bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis and Treatment of Skipped Multifocal Spinal Tuberculosis Lesions
Authors: Na Shibo , Lyu ZhenShan , Zhang Shaokun
Published: April 2023

Spinal tuberculosis, also known as Pott's disease or tuberculous spondylitis, is usually secondary to primary infection in the lungs or other systems, and in most instances, is thought to be transmitted via blood. Typical manifestations of infection include narrowing of the intervertebral disc by erosion and bone destruction of adjacent vertebrae. Atypical spinal tuberculosis is a specific type of spinal tuberculosis. It mainly consists of single vertebral lesions, single posterior structure lesions, multiple vertebral lesions, and intra‐spinal lesions. Skipped multifocal spinal tuberculosis is one of these types and is characterized by two or more vertebral lesions without the involvement of the adjoining intervertebral discs, regardless of their location. To date, only a few cases have been reported. Upon clinical admission, it can be treated conservatively or surgically, depending on the patient's symptoms. In addition, gene or biological therapies are being investigated. However, because of the exceptional imaging findings and insidious symptoms, it is often misdiagnosed as a neoplastic lesion, osteoporotic fracture, or other infectious spondylitis, increasing the risk of neurological deficit and kyphotic deformity, and delaying the optimal treatment window. In this study, we review the diagnosis and treatment strategies for skipped multifocal spinal tuberculosis lesions and enumerate the common differential diagnoses, to provide reference and guidance for clinical treatment and diagnosis direction.
Intrinsic morphology and spatial distribution of non‐structural carbohydrates contribute to drought resistance of two mulberry cultivars
Authors: Zhai Z. , Fang Y. , Cheng J. , Tian Y. , Liu L. , Cao X.
Published: April 2023

Drought is one of the most adverse environmental stresses limiting plant growth and productivity. However, the underlying mechanisms regarding metabolism of non‐structural carbohydrates (NSC) in source and sink organs are still not fully elucidated in woody trees.

Saplings of mulberry cv Zhongshen1 and Wubu were subjected to a 15‐day progressive drought stress. NSC levels and gene expression involved in NSC metabolism were investigated in roots and leaves. Growth performance and photosynthesis, leaf stomatal morphology, and other physiological parameters were also analysed.

Under well‐watered conditions, Wubu had a higher R/S, with higher NSC in leaves than in roots; Zhongshen1 had a lower R/S with higher NSC in roots than leaves. Under drought stress, Zhongshen1 showed decreased productivity and increased proline, abscisic acid, ROS content and activity of antioxidant enzymes, while Wubu sustained comparable productivity and photosynthesis. Interestingly, drought resulted in decreased starch and slightly increased soluble sugars in leaves of Wubu, accompanied by notable downregulation of starch‐synthesizing genes and upregulation of starch‐degrading genes. Similar patterns in NSC levels and relevant gene expression were also observed in roots of Zhongshen1. Concurrently, soluble sugars decreased and starch was unchanged in roots of Wubu and leaves of Zhongshen1. However, gene expression of starch metabolism in roots of Wubu was unaltered, but in leaves of Zhongshen1 starch metabolism was more activated.

These findings revealed that intrinsic R/S and spatial distribution of NSC in roots and leaves concomitantly contribute to drought resistance in mulberry.
Nutrient dynamics of 12 Sphagnum species during establishment on a rewetted bog
Authors: Käärmelahti S. A. , Temmink R. J. M. , van Dijk G. , Prager A. , Kohl M. , Gaudig G. , Koks A. H. W. , Liu W. , Vroom R. J. E. , Gerwing K. , Peters C. J. H. , Krebs M. , Fritz C.
Published: April 2023

Peatland degradation through drainage and peat extraction have detrimental environmental and societal consequences. Rewetting is an option to restore lost ecosystem functions, such as carbon storage, biodiversity and nutrient sequestration. Peat mosses (Sphagnum) are the most important peat‐forming species in bogs. Most Sphagnum species occur in nutrient‐poor habitats; however, high growth rates have been reported in artificial nutrient‐rich conditions with optimal water supply.

Here, we demonstrate the differences in nutrient dynamics of 12 Sphagnum species during their establishment in a 1‐year field experiment at a Sphagnum paludiculture area in Germany. The 12 species are categorized into three groups (slower‐, medium‐ and fast‐growing). Establishment of peat mosses is facilitated by constant supply of nutrient‐rich, low pH, and low alkalinity surface water.

Our study shows that slower‐growing species (S. papillosum, S. magellancium, S. fuscum, S. rubellum, S. austinii; often forming hummocks) displayed signs of nutrient imbalance. These species accumulated higher amounts of N, P, K and Ca in their capitula, and had an elevated stem N:K quotient (>3). Additionally, this group sequestered less C and K per m2 than the fast and medium‐growing species (S. denticulatum, S. fallax, S. riparium, S. fimbriatum, S. squarrosum, S. palustre, S. centrale). Lower lawn thickness may have amplified negative effects of flooding in the slower‐growing species.

We conclude that nutrient dynamics and carbon/nutrient sequestration rates are species‐specific. For bog restoration, generating ecosystem services or choosing suitable donor material for Sphagnum paludiculture, it is crucial to consider their compatibility with prevailing environmental conditions.
Chip Level Thermal Performance Measurements in Two-Phase Immersion Cooling
Authors: Shah Jimil M. , Crandall Thomas , Tuma Phillip E.
Published: April 2023

Two-phase immersion cooling (2PIC) has been proposed as a means of economically increasing overall energy efficiency while accommodating increased chip powers and system-level power density. Designers unfamiliar with Two-phase immersion technology may be unaware of the chip-level thermal performance capabilities of the technology. This performance, in the case of a lidded processor, is quantified as a case-to-fluid thermal resistance, Rcf. This work made use of boiler assemblies comprised of copper plates to which two porous metallic boiling enhancement coatings (BECs) had been applied. These boiler assemblies were applied with conventional thermal grease to a thermal test vehicle (TTV) emulating the Skylake series of 8th Gen Intel® Xeon® CPUs and a thermal test slug (TTS) emulating the Advanced Micro Devices, Inc. (AMD) EPYCTM processors. Both were tested in saturated 3MTM FluorinertTM FC-3284 fluid. The lowest Rcf = 0.020 °C/W was achieved on the TTS at 350 W. The paper also includes additional TTS data gathered with different boiler assemblies and Thermal Interface Materials as well as field data in the form of Rcf or junction-to-fluid thermal resistances, Rjf, for different live silicon chips.
Study of Injector Geometry and Parcel Injection Location on Spray Simulation of the Engine Combustion Network Spray G Injector
Authors: Kumar Aman , Van Dam Noah
Published: April 2023

Parcel-based simulations are the most common method to simulate fuel sprays, especially for reacting conditions, due to their lower computational cost compared to more highly resolved simulations. It is important, however, to understand how spray boundary conditions are used to initialize the parcels that represent the atomizing fluid affect downstream conditions and overall simulation performance. Traditionally, when parcel simulations are used, the injector tip geometry is either significantly simplified or removed altogether due to resolution limits. Recent advances in computational power and numerical methods, however, have made it possible to resolve flow through these features. Previous work has shown some potential effects of even simple injector tip geometries, and this study investigates the effect of very detailed nozzle geometries on parcel-based simulations that have typically ignored these details. Four different parameters were investigated: whether a simulation includes a detailed injector tip geometry or a flat surface; whether parcels are initialized at the counterbore exit, which is more common, or at the nozzle exit; the use of an experimentally derived rate of injection or one-way coupling with a separate internal nozzle volume of fluid (VOF) simulation; the use of nominal or measured injector geometry. Simulations were compared using both global penetrations as well as local data near the injector. Spray penetration and other global measures showed limited sensitivity to boundary conditions/initialization procedure, but local data such as the local liquid volume fraction showed greater variation between the conditions, which may have an impact on mixing and combustion predictions in engine applications.
Numerical Investigation of a Heavy-Duty Compression Ignition Engine Converted to Ammonia Spark-Ignition Operation
Authors: Liu Jinlong , Ulishney Christopher J. , Dumitrescu Cosmin Emil
Published: April 2023

Global decarbonization requires the increased use of zero-carbon fuels. Compared to hydrogen, ammonia is easier to store, transport, and produce. In addition, products of complete combustion of ammonia are water and nitrogen. Therefore, ammonia is an ideal green fuel for internal combustion engines. Drawbacks relate to the high ignition energy and low laminar flame speed of ammonia. This three-dimensional numerical study investigated the potential of converting existing diesel engines to ammonia spark ignition operation. Results indicated a slower kernel inception process, but the speed of the fully developed turbulent flame was enough to complete the bulk combustion process despite the lower laminar flame speed. The problem with pure ammonia operation was the reduced combustion efficiency and the high level of unburned ammonia emissions since the slow spark inception process can be compensated by a larger compression ratio. The results also suggested that emissions formation and subsequent oxidation were a more complex phenomenon. For example, lean ammonia combustion produced higher nitrogen oxides (NOX) concentrations due to the nitrogen in the fuel, despite the lower combustion temperature. Moreover, advancing spark timing reduced the NOX emissions, which was opposite to the traditional spark ignition engines. Additionally, the ammonia in engine crevices that escaped the late oxidation process was the main source of nitrous oxide (N2O) species in the exhaust gas that usually do not appear in traditional engines. Overall, all these results suggested that more fundamental research on ammonia combustion is needed to understand its use in efficient, decarbonized engines.
Super-resolution imaging with modulation of point spread function
Authors: Lu Jian-Yu
Published: April 2023

The spatial resolution of an imaging system using waves is limited by the spatial bandwidth of the point spread function (PSF) of the system, which is related to the wavelength. However, when the PSF is modulated either in amplitude or phase or in both, the resulting spatial bandwidth of the PSF is increased. In this study, the PSF-modulation method is used to obtain super-resolution imaging of objects and to distinguish wave sources that are closely located in space and are not normally separable due to diffraction limit. In imaging using waves, such as ultrasound, acoustics, optics, electromagnetics, radar, and sonar, the PSF can be modulated in their respective fields. For example, in ultrasound, shear wave in biological soft tissues has a low wave speed and thus has a small wavelength. A ring-shaped shear wave can be generated locally (remotely) deep in the tissue by the radiation force of a focused Bessel beam, X wave, or other limited-diffraction beam at their focuses [Lu, 2021 IEEE IUS, 2021 ASA POMA] to produce a sharp peak at the center of the ring (due to shear wave focusing with a small wavelength). This sharp peak of the shear wave modulates the center of a conventional focused beam transmitted after the shear wave ring is produced. The modulated focused beam is then used to scan through an object to obtain a super-resolution image after removing the contribution of the original beam. In this talk, the theory, computer simulation, and experiment results of the super-resolution method will be presented.
Project based learning (PBL): Less project, more problem
Authors: Riegel Kimberly A.
Published: April 2023

Project based learning (PBL) has been shown to be an effective and engaging way of teaching. Though it has been used in many disciplines, it has been specifically employed in physics and engineering often and has been written about in many journals showing the effective outcomes and student growth when this technique is employed. Therefore, when I had a small intimate class of 8 students for introductory physics, the prospect of designing a PBL based course to engage students in thoughtful projects and effective teaching seemed exciting. It took only four weeks before the course structure began to fall apart. By the end of the course, my carefully planned course was completely unrecognizable. In this presentation, I will outline some example projects and what went wrong. I will also discuss how I was able to pivot during the course, the course outcomes and some lessons learned.
Acoustic scattering from rough elastic cylinders partially insonified by directional sonars: Effects of rms roughness and correlation length
Authors: Al Mursaline Miad , Stanton Timothy K. , Lavery Andone C.
Published: April 2023

A modal-series-based model for acoustic scattering from smooth and rough elastic cylinders insonified by directional sonars is derived. Sonar directivity, Fresnel zone effects, spherical spreading of the incident field, and axially propagating guided waves excited by this spreading are included while end-effects are assumed to be negligible. The performance of the scattering model is evaluated against laboratory monostatic and bistatic measurements of scattering from both smooth and rough elastic cylinders. Three aspects of scattering — overall scattering levels, resonance frequencies, and resonance shapes — are analyzed both theoretically and experimentally. The roughness on the cylinder has a Gaussian distribution and is characterized by a random variation of the cylinder radius along its length. Effects of various statistical properties of this one-dimensional roughness, such as different rms roughness for a given correlation length and different correlation lengths for fixed rms roughness, are investigated.
Quantitative characterization of the ultrasound thermal strains in tissue mimicking phantoms with different oil concentrations
Authors: Sheng Zhiyu , Wei Ran , Chen Mengyue , Zhang Bohua , Kim Howuk , Geng Xuecang , Jiang Xiaoning , Kim Kang
Published: April 2023

Ultrasound thermal strain imaging (US-TSI) has been known for the capability of tissue characterization according to distinct sound speed change in different tissues when temperature increases. US-TSI for detecting lipids in atherosclerosis plaques and fatty livers has previously been reported while some practical challenges were not fully addressed, especially due to physiological motions. To overcome such limitation, we recently developed an ultrasound transducer that combines an acoustic heating array and an imaging array to achieve US-TSI with heating performed in a region of approximately 10 mm by 5 mm by 2 mm within a very short time period of about 50 ms compared both cardiac and breathing motions. To characterize the new US-TSI probe, a thorough benchtop investigation was performed on the relationship among the threekey variables for TSI: thermal strain, temperature increase, and lipid concentration. In the experiments, homogeneous oil-in-gelatin phantoms of different oil concentrations were fabricated to simulate different lipid-plaque concentrations. Temperature curves were recorded by a thermal couple with millisecond-level time constant. Thermal strains were computed by developed US-TSI signal processing procedures. The results build a tissue-temperature-strain model and calibrate the new US-TSI probe for in vivo atherosclerosis plaque characterization.
Spatial clustering of sound speed distributions
Authors: Williams Duncan
Published: April 2023

It is increasingly important to our understanding of the effects of climate change on our oceans that we can model sound propagation in the future environments that are being predicted. This brings conflicting demands to increase the fidelity of sound propagation models, to account for a greater number of dynamic ocean properties, and their efficiency, in particular, to account for the spatial and temporal distribution of sound speed data. In this paper, different spatial clustering methods are developed to group similar sound speed data into a small number of clusters based on acoustically relevant properties of the sound speed structure. The clusters then represent the sound speed distribution, derived from thousands of individual sound speed profiles, with a small number of effective sound speed profiles which have similar properties. This is illustrated on data for the Norwegian Sea where the performance of each method is evaluated, using measures of the separation between clusters, and by comparing sound speed predictions using profiles sampled from each cluster and using the effective sound speed profile. We show that spatial clustering is an effective tool for reducing the number of sound speed profiles that are needed to represent their spatial distribution.
Bioinspired, ingestible electroceutical capsules for hunger-regulating hormone modulation
Authors: Ramadi Khalil B. , McRae James C. , Selsing George , Su Arnold , Fernandes Rafael , Hickling Maela , Rios Brandon , Babaee Sahab , Min Seokkee , Gwynne Declan , Jia Neil Zixun , Aragon Aleyah , Ishida Keiko , Kuosmanen Johannes , Jenkins Josh , Hayward Alison , Kamrin Ken , Traverso Giovanni
Published: April 2023

The gut-brain axis, which is mediated via enteric and central neurohormonal signaling, is known to regulate a broad set of physiological functions from feeding to emotional behavior. Various pharmaceuticals and surgical interventions, such as motility agents and bariatric surgery, are used to modulate this axis. Such approaches, however, are associated with off-target effects or post-procedure recovery time and expose patients to substantial risks. Electrical stimulation has also been used to attempt to modulate the gut-brain axis with greater spatial and temporal resolution. Electrical stimulation of the gastrointestinal (GI) tract, however, has generally required invasive intervention for electrode placement on serosal tissue. Stimulating mucosal tissue remains challenging because of the presence of gastric and intestinal fluid, which can influence the effectiveness of local luminal stimulation. Here, we report the development of a bioinspired ingestible fluid-wicking capsule for active stimulation and hormone modulation (FLASH) capable of rapidly wicking fluid and locally stimulating mucosal tissue, resulting in systemic modulation of an orexigenic GI hormone. Drawing inspiration from
Moloch horridus,
the “thorny devil” lizard with water-wicking skin, we developed a capsule surface capable of displacing fluid. We characterized the stimulation parameters for modulation of various GI hormones in a porcine model and applied these parameters to an ingestible capsule system. FLASH can be orally administered to modulate GI hormones and is safely excreted with no adverse effects in porcine models. We anticipate that this device could be used to treat metabolic, GI, and neuropsychiatric disorders noninvasively with minimal off-target effects.
PlyKp104, a Novel Phage Lysin for the Treatment of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Other Gram-Negative ESKAPE Pathogens
Authors: Euler Chad W. , Raz Assaf , Hernandez Anaise , Serrano Anna , Xu Siyue , Andersson Martin , Zou Geng , Zhang Yue , Fischetti Vincent A. , Li Jinquan
Published: April 2023

Klebsiella pneumoniae
and
Pseudomonas aeruginosa
are two leading causes of burn and wound infections, pneumonia, urinary tract infections, and more severe invasive diseases, which are often multidrug resistant (MDR) or extensively drug resistant. Due to this, it is critical to discover alternative antimicrobials, such as bacteriophage lysins, against these pathogens.
Genomic and Secretomic Analyses of the Newly Isolated Fungus
Perenniporia fraxinea
SS3 Identified CAZymes Potentially Related to a Serious Pathogenesis of Hardwood Trees
Authors: Matsumoto Ruy , Mehjabin Jakia Jerin , Noguchi Hideki , Miyamoto Toshizumi , Takasuka Taichi E. , Hori Chiaki
Published: April 2023

Many studies have been done to understand the mechanisms underlying the degradation of plant cell walls of dead trees by wood decay fungi. However, little is known about how some of these fungi weaken living trees as pathogens.
P. fraxinea
belongs to the Polyporales, a group of strong wood decayers, and is known to aggressively attack and fell standing hardwood trees all over the world.
Diverse Molecular Mechanisms Underlying Microbe-Inducing Male Killing in the Moth Homona magnanima
Authors: Arai Hiroshi , Takamatsu Takumi , Lin Shiou-Ruei , Mizutani Tetsuya , Omatsu Tsutomu , Katayama Yukie , Nakai Madoka , Kunimi Yasuhisa , Inoue Maki N.
Published: April 2023

Many microbes induce male killing (MK) in various insect species. However, it is not well understood whether microbes adopt similar or different MK mechanisms.
Draft Genome Sequence of Legionella pneumophila subsp.
pneumophila
Strain DSM 25199
Authors: Nezam-Abadi Neda , Turkington Christopher J. R. , Draper Lorraine A. , Shkoporov Andrey N. , Ross R. Paul , Hill Colin
Published: April 2023

Here, we report the 3,426,844-bp draft genome sequence of
Legionella pneumophila
subsp.
pneumophila
strain DSM 25199, a serogroup 1 strain of
L. pneumophila
. The assembly consists of 24 contigs with an
N
50
of 300,843 bp.
Draft Genome Sequence of Bacillus thuringiensis SS2, from Dibenzofuran-Contaminated Soil, Reveals Putative Aromatic Compound Degradation Genes
Authors: Saibu Salametu , Nsa Imade Y. , Odunsi Ayodeji A. , Akinyemi Nwanneka M. , Oyetibo Ganiyu O. , Adebusoye Sunday A.
Published: April 2023

The draft genome sequence of strain
Bacillus thuringiensis
SS2 consists of 426 contigs assembled at the scaffold level, totaling 5,030,306 bp, and contains 5,288 putative PATRIC protein-coding genes, including genes responsible for total benzoate consumption, degradation of halogenated compounds, heavy metal tolerance/resistance, biosynthesis of secondary metabolites, and microcin C7 self-immunity protein.
Comparative Functional Genome Analysis Reveals the Habitat Adaptation and Biocontrol Characteristics of Plant Growth-Promoting Bacteria in NCBI Databases
Authors: Wang Zhen , Lu Kaiheng , Liu Xuan , Zhu Yuping , Liu Changhong
Published: April 2023

Plant growth-promoting bacteria (PGPB) are essential for the effectiveness of biocontrol agents in plant phyllosphere and rhizosphere. However, little is known about the ecological adaptation of PGPB to different habitats.
Erratum to: Switches of Powerful Nanosecond Current Pulses Based on High-Voltage Units of Shock Ionized Dynistors
Authors: Korotkov S. V. , Aristov Yu. V. , Korotkov D. A.
Published: April 2023

An Erratum to this paper has been published: https://doi.org/10.1134/S0020441223010311
Quality of life of children and young people with anterior chest wall deformity: a systematic review of the literature
Authors: Johnstone Ashley D , Davis Carl , Roberts Nicola J , Sharp Kath
Published: April 2023

Objective

The aim of this study was to evaluate the current evidence regarding the quality of life (QoL) of children and young people with anterior chest wall deformity (ACWD).

Methods

Using a defined search strategy, a systematic review of the literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results

The search identified 305 articles, after refinement, the full text of 51 studies were reviewed and 10 included in the review. A total of eight studies described QoL associated with the correction of ACWD and two studies reported on QoL without correction. The surgical correction of ACWD was reported in six studies and non-surgical correction in two studies. A total of three disease-specific and 24 generic QoL measures were used. The variation in QoL outcome measures, together with a lack of consistency in the time scales of data collection, did not allow for direct comparison between studies. However, the improvement in psychosocial QoL following correction of ACWD is clear. The impact of ACWD on physical QoL is less defined and the influence of age, gender, severity and type of deformity is uncertain. The literature identified primarily surrounds QoL outcomes in relation to surgical correction and is therefore not representative of all children and young people with ACWD.

Conclusions

Correction of ACWD is associated with significant improvement in the psychosocial QoL of children and young people. Further work is required to standardise QoL data collection for all children with ACWD to achieve a greater understanding of the impact and guide future management.
Neonatal outcomes following early fetal growth restriction: a subgroup analysis of the EVERREST study
Authors: Lingam Ingran , Okell Jade , Maksym Katarzyna , Spencer Rebecca , Peebles Donald , Buquis Gina , Ambler Gareth , Morsing Eva , Ley David , Singer Dominique , Tenorio Violeta , Dyer Jade , Ginsberg Yuval , Weissbach Tal , Huertas-Ceballos Angela , Marlow Neil , David Anna
Published: April 2023

Objective

To quantify the risks of mortality, morbidity and postnatal characteristics associated with extreme preterm fetal growth restriction (EP-FGR).

Design

The EVERREST (Doesvascular endothelial growth factor gene therapy safely improve outcome in severeearly-onset fetal growth restriction?) prospective multicentre study of women diagnosed with EP-FGR (singleton, estimated fetal weight (EFW) <3rd percentile, <600 g, 20+0–26+6weeks of gestation). The UK subgroup of EP-FGR infants (<36 weeks) were sex-matched and gestation-matched to appropriate for age (AGA) infants born in University College London Hospital (1:2 design, EFW 25th−75th percentile).

Setting

Four tertiary perinatal units (UK, Germany, Spain, Sweden).

Main outcomes

Antenatal and postnatal mortality, bronchopulmonary dysplasia (BPD), sepsis, surgically treated necrotising enterocolitis (NEC), treated retinopathy of prematurity (ROP).

Results

Of 135 mothers recruited with EP-FGR, 42 had a stillbirth or termination of pregnancy (31%) and 93 had live births (69%). Postnatal genetic abnormalities were identified in 7/93 (8%) live births. Mean gestational age at birth was 31.4 weeks (SD 4.6). 54 UK-born preterm EP-FGR infants (<36 weeks) were matched to AGA controls. EP-FGR was associated with increased BPD (43% vs 26%, OR 3.6, 95% CI 1.4 to 9.4, p=0.01), surgical NEC (6% vs 0%, p=0.036) and ROP treatment (11% vs 0%, p=0.001). Mortality was probably higher among FGR infants (9% vs 2%, OR 5.0, 95% CI 1.0 to 25.8, p=0.054). FGR infants more frequently received invasive ventilation (65% vs 50%, OR 2.6, 95% CI 1.1 to 6.1, p=0.03), took longer to achieve full feeds and had longer neonatal stays (median difference 6.1 days, 95% CI 3.8 to 8.9 and 19 days, 95% CI 9 to 30 days, respectively, p<0.0001).

Conclusions

Mortality following diagnosis of EP-FGR is high. Survivors experience increased neonatal morbidity compared with AGA preterm infants.

Trial registration number

NCT02097667.
‘Body on the line’: experiences of tackle injury in women’s rugby union – a grounded theory study
Authors: Dane Kathryn , Foley Geraldine , Wilson Fiona
Published: April 2023

Objectives

Tackle-related injuries account for up to 67% of all match injuries in women’s rugby union. The perspective of women players on tackle injury can help key stakeholders understand psychosocial determinants of tackle injury risk and prevention. We aimed to capture psychosocial processes that explain tackle injury experiences and behaviours in women’s rugby union.

Methods

We conducted a qualitative study using a grounded theory approach. Adult women players, with at least 1-year senior level experience, were recruited from Europe, South Africa and Canada between December 2021 and March 2022. Data were collected through semistructured interviews and analysed in line with grounded theory coding procedures.

Results

Twenty-one players, aged 20–48 years with a mean 10.6 years of rugby playing experience, participated. In our analysis, we identified three categories central to participants’ experiences of tackle injury: (1) embodied understandings of tackle injury, (2) gender and tackle injury risk and (3) influences on tackle injury behaviours. Participants reported a sense of fear in their experience of tackling but felt that tackle injuries were an inevitable part of the game. Tackle injury was described based on performance limitations. Tackle injury risks and behaviours were influenced by gendered factors perpetuated by relations, practices and structures within the playing context of women’s rugby union.

Conclusion

Women’s tackle injury experiences were intertwined with the day-to-day realities of marginalisation and under preparedness. Grounded in the voices of women, we have provided recommendations for key stakeholders to support tackle injury prevention in women’s rugby.
Experience of loneliness during the COVID-19 pandemic: a cross-sectional study of 50 968 adult Danes
Authors: Christoffersen Lea AN , Helenius Dorte , Schwinn Michael , Erikstrup Christian , Hjalgrim Henrik , Nissen Janna , Banasik Karina , Nielsen Kaspar , Kaspersen Kathrine A , Dinh Khoa M , Bruun Mie T , Ostrowski Sisse R , Sækmose Susanne , Hansen Thomas F , Werge Thomas , Didriksen Maria , Pedersen Ole Birger
Published: April 2023

Objectives

To examine the level of loneliness experienced during the COVID-19 pandemic in Denmark and to identify associated behavioural patterns and demographic factors.

Design

Cross-sectional cohort study.

Setting

Includes Danish active and former blood donors.

Participants

A questionnaire was sent to 124 307 active and former blood donors, of these a total of 50 968 participants completed the study questionnaire (response rate=41%).

Primary and secondary outcome measures

Subjective experience of loneliness was measured using the 3-item University of California, Los Angeles Loneliness Scale (UCLA-3). Besides the UCLA-3, the respondents answered items on sociodemographic and economic characteristics, items on precautionary measures taken to avoid COVID-19 infection as well as on COVID-19 anxiety.

Results

The participants indicated their experienced level of loneliness both before and during the pandemic. Comparing the two reports yielded a mean increase in loneliness scores of 14.1% (p<0.001). Exploratory factor analysis identified the factorwell-being, which comprised three questionnaire items related to emotional heath, physical health and happiness. A high score on the factorwell-beingwas associated with reduced levels of loneliness (coefficient=−0.47, 95% CI −0.49 to −0.46)). Furthermore, women were more likely than men to have experienced increased levels of loneliness during the pandemic (coefficient=0.27, 95% CI 0.25 to 0.29). Furthermore, a negative correlation between higher age and change in loneliness score was observed.

Conclusions

The findings document an increase in the level of experienced loneliness during the COVID-19 pandemic, particularly affecting individuals with low well-being, women and younger individuals.
Pattern and prevalence of vaping nicotine and non-nicotine drugs in the United Kingdom: a cross-sectional study
Authors: Roberts Emmert , Taylor Eve , Cox Sharon , Brose Leonie , McNeill Ann , Robson Deborah
Published: April 2023

Objectives

Electronic vaping devices are being used to consume nicotine and non-nicotine psychoactive drugs. We aimed to determine the pattern and prevalence of using vaping devices for nicotine and/or non-nicotine drug administration in the United Kingdom and how these differ by drug type and individual sociodemographic characteristics. We explored reasons for vaping onset and continuation.

Design

An online cross-sectional survey

Participants

A convenience sample of adults (aged ≥18 years) in the UK.

Primary and secondary outcome measures

The primary outcome was prevalence of current use (within the last 30 days) of a vaping device to administer either nicotine or 18 types of non-nicotine drugs. We additionally evaluated reasons for onset and continuation of vaping. Sociodemographic characteristics were compared between the UK general population using census data and those vaping non-nicotine drugs.

Results

We recruited 4027 participants of whom 1637 (40.7%) had ever used an electronic vaping device; 1495 (37.1%) had ever vaped nicotine and 593 (14.7%) had ever vaped a non-nicotine drug. Overall, 574 (14.3%) currently vaped nicotine and 74 (1.8%) currently vaped a non-nicotine drug. The most common currently vaped non-nicotine drug was cannabis (n=58, 1.4%). For nicotine, people’s modal reasons to start and continue vaping was to quit smoking tobacco. For almost all other drugs, people’s modal reason to start vaping was curiosity and to continue was enjoyment. Compared with the general population, the population who had ever vaped a non-nicotine drug were significantly younger, had more disabilities and fewer identified as white, female, heterosexual or religious.

Conclusions

A non-trivial number of people report current use and ever use of an electronic vaping device for non-nicotine drug administration. As vaping technology advances and drug consumption changes, understanding patterns of use and associated behaviours are likely to be increasingly important to both users and healthcare professionals.
Lived experience of patients with Long COVID: a qualitative study in the UK
Authors: Thomas Callum , Faghy Mark A , Owen Rebecca , Yates James , Ferraro Francesco , Bewick Tom , Haggan Kate , Ashton Ruth E M
Published: April 2023

Background

Long COVID is a rapidly evolving global health crisis requiring interdisciplinary support strategies that incorporate the lived experience of patients. Currently, there is a paucity of research documenting the day-to-day experiences of patients living with Long COVID.

Objective

To explore the lived experience of Long COVID patients.

Study design

Longitudinal, observation study.

Setting

An inductive, data-driven, qualitative approach was used to evaluate hand-written diaries obtained from individuals who had been referred to a Derbyshire Long COVID clinic.

Participants

12 participants (11 females, age 49±10 years, 11 Caucasians) were recruited. Participants were included if they had a previous confirmed or suspected COVID-19 infection with ongoing recovery, >18 years old, understood the study requirements and provided informed consent.

Method

Participants were directed to complete self-report diaries over 16 weeks. Responses were transcribed verbatim and analysed using thematic analysis.

Results

Three key themes were highlighted: (1) understanding who helps patients manage symptoms, (2) daily activities and the impact on quality of life and health status and (3) the effect of turbulent and episodic symptom profiles on personal identity and recovery.

Conclusions

The novel challenges presented by Long COVID are complex with varying inter-related factors that are broadly impacting functional status and quality of life. Support mechanisms must incorporate the lived experiences and foster true collaborations between health professionals, patients and researchers to improve patient outcomes.

Trial registration number

NCT04649957.
Barriers to birth preparedness and complication readiness among pregnant women in rural Ethiopia: using a mixed study design, 2020
Authors: Gedefa Abdi Geda , Bekele Alazar Ayalew , Kitila Keno Melkamu , Eba Lemi Bacha
Published: April 2023

Objective

To assess birth preparedness and complication readiness (BPCR) and associated factors among pregnant women in Bachoo District, Oromia, Ethiopia.

Design

A mixed cross-sectional study design was employed to conduct this study.

Setting

A community-based cross-sectional study was done in the rural community of Bachoo District of Iluu Abbaa Boor Zone, Oromia Region, Southwest Ethiopia.

Participants

A total of 307 pregnant women participated in the quantitative study, 51 respondents were involved in the qualitative part. A simple random sampling technique was used to select the final respondents. Data were entered into EpiData V.3.1 and analysed using SPSS V.22. Binary and multivariable logistic regression analysis was done. The level of statistical significance was declared at a p<0.05. Three focus group discussions and 21 in-depth interviews were conducted, and the data were analysed using thematic analysis and triangulated to support the findings of the quantitative study.

Result

The prevalence of BPCR was 30.6%. Being governmental employee ((adjusted OR, AOR=3.22 95% CI (1.49 to 11.79)), educational status of secondary and above ((AOR=1.9 95% CI (1.15 to 3.84)), multigravidity ((AOR=5.96, 95% CI (1.18 to 3.68)), having four or above ANC visits ((AOR=4.25 CI (1.38 to 7.84)), participating in pregnant women conference ((AOR=2.11 95% CI (1.07 to 3.78)), having good knowledgeable of obstetrics danger signs ((AOR=10.4 95% CI (5.57 to 19.60)), hearing the term BPCR ((AOR=4.36, 95% CI (1.93 to 9.82)) were among factors significantly associated with BPCR. The qualitative study also showed that poor maternal knowledge on birth preparedness and obstetric danger signs, negligence and weak support systems in the community were among the main barriers.

Conclusion and recommendation

This study demonstrated that the practice of BPCR in the study area was very low. Therefore, healthcare providers in the study area should strengthen BPCR knowledge through educating women the community at large.
Efficiency and effectiveness of intensive multidisciplinary follow-up of patients with stroke/TIA or myocardial infarction compared to usual monitoring: protocol of a pragmatic randomised clinical trial. DiVa (Dijon vascular) study
Authors: Béjot Yannick , Soilly Anne-Laure , Bardou Marc , Duloquin Gauthier , Pommier Thibaut , Laurent Gabriel , Cottin Yves , Vadot Lucie , Adam Héloïse , Boulin Mathieu , Giroud Maurice
Published: April 2023

Introduction

The ongoing ageing population is associated with an increase in the number of patients suffering a stroke, transient ischaemic attack (TIA) or myocardial infarction (MI). In these patients, implementing secondary prevention is a critical challenge and new strategies need to be developed to close the gap between clinical practice and evidence-based recommendations. We describe the protocol of a randomised clinical trial that aims to evaluate the efficiency and effectiveness of an intensive multidisciplinary follow-up of patients compared with standard care.

Methods and analysis

The DiVa study is a randomised, prospective, controlled, multicentre trial including patients >18 years old with a first or recurrent stroke (ischaemic or haemorrhagic) or TIA, or a type I or II MI, managed in one of the participating hospitals of the study area, with a survival expectancy >12 months. Patients will be randomised with an allocation ratio of 1:1 in two parallel groups: one group assigned to a multidisciplinary, nurse-based and pharmacist-based 2-year follow-up in association with general practitioners, neurologists and cardiologists versus one group with usual follow-up. In each group for each disease (stroke/TIA or MI), 430 patients will be enrolled (total of 1720 patients) over 3 years. The primary outcome will be the incremental cost–utility ratio at 24 months between intensive and standard follow-up in a society perspective. Secondary outcomes will include the incremental cost–utility ratio at 6 and 12 months, the incremental cost-effectiveness ratio at 24 months, reduction at 6, 12 and 24 months of the rates of death, unscheduled rehospitalisation and iatrogenic complications, changes in quality of life, net budgetary impact at 5 years of the intensive follow-up on the national health insurance perspective and analysis of factors having positive or negative effects on the implementation of the project in the study area.

Ethics and dissemination

Ethical approval was obtained and all patients receive information about the study and give their consent to participate before randomisation. Results of the main trial and each of the secondary analyses will be submitted for publication in a peer-reviewed journal.

Trial registration number

ClinicalTrials.gov Identifier:NCT04188457. Registered on 6 December 2019.
New prolonged opioid consumption after major surgery in Sweden: a population-based retrospective cohort study
Authors: Lindeberg Felix C B , Bell Max , Larsson Emma , Hallqvist Linn
Published: April 2023

Objective

Given that long-term opioid usage is an important problem worldwide and postsurgical pain is a common indication for opioid prescription, our primary objective was to describe the frequency of new prolonged opioid consumption after major surgery in Sweden and, second, to evaluate potential associated risk factors.

Design

Cohort study including data from 1 January 2007 to 31 December 2014. Data regarding surgical procedures, baseline characteristics and outcomes was retrieved from the Orbit surgical planning system, the Swedish national patient register and the Swedish cause of death register.

Setting

Observational multicentre cohort study with data from 23 Swedish hospitals.

Participants

We included 216 877 patients aged ≥18 years, undergoing non-cardiac surgery, not exposed to opioids 180 days before and alive 12 months after surgery.

Primary and secondary outcome measures

The primary endpoint was collection of at least three opioid prescriptions during the first postoperative year; within 90 days, day 91–180 and 181–365 after surgery in a previously opioid-naïve patient. Second, multivariable logistic regression analysis was conducted to explore potential risk factors associated with prolonged opioid use.

Results

Of the 216 877 patients identified to undergo analysis, 15 081 (7.0%) developed new prolonged opioid consumption. Several risk factors were identified. Having a history of psychiatric disease was identified as the strongest risk factor (adjusted odds ratio: 1.94; 95% CI: 1.87 to 2.00).

Conclusion

In a large Swedish cohort of surgical patients, 7% developed new prolonged opioid consumption after major surgery. Our data on susceptible patients could help clinicians reduce the number of prolonged opioid users by adapting their analgesic and preventative strategies.
Long-term psychosocial consequences of false-positive screening mammography: a cohort study with follow-up of 12–14 years in Denmark
Authors: Gram Emma Grundtvig , Siersma Volkert , Brodersen John Brandt
Published: April 2023

Objective

To compare the long-term psychosocial consequences of mammography screening among women with breast cancer, normal results and false-positive results.

Design

A matched cohort study with follow-up of 12–14 years.

Setting

Denmark from 2004 to 2019.

Participants

1170 women who participated in the Danish mammography screening programme in 2004–2005.

Intervention

Mammography screening for women aged 50–69 years.

Outcome measures

We assessed the psychosocial consequences with the Consequences Of Screening–Breast Cancer, a condition-specific questionnaire that is psychometrically validated and encompasses 14 psychosocial dimensions.

Results

Across all 14 psychosocial outcomes, women with false-positive results averagely reported higher psychosocial consequences compared with women with normal findings. Mean differences were statistically insignificant except for the existential values scale: 0.61 (95% CI (0.15 to 1.06), p=0.009). Additionally, women with false-positive results and women diagnosed with breast cancer were affected in a dose–response manner, where women diagnosed with breast cancer were more affected than women with false-positive results.

Conclusion

Our study suggests that a false-positive mammogram is associated with increased psychosocial consequences 12–14 years after the screening. This study adds to the harms of mammography screening. The findings should be used to inform decision-making among the invited women and political and governmental decisions about mammography screening programmes.
External validation of Glasgow-Blatchford, modified Glasgow-Blatchford and CANUKA scores to identify low-risk patients with upper gastrointestinal bleeding in emergency departments: a retrospective cohort study
Authors: Pognonec Célina , Dirhoussi Zidane , Cury Nicolas , Moreau Marie , Billard Charlotte , Yordanov Youri , Thiebaud Pierre-Clément
Published: April 2023

Background

Upper gastrointestinal bleeding (UGIB) is a medical emergency with an approximate mortality of 10%, which results in a high hospitalisation rate. The Glasgow-Blatchford score (GBS) is recommended to identify low-risk patients who can be discharged from the emergency department (ED). A modified GBS (mGBS) and CANUKA score have recently been proposed but have not been well studied. The aim of this study was to assess whether the use of GBS, mGBS or CANUKA score could identify patients at low risk of death or need for intervention.

Methods

A single-centre retrospective study was performed including patients with suspected UGIB visiting the ED of Saint-Antoine hospital (Paris, France) from January 2016 to December 2018. Demographic and medical data needed to calculate GBS and CANUKA were collected, as well as outcomes data. Need for intervention was defined as the need for blood transfusion, endoscopic haemostasis or rebleeding within 7 days. In-hospital mortality was also collected. Sensitivity, specificity and predictive values were measured for the score thresholds of interest.

Results

A total of 386 patients were included. Median age was 60 years (38–78), 65.3% (n=252) were male and 60% (n=233) were hospitalised. A GBS≤1, mGBS=0 and CANUKA≤2 categorised 24.9%, 18.2% and 18.9% of patients as low risk, respectively. There was a need for intervention in 2.2%, 4.6% and 0% of those patients categorised as low risk by GBS, mGBS and CANUKA, respectively. No deaths occurred in the patients identified as low risk, regardless of the score used. All scores had a high sensitivity and negative predictive value.

Conclusions

In patients with UGIB, the use of a GBS≤1 or CANUKA score ≤2 appears to be safe for identifying patients at low risk of death or need for intervention.