bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of risk factors associated with unintentional injury in children: Case‐control study
Authors: Celen Raziye , Ozaydin Tuba , Yorulmaz Alaaddin
Published: December 2022

Objective

This study aimed to determine the risk factors associated with unintentional injury in children aged 0–6 years.

Design

This is a case‐control study.

Sample

A total of 150 participants (n: 75 case group, n: 75 control group) were included in the study. The case group consisted of mothers of children who had unintentional injuries and the control group was composed of the mothers of children who did not have unintentional injuries.

Measurements

Data were collected using the Participant Information Form and the Identification of Safety Precautions of Mothers with 0–6 year‐old Children for the Prevention of Unintentional Injuries Scale.

Results

The mean attitude score of the mothers in the case group toward preventing unintentional injury (177.72 ± 15.53) was found to be higher than the mean score of the mothers in the control group (171.64 ± 17.93). An increase in mothers' scores on preventing unintentional injury reduces the risk of children having unintentional injuries 0.98 times.

Conclusion

The findings of the study revealed that mothers’ attitudes toward preventing injury, the birth order of the child, and the child having a disability increase risk for unintentional injury.
A case of extensively spreading acinic cell carcinoma of the breast with microglandular features
Authors: Sugino Takashi , Kakuda Yuko , Yasui Haruna , Oishi Takuma , Norose Tomoko , Kawata Takuya , Tadokoro Yukiko , Nishimura Seiichiro
Published: December 2022

Acinic cell carcinoma (ACC) is an exceptionally rare type of breast carcinoma with a low‐grade morphology and a favorable prognosis. It is postulated to be a type of invasive carcinoma arising in microglandular adenosis (MGA). We report a case of extensively spreading ACC of the breast with MGA‐like features. Macroscopically, yellowish nodules were widely distributed throughout the right breast, up to the axilla, without mass formation. Microscopically, the tumor consisted of two distinct carcinoma components: one was multiple nodular lesions showing invasive carcinoma with fused solid nests, and the other was a widely spreading lesion exhibiting MGA‐like features with uniform small single glands. Immunohistochemically, both components were negative for ER, PR, and HER2, and expressed EMA, S100 and lysozyme. The distinct morphology and molecular expression indicated ACC. The single glands in the MGA‐like area lacked myoepithelial cells but were linearly surrounded by type IV collagen, a basement membrane component. This case supports the hypothesis that ACC and MGA have the same lineage and indicates that ACC is not necessarily a low‐grade malignancy and can be aggressive.
The legitimation of Askar Akaev through cultural performance in Kyrgyzstan (1991–2005)
Authors: Sheranova Arzuu
Published: December 2022

In contrast to existing nationalism studies on Central Asia, I argue that state‐sponsored celebrations in Kyrgyzstan were multi‐functional and were used to maintain political legitimation based on the politics of Kyrgyz mega‐celebrations held during the presidency of Askar Akaev (1991–2005). I propose that in weak democracies like Kyrgyzstan, with widespread electoral malpractice, political legitimacy is shaky and that therefore the political leadership seeks to maintain its legitimacy using various means. Rule by coercion is not a practical option for such regimes because it does not provide them with long‐term legitimacy. As I demonstrate in the paper, Akaev's regime relied on thecultural performancemode of self‐legitimization because it lacked other options for legitimation. Specifically, the mega‐celebrations for the 1,000‐year anniversary ofThe Epic of Manasin 1995, for the 3,000‐year anniversary of the city of Osh in 2000, and for the 2,200‐year anniversary of Kyrgyz statehood in 2003 – each of them led and promoted by Akaev – secured his re‐election and ensured the political stability and legitimacy of his regime. I conclude that in Central Asia nation‐building and legitimacy do not exist as separate processes and that state‐sponsored celebrations should therefore be treated as both nation‐buildingandlegitimation projects.
A concurrent prenatal exercise program increases neonatal and placental weight and shortens labor: The GESTAFIT project
Authors: Baena‐García Laura , de la Flor‐Alemany Marta , Coll‐Risco Irene , Reoyo Olga Roldán , Aranda Pilar , Aparicio Virginia A.
Published: December 2022

Objective

To explore the influence of a supervised concurrent exercise‐training program during pregnancy on maternal and neonatal birth‐related outcomes and type of birth.

Methods

One hundred and fifty‐nine Caucasian pregnant women from the GESTAFIT project participated in this quasi‐experimental study and were allocated into control [(n = 86), (age 33.1 ± 4.8 years old, BMI 24.8 ± 4.1 kg/m2)] or exercise group [(n = 50) (age 33.1 ± 4.1 years old, BMI: 24.7 ± 4.1 kg/m2)]. The exercise group followed a 60‐min 3 days/week concurrent (aerobic and strength) training program from the 17th gestational week until birth. Maternal and neonatal birth‐related outcomes (i.e., gestational age at birth, duration of labor, placental and neonatal weight and type of birth) were collected from obstetric medical records. Umbilical arterial and venous blood gas analysis were assessed after birth.

Results

The exercise group increased average duration of the first stage of labor [between‐group differences (B): 80.8 min, 95% confidence interval (CI), 4.18, 157.31, p = 0.03] and decreased duration of the second stage of labor [between‐group differences (B): 29.8 min, 95% CI: −55.5, −4.17, p = 0.02] compared to the control group. The exercise group showed greater placental [between‐group differences (B): 53.3 g (95% CI: 9.99, 96.7, p = 0.01)] and neonatal [between‐group differences (B): 161.8 g (95% CI: 9.81, 313.8, p = 0.033)] weight compared to the control group. No differences between groups were found regarding type of birth (p > 0.05).

Conclusions

A concurrent and supervised physical exercise program during pregnancy is safe and could promote better maternal and neonatal birth‐related outcomes. More studies are needed to clarify the mechanisms by which physical exercise increases neonatal and placenta weight.
Control over Muslim Women's Bodies: A Critical Review
Authors: Babakhani Atieh
Published: December 2022

Struggling between the contradictory demands of colonial and neocolonial forces, Muslim women have been constantly at the center of ideological, political, and religious discourses and subjected to surveillance at multiple levels. More specifically, Muslim women's bodily practices, particularly the veil, as an embodied marker of difference that challenges the Western ideals of femininity and signals the “Otherness” of Muslim women, have been at the center of debates on Muslim women's bodies and embodiment. This thematic review of feminist scholarship on regulating and controlling Muslim women's bodies suggests that postcolonial and postsecular feminists have tried to alter narratives portraying veiled Muslim women as “victims” of patriarchal oppression and have disputed representations of Muslim women as “Others.” However, important nuances of Iranian Muslim women's multidimensional and complex decisions, informed by multiple matrixes of power, whether in the form of self‐regulation or through the constant control of the surveilling gaze of dominant “Others,” remain to be explored.
Effect of straw biochar application on soil carbon, greenhouse gas emissions and nitrogen leaching: A vegetable crop rotation field experiment
Authors: Zhang Jining , Sun Huifeng , Ma Jia , Zhang Xianxian , Wang Cong , Zhou Sheng
Published: December 2022

Intensive vegetable crop systems are rapidly developing, with consequences for greenhouse gas (GHGs) emissions, nitrogen leaching and soil carbon. We undertook a field trial to explore the effect of biochar application (0, 10, 20 and 40 t ha−1) on these factors in lettuce, water spinach and ice plant rotation. Our results show that the 20 and 40 t ha−1soil treatments resulted in the SOC content being 26.3% and 29.8% higher than the control (0 t ha−1), respectively, with significant differences among all treatments (p < .05). Biochar application caused N2O emissions to decrease during the lettuce and water spinach seasons, by 1.5%–33.6% and 12.4%–40.5%, respectively, compared the control, with the 20 t ha−1application rate resulting in the lowest N2O emissions. Biochar also decreased the dissolved nitrogen (DN) concentration in leachate by 9.8%–36.2%, following a 7.3%–19.9% reduction in dissolved nitrogen in the soil. Similarly, biochar decreased the nitrate (NO3−) concentrations in leachate by 3.9%–30.2%, following a 3.8%–16.7% reduction in the soil nitrate level. Overall, straw biochar applied at rate of 20 t ha−1produced the lowest N2O emissions and N leaching, while, increasing soil carbon.
Role of Real Estate in a Mixed-Asset Portfolio and the Impact of Illiquidity
Authors: Günther Robin , Wills Nadine , Piazolo Daniel
Published: December 2022

Real estate ratios have increased in recent years. This article thus examines the diversification potential of real estate investments that German investors can achieve at a global scale. To this end, it analyzes how the illiquidity of some real estate investments or the illiquidity preference of an investor can bring about optimal investment ratios. Optimum allocation quotas for German investors with a wide range of mixed-asset allocations are examined. In addition to traditional optimizations, this article applies the three-fund theorem to include liquid and illiquid forms of real estate investment and to determine optimum allocation ratios. While real estate may be an essential component in a mixed-asset portfolio, it is not included in all optimal portfolios. An optimal portfolio also depends on the investment form, insofar as real estate vehicles are not always suitable for diversifying the portfolio risk or for improving the performance of a mixed-asset portfolio. Moreover, illiquid investment vehicles can often provide strong diversification benefits. The optimum allocations to real estate thus depend on the investor’s illiquidity acceptance, even if allocation dominance has increased in recent years. While many studies have demonstrated the advantage that investors gain from adding certain real estate assets, such as those obtained by direct investments, this study goes further by examining the comparative advantage of different real estate investment forms within a variety of asset classes. New insights can thus be gained by considering investors’ liquidity preferences within a given portfolio. One of these insights is that there is a trade-off between illiquidity and diversification potential. Another is that optimum portfolio allocations depend on illiquidity acceptance. These findings therefore also provide practical guidance not only to German investors with a global portfolio diversification but also to practitioners who add illiquid asset classes to their portfolio, to say nothing of the valuable field knowledge it offers to researchers in this field.
Perfectly contractile graphs and quadratic toric rings
Authors: Ohsugi Hidefumi , Shibata Kazuki , Tsuchiya Akiyoshi
Published: December 2022

Perfect graphs form one of the distinguished classes of finite simple graphs. In 2006, Chudnovsky, Robertson, Seymour, and Thomas proved that a graph is perfect if and only if it has no odd holes and no odd antiholes as induced subgraphs, which was conjectured by Berge. We consider the class of graphs that have no odd holes, no antiholes, and no odd stretchers as induced subgraphs. In particular, every graph belonging to is perfect. Everett and Reed conjectured that a graph belongs to if and only if it is perfectly contractile. In the present paper, we discuss graphs belonging to from a viewpoint of commutative algebra. In fact, we conjecture that a perfect graph belongs to if and only if the toric ideal of the stable set polytope of is generated by quadratic binomials. Especially, we show that this conjecture is true for Meyniel graphs, perfectly orderable graphs, and clique separable graphs, which are perfectly contractile graphs.
Measuring tinnitus in pharmaceutical clinical trials
Authors: Jin In-Ki , Tyler Richard S.
Published: December 2022

This paper reviews methods and considerations for measuring tinnitus in clinical trials designed to evaluate treatment options using investigational medicinal products. Tests applied in tinnitus-related research and clinical practice have their own measurement purposes, advantages, and limitations. If the characteristics of each test method are well understood, the test can be effectively used in clinical trials. For the accuracy of clinical trial results, it is necessary to use a test tool with verified validity, reliability, and sensitivity. If a test tool that is likely to have high variability in the same individual is required in the clinical trial, strategies to increase the reliability of the test, such as repeat measurements, may also be needed. In addition, a test tool that meets the purpose of the clinical trial should be selected. For example, the tinnitus questionnaire is appropriate to assess reactions to tinnitus, and measurements of tinnitus loudness or pitch are appropriate to evaluate the psychoacoustic characteristics of tinnitus. In conclusion, the use of validated test tools that meet the purpose of the trial will help with the accuracy of the clinical trial results.
The myth of categorical perception
Authors: McMurray Bob
Published: December 2022

Categorical perception (CP) is likely the single finding from speech perception with the biggest impact on cognitive science. However, within speech perception, it is widely known to be an artifact of task demands. CP is empirically defined as a relationship between phoneme identification and discrimination. As discrimination tasks do not appear to require categorization, this was thought to support the claim that listeners perceive speech solely in terms of linguistic categories. However, 50 years of work using discrimination tasks, priming, the visual world paradigm, and event related potentials has rejected the strongest forms of CP and provided little strong evidence for any form of it. This paper reviews the origins and impact of this scientific meme and the work challenging it. It discusses work showing that the encoding of auditory input is largely continuous, not categorical, and describes the modern theoretical synthesis in which listeners preserve fine-grained detail to enable more flexible processing. This synthesis is fundamentally inconsistent with CP. This leads to a different understanding of how to use and interpret the most basic paradigms in speech perception—phoneme identification along a continuum—and has implications for understanding language and hearing disorders, development, and multilingualism.
Properties and Activity of Peptide Derivatives of ACE2 Cellular Receptor and Their Interaction with SARS-CoV-2 S Protein Receptor-Binding Domain
Authors: Sidorova M. V. , Bibilashvili R. S. , Avdeev D. V. , Kozhokar U. S. , Palkeeva M. E. , Ovchinnikov M. V. , Molokoedov A. S. , Shirokov D. A. , Semyonova A. V. , Uvarova V. I. , Kulyaev P. O. , Khvatov E. V. , Ignatova A. A. , Feofanov A. V. , Osolodkin D. I. , Porozov Yu. B. , Kozlovskaya L. I. , Ishmukhametov A. A. , Parfyonova Ye. V. , Egorov A. M.
Published: December 2022

The aim of this work was to design and characterize peptides based on the α-helices h1 and h2 of the ACE2 receptor, forming the interaction interface between the receptor-binding domain (RBD) of the SARS-CoV-2 S protein and the cellular ACE2 receptor. Monomeric and heterodimeric peptides connected by disulfide bonds at different positions were synthesized. Solubility, RBD-binding affinity, and peptide helicity were experimentally measured, and molecular dynamics simulation was performed in various solvents. It was established that the preservation of the helical conformation is a necessary condition for the binding of peptides to RBD. The peptides have a low degree of helicity and low affinity for RBD in water. Dimeric peptides have a higher degree of helicity than monomeric ones, probably due to the mutual influence of helices. The degree of helicity of the peptides in trifluoroethanol is the highest; however, for in vitro studies, the most suitable solvent is a water-ethanol mixture.
On the Mystery of One Bead
Authors: Tereschenko E. Yu. , Kuzina I. N. , Mandrykina A. V. , Kondratev O. A. , Kulikova E. S. , Svetogorov R. D. , Gureva P. V. , Kovalenko E. S. , Murashev M. M. , Vaschenkova E. S. , Ismagulov A. M. , Retivov V. M. , Yatsishina E. B.
Published: December 2022

The results of studying a biconical glass bead (14th century) found during excavations by the Institute of Archaeology, Russian Academy of Sciences, at the settlement of Rostislavl (urban district of Kolomna, Moscow oblast) in 2018 are presented. The studied bead specimen differs significantly from all beads traditionally found during excavations in this region. A combination of a complex of imaging methods (X-ray and neutron tomography), large-scale X-ray fluorescence mapping of the distribution of elements, scanning electron microscopy with energy-dispersive X-ray microanalysis, and phase analysis allow us to determine that the bead decoration was formed by several layers of materials of different composition. Quantitative information about the base composition and trace components is obtained by laser ablation inductively coupled plasma mass spectrometry. It is revealed that the bead was made by combining separate layers of the base and decorating material from glasses of two classes, lead silicate and potash lead. Both established glass classes bring it closer to the medieval glasses of Central Europe. In this case, such a combination of the composition and manufacturing technique of similar objects was first found on the territory of Old Russia.
Nodular lymphangitis due to nocardiosis
Authors: Cantón De Seoane Juan , Cabanillas Navarro Irene , Quevedo Soriano Sara , Lois Martínez Nagore
Published: December 2022

Nodular lymphangitis is an infectious disease characterised by the development of inflammatory skin nodules that follow the direction of lymphatic drainage. We present a woman in her 70s with nodular lymphangitis that developed after mild trauma with a cactus. Surgical intervention was performed on a finger abscess with isolation ofNocardia brasiliensisin the microbiological samples. Initial antibiotherapy was modified, treating with cotrimoxazole, firstly intravenous and finally oral, therapy during 3 months with a complete resolution of the infection.
Incidence and outcomes of intrapartum-related neonatal encephalopathy in low-income and middle-income countries: a systematic review and meta-analysis
Authors: Kukka Antti Juhani , Waheddoost Sara , Brown Nick , Litorp Helena , Wrammert Johan , KC Ashish
Published: December 2022

Aim

To examine the incidence of intrapartum-related neonatal encephalopathy, and neonatal mortality and neurodevelopmental outcomes associated with it in low-income and middle-income countries.

Methods

Reports were included when neonatal encephalopathy diagnosed clinically within 24 hours of birth in term or near-term infants born after intrapartum hypoxia-ischaemia defined as any of the following: (1) pH≤7.1 or base excess ≤−12 or lactate ≥6, (2) Apgar score ≤5 at 5 or 10 min, (3) continuing resuscitation at 5 or 10 min or (4) no cry from baby at 5 or 10 min. Peer-reviewed articles were searched from Ovid MEDLINE, Cochrane, Web of Science and WHO Global Index Medicus with date limits 1 November 2009 to 17 November 2021. Risk of bias was assessed using modified Newcastle Ottawa Scale. Inverse variance of heterogenicity was used for meta-analyses.

Results

There were 53 reports from 51 studies presenting data on 4181 children with intrapartum-related neonatal encephalopathy included in the review. Only five studies had data on incidence, which ranged from 1.5 to 20.3 per 1000 live births. Neonatal mortality was examined in 45 studies and in total 636 of the 3307 (19.2%) infants died. Combined outcome of death or moderate to severe neurodevelopmental disability was reported in 19 studies and occurred in 712 out of 1595 children (44.6%) with follow-up 1 to 3.5 years.

Conclusion

Though there has been progress in some regions, incidence, case mortality and morbidity in intrapartum-related neonatal encephalopathy has been static in the last 10 years.

PROSPERO registration number

CRD42020177928.
Expert consensus on core topics of sustainable development online learning module for family physicians: a Delphi study
Authors: Suvarnabhumi Krishna , Jorajit Sujitra , Dechpichai Wan , Ativitthayaporn Jarus
Published: December 2022

Objectives

Medical institutions must provide learning experiences that enhance the knowledge and perspectives of sustainable development (SD) to prepare trainees of family medicine to become competent global citizens. The aim of this study was to develop an SD online learning module for trainees of family medicine.

Design

This mixed-methods study was conducted from January 2020 to May 2021, beginning with a literature review concerning Sustainable Development Goals (SDGs) and Education for Sustainable Development in medicine. In-depth interviews were held to assess the relevant needs of family medicine training, followed by a two-round Delphi survey with experienced educators (N=21) in family medicine to refine and achieve consensus on the appropriate SDG topics for family physicians.

Setting

All residency training programmes in Thailand.

Participants

Members of the Residency Training Committee, Royal College of Family Physicians of Thailand.

Results

The literature review and in-depth interviews identified 12 topics of SD that were required for family physicians. The first round of the Delphi survey was concluded by identifying seven core topics with additional suggestions. In the second round, a consensus was obtained among the experienced educators regarding seven core topics as (1) a definition of SD, (2) principles of SD, (3) SDG, (4) a new concept of SD, (5) SD in the context of Thailand, (6) SD and principles of family medicine and (7) SD and family practice. These core topics were grouped within three main objectives and three submodules.

Conclusions

An online learning module of SD for family physicians was developed using modiﬁed Delphi method. This included three submodules as (1) concept and principles of SD, (2) SDG and (3) SD and its integration with family practice. This online learning module will provide additional resources for trainees of family medicine and Thai family physicians to expand their knowledge and perspectives of SD.
Measuring emotional well-being through subjective report: a scoping review of reviews
Authors: Koslouski Jessica B , Wilson-Mendenhall Christine D , Parsafar Parisa , Goldberg Simon , Martin Michelle Y , Chafouleas Sandra M
Published: December 2022

Objective

This scoping review of reviews aims to describe the current landscape of measures of emotional well-being (EWB).

Methods

Following established practices for scoping reviews, we searched the PsycInfo, ERIC, Scopus and PubMed databases in June and July 2021 for reviews of measures of EWB that described their review methods and psychometric properties of included measures. From each eligible article, two coders independently extracted the authors’ (1) definition of EWB, (2) purpose for the review, (3) methods (eg, search terms, inclusion and exclusion criteria), (4) identified measures (including any noted adaptations) and (5) the scope of psychometric information presented. Descriptive and content analyses were used to examine data.

Results

Forty-nine reviews were included in this scoping review. Reviews included anywhere between 1 and 34 measures of EWB and 135 unique EWB measures were captured across all reviews. We found that there was no consistent definition of EWB, identified measures varied widely and reviews were published in a range of disciplines. Psychometric evidence varied as did authors’ purposes for conducting the reviews.

Conclusions

Overall, these reviews suggest that literature on EWB measurement is disjointed and diffuse. Conceptual integration and harmonisation of measures is needed to advance knowledge of EWB and its measurement.

Trial registration numbers

10.17605/OSF.IO/BQDS7 and 10.17605/OSF.IO/WV8PF.
Descriptive epidemiology of gynaecological cancers in southern Ethiopia: retrospective cross-sectional review
Authors: Gebretsadik Achamyelesh , Bogale Netsanet , Dulla Dubale
Published: December 2022

Objective

To determine the epidemiology of gynaecological cancer among patients treated at Hawassa University Comprehensive and Specialized Hospital (HUCSH) from 2013 to 2019.

Design

A retrospective cross-sectional review.

Setting, participants, and outcome measure

A total of 3002 patients’ cards with a diagnosis of cancer at a tertiary hospital named HUCSH were reviewed between February and May 2020. HUCSH is the only oncological care centre in the southern region of Ethiopia. Of this all-gynaecological cancer charts were extracted and descriptive and trend analyses were done. The review was conducted between February and May 2020.

Result

Out of all 3002 cancer cases, 522 (17.4%) cases of gynaecological cancers were identified in 7 years. Cervical cancer accounted for 385 (73.8%) of all gynaecological cancers in this study, the next most common gynaecological cancers were ovarian cancer 55(10.5%) and endometrial cancer 51(9.8%), respectively. The mean (SD) age was 44.84 (12.23). Trends of all identified gynaecological cancers showed continuous increments of caseload year to year. Since 2016 increment of cervical cancer is drastically vertical compared with others.

Conclusion

Despite the limited use of a registration and referral system in primary health institutions, the burden of gynaecological cancers has increased over time. Treatment steps should be taken as soon as possible after a cancer diagnosis to prevent the disease from progressing.
Implementing an exercise oncology model to reach rural and remote individuals living with and beyond cancer: a hybrid effectiveness-implementation protocol for project EXCEL (EXercise for Cancer to Enhance Living Well)
Authors: Culos-Reed Nicole , Wagoner Chad W , Dreger Julianna , McNeely Margaret L , Keats Melanie , Santa Mina Daniel , Cuthbert Colleen , Capozzi Lauren C , Francis George J , Chen Guanmin , Ester Manuel , McLaughlin Emma , Eisele Max , Sibley Daniel , Langley Jodi , Chiekwe Joy , Christensen Thomas
Published: December 2022

Introduction

Individuals living with and beyond cancer from rural and remote areas lack accessibility to supportive cancer care resources compared with those in urban areas. Exercise is an evidence-based intervention that is a safe and effective supportive cancer care resource, improving physical fitness and function, well-being and quality of life. Thus, it is imperative that exercise oncology programs are accessible for all individuals living with cancer, regardless of geographical location. To improve accessibility to exercise oncology programs, we have designed the EXercise for Cancer to Enhance Living Well (EXCEL) study.

Methods and analysis

EXCEL is a hybrid effectiveness-implementation study. Exercise-based oncology knowledge from clinical exercise physiologists supports healthcare professionals and community-based qualified exercise professionals, facilitating exercise oncology education, referrals and programming. Recruitment began in September 2020 and will continue for 5 years with the goal to enroll ~1500 individuals from rural and remote areas. All tumour groups are eligible, and participants must be 18 years or older. Participants take part in a 12-week multimodal progressive exercise intervention currently being delivered online. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework is used to determine the impact of EXCEL at participant and institutional levels. Physical activity, functional fitness and patient-reported outcomes are assessed at baseline and 12-week time points of the EXCEL exercise intervention.

Ethics and dissemination

The study was approved by the Health Research Ethics Board of Alberta. Our team will disseminate EXCEL information through quarterly newsletters to stakeholders, including participants, qualified exercise professionals, healthcare professionals and community networks. Ongoing outreach includes community presentations (eg, support groups, fitness companies) that provide study updates and exercise resources. Our team will publish manuscripts and present at conferences on EXCEL’s ongoing implementation efforts across the 5-year study.

Trial registration number

NCT04478851.
Prevalence of human papillomavirus in Wenzhou, China: a cross-sectional study of 127 938 outpatient women
Authors: Zhang Mengqi , Chen Gang , Dai Xuchao , Wu Zhigang , Huang Hong , Zheng Yuanyuan
Published: December 2022

Objectives

Understanding the prevalence and genotype distribution of human papillomavirus (HPV) is critical for managing HPV vaccination programmes. Using a retrospective cross-sectional study, we examined long-term trends of HPV prevalence in Wenzhou, a coastal city in China.

Setting and participants

Cervical exfoliated cells were collected from 127 938 women who underwent cervical cancer screening at the gynaecology outpatient clinic of Wenzhou People’s Hospital from January 2011 to December 2020. HPV infections and genotypes were determined. The HPV genotypes were 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 6, 11, 42, 43, 44 and 81. From 2011 to 2014, we used PCR and inflow hybridisation for typing assays. In 2015–2020, HPV genotyping was performed on the collected specimens using PCR and flow fluorescence hybridisation.

Results

The overall prevalence of HPV infection was 17.8%. Across age groups, the prevalence fluctuated between 15.9% and 37.4%, with two peaks in the ≤20 and ≥51 year groups. The annual prevalence varied between 12.2% and 28.8%, with a significant decrease in 2011–2018 and a flat trend in 2018–2020. The five most common HPV genotypes were HPV52 (3.6%), 16 (3.0%), 58 (2.5%), 53 (1.9%) and 81 (1.3%). The prevalence of high-risk gene subtypes HPV56, 59 and the low-risk subtype HPV44 increased. Single HPV infection was the most common.

Conclusion

The prevalence of HPV in Wenzhou is low to mid-range; however, the high-risk genetic subtypes HPV56 and 59 have increased in recent years. We need to promote HPV vaccination and increase education regarding safer sex.
Community pharmacy and general practice collaborative and integrated working: a realist review protocol
Authors: Owen Emily Claire , Abrams Ruth , Cai Ziyue , Duddy Claire , Fudge Nina , Hamer-Hunt Julia , Husson Fran , Mahtani Kamal Ram , Ogden Margaret , Swinglehurst Deborah , Turner Malcolm , Whittlesea Cate , Wong Geoff , Park Sophie
Published: December 2022

Introduction

Increasing collaborative and integrated working between General practice (GP) and Community pharmacy (CP) is a key priority of the UK National Health Service and has been proposed as a solution to reducing health system fragmentation, improving synergies and coordination of care. However, there is limited understanding regarding how and under which circumstances collaborative and integrated working between GP and CP can be achieved in practice and how regulatory, organisational and systemic barriers can be overcome.

Methods and analysis

The aim of our review is to understand how, when and why working arrangements between GP and CP can provide the conditions necessary for optimal communication, decision-making, and collaborative and integrated working. A realist review approach will be used to synthesise the evidence to make sense of the complexities inherent in the working relationships between GP and CP. Our review will follow Pawson’s five iterative stages: (1) finding existing theories; (2) searching for evidence (our main searches were conducted in April 2022); (3) article selection; (4) data extraction and (5) synthesising evidence and drawing conclusions. We will synthesise evidence from grey literature, qualitative, quantitative and mixed-methods research. The research team will work closely with key stakeholders and include patient and public involvement and engagement throughout the review process to refine the focus of the review and the programme theory. Collectively, our refined programme theory will explain how collaborative and integrated working between GP and CP works (or not), for whom, how and under which circumstances.

Ethics and dissemination

Formal ethical approval is not required for this review as it draws on secondary data from published articles and grey literature. Findings will be widely disseminated through: publication in peer-reviewed journals, seminars, international conference presentations, patients’ association channels, social media, symposia and user-friendly summaries.

PROSPERO registration number

CRD42022314280.
Clinical spotlight intervention to accelerate translation of evidence-based practices in primary care
Authors: Chawla Kavita , Furlong Richard , Kamo Norris , Gerbino Ingrid , Smith Donna , Blackmore Craig
Published: December 2022

Evidence-based medical practice is often slow to diffuse into widespread clinical practice. To accelerate translation of updated best practices into clinical care, we developed a quality improvement intervention called the ‘Clinical Spotlight’. This programme was based on a knowledge translation model of four steps: education on evidence-based practices, using Lean for incorporation into patient care flow, support of implementation and sustainability, and measurement of outcomes. Using the Clinical Spotlight intervention for addressing the care of patients with type 2 diabetes was associated with appropriate increases in the use of newer classes of glycaemic control medications. We demonstrate statistically significant increases in the use of promoted glycaemic control agents (sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist classes of drugs) at the time of intervention. We conclude that translation of evidence-based practices into clinical care can be enhanced through an educational intervention linked to Lean process improvement and with supported implementation. We are currently expanding our programme to additional clinical areas in primary care.
1583 Impact of digital technology in care homes on Emergency Department attendances
Authors: Garner Alex , Knight Jo , Preston Nancy , Dixon Simon , Watchorn Sam , Caiado Camila , McShane Catherine , King Graham , Mason Suzanne
Published: December 2022

Aims, Objectives and Background

HealthCall is a digital health initiative that aims to reduce emergency department attendances by upskilling care home staff to use app-based technology whereby residents with new clinical presentations’ observations are recorded electronically using a structured SBAR approach. Information is fed to a Single Point of Access where clinical staff triage the referrals. This study evaluated the effectiveness of the HealthCall technology across the North East of England to safely reduce ED referrals and attendance.

Method and Design

The study included 122 care homes covering the study period 2018–2021. Routinely collected secondary care data from County Durham and Darlington NHS Foundation Trust was linked with clinical data from HealthCall. We describe the change in ED attendances over the period before, during and after the introduction of the technology to the care homes. We fitted Poisson generalised linear mixture models to monthly counts of emergency attendances. Covariates were included to adjust for seasonality and external factors such as COVID-19, and hierarchical random intercepts were included to account for both individual and care home variability. The impact of HealthCall technology usage on residents’ expected number of attendances is tested as a ‘step’ change at intervention and a ‘slope’ change post intervention.

Results and Conclusion

We identified 8,702 care home residents through linkage between the secondary care and HealthCall datasets. Preliminary results suggest the use of HealthCall reduces expected monthly ED attendances for care home residents by 16% (95%CI 5 to 25, p-value<0.001). No significant change was observed in the impact of HealthCall during the post-intervention period.

This study finds that the implementation of the HealthCall technology reduces the expected number of monthly emergency department attendances for residents. The technology allows for ongoing monitoring of resident health alongside providing more convenient and timely access to clinical advice that promotes more appropriate and resident-focussed decision leading to fewer unnecessary ED attendances.
1475 Derivation of a tool to predict mortality in a population of frequent attenders to an inner city emergency department
Authors: Stanley Lilian , Dilly Mya , Schulkind Jasmine , Buckland Sally , White Paul , Chandrasakera Raoul
Published: December 2022

Aims, Objectives and Background

The Royal College of Emergency Medicine defines Frequent Attenders (FA) as anyone who attends the Emergency Department(ED) five or more times per year. This group has a high mortality and is a significant burden on services. The Bristol Royal infirmary (BRI) is a city-centre adult-only ED, where 1.8% of our patients are FAs, with a 5 year mortality rate of 20% in this group. Our aim was to further develop a triage tool used by the BRI High Impact User team, by determining which factors increase mortality in our population.

Method and Design

Data was collected retrospectively from 250 electronic patient records, randomly selected from 1780 FAs attending in 2016. Six variables were chosen for analysis: current mental health problems(MHP), homelessness, injecting drug use, alcohol misuse, chronic medical problems(CMP) and number of attendances that year. Data on age, gender and 5-year mortality were also recorded. Logistic regression modeling was performed to determine which factors best predicted 5-year mortality.

Results and Conclusion

Univariate analysis, found that age and CMPs were the only two variables independently associated with 5-year mortality.

FAs attending 10–20 times per year with MHP(n=22) had a higher mortality (31.3%) than those in the >20 attendances group (n=6) where 5-year mortality was 0%. Multivariate analysis suggested different predictors of mortality depending on the presence or absence of MHP. Therefore two different algorithms were derived; both of which had AUROC of over 0.7.

This was a small-scale service development using a specific cohort of FAs. Our findings are not generalisable. However they highlight a complex relationship between risk factors, attendance frequency and mortality. We must question whether efforts to reduce ED attendances for FAs risks inadvertently discouraging high risk patients from accessing potentially protective interactions. We hope to encourage other EDs to develop similar tools for their FA populations.
Diagnosis of delirium: a practical approach
Authors: Alexander Sian K , Needham Edward
Published: December 2022

Delirium is an acute disorder of fluctuating attention and awareness with cardinal features that allow it to be positively distinguished from other causes of an acute confusional state. These features include fluctuations, prominent inattentiveness with other cognitive deficits, a change in awareness and visual hallucinations. We describe a framework for diagnosing delirium, noting the need to consider certain caveats and differential diagnoses. Delirium is a clinical diagnosis where a thorough history and clinical examination are much more helpful diagnostically than any single test or combination of tests.
Epidemiological characteristics of live births with esophageal atresia in Sao Paulo State, Brazil, from 2005 to 2018
Authors: Silvestri Emilli Freitas , Oliveira Eduardo Jamil Farah , Chiedde Marcela , Santos Edige Felipe Sousa , Calderon Mauricio Giusti
Published: December 2022

Background

The estimated prevalence of esophageal atresia (EA) is 1 in 2500–4500 live births (LBs). Researchers have already identified risk factors, but the mechanisms are still unknown. The aim of this study is to identify EA prevalence trends and its risk factors in the São Paulo State (SPS) population database.

Methods

We conducted a population-based study using all EA cases identified by the Live Births Information System across 14 years (2005–2018) to estimate EA prevalence trends in recent years, stratified by maternal age and SPS geographical clusters. We calculated the prevalence trends, regression coefficient (β), annual percent change (APC), and 95% confidence interval (CI).

Results

We found 820 EA cases among 8,536,101 LBs with a prevalence of 1.0/10,000 LBs in SPS, Brazil. There was no significant difference in distribution by sex. Among all the cases, the majority (65%) were Caucasian; 51.8% were born at term; 43% had weight of ≥2500 g; 95.4% were singleton; and 73.4% of births were by cesarean section. From 2005 to 2018, there was an increasing trend of EA prevalence (APC=6.5%) with the highest APC of 12.2%. The highest EA prevalence rate (1.7/10,000 LB) was found in the group with maternal age of ≥35 years. No significant seasonal variation was found based on the conception month (p=0.061).

Conclusions

EA had an increasing prevalence trend in SPS, Brazil, in recent years, with the highest prevalence rate in the group with maternal age of ≥35 years. No seasonality was observed. This population-based study is the first to summarize the current epidemiology of EA in SPS LB.
Regular projections of the link L6n1
Authors: Alba Andrea , Ramírez Santino , Salazar Gelasio
Published: December 2022

Given a link projection [Formula: see text] and a link [Formula: see text], it is natural to ask whether it is possible that [Formula: see text] is a projection of [Formula: see text]. Taniyama answered this question for the cases in which [Formula: see text] is a prime knot or link with crossing number at most five. Recently, Takimura settled the issue for the knot [Formula: see text]. We answer this question for the case in which [Formula: see text] is the link [Formula: see text].
Matrix-valued Schrödinger operators over finite adeles
Authors: Urban R.
Published: December 2022

Let [Formula: see text] be an algebraic number field. With [Formula: see text] we associate the ring of finite adeles [Formula: see text] In this paper we give a path integral formula for the propagator of a quantum mechanical system over the abelian group [Formula: see text] Specifically, we consider matrix-valued Hamiltonian operators [Formula: see text] where [Formula: see text] is the Vladimirov operator and [Formula: see text] is a non-negative definite potential. The free part of the Hamiltonian gives rise to a measure on the Skorokhod space of paths which allows us to prove the Feynman–Kac formula for the Schrödinger semigroup generated by [Formula: see text] This formula is given in terms of the ordered time exponentials.
On the clique number and independence number of the cyclic graph of a semigroup
Authors: Dalal Sandeep , Kumar Jitender , Singh Siddharth
Published: December 2022

The cyclic graph [Formula: see text] of a semigroup [Formula: see text] is the simple undirected graph whose vertex set is [Formula: see text] and two vertices [Formula: see text] are adjacent if the subsemigroup generated by [Formula: see text] and [Formula: see text] is monogenic. In this paper, we determine the clique number of [Formula: see text] for an arbitrary semigroup [Formula: see text]. Further, we obtain the independence number of [Formula: see text] if [Formula: see text] is a finite monogenic semigroup. At the final part of this paper, we give bounds for independence number of [Formula: see text] if [Formula: see text] is a semigroup of bounded exponent and we also characterize the semigroups attaining the bounds.
EVOLUTIONARY ANALYSIS OF PRISONER’S DILEMMA GAMES BASED ON MIXED RANDOM-CONFORMITY SELECTING MODEL
Authors: WANG JIANXIA , HAO MENGQI , MA JINLONG , LI SUFENG
Published: December 2022

Inspired by the conformity phenomenon in human society, we develop a mixed neighbor selecting model adopting random-conformity rule to explore the evolutionary weak prisoner’s dilemma game. The neighbor selection rule of nodes is adjusted based on their fitness and collective influence. Under the degree-normalized payoff framework, the findings derived from Monte Carlo simulations reveal that this mixed selecting model can contribute to an impressive improvement in the Barabási-Albert network’s cooperation. In addition, experimental data obtained by investigating the game-learning skeleton indicate that, in this mixed random-conformity selecting model, normalized collective influence at moderate depth length enables influential nodes to maintain a cooperative strategy for an extended period of time. This can promote the emergence of cooperative strategies at low-degree nodes by facilitating the formation of stable cooperation-clusters centered on high-degree nodes. In addition, the normalized collective influence at excessive depth length increases the likelihood that influential nodes become defectors, thereby inhibiting the growth of cooperation-clusters and limiting cooperation.
QCA-Based Reliable Fundamental Units for Multiplexer-Demultiplexer and D-Flip-Flop
Authors: Sharma Vijay Kumar
Published: December 2022

Quantum-dot cellular automata (QCA) is an advanced nanotechnology. It is applied to delineate nanoscale technology-based logic circuits. It can potentially be replaced the complementary metal oxide semiconductor (CMOS) technology. This paper proposes an optimal and single clocked multiplexer (Mux) circuit, which is made with the help of 12 number of QCA cells in QCA nanotechnology. The proposed Mux circuit is designed in such a way that it can be used easily for the design of the demultiplexer (DeMux) and data flip-flop (DFF) circuits. The proposed Mux is easily converted to DeMux by exchanging the input and output terminals only. The effectiveness of the proposed Mux, DeMux, and DFF is examined with the designs that are similar and available in literature using the QCA Designer-E and QCA Pro tools. The design of the proposed Mux is 89.06% fault-tolerant and has decreased the quantum cost by 62.50% as compared to best reported design. Energy measurement plays a key role when designs are operating at nanoscale level. Energy approximation is done with the help of the QCA Pro tool. The proposed designs are more energy efficient compared to the existing works.
POT–CSA/ZnO Nanocomposites: Synthesis and Characterization
Authors: AL-Kabbi Alaa S. , Mohammed Kahtan A. , Ziadan Kareema M.
Published: December 2022

To create a (POT–CSA/ZnO) nanocomposite, a chemical oxidative polymerization of O-toluidine was carried out in the presence of nano ZnO. This step took place throughout the synthesis. In the attendance of hydro chloric acid (HCl) and ammonium persulfate (APS) as an oxidant and camphor solfunic acid (CSA) as a dopant, polymerization can be accomplished by using a monomer mixture with an equal molar ratio. Scanning electron microscope (SEM), X-ray diffraction (XRD), Fourier transform-infrared spectroscopy (FTIR), and UV–Vis spectroscopy were utilized in the procedure of characterizing the material. The results displayed that the polymer film revealed both excitonic transition [Formula: see text]–[Formula: see text] and to [Formula: see text]* transition. The semiconducting character of the composite can be confirmed by its electrical conductivity.