bluuebunny/crossref_metadata_2025 huggingface dataset:
Design, Analysis, and Manufacture of an Axial Length-Saving Disk-Oriented Engine
Authors: Staton Bennett M. , Bohan Brian T. , Polanka Marc D. , Goss Larry P.
Published: August 2020

A disk-oriented engine was designed to reduce the overall length of a gas turbine engine, combining a single-stage centrifugal compressor and radial in-flow turbine (RIT) in a back-to-back configuration. The focus of this research was to understand how this unique flow path impacted the combustion process. Computational analysis was accomplished to determine the feasibility of reducing the axial length of a gas turbine engine utilizing circumferential combustion. The desire was to maintain circumferential swirl from the compressor through a U-bend combustion path. The U-bend reverses the outboard flow from the compressor into an integrated turbine guide vane in preparation for power extraction by the RIT. The computational targets for this design were a turbine inlet temperature of 1300 K, operating with a 3% total pressure drop across the combustor, and a turbine inlet pattern factor (PF) of 0.24 to produce a cycle capable of creating 668 N of thrust. By wrapping the combustion chamber about the circumference of the turbomachinery, the axial length of the entire engine was reduced. Reallocating the combustor volume from the axial to radial orientation reduced the overall length of the system up to 40%, improving the mobility and modularity of gas turbine power in specific applications. This reduction in axial length could be applied to electric power generation for both ground power and airborne distributive electric propulsion. Computational results were further compared to experimental velocity measurements on custom fuel–air swirl injectors at mass flow conditions representative of 668 N of thrust, providing qualitative and quantitative insight into the stability of the flame anchoring system. From this design, a full-scale physical model of the disk-oriented engine was designed for combustion analysis.
Flow Boiling in a Parallel Strip Fin Heat Sink With Nonuniform Heat Flux Conditions
Authors: Ren Kexian , Miao Ze , Yang Bo , Yang Tongzhi , Yuan Weixing
Published: August 2020

This study investigates the thermal performance of a parallel strip fin heat sink (PSFHS) under various heat flux conditions at a flowrate of 100 ml/min, including uniform heat flux and nonuniform heat flux. The heat sink consists of 150 fins with a width of 1 mm, a height of 5.5 mm, and a pitch of 1 mm and has a Z-type inlet/outlet arrangement. Nine separate heaters offer thermal load to the heat sink in order to provide a uniform or nonuniform heat flux. The flow boiling process is captured by a high-speed camera. The temperatures of the heaters have been measured under the uniform and nonuniform heat flux conditions. In addition, the pressure drops inside the heat sink are also obtained. A minichannel heat sink (MCHS) with the same channel dimensions and inlet/outlet configuration is tested too. A comparison between MCHS and PSFHS is discussed in detail, which helps to understand the flow boiling characteristic in PSFHS.
The Cooling Performance of Mixed Convection in a Ventilated Enclosure With Different Ports Configurations
Authors: Dhahad Hayder A. , Al-Sumaily Gazy F. , Habeeb Laith J. , Thompson Mark C.
Published: August 2020

Mixed convection heat transfer in a vertically oriented air-cooled square enclosure is simulated numerically using the finite volume method. The vertical left wall being heated and all others are considered insulated. The effects of six opposite and staggered inlet/outlet openings' locations over the top and bottom walls are investigated, with different sizes of the opening height (0.05 ≤d/H≤ 0.3). The objective is to figure out the better size and location of inlet and outlet to acquire more efficient cooling system in the enclosure by maximizing the heat removal rate. This is conducted over ranges of the governing parameters, which are the Richardson number (0 ≤Ri≤ 30) and the Reynolds number (50 ≤Re≤ 250). The results show that the level of heat transfer enhancement increases with increasing the opening height, with an optimal size of d/H = 0.25 for obtaining maximum heat removal, for all Richardson and Reynolds numbers. The results also indicate that the higher heat dissipation occurs when the cold air is injected vertically near the hot wall and exits the enclosure from the opposite or staggered outlet, for all Richardson and Reynolds numbers.
If It All Comes Down to Bodily Awareness, How Do We Know? Assessing Bodily Awareness
Authors: Mehling Wolf E.
Published: August 2020

A purported key mechanism of action in most mind–body movement approaches is the maturation and development of bodily awareness. This is an experiential learning process with its own phenomenology, underlying neurological processes, and challenges for scientific study. This report focuses on the assessment of changes in bodily awareness, which is of key importance for the documentation of this learning process for both research and clinical application. Objective assessments requiring lab equipment are briefly reviewed. Qualitative assessments can be performed by interviews, focus groups, and second-person observation of movement performance. In addition, systematically developed self-report questionnaires have become available in recent years, have undergone extensive validation, and are presented here.
Evidence for the Effectiveness of the Feldenkrais Method
Authors: Stephens James , Hillier Susan
Published: August 2020

The Feldenkrais method (FM) is a process that uses verbally and manually guided exploration of novel movements to improve individuals’ self-awareness and coordination. This paper reviews recent literature evaluating the therapeutic value of the FM for improving balance, mobility, and coordination and its effectiveness for management of chronic pain. The authors also explore and discuss studies that have investigated some of the other bodily effects and possible mechanisms of action, such as (a) the process of learning itself, (b) focus of attention during motor learning, (c) autonomic regulation, and (d) body image. They found that research clearly supports the effectiveness of the FM for improvement of balance and chronic pain management. The exploration into mechanisms of action raises interesting questions and possibilities for further investigation.
Conformational dynamics of a G protein–coupled receptor helix 8 in lipid membranes
Authors: Dijkman Patricia M. , Muñoz-García Juan C. , Lavington Steven R. , Kumagai Patricia Suemy , dos Reis Rosana I. , Yin Daniel , Stansfeld Phillip J. , Costa-Filho Antonio José , Watts Anthony
Published: August 2020

Helix 8 of the GPCR neurotensin receptor 1 is stabilised by specific lipid-protein interactions.
High-brightness lasing at submicrometer enabled by droop-free fin light-emitting diodes (LEDs)
Authors: Nikoobakht Babak , Hansen Robin P. , Zong Yuqin , Agrawal Amit , Shur Michael , Tersoff Jerry
Published: August 2020

We report a bright fin light-emitting diode pixel that with increasing electrical current flux, can switch to a bright laser.
Near–atomic-scale observation of grain boundaries in a layer-stacked two-dimensional polymer
Authors: Qi Haoyuan , Sahabudeen Hafeesudeen , Liang Baokun , Položij Miroslav , Addicoat Matthew A. , Gorelik Tatiana E. , Hambsch Mike , Mundszinger Manuel , Park SangWook , Lotsch Bettina V. , Mannsfeld Stefan C. B. , Zheng Zhikun , Dong Renhao , Heine Thomas , Feng Xinliang , Kaiser Ute
Published: August 2020

A transmission electron microscopy study reveals grain boundaries and their formation mechanisms in 2D polymers.
Noncanonical function of an autophagy protein prevents spontaneous Alzheimer’s disease
Authors: Heckmann Bradlee L. , Teubner Brett J. W. , Boada-Romero Emilio , Tummers Bart , Guy Clifford , Fitzgerald Patrick , Mayer Ulrike , Carding Simon , Zakharenko Stanislav S. , Wileman Thomas , Green Douglas R.
Published: August 2020

Mice with mutant ATG16L develop spontaneous, severe Alzheimer’s-like disease with age, despite normal autophagy.
Estimation of incubation period distribution of COVID-19 using disease onset forward time: A novel cross-sectional and forward follow-up study
Authors: Qin Jing , You Chong , Lin Qiushi , Hu Taojun , Yu Shicheng , Zhou Xiao-Hua
Published: August 2020

This study estimated the incubation distribution of COVID-19 using the theory of renewal process.
Implications of Foraging and Interspecies Interactions of Birds for Carriage of Escherichia coli Strains Resistant to Critically Important Antimicrobials
Authors: Mukerji Shewli , Gunasekera Samantha , Dunlop James Nicholas , Stegger Marc , Jordan David , Laird Tanya , Abraham Rebecca Jane , Barton Mary , O’Dea Mark , Abraham Sam
Published: August 2020

It has been shown that 20% of Australian silver gulls carry drug-resistant
Escherichia coli
strains of anthropogenic origin associated with severe diseases, such as sepsis and urinary tract infections, in humans. To further characterize the dynamics of drug-resistant
E. coli
in wildlife populations, we investigated the carriage of critically important antimicrobial (CIA) drug-resistant
E. coli
in four bird species in a common environment. Our results indicated that gulls, pigeons, and penguins carried drug-resistant
E. coli
strains, and analysis of mobile genetic elements associated with resistance genes indicated interspecies resistance transfer. Terns, representing a bird species that forages on natural food sources at sea and distant from humans, did not test positive for drug-resistant
E. coli
. This study demonstrates carriage of CIA-resistant bacteria in multiple bird species living in areas commonly inhabited by humans and provides further evidence for a leapfrog effect of resistance in wildlife, facilitated by feeding habits.
Autotransporters Drive Biofilm Formation and Autoaggregation in the Diderm Firmicute Veillonella parvula
Authors: Béchon Nathalie , Jiménez-Fernández Alicia , Witwinowski Jerzy , Bierque Emilie , Taib Najwa , Cokelaer Thomas , Ma Laurence , Ghigo Jean-Marc , Gribaldo Simonetta , Beloin Christophe
Published: August 2020

Veillonella parvula
is an anaerobic commensal and opportunistic pathogen whose ability to adhere to surfaces or other bacteria and form biofilms is critical for it to inhabit complex human microbial communities such as the gut and oral microbiota. Although the adhesive capacity of
V. parvula
has been previously described, very little is known about the underlying molecular mechanisms due to a lack of genetically amenable
Veillonella
strains. In this study, we took advantage of a naturally transformable
V. parvula
isolate and newly adapted genetic tools to identify surface-exposed adhesins called autotransporters as the main molecular determinants of adhesion in this bacterium. This work therefore provides new insights on an important aspect of the
V. parvula
lifestyle, opening new possibilities for mechanistic studies of the contribution of biofilm formation to the biology of this major commensal of the oral-digestive tract.
Presence of Endogenous Viral Elements Negatively Correlates with Feline Leukemia Virus Susceptibility in Puma and Domestic Cat Cells
Authors: Chiu Elliott S. , VandeWoude Sue
Published: August 2020

Feline leukemia virus (FeLV) can infect a variety of felid species. Only the primary domestic cat host and related small cat species harbor a related endogenous virus in their genomes. Previous studies noted a negative association between the endogenous virus copy number and exogenous virus infection in domestic cats. This report shows that puma cells, which lack endogenous FeLV, produce more virus more rapidly than domestic cat fibroblasts following cell culture challenge. We document a strong association between domestic cat cell susceptibility and FeLV long terminal repeat (LTR) copy number, similar to observations in natural FeLV infections. Viral replication does not, however, correlate with FeLV
env
copy number, suggesting that this effect is specific to FeLV-LTR elements. This discovery indicates a protective capacity of the endogenous virus against the exogenous form, either via direct interference or indirectly via gene regulation, and may suggest evolutionary outcomes of retroviral endogenization.
Supplemental Material: Rapid expansion of meso-megathermal rain forests into the southern high latitudes at the onset of the Paleocene-Eocene Thermal Maximum
Authors: Huurdeman Emiel , al. et
Published: August 2020

Table S1 (nearest living relatives of the encountered sporomorphs), Table S2 (climatic parameters and modern distribution of the nearest living relatives), Text S1 including Figure S1 (source of the encountered biomarkers), Text S2 (timing of individual proxy signals), and Figures S2 and S3 (plates with photographs of encountered sporomorphs).
Molecular and clinical characteristics of monogenic diabetes mellitus in southern Chinese children with onset before 3 years of age
Authors: Lin Yunting , Sheng Huiying , Ting Tzer Hwu , Xu Aijing , Yin Xi , Cheng Jing , Mei Huifen , Shao Yongxian , Zeng Chunhua , Zhang Wen , Rao Min , Liu Li , Li Xiuzhen
Published: August 2020

Introduction

A specific molecular diagnosis of monogenic diabetes mellitus (MDM) will help to predict the clinical course and guide management. This study aims to identify the causative genes implicated in Chinese patients with MDM with onset before 3 years of age.

Research design and methods

71 children with diabetes mellitus (43 diagnosed before 6 months of age, and 28 diagnosed between 6 months and 3 years of age who were negative for diabetes-associated autoantibodies) underwent genetic testing with a combination strategy of Sanger sequencing, chromosome microarray analysis and whole exome sequencing. They were categorized into four groups according to the age of onset of diabetes (at or less than 6 months, 6 to 12 months, 1 to 2 years, 2 to 3 years) to investigate the correlation between genotype and phenotype.

Results

Genetic abnormalities were identified in 39 of 71 patients (54.93%), namelyKCNJ11(22),ABCC8(3),GCK(3),INS(3),BSCL2(1) and chromosome abnormalities (7). The majority (81.40%, 35/43) of neonatal diabetes diagnosed less than 6 months of age and 33.33% (3/9) of infantile cases diagnosed between 6 and 12 months of age had a genetic cause identified. Only 11.11% (1/9) of cases diagnosed between 2 and 3 years of age were found to have a genetic cause, and none of the 10 patients diagnosed between 1 and 2 years had a positive result in the genetic analysis. Vast majority or 90.48% (19/21) of patients withKCNJ11(19) orABCC8(2) variants had successful switch trial from insulin to oral sulfonylurea.

Conclusions

This study suggests that genetic testing should be given priority in diabetes cases diagnosed before 6 months of age, as well as those diagnosed between 6 and 12 months of age who were negative for diabetes-associated autoantibodies. This study also indicates significant impact on therapy with genetic cause confirmation.
Association between a biomarker of glucose spikes, 1,5-anhydroglucitol, and cancer mortality
Authors: Kira Sakurako , Ito Chikako , Fujikawa Rumi , Misumi Munechika
Published: August 2020

Introduction

1,5-Anhydroglucitol (1,5-AG) is a biomarker of glucose spikes. To evaluate the effect of acute glucose excursions on cancer death, we clarified the association between 1,5-AG and cancer mortality among Japanese individuals with normal glucose tolerance.

Research design and methods

We measured 1,5-AG in 6783 (2842 men, 3941 women) individuals with normal fasting and 2-hour plasma glucose who received a 75 g oral glucose tolerance test between 1994 and 2012. They were followed for mortality until August 2013. A systematic review of death certificates was used to confirm the cause of death. We divided the participants into four groups according to the quartile of 1,5-AG level at registration. We used Cox regression to clarify the association between 1,5-AG levels and cancer mortality with multivariate adjustment for possible confounders.

Results

During the follow-up period (median, 10.0 years), 140 men and 109 women died of cancer. The HR for cancer mortality of the lowest quartile group was higher than that of the highest quartile group in men (HR, 2.62; 95% CI, 1.60 to 4.41) and in women (HR, 1.47; 95% CI, 0.88 to 2.47). These associations were not attenuated with further adjustment for HbA1c.

Conclusions

1,5-AG was associated with high risk of cancer mortality in Japanese men after adjustment for HbA1c.
The civil registration system is a potentially viable data source for reliable subnational mortality measurement in India
Authors: Rao Chalapati , Gupta Mamta
Published: August 2020

Introduction

The Indian national Civil Registration System (CRS) is the optimal data source for subnational mortality measurement, but is yet under development. As an alternative, data from the Sample Registration System (SRS), which covers less than 1% of the national population, is used. This article presents a comparison of mortality measures from the SRS and CRS in 2017, and explores the potential of the CRS to meet these subnational data needs.

Methods

Data on population and deaths by age and sex for 2017 from each source were used to compute national-level and state-level life tables. Sex-specific ratios of death probabilities in five age categories (0–4, 5–14, 15–29, 30–69, 70–84) were used to evaluate CRS data completeness using SRS probabilities as reference values. The quality of medically certified causes of death was assessed through hospital reporting coverage and proportions of deaths registered with ill-defined causes from each state.

Results

The CRS operates through an extensive infrastructure with high reporting coverage, but child deaths are uniformly under-reported, as are female deaths in many states. However, at ages 30–69 years, CRS death probabilities are higher than the SRS values in 15 states for males and 10 states for females. SRS death probabilities are of limited precision for measuring mortality trends and differentials. Data on medically certified causes of death are of limited use due to low hospital reporting coverage.

Conclusions

The Indian CRS is more reliable than the SRS for measuring adult mortality in several states. Targeted initiatives to improve the recording of child and female deaths, to strengthen the reporting and quality of medically certified causes of death, and to promote use of verbal autopsy methods can establish the CRS as a reliable source of subnational mortality statistics in the near future.
Effectiveness of primary care gatekeeping: difference-in-differences evaluation of a pilot scheme in China
Authors: Xu Jin , Powell-Jackson Timothy , Mills Anne
Published: August 2020

Introduction

This paper evaluates the effectiveness of a gatekeeping pilot in shifting resources and patient visits from hospitals to primary care facilities under the Chinese New Rural Cooperative Medical Scheme.

Methods

We applied a difference-in-differences regression analysis using claims data from a pilot district in northern China. The study covered 200 685 enrollees in 17 townships in 2012 and followed-up the townships over 12 year-quarters until the end of 2014.

Results

The gatekeeping pilot led to significantly more patients visiting primary care facilities (55.3%, p=0.001), but there was little evidence of increased ambulatory spending on primary care (1.6%, p=0.884). The pilot reduced hospital visits by 23.9% (p=0.048) and ambulatory spending at the hospitals by 22.4% (p=0.011).

Conclusions

This first impact evaluation of gatekeeping outside high-income countries found that gatekeeping policy did not seem to have expanded the care provided by primary care facilities, despite an increased volume of claimed visits. Although claimed patient visits and expenditure at hospitals reduced, we suspect this may have been because patients found it either cumbersome or difficult to obtain reimbursement for their care.
Illicit drug use and self-reported vision loss among military service members or veterans
Authors: McDaniel Justin Tyler , Jenkins W D , Albright D L , Null D , McIntosh S , McDaniel M R
Published: August 2020

Introduction

Little is known about differences in vision loss prevalence among service members or veterans (SMVs) and civilians; further, no study has compared vision loss risk factors in these two populations. As such, we seek to fill this gap in the literature.

Methods

In this cross sectional study, we obtained data on 106 SMVs and 1572 civilians from the 2013–2018 National Health and Nutrition Examination Surveys. We compared the prevalence of or mean values of vision loss risk factors between SMVs and civilians using the Wald χ2 statistic or Kruskal-Wallis test. Further, we examined the relative strength of 17 vision loss risk factors in predicting self-reported vision loss via Firth’s logistic regression.

Results

SMVs had a significantly higher prevalence of illicit drug use (20.75% vs 13.62%) and HIV (1.89% vs 0.41%), while civilians had a higher prevalence of poor dietary habits (7.61% vs 13.21%). SMVs also had higher mean values of systolic blood pressure (125.85 vs 122.53 mmHg), pack years of cigarette smoking (8.29 vs 4.25), and sedentary minutes per day (379.15 vs 337.07 min). More SMVs (8.49%) self-reported vision loss than civilians (4.48%). After adjustment for covariates, illicit drug use (adjusted β coefficient=0.72, p=0.02) was associated with self-reported vision loss.

Conclusions

This study indicates that self-reported vision loss among SMVs is more prevalent than among civilians, and vision loss in SMVs is associated with severe or prolonged illicit drug use.
Cost-effectiveness analysis of ixekizumab versus secukinumab in patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis in Spain
Authors: Schweikert Bernd , Malmberg Chiara , Núñez Mercedes , Dilla Tatiana , Sapin Christophe , Hartz Susanne
Published: August 2020

Objective

To conduct a cost-effectiveness analysis from the perspective of the Spanish National Health System (NHS) comparing ixekizumab versus secukinumab.

Design

A Markov model with a lifetime horizon and monthly cycles was developed based on the York model. Four health states were included: a biological disease-modifying antirheumatic drug (bDMARD) induction period of 12 or 16 weeks, maintenance therapy, best supportive care (BSC) and death. Treatment response was assessed based on both Psoriatic Arthritis Response Criteria (PsARC) and ≥90% improvement in the Psoriasis Area Severity Index score (PASI90). At the end of the induction period, responders transitioned to maintenance therapy. Non-responders and patients who discontinued maintenance therapy transitioned to BSC. Clinical efficacy data were derived from a network meta-analysis. Health utilities were generated by applying a regression analysis to Psoriasis Area Severity Index and Health Assessment Questionnaire‒Disability Index scores collected in the ixekizumab SPIRIT studies. Results were subject to extensive sensitivity and scenario analysis.

Setting

Spanish NHS.

Participants

A hypothetical cohort of bDMARD-naïve patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis was modelled.

Interventions

Ixekizumab and secukinumab.

Results

Ixekizumab performed favourably over secukinumab in the base-case analysis, although cost savings and quality-adjusted life-year (QALY) gains were modest. Total costs were €153 901 compared with €156 559 for secukinumab (difference −€2658). Total QALYs were 9.175 vs 9.082 (difference 0.093). Base-case results were most sensitive to the annual bDMARD discontinuation rate and the modification of PsARC and PASI90 response to ixekizumab or secukinumab.

Conclusion

Ixekizumab provided more QALYs at a lower cost than secukinumab, with differences being on a relatively small scale. Sensitivity analysis showed that base-case results were generally robust to changes in most input parameters.

Trial registration number

SPIRIT-P1: NCT01695239; Post-results, SPIRIT-P2: NCT02349295; Post-results.
Ozone exposure and health effects: a protocol for an umbrella review and effect-specific systematic maps
Authors: Zhao Tianyu , Markevych Iana , Janßen Christian , Nowak Dennis , Steckling-Muschack Nadine , Heinrich Joachim
Published: August 2020

Introduction

Ambient ozone exposure may be adverse to health. Since the reported associations between ozone and health effects are heterogeneous and the underlying pathways are indistinct, the overall relationship remains unclear. Only a few overall syntheses of the evidence regarding ozone and health effects are available to date.

Methods and analysis

We plan to summarise the current evidence on ozone-related health effects systematically. First, to identify the possible associations between ambient ozone exposure and health outcomes, we will conduct an umbrella review. PubMed, Web of Science and grey literature will be searched for systematic reviews on exposure to ambient ozone and any possible health endpoints published before 31 May 2019. Data selection and extraction will be carried out by one reviewer, and a second reviewer will check the agreement of a sample of the studies. The methodological quality of the eligible systematic reviews and level of evidence regarding ozone and every specific health effect will be evaluated. Second, for each of the identified effects with a high level of evidence, comprehensive information retrievals will be conducted, considering both epidemiological and experimental studies. The study selection and data mapping will be carried out by one reviewer and checked by the second reviewer. We will summarise the information of the filtered epidemiological and experimental studies to conduct several systematic maps presenting the currently available evidence for the specific health effect. Because the association between ozone exposure and chronic obstructive pulmonary disease (COPD) is relatively well investigated, we will at least conduct one systematic map of ozone and COPD.

Ethics and dissemination

No ethical approval is required for this study. The completed umbrella review and systematic maps will be considered for publication and presentation. We will additionally upload the relevant data to publicly accessible online databases.

PROSPERO registration number

CRD42019123064.
Microwave ablation versus radiofrequency ablation for the treatment of severe complicated monochorionic pregnancies in China：protocol for a pilot randomised controlled trial
Authors: Xie Jialei , Cheng Ziyi , Wu Tianchen , Wei Yuan , Wang Xiaoli
Published: August 2020

Introduction

Complicated monochorionic twin pregnancies are often associated with high perinatal morbidity and mortality, some of which are severe enough to require a gestational reduction surgery to improve fetal survival and reduce disabilities. While radiofrequency ablation is currently the most commonly used procedure with higher fetal survival and fewer maternal and fetal complications compared with other surgical methods, the therapeutic effect of microwave ablation (MWA) is reported to be better, presumably due to the higher thermal effect and fewer restrictions. Currently there is limited evidence to prove the feasibility of MWA for selective reduction. The aim of this pilot study is to explore the feasibility, efficacy and safety of MWA reduction for severe complicated monochorionic pregnancies and may provide evidence for using the MWA in intrauterine surgeries extensively.

Methods and analysis

This is a study protocol for a parallel-design pilot randomised controlled trial. 60 eligible patients with severe complicated monochorionic pregnancies will be randomised in a ratio of 1:1 to MWA group and radiofrequency group. Patients will be followed up until 6 months of age of the retained fetal. The primary analysis will compare the rates of neonatal survival at 28 days to evaluate the effect of MWA. The study will also evaluate the safety profile of MWA including the occurrence of postoperative adverse events and maternal and fetal complications. Additional secondary outcomes to be explored include the condition of neonatal asphyxia and the growth of surviving fetus at 6 months. Outcomes will be analysed by both a frequentist and the Bayesian statistical approach.

Ethics and dissemination

This study was approved by the ethical review committee of the Peking University Third Hospital (Beijing, China). The results of this study will be published in peer-reviewed scientific journals and presented at relevant academic conferences.

Trial registration number

NCT04014452; Pre-results.
Journal editors’ perspectives on the communication practices in biomedical journals: a qualitative study
Authors: Glonti Ketevan , Boutron Isabelle , Moher David , Hren Darko
Published: August 2020

Objective

To generate an understanding of the communication practices that might influence the peer-review process in biomedical journals.

Method

Recruitment was based on purposive maximum variation sampling. We conducted semistructured interviews. Data were analysed using thematic analysis method.

Participants

56 journal editors from general medicine (n=13) and specialty (n=43) biomedical journals. Most were editor-in-chiefs (n=39), men (n=40) and worked part time (n=50).

Results

Our analysis generated four themes (1) providing minimal guidance to peer reviewers—two subthemes described the way journal editors rationalised their behaviour: (a) peer reviewers should know without guidelines how to review and (b) detailed guidance and structure might have a negative effect; (2) communication strategies of engagement with peer reviewers—two opposing strategies that journal editors employed to handle peer reviewers: (a) use of direct and personal communication to motivate peer reviewers and (b) use of indirect communication to avoid conflict; (3) concerns about impact of review model on communication—maintenance of anonymity as a means of facilitating critical and unburdened communication and minimising biases and (4) different practices in the moderation of communication between authors and peer reviewers—some journal editors actively interjected themselves into the communication chain to guide authors through peer reviewers’ comments, others remained at a distance, leaving it to the authors to work through peer reviewers’ comments.

Conclusions

These journal editors’ descriptions reveal several communication practices that might have a significant impact on the peer-review process. Editorial strategies to manage miscommunication are discussed. Further research on these proposed strategies and on communication practices from the point of view of authors and peer reviewers is warranted.
Longitudinal panel data study of self-rated health among migrants in French-speaking Switzerland, 2003–2017
Authors: Mota Pau , Saez Marc , Selby Kevin , Bodenmann Patrick
Published: August 2020

Introduction

Studies have documented poorer health among migrants than natives of several European countries, but little is known for Switzerland. We assessed the association between country of birth, socioeconomic factors and self-reported health (SRH) in a prospective cohort of adults living in Lausanne, Switzerland.

Methods

We used the data from the Colaus panel data study for three periods: 2003–2006 (n=6733), 2009–2012 (n=5064) and 2014–2017 (n=4555) corresponding to 35% of the source population. The response variable was SRH. Main explanatory variables were socioeconomic status, educational level, professional status, income, gender, age and years in Switzerland. The main covariate was country of birth, dichotomised as born in Switzerland or not. We specified random effects logistic regressions and used Bayesian methods for the inference.

Results

Being born outside of Switzerland was not associated with worse SRH (OR 1.09, 95% CI 0.52 to 2.31). Several other patient variables were, however, predictive of poor health. Educational level was inversely associated with the risk of reporting poor health. Monthly household income showed a gradient where higher income was associated with lower odds of reporting poor SRH, for both for migrants and non-migrants. Migrant women had lower odds of reporting poor SRH than men (OR 0.73, 95% CI 0.55 to 0.98). Migrant people living in couple have less risk of reporting poor SRH than people who live alone and the risk is lower for migrant people living in couple with children (OR 0.66, 95% CI 0.55 to 0.80).

Discussion

Migrant status was not associated with poorer SRH. However, differences in SRH were observed based on gender, age and several social determinants of health.
Long-term effectiveness and safety of infliximab, golimumab and ustekinumab in patients with psoriatic arthritis from a Canadian prospective observational registry
Authors: Rahman Proton , Arendse Regan , Khraishi Majed , Sholter Dalton , Sheriff Maqbool , Rampakakis Emmanouil , Lehman Allen J , Nantel Francois
Published: August 2020

Objectives

The objectives of this study were to describe the demographic profile and baseline disease characteristics of patients with psoriatic arthritis (PsA) treated with either infliximab (IFX), subcutaneous golimumab (GLM) or ustekinumab (UST) treatment in Canadian routine care setting along with assessing long-term effectiveness and safety.

Methods

Patients with PsA were enrolled into the Biologic Treatment Registry Across Canada registry (ClinicalTrials.gov Identifier: NCT00741793) from 2005 to 2017. The study visits occurred at study enrolment (baseline) and every 6 months thereafter. Effectiveness was assessed by changes in disease parameters (joint counts, Psoriasis Area Severity Index (PASI), Health Assessment Questionnaire, patient/physician global, minimal disease activity, enthesitis, dactylitis, erythrocyte sedimentation rate, C reactive protein). Improvements from baseline were explored with the paired t-test and the McNemar’s test. Safety was evaluated by assessing the incidence of adverse events (AEs) and drug survival rates.

Results

A total of 111 IFX-treated, 281 GLM-treated and 70 UST-treated patients were enrolled. Most baseline disease parameters remained similar over time in all three cohorts. UST-treated patients had lower mean baseline Disease Activity Score in 28 joints CRP, swollen joint based on 28 joints and higher PASI compared with patients treated with GLM. Treatment with IFX, GLM and UST was associated with significant improvements in all disease parameters over time (p<0.001) from baseline up to 84, 84 and 40 months, respectively.

AEs were reported for 74.8%, 69.8% and 52.9% (138, 114 and 115 events/100 patient-years (PYs)) covering 325, 567 and 87 years of exposure for IFX-treated, GLM-treated and UST-treated patients, respectively. Severe AEs were reported in 19.8%, 8.5% and 5.7% (8.8, 7.2 and 8.0 events/100 PYs) in IFX-treated, GLM-treated and UST-treated patients, respectively. The proportion of patients who discontinued treatment were 63.1%, 50.9% and 50.0%, respectively.

Conclusions

IFX, GLM and UST treatment significantly reduced disease activity and improved functionality in patients with PsA followed by routine clinical practice and had a safety profile similar to that previously reported in the literature.

Trial registration number

NCT00741793.
Physician staffed emergency medical service for children: a retrospective population-based registry cohort study in Odense region, Southern Denmark
Authors: Overgaard Morten Føhrby , Heino Anssi , Andersen Sofie Allerød , Thomas Owain , Holmén Johan , Mikkelsen Søren
Published: August 2020

Objectives

The aim of this study is to determine diagnostic patterns in the prehospital paediatric population, age distribution, the level of monitoring and the treatment initiated in the prehospital paediatric case. Hypothesis was that advanced prehospital interventions are rare in the paediatric patient population.

Setting

We performed a retrospective population-based registry cohort study of children attended by a physician-staffed emergency medical service (EMS) unit (P-EMS), in the Odense area of Denmark during a 10-year study period.

Participants

We screened 44 882 EMS contacts and included 5043 children. Patient characteristics, monitoring and interventions performed by the P-EMS crews were determined.

Results

We found that paediatric patients were a minority among patients attended by P-EMS units: 11.2% (10.9 to 11.5) (95% CI) of patients were children. The majority of the children were <5 years old; one-third being <2 years old. Respiratory problems, traffic accidents and febrile seizures were the three most common dispatch codes. Oxygen supplementation, intravenous access and application of a cervical collar were the three most common interventions. Oxygen saturation and heart rate were documented in more than half of the cases, but more than one-third of the children had no vital parameters documented. Only 22% of the children had respiratory rate, saturation, heart rate and blood pressure documented. Prehospital invasive procedures such as tracheal intubation (n=74), intraosseous access (n=22) and chest drainage (n=2) were infrequently performed.

Conclusion

Prehospital paediatric contacts are uncommon, more frequently involving smaller children. Monitoring or at least documentation of basic vital parameters is infrequent and may be an area for improvement. Advanced and potentially life-saving prehospital interventions provide a dilemma since these likely occur too infrequently to allow service providers to maintain their technical skills working solely in the prehospital environment.
Identifying optimal frameworks to implement or evaluate digital health interventions: a scoping review protocol
Authors: Soobiah Charlene , Cooper Madeline , Kishimoto Vanessa , Bhatia R Sacha , Scott Ted , Maloney Shelagh , Larsen Darren , Wijeysundera Harindra C , Zelmer Jennifer , Gray Carolyn Steele , Desveaux Laura
Published: August 2020

Introduction

Digital health interventions (DHIs) are defined as health services delivered electronically through formal or informal care. DHIs can range from electronic medical records used by providers to mobile health apps used by consumers. DHIs involve complex interactions between user, technology and the healthcare team, posing challenges for implementation and evaluation. Theoretical or interpretive frameworks are crucial in providing researchers guidance and clarity on implementation or evaluation approaches; however, there is a lack of standardisation on which frameworks to use in which contexts. Our goal is to conduct a scoping review to identify frameworks to guide the implementation or evaluation of DHIs.

Methods and analysis

A scoping review will be conducted using methods outlined by the Joanna Briggs Institute reviewers’ manual and will conform to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Studies will be included if they report on frameworks (ie, theoretical, interpretive, developmental) that are used to guide either implementation or evaluation of DHIs. Electronic databases, including MEDLINE, EMBASE, CINAHL and PsychINFO will be searched in addition to grey literature and reference lists of included studies. Citations and full text articles will be screened independently in Covidence after a reliability check among reviewers. We will use qualitative description to summarise findings and focus on how research objectives and type of DHIs are aligned with the frameworks used.

Ethics and dissemination

We engaged an advisory panel of digital health knowledge users to provide input at strategic stages of the scoping review to enhance the relevance of findings and inform dissemination activities. Specifically, they will provide feedback on the eligibility criteria, data abstraction elements, interpretation of findings and assist in developing key messages for dissemination. This study does not require ethical review. Findings from review will support decision making when selecting appropriate frameworks to guide the implementation or evaluation of DHIs.
The association between cigarette smoking, cancer screening, and cancer stage: a prospective study of the women’s health initiative observational cohort
Authors: Eng Victor A , David Sean P , Li Shufeng , Ally Mina S , Stefanick Marcia , Tang Jean Y
Published: August 2020

Objective

To assess the dose-dependent relationship between smoking history and cancer screening rates or staging of cancer diagnoses.

Design

Prospective, population-based cohort study.

Setting

Questionnaire responses from the Women’s Health Initiative (WHI) Observational Study.

Participants

89 058 postmenopausal women.

Outcome measures

Logistic regression models were used to assess the odds of obtaining breast, cervical, and colorectal cancer screening as stratified by smoking status. The odds of late-stage cancer diagnoses among patients with adequate vs inadequate screening as stratified by smoking status were also calculated.

Results

Of the 89 058 women who participated, 52.8% were never smokers, 40.8% were former smokers, and 6.37% were current smokers. Over an average of 8.8 years of follow-up, current smokers had lower odds of obtaining breast (OR 0.55; 95% CI 0.51 to 0.59), cervical (OR 0.53; 95% CI 0.47 to 0.59), and colorectal cancer (OR 0.71; 95% CI 0.66 to 0.76) screening compared with never smokers. Former smokers were more likely than never smokers to receive regular screening services. Failure to adhere to screening guidelines resulted in diagnoses at higher cancer stages among current smokers for breast cancer (OR 2.78; 95% CI 1.64 to 4.70) and colorectal cancer (OR 2.26; 95% CI 1.01 to 5.05).

Conclusions

Active smoking is strongly associated with decreased use of cancer screening services and more advanced cancer stage at the time of diagnosis. Clinicians should emphasise the promotion of both smoking cessation and cancer screening for this high-risk group.
Prevalence of chronic kidney disease in adults in England: comparison of nationally representative cross-sectional surveys from 2003 to 2016
Authors: Hounkpatin Hilda O , Harris S , Fraser Simon D S , Day Julie , Mindell Jennifer S , Taal Maarten W , O'Donoghue Donal , Roderick Paul J
Published: August 2020

Objectives

To identify recent trends in chronic kidney disease (CKD) prevalence in England and explore their association with changes in sociodemographic, behavioural and clinical factors.

Design

Pooled cross-sectional analysis.

Setting

Health Survey for England 2003, 2009/2010 combined and 2016.

Participants

17 663 individuals (aged 16+) living in private households.

Primary and secondary outcome measures

Prevalence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and albuminuria (measured by albumin–creatinine ratio) during 2009/2010 and 2016 and trends in eGFR between 2003 and 2016. eGFR was estimated using serum creatinine Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations.

Results

GFR <60 mL/min/1.73 m2 prevalence was 7.7% (95% CI 7.1% to 8.4%), 7.0% (6.4% to 7.7%) and 7.3%(6.5% to 8.2%) in 2003, 2009/2010 and 2016, respectively. Albuminuria prevalence was 8.7% (8.1% to 9.5%) in 2009/2010 and 9.8% (8.7% to 10.9%) in 2016. Prevalence of CKD G1-5 (eGFR <60 mL/min/1.73 m2 or albuminuria) was 12.6% (11.8% to 13.4%) in 2009/2010 and 13.9% (12.8% to 15.2%) in 2016. Prevalence of diabetes and obesity increased during 2003–2016 while prevalence of hypertension and smoking fell. The age-adjusted and gender-adjusted OR of eGFR <60 mL/min/1.73 m2 for 2016 versus 2009/2010 was 0.99 (0.82 to 1.18) and fully adjusted OR was 1.13 (0.93 to 1.37). There was no significant period effect on the prevalence of albuminuria or CKD G1-5 from 2009/2010 to 2016 in age and gender or fully adjusted models.

Conclusion

The fall in eGFR <60 mL/min/1.73 m2 seen from 2003 to 2009/2010 did not continue to 2016. However, absolute CKD burden is likely to rise with population growth and ageing, particularly if diabetes prevalence continues to increase. This highlights the need for greater CKD prevention efforts and continued surveillance.
Biomechanical risk factors of lower back pain in cricket fast bowlers using inertial measurement units: a prospective and retrospective investigation
Authors: Senington Billy , Lee Raymond Y , Williams Jonathan M
Published: August 2020

Objectives

To investigate spinal kinematics, tibial and sacral impacts during fast bowling, among bowlers with a history of low back pain (LBP) (retrospective) and bowlers who developed LBP in the follow-up season (prospective).

Methods

35 elite male fast bowlers; senior (n=14; age=24.1±4.3 years; height=1.89±0.05 m; weight=89.2±4.6 kg) and junior (n=21; age=16.9±0.7; height=1.81±0.05; weight=73.0±9.2 kg) were recruited from professional county cricket clubs. LBP history was gathered by questionnaire and development of LBP was monitored for the follow-up season. Spinal kinematics, tibial and sacral impacts were captured using inertial measurement units placed over S1, L1, T1 and anteromedial tibia. Bonferroni corrected pairwise comparisons and effect sizes were calculated to investigate differences in retrospective and prospective LBP groups.

Results

Approximately 38% of juniors (n=8) and 57% of seniors (n=8) reported a history of LBP. No differences were evident in spinal kinematics or impacts between those with LBP history and those without for seniors and juniors. Large effect sizes suggest greater rotation during wind-up (d=1.3) and faster time-to-peak tibial impacts (d=1.5) in those with no history of LBP. One junior (5%) and four (29%) seniors developed LBP. No differences were evident in spinal kinematics or impacts between those who developed LBP and those who did not for seniors. In seniors, those who developed LBP had lower tibial impacts (d=1.3) and greater lumbar extension (d=1.9) during delivery.

Conclusion

Retrospective analysis displayed non-significant differences in kinematics and impacts. It is unclear if these are adaptive or impairments. Prospective analysis demonstrated large effect sizes for lumbar extension during bowling suggesting a target for future coaching interventions.