads as
Dunkin
and not
unkind.

We address this problem by drawing on successful developments in natural language processing and machine learning, in particular, learning to re-rank and neural networks, to present post-process frameworks that improve state-of-the-art text spotting systems without the need for costly data-driven re-training or tuning procedures.

Discovering the degree of semantic relatedness of candidate words and their image context is a task related to assessing the semantic similarity between words or text fragments. However, semantic relatedness is more general than similarity (e.g.,
car, road
, and
traffic light
are related but not similar) and requires certain adaptations. To meet the requirements of these broader perspectives of semantic similarity, we develop two approaches to learn the semantic relatedness of the spotted word and its environmental context: word-to-word (object) or word-to-sentence (caption). In the word-to-word approach, word embedding based re-rankers are developed. The re-ranker takes the words from the text spotting baseline and re-ranks them based on the visual context from the object classifier. For the second, an end-to-end neural approach is designed to drive image description (caption) at the sentence-level as well as the word-level (objects) and re-rank them based not only on the visual context but also on the co-occurrence between them.

As an additional contribution, to meet the requirements of data-driven approaches such as neural networks, we propose a visual context dataset for this task, in which the publicly available COCO-text dataset
1
has been extended with information about the scene (including the objects and places appearing in the image) to enable researchers to include the semantic relations between texts and scene in their Text Spotting systems, and to offer a common evaluation baseline for such approaches.

Awarded by:
Universitat Politècnica de Catalunya, Barcelona, Spain on 10 September 2020.

Supervised by:
Lluís Padró and Francesc Moreno-Noguer.

Available at:
https://upcommons.upc.edu/handle/2117/334952.
Maternal Mortality in the United States: Trends and Opportunities for Prevention
Authors: Wang Siwen , Rexrode Kathryn M. , Florio Andrea A. , Rich-Edwards Janet W. , Chavarro Jorge E.
Published: January 2023

Maternal mortality is unusually high in the United States compared to other wealthy nations and is characterized by major disparities in race/ethnicity, geography, and socioeconomic factors. Similar to other developed nations, the United States has seen a shift in the underlying causes of pregnancy-related death, with a relative increase in mortality resulting from diseases of the cardiovascular system and preexisting medical conditions. Improved continuity of care aimed at identifying reproductive-age women with preexisting conditions that may heighten the risk of maternal death, preconception management of risk factors for major adverse pregnancy outcomes, and primary care visits within the first year after delivery may offer opportunities to address gaps in medical care contributing to the unacceptable rates of maternal mortality in the United States.
SEMA5A-PLXNB3 Axis Promotes PDAC Liver Metastasis Outgrowth through Enhancing the Warburg Effect
Authors: Wang Kun , He Min , Fan Xin , Zhou Jian , Yang Jian , Wang Lin , Zhao Zhihong , Dai Chun , Zhang Zixiang
Published: January 2023

Patients bearing liver metastasis of pancreatic adeno carcinoma (PDAC) suffer from poor prognosis due to its short duration and high mortality. Complex tumor microenvironment (TME) exists in liver metastatic niches, and tumor-associated macrophages (TAMs) have play vital roles in metastasis generation and outgrowth. We have discovered that M2 type TAM-derived SEMA5A could bind to its tumor cell-expressed receptor PLXNB3 to promote tumor cell proliferation and outgrowth. We utilized liver metastasis samples of PDAC patients, intrasplenic injection mouse models, and KrasG12D/Trp53R172H/Pdx1-Cre (KPC) mouse models for in vivo study. In mechanism investigation, we have discovered that SEMA5A-PLXNB3 axis could achieve tumor cell proliferation and survival via enhancing aerobic glycolysis termed as the Warburg effects. Targeting this axis may be a potential therapeutic approach for PDAC patients with unresectable liver metastasis.