bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-care interventions in stroke survivor–caregiver dyads: a protocol for systematic review and meta-analysis
Authors: Wang Wenna , Lin Beilei , Mei Yongxia , Zhang Zhenxiang , Zhou Bing
Published: December 2021

Introduction

Stroke is known as one of the leading causes of mortality and disability worldwide. Self-care plays a significant role in improving the quality of life, self-efficacy and many other outcomes of stroke survivors. However, it is a dyadic phenomenon where patient self-care and the caregiver contribution to self-care are inter-related in terms of predictors and outcomes. Currently, there is still no systematic assessment conducted to examine the overall effectiveness of self-care interventions carried out in stroke survivor–caregiver dyads and explore the effect on stroke survivor and/or caregiver outcomes.

Methods

We plan to conduct a systematic review and meta-analysis of the evidence regarding the self-care interventions carried out in stroke survivor–caregiver dyads. We will undertake a systematic search of multiple databases including PubMed, Web of Science, CINAHL, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials and four Chinese databases (CNKI, CBM, WANFANG and VIP) from inception to July 2021 for the purpose of collecting the relevant articles. The eligible studies are defined as those original researches, written in English or Chinese, on self-care interventions in stroke survivor–caregiver dyad samples. Two independent researchers will be deployed to identify the eligible trials according to the selection criteria and extract the relevant data. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist has been used for this protocol. We will use the Cochrane Risk for Bias tool to assess the risk of bias for randomised controlled trials.

Ethics and dissemination

In our review, any identifiable patient data will be excluded, which removes the need for ethical approval and participant consent. The final results of our study will be published in an open-access peer-reviewed journal, and abstract will be presented at suitable national/international conferences.

PROSPERO registration number

CRD42021239824.
Experiences of living with developmental dysplasia of the hip in adults not eligible for surgical treatment: a qualitative study
Authors: Jorgensen Martin Dan , Frederiksen Sarah Bournonville , Sørensen Dorthe , Jacobsen Julie Sandell
Published: December 2021

Objectives

Adults with developmental dysplasia of the hip face barriers in their everyday lives due to pain and physical limitations. In Denmark, some patients may not be eligible for hip-preserving surgery due to being overweight, hip osteoarthritis, age above 45 years, negative impingement test or not wishing to undergo surgery. These patients are left with no evidence-based treatment option. The patient perspective when not being eligible for surgery has not yet been investigated. This study aimed to explore the experiences of living with developmental dysplasia of the hip in adults not eligible for hip-preserving surgery.

Design and participants

In this qualitative study, we used a phenomenological–hermeneutic approach to explore the experiences of living with developmental dysplasia of the hip. We conducted semistructured interviews with 17 purposefully selected patients (median age 37 (range 19–50) years). The patients were recruited from a population of 30 patients included in a larger feasibility study evaluating a 6-month exercise and patient education intervention. We used a ricoeur-inspired method to analyse and interpret the interview data.

Results

Three themes were identified. First, developmental dysplasia of the hip is more than just a joint disease. Second, living with pain is difficult when pain has its own life. Third, limitations imposed by hip problems challenge the perception of oneself as young, active and independent. Identity, meaningfulness, control over pain and coping with pain were areas of the patients’ lives that were influenced.

Conclusion

Living with developmental dysplasia of the hip had a considerable impact on the patients of this study and their everyday life in several areas. Therefore, it may be relevant to approach patients with developmental dysplasia of the hip from a biopsychosocial point of view. However, further research is required to obtain a better understanding of the experiences of living with developmental dysplasia of the hip.
Prediction of chronic postsurgical pain in adults: a protocol for multivariable prediction model development
Authors: Papadomanolakis-Pakis Nicholas , Haroutounian Simon , Christiansen Christian Fynbo , Nikolajsen Lone
Published: December 2021

Introduction

Chronic postsurgical pain (CPSP) is a condition that affects an estimated 10%–50% of adults, depending on the surgical procedure. CPSP often interferes with activities of daily living and may have a negative impact on quality of life, emotional and physical well-being. Clinical prediction models can help clinicians target preventive strategies towards patients at high-risk of CPSP. Therefore, the objective of this study is to develop a clinically applicable and generalisable prediction model for CPSP in adults.

Methods and analysis

This research will be a prospective single-centre observational cohort study in Denmark spanning approximately 1 year or until a predefined number of patients are recruited (n=1526). Adult patients aged 18 years and older scheduled to undergo surgery will be recruited at Aarhus University Hospital. The primary outcome is CPSP 3 months after surgery defined as average pain intensity at rest or on movement ≥3 on numerical rating scale (NRS) within the past week, and/or average pain interference ≥3 on NRS among any of seven short-form Brief Pain Inventory items in the past week (general activity, mood, walking ability, normal work (including housework), relations with other people, sleep and enjoyment of life). Logistic regression will be used to conduct multivariate analysis. Predictive model performance will be evaluated by discrimination, calibration and model classification.

Ethics and dissemination

This research has been approved by Central Region Denmark and will be conducted in accordance with the Danish Data Protection Act and Declaration of Helsinki. Study findings will be disseminated through conference presentations and peer-reviewed publication. A CPSP risk calculator (CPSP-RC) will be developed based on predictors retained in the final models. The CPSP-RC will be made available online and as a mobile application to be easily accessible for clinical use and future research including validation and clinical impact assessments.

Trial registration number

NCT04866147.
Using natural language processing to extract self-harm and suicidality data from a clinical sample of patients with eating disorders: a retrospective cohort study
Authors: Cliffe Charlotte , Seyedsalehi Aida , Vardavoulia Katerina , Bittar André , Velupillai Sumithra , Shetty Hitesh , Schmidt Ulrike , Dutta Rina
Published: December 2021

Objectives

The objective of this study was to determine risk factors for those diagnosed with eating disorders who report self-harm and suicidality.

Design and setting

This study was a retrospective cohort study within a secondary mental health service, South London and Maudsley National Health Service Trust.

Participants

All diagnosed with an F50 diagnosis of eating disorder from January 2009 to September 2019 were included.

Intervention and measures

Electronic health records (EHRs) for these patients were extracted and two natural language processing tools were used to determine documentation of self-harm and suicidality in their clinical notes. These tools were validated manually for attribute agreement scores within this study.

Results

The attribute agreements for precision of positive mentions of self-harm were 0.96 and for suicidality were 0.80; this demonstrates a ‘near perfect’ and ‘strong’ agreement and highlights the reliability of the tools in identifying the EHRs reporting self-harm or suicidality. There were 7434 patients with EHRs available and diagnosed with eating disorders included in the study from the dates January 2007 to September 2019. Of these, 4591 (61.8%) had a mention of self-harm within their records and 4764 (64.0%) had a mention of suicidality; 3899 (52.4%) had mentions of both. Patients reporting either self-harm or suicidality were more likely to have a diagnosis of anorexia nervosa (AN) (self-harm, AN OR=3.44, 95% CI 1.05 to 11.3, p=0.04; suicidality, AN OR=8.20, 95% CI 2.17 to 30.1; p=0.002). They were also more likely to have a diagnosis of borderline personality disorder (p≤0.001), bipolar disorder (p<0.001) or substance misuse disorder (p<0.001).

Conclusion

A high percentage of patients (>60%) diagnosed with eating disorders report either self-harm or suicidal thoughts. Relative to other eating disorders, those diagnosed with AN were more likely to report either self-harm or suicidal thoughts. Psychiatric comorbidity, in particular borderline personality disorder and substance misuse, was also associated with an increase risk in self-harm and suicidality. Therefore, risk assessment among patients diagnosed with eating disorders is crucial.
Implementation, efficacy and cost effectiveness of the unified protocol in a blended format for the transdiagnostic treatment of emotional disorders: a study protocol for a multicentre, randomised, superiority controlled trial in the Spanish National Health System
Authors: Osma J , Martínez-García Laura , Peris-Baquero Óscar , Navarro-Haro María Vicenta , González-Pérez Alberto , Suso-Ribera Carlos
Published: December 2021

Introduction

Emotional disorders (EDs) have become the most prevalent psychological disorders in the general population, which has boosted the economic burden associated with their management. Approximately half of the individuals do not receive adequate treatment. Consequently, finding solutions to deliver cost-effective treatments for EDs has become a key goal of today’s clinical psychology. Blended treatments, a combination of face-to-face and online interventions, have emerged as a potential solution to the previous. The Unified Protocol for the Transdiagnostic Treatment of EDs (UP) might serve this purpose, as it can be applied to a variety of disorders simultaneously and its manualised format makes it suitable for blended interventions.

Methods and analysis

The study is a multicentre, randomised, superiority, clinical trial. Participants will be 310 individuals with a diagnosis of an ED. They will be randomised to a treatment as usual (individual cognitive behavioural therapy) or a UP condition in a blended format (face-to-face individual UP +online, app-based UP). Primary outcomes will be ED diagnostic criteria and depression and anxiety symptoms. Cost efficiency of the intervention, app usability, as well as opinion and confidence in the treatment will also be evaluated. Assessment points will include baseline and 3 months, 6 months and 12 months after UP treatment.

Ethics and dissemination

The study has received approvals by the Ethics Research Committee of Navarra, Castellón, Euskadi, Castilla y León, Extremadura, Lleida and Aragón. The study is currently under an approval process by the Ethics Research Committees of all the remaining collaborating centres. Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings.

Trial registration number

NCT04304911.
Participatory approaches in the context of research into workplace health promotion to improve physical activity levels and reduce sedentary behaviour among office-based workers: protocol for a scoping review
Authors: Buffey Aidan John , Carson Brian , Donnelly Alan , Salsberg Jon
Published: December 2021

Introduction

Physical activity (PA) workplace health promotion (WHP) interventions have traditionally used a top-down research approach where end-users are considered as passive subjects. Whereas participatory research (PR) involves the end-users within the research process utilising a bottom-up approach which allows the integration of the researcher’s expertise and the end-users lived experiences, which has been shown to aid in the acceptability and relevance of the research. This protocol describes a scoping review which will explore, identify and map PR techniques and their impact when used in office-based WHP interventions designed to improve PA and reduce sedentary behaviour levels.

Methods and analysis

This scoping review will follow the guidelines and framework proposed by Levacet aland Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Articles will be retrieved via five databases: Web of Science, PubMed, Scopus, Google Scholar and OpenGrey, searching from 1 January 1995, to the date of search in 2022. A search strategy was piloted, to identify appropriate keywords and MeSH terms. Two independent reviewers will screen retrieved articles based on our inclusion and exclusion criteria by title and abstract first, followed by the full text. Our key inclusion criteria relating to our population, intervention, comparison, outcome framework will be to include studies which focused on office-based working adults and that the PA WHP took a PR approach. Articles written in non-English languages will be excluded. Any discrepancies will be discussed until a consensus is reached. Data will be extracted, charted and summarised via a narrative synthesis and qualitative thematic analyses.

Ethics and dissemination

Ethical approval was not required for this scoping review. The completed scoping review findings will be disseminated in a peer-reviewed journal which has a research scope that encompasses PR and WHP. The findings will be presented at appropriate academic conferences and to project partners to inform the design of a WHP intervention.
The DEXA-CORT trial: study protocol of a randomised placebo-controlled trial of hydrocortisone in patients with brain tumour on the prevention of neuropsychiatric adverse effects caused by perioperative dexamethasone
Authors: Koning Anne-Sophie C A M , Satoer Djaina D , Vinkers Christiaan H , Zamanipoor Najafabadi Amir H , Biermasz Nienke R , Nandoe Tewarie Rishi D S , Moojen Wouter A , van Rossum Elisabeth F C , Dirven Clemens M F , Pereira Alberto M , van Furth Wouter R , Meijer Onno C
Published: December 2021

Introduction

The synthetic glucocorticoid dexamethasone can induce serious neuropsychiatric adverse effects. Dexamethasone activates the glucocorticoid receptor (GR) but, unlike endogenous cortisol, not the mineralocorticoid receptor (MR). Moreover, dexamethasone suppresses cortisol production, thereby eliminating its MR binding. Consequently, GR overactivation combined with MR underactivation may contribute to the neuropsychiatric adverse effects of dexamethasone. The DEXA-CORT trial aims to reactivate the MR using cortisol to reduce neuropsychiatric adverse effects of dexamethasone treatment.

Methods and analysis

The DEXA-CORT study is a multicentre, randomised, double-blind, placebo-controlled trial in adult patients who undergo elective brain tumour resection treated perioperatively with high doses of dexamethasone to minimise cerebral oedema. 180 patients are randomised between treatment with either two times per day 10 mg hydrocortisone or placebo during dexamethasone treatment. The primary study outcome is the difference in proportion of patients scoring ≥3 points on at least one of the Brief Psychiatric Rating Scale (BPRS) questions 5 days postoperatively or earlier at discharge. Secondary outcomes are neuropsychiatric symptoms, quality of sleep, health-related quality of life and neurocognitive functioning at several time points postoperatively. Furthermore, neuropsychiatric history, serious adverse events, prescribed (psychiatric) medication and referrals or evaluations of psychiatrist/psychologist and laboratory measurements are assessed.

Ethics and dissemination

The study protocol has been approved by the Medical Research Ethics Committee of the Leiden University Medical Center, and by the Dutch competent authority, and by the Institutional Review Boards of the participating sites. It is an investigator-initiated study with financial support by The Netherlands Organisation for Health Research and Development (ZonMw) and the Dutch Brain Foundation. Results of the study will be submitted for publication in a peer-reviewed journal.

Trial registration number

NL6726 (Netherlands Trial Register); open for patient inclusion. EudraCT number 2017-003705-17.
Cost analysis of managing B3 breast lesions by vacuum excision at Leeds Breast Unit using a decision model
Authors: Yaziji Nahel , Sharma Nisha , Selfridge Joe , Sagoo Gurdeep Singh
Published: December 2021

Objective

To develop an economic model to evaluate the cost of using vacuum-assisted excision (VAE) for managing B3 breast lesions.

Design

A decision tree of managing B3 breast lesions was developed to compare the costs of VAE with diagnostic excision (DE) from the perspective of the healthcare provider. Two different diagnostic pathways were compared which describe alternative approaches to the management of B3 lesions using inputs derived from a mix of primary and secondary data.

Setting

Based on a study conducted at Leeds Breast Unit, UK.

Participants

398 patients enter the model having undergone initial core needle biopsy, or vacuum-assisted biopsy, and diagnosed with B3 breast lesion.

Main outcome measures

The economic impact, in terms of cost, of various scenarios using analysis of extremes and probabilistic sensitivity analysis.

Results

VAE reduced the cost per patient by £1510.75. Analysis of extremes showed that managing B3 lesions using VAE was cost saving except the case where a combination of the highest cost associated with VAE and the lowest cost for DE were used. Probabilistic sensitivity analysis showed that using VAE for managing B3 lesions has a probability of 0.9 of being cost saving compared with using DE.

Conclusion

This analysis shows the potential cost saving of using VAE as an alternative for managing B3 breast lesions compared with DE. Further research in this area and the effect of the VAE on patients’ quality of life is warranted.
Identifying patient characteristics associated with potentially redirectable paramedic transported emergency department visits in Ontario, Canada: a population-based cohort study
Authors: Strum Ryan P , Tavares Walter , Worster Andrew , Griffith Lauren E , Costa Andrew P
Published: December 2021

Objective

Paramedic redirection from emergency department (ED) to subacute centres may be more beneficial for some patients, though little is known about which patients are potentially appropriate. We examined whether patient characteristics were associated with ED visits when the main intervention was suitable to be performed in a subacute centre.

Methods

We conducted a retrospective observational study using the National Ambulatory Care Reporting System from 2014 to 2018 in Ontario, Canada. We included all adult patients transported by paramedics and had a main physician intervention recorded. We used results of a RAND/UCLA modified Delphi study to categorise patients into either ED or a subacute care (urgent care and/or general practice centre) based on their main intervention. An independent logistic regression model was analysed for each subacute centre.

Results

A total of 2 394 072 ED visits were included; 59% of ED interventions were categorised as ‘urgent care’, 27% ‘ED only’, 9% either ‘urgent care’ or ‘general practice’ and 5% had an intervention not previously classified. ED visits suitable for ‘general practice’ had the highest percentage of patients discharged, while ‘ED only’ had the lowest. Lower medical acuity, younger age, time of triage in evening and overnight, and discharged from ED were independently associated with both subacute centres. ‘Urgent care’ visits/interventions were associated with an ED main diagnosis of the respiratory system (OR 3.49), while ‘general practice’ visits were associated with mental health disorders (OR 9.85) and injury/poison/consequences of external causes (OR 3.38).

Conclusions

The majority of ED visits had a main intervention that could have potentially been conducted in a subacute centre. We identified characteristics and diagnostic patterns associated with ED visits when the main intervention was categorised as a subacute centre intervention. This study contributes knowledge to inform which patients are potentially appropriate for paramedic redirection.
Prediction of emotional exhaustion over the course of the COVID-19 pandemic in primary care dental staff: an intensive longitudinal study
Authors: Freeman Ruth , Knights Jennifer , Beaton Laura , Araujo Mariana , Yuan Siyang , Clarkson Jan , Young Linda , Humphris Gerald
Published: December 2021

Objective

To investigate the fatigue trajectory during a 6-month duration of the COVID-19 pandemic for dental health professionals in primary dental care and for those in training.

Design

A longitudinal intensive panel diary was conducted (July–December 2020) assessing weekly self-ratings of emotional fatigue.

Setting

Dental care services in Scotland.

Participants

Dental trainees and primary dental care staff (N=53). These data were merged with respondents’ replies to a cross-sectional baseline survey (Humphriset al). Recruitment was through ‘Portal’, an online tool administered by National Health Service Education for Scotland. Questback software was employed for data collection.

Primary and secondary outcome measures

The diary questionnaire, consisted of a three-item fatigue scale and, from the baseline survey, three multi-item scales including: preparedness (14 items of the Dental Professional Preparedness for Practice Scale), the 22-item Impact of Event Scale-Revised and depressive symptomatology using the Patient Health Questionnaire-2. Statistical analysis included estimating the variability of fatigue over the study duration using a multilevel linear growth model. In addition, a path analysis was performed to determine the ability of preparedness and COVID-19 pandemic trauma to predict fatigue trajectories directly, or mediated through depressive symptomatology.

Results

A large variation of fatigue trajectories (p<0.001) was found from staff who completed a mean of 11 weekly uploads of their diary (diary uploads: minimum 4–maximum 24). The average slope was positive (standardised estimate=0.13, 95% CI: 0.07 to 0.19, p<0.001). Slope variation was modelled successfully from baseline data showing direct and indirect effects from preparedness, trauma and depressive symptoms.

Conclusion

Staff who volunteered to participate over a significant period of the COVID-19 pandemic in Scotland displayed a highly significant variety of individual trajectories. The results show some consistency with a job demands-resources model of burnout development. Suitable resource structures are indicated for staff over periods of extensive public service change.
EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI): study protocol for a multicentre, observational trial
Authors: Weiss Raphael , Saadat-Gilani Khaschayar , Kerschke Laura , Wempe Carola , Meersch Melanie , Zarbock Alexander
Published: December 2021

Introduction

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI.

Methods and analysis

EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI.

Ethics and dissemination

EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials.

Trial registration number

NCT04165369.
Hyperuricaemia and associated factors among the oldest-old population in the urban areas of Chengdu, China: a community-based cross-sectional study
Authors: Chen Xiang-Ji , Zhang Wenqiang , Yuan Rui-Li , Huang Xiao-Bo , Liu Ya , Xu Rong-Hua , Wei Dong , Tang Wei-Wei
Published: December 2021

Objectives

To investigate the prevalence of hyperuricaemia among the oldest-old persons in Chengdu and identify associated factors to provide information on achieving healthy ageing in China.

Design

A community-based cross-sectional study.

Setting

Jinjiang, Qingyang, Longquanyi locating in the southeast, the northwest and the east of Chengdu, respectively, were chosen as the study sites.

Participants

A representative sample of 1391 people aged over 80 years were enrolled from September 2015 to June 2016, and 106 participants were excluded due to missing information. Thus, a total of 1285 participants were analysed in this study.

Outcome measures

Hyperuricaemia was defined as serum uric acid >420 µmol/L in men or serum uric acid >360 µmol/L in women. A univariable logistic regression model and a multivariable logistic regression model were used to estimate the ORs and 95% CI to explore the associated risk factors of hyperuricaemia.

Results

The overall prevalence of hyperuricaemia among the oldest-old was 29.6%. There was no significant sex difference in the prevalence of hyperuricaemia, 29.1% in men vs 30.0% in women (p>0.05). Hyperlipidaemia and overweight were associated with the risk of hyperuricaemia both in men (OR 1.86; 95% CI 1.27 to 2.72; OR 2.44; 95% CI 1.42 to 4.19) and in women (OR 1.78; 95% CI 1.23 to 2.58; OR 2.95; 95% CI 1.89 to 4.61). Additionally, diabetes mellitus was associated with an increased prevalence of hyperuricaemia only in women (OR 1.99; 95% CI: 1.34 to 2.97).

Conclusion

The burden of hyperuricaemia is substantial among the oldest-old population in the urban areas of Chengdu, China.
START adolescents: study protocol of a randomised controlled trial to investigate the efficacy of a low-threshold group treatment programme in traumatised adolescent refugees
Authors: Sobanski Esther , Hammerle Florian , Dixius Andrea , Möhler Eva , Koudela-Hamila Susanne , Ebner-Priemer Ulrich , Merz Christian J , In-Albon Tina , Pollitt Brigitte , Christiansen Hanna , Kolar David , Ocker Susanne , Fischer Nicole , Burghaus Ina , Huss Michael
Published: December 2021

Introduction

No evaluated therapeutic approaches, that can efficiently be established in routine mental healthcare, are currently available for traumatised adolescent refugees in Germany. This study evaluates the efficacy of the Stress-Traumasymptoms-Arousal-Regulation-Treatment (START) programme to reduce trauma-related symptoms and psychological distress in traumatised adolescent refugees based in Germany.

Methods and analysis

This randomised, waiting-list-controlled, multicentre trial with a 12-week follow-up will include 174 refugee minors with partial or full post-traumatic stress disorder who are fluent in either Arabic, Dari, English, German or Somali. Eligible refugee minors will be randomised to the START or waiting-list control groups. The manualised 8-week START programme is based on techniques of dialectical behaviour therapy (DBT), fosters adaptive coping with emotional distress and traumatic symptoms and comprises eight therapy modules and a booster session. Study assessments are planned at baseline, post-treatment (ie, after programme participation or waiting time), booster session at week 12 or 12-week waiting time, and at the 12-week follow-up. Primary and coprimary outcomes are changes in psychological distress and traumatic symptoms at post-treatment and will be analysed as response variables in linear mixed regression models. Secondary outcomes are changes in further trauma-related and other psychopathological symptoms, emotion regulation and intermediate effects of the programme at follow-up. We will also assess effects of the programme with ecological momentary assessments and on neuroendocrine stress parameters using hair cortisol.

Ethics and dissemination

This study has been approved by the lead ethics committee of Rhineland-Palatinate and the ethics committees of participating sites. The study results will be disseminated through peer-reviewed publications and scientific conferences.

Trial registration number

DRKS00020771.
Designing the physical environment for inpatient palliative care: a narrative review
Authors: Wong Kevin , McLaughlan Rebecca , Collins Anna , Philip Jennifer
Published: December 2021

Background

It is essential that the physical environments in which inpatient palliative care is provided support the needs of patients and the facilitate the multidimensional delivery of palliative care. This review aims to identify the features and characteristics of inpatient palliative care environments that enhance or detract from the patient experience; and identify opportunities for progress within this field.

Method

Three databases were searched: MEDLINE (1946–2020), PsycINFO (1806–2020) and CINAHL (1937–2020). Articles were screened by title and abstract with included studies read in full for data extraction. Data synthesis involved thematic analysis informed by the findings of the included literature. Inclusion criteria were studies with empirical methodology examining adult palliative care in the hospital, hospice or nursing home environment. Studies that examined palliative care delivered within the emergency department, ICU or within the home were excluded, as were those related to paediatric palliative care.

Results

Four main themes were identified: the provision of privacy, facilitating interactions with family, facilitating comfort through homeliness and connections to nature.

Conclusions

The board acceptance of single rooms as the preeminent design solution for supporting privacy, dignity and family interaction, alongside current conceptions of homeliness that typically focus on matters of interior design, are limiting possibilities for further design innovation within palliative care settings. Research that investigates a broader set of design strategies through which the built environment can support care, alongside enhanced interdisciplinary collaboration, could positively contribute to patient and family experiences of inpatient palliative care.
Markers of kidney tubular and interstitial injury and function among sugarcane workers with cross-harvest serum creatinine elevation
Authors: Hansson Erik , Wegman David H , Wesseling Catharina , Glaser Jason , Schlader Zachary J , Wijkström Julia , Jakobsson Kristina
Published: December 2021

Objectives

Serum creatinine (SCr) is a routine marker of kidney injury but also increases with dehydration and muscular work. This study was to elucidate whether increase in SCr is associated with more specific markers of kidney tubular and interstitial injury and function, during prolonged heat stress among workers at high risk of chronic kidney disease of non-traditional origin (CKDnt).

Methods

Urine monocyte chemoattractant protein-1 (MCP-1), kidney injury molecule-1 (KIM-1), calbindin, glutathione S-transferase-π (GST-π), clusterin, interleukin 18 and albumin, fractional excretion of potassium (FEK), blood haemoglobin, serum potassium, ferritin and erythropoietin were measured before and after harvest in a sample of 30 workers with a ≥0.3 mg/dL SCr increase across harvest (cases), and 53 workers with stable SCr (controls).

Results

Urine MCP-1 (p for differential cross-harvest trend <0.001), KIM-1 (p=0.002), calbindin (p=0.02), GST-π (p=0.04), albumin (p=0.001) and FEK (p<0.001) increased in cases, whereas blood haemoglobin (p<0.001) and serum erythropoietin (p<0.001) decreased.

Conclusion

Several markers of tubular and interstitial injury and function changed as SCr increased across a harvest season, supporting the use of SCr as an indicator of kidney injury in physically active workers regularly exposed to heat stress. Repeated injury similar to that described here, and continued work under strenuous and hot conditions with similarly elevated injury markers is likely to worsen and possibly initiate CKDnt.
Effective action of string theory at order $$\alpha '$$ in the presence of boundary
Authors: Garousi Mohammad R.
Published: December 2021

Recently, using the assumption that the string theory effective action at the critical dimension is background independent, the classical on-shell effective action of the bosonic string theory at order $$\alpha '$$

α
′

in a spacetime manifold without boundary has been reproduced, up to an overall parameter, by imposing the O(1, 1) symmetry when the background has a circle. In the presence of the boundary, we consider a background which has boundary and a circle such that the unit normal vector of the boundary is independent of the circle. Then the O(1, 1) symmetry can fix the bulk action without using the lowest order equation of motion. Moreover, the above constraints and the constraint from the principle of the least action in the presence of boundary can fix the boundary action, up to five boundary parameters. In the least action principle, we assume that not only the values of the massless fields but also the values of their first derivatives are arbitrary on the boundary. We have also observed that the cosmological reduction of the leading order action in the presence of the Hawking–Gibbons boundary term, produces zero cosmological boundary action. Imposing this as another constraint on the boundary couplings at order $$\alpha '$$

α
′

, we find the boundary action up to two parameters. For a specific value for these two parameters, the gravity couplings in the boundary become the Chern–Simons gravity plus another term which has the Laplacian of the extrinsic curvature.
Improved Locality Preserving Projection for Hyperspectral Image Classification in Probabilistic Framework
Authors: Majdar Reza Seifi , Ghassemian Hassan
Published: December 2021

Unlabeled samples and transformation matrix are two main parts of unsupervised and semi-supervised feature extraction (FE) algorithms. In this manuscript, a semi-supervised FE method, locality preserving projection in the probabilistic framework (LPPPF), to find a sufficient number of reliable and unmixed unlabeled samples from all classes and constructing an optimal projection matrix is proposed. The LPPPF has two main steps. In the first step, a number of reliable unlabeled samples are selected based on the training samples, spectral features, and spatial information in the probabilistic framework. In this way, the spectral and spatial probability distribution function is calculated for each unlabeled sample. Therefore, the spectral features and spatial information are integrated together with a joint probability distribution function. Finally, a sufficient number of unlabeled samples with the highest joint probability distribution are selected. In the second step, the selected unlabeled samples are applied to construct the transformation matrix based on the spectral and spatial information of the unlabeled samples. The adjacency graph is improved by using new weights based on spectral and spatial information. This method is evaluated on three data sets: Indian Pines, Pavia University, and Kennedy Space Center (KSC) and compared with some recent and well-known supervised, semi-supervised, and unsupervised FE methods. Various experiments demonstrate the efficiency of the LPPPF in comparison with the other FE methods. LPPPF has also considerable performance with limited training samples.
Large-Scale Local Online Similarity/Distance Learning Framework Based on Passive/Aggressive
Authors: Hamdan Baida , Zabihzadeh Davood
Published: December 2021

Similarity/distance measures play a key role in many machine learning, pattern recognition, and data mining algorithms, which leads to the emergence of the metric learning field. Many metric learning algorithms learn a global distance function from data that satisfies the constraints of the problem. However, in many real-world datasets, where the discrimination power of features varies in the different regions of input space, a global metric is often unable to capture the complexity of the task. To address this challenge, local metric learning methods are proposed which learn multiple metrics across the different regions of the input space. Some advantages of these methods include high flexibility and learning a nonlinear mapping, but they typically achieve at the expense of higher time requirements and overfitting problems. To overcome these challenges, this research presents an online multiple metric learning framework. Each metric in the proposed framework is composed of a global and a local component learned simultaneously. Adding a global component to a local metric efficiently reduces the problem of overfitting. The proposed framework is also scalable with both sample size and the dimension of input data. To the best of our knowledge, this is the first local online similarity/distance learning framework based on Passive/Aggressive (PA). In addition, for scalability with the dimension of input data, Dual Random Projection (DRP) is extended for local online learning in the present work. It enables our methods to run efficiently on high-dimensional datasets while maintaining their predictive performance. The proposed framework provides a straightforward local extension to any global online similarity/distance learning algorithm based on PA. Experimental results on some challenging datasets from machine vision community confirm that the extended methods considerably enhance the performance of the related global ones without increasing the time complexity.
A Low Distortion Mesh Parameterization Mapping Method Based on Proxy Function and Combined Newton
Authors: Cai Xingquan , Feng Dingwei , Cai Mohan , Sun Chen , Sun Haiyan
Published: December 2021

To address the issues of low efficiencies and serious mapping distortions in current mesh parameterization methods, we present a low distortion mesh parameterization mapping method based on proxy function and combined Newton’s method in this paper. First, the proposed method calculates visual blind areas and distortion prone areas of a 3D mesh model, and generates a model slit. Afterwards, the method performs the Tutte mapping on the cut three-dimensional mesh model, measures the mapping distortion of the model, and outputs a distortion metric function and distortion values. Finally, the method sets iteration parameters, establishes a reference mesh, and finds the optimal coordinate points to get a convergent mesh model. When calculating mapping distortions, Dirichlet energy function is used to measure the isometric mapping distortion, and MIPS energy function is used to measure the conformal mapping distortion. To find the minimum value of the mapping distortion metric function, we use an optimal solution method combining proxy functions and combined Newton’s method. The experimental data show that the proposed method has high execution efficiency, fast descending speed of mapping distortion energy and stable optimal value convergence quality. When a texture mapping is performed, the texture is evenly colored, close laid and uniformly lined, which meets the standards in practical applications.
Knowledge Mapping Analysis of Manufacturing Product Innovation Based on CiteSpace
Authors: Zhang Shuo , Zou Hua , Sun Jian
Published: December 2021

Manufacturing product innovation is increasingly showing a green, low-carbon, systematic ecological innovation development trend. In this paper, using CiteSpace analysis method and assisted by BICOMB2 software, the literature of CNKI (1992–2019) and WOS (1995–2019) database was analyzed to construct the knowledge mapping of manufacturing product innovation, and the research findings were as follows: (i) The research is mainly concentrated in China, the United States, the United Kingdom, Germany and other countries. The number of Chinese scholars’ research is the largest, but the American scholars’ research is the first in novelty and prospective, and its sigma value is as high as 294.17. (ii) In recent years, Shanghai Jiaotong University, Xi’an University of Technology, Hunan University and other research institutions have recently produced more research results on product innovation. Among them, Shanghai Jiaotong University can be ranked first. (ii) “Green product innovation” and “product innovation performance” can continue to be the hot spots for future manufacturing product innovation and development.
Holomorphic integer graded vertex superalgebras
Authors: van Ekeren Jethro , Rodríguez Morales Bely
Published: December 2021

In this paper, we study holomorphic [Formula: see text]-graded vertex superalgebras. We prove that all such vertex superalgebras of central charge [Formula: see text] and [Formula: see text] are purely even. For the case of central charge [Formula: see text] we prove that the weight-one Lie superalgebra is either zero, of superdimension [Formula: see text], or else is one of an explicit list of 1332 semisimple Lie superalgebras.
A Novel Enhanced Russell Graph Efficiency Measure in Network DEA
Authors: Eslami Robabeh , Khoveyni Mohammad
Published: December 2021

Hitherto, the presented models for measuring the efficiency score of multi-stage decision-making units (DMUs) either are nonlinear or require to specify the weights for combining their divisional efficiencies. The nonlinearity leads to high computational complexity for these models, especially when used for problems with enormous dimensions, and also assigning various weights to the divisional efficiencies causes to obtain different efficiency scores for the multi-stage network system. To tackle these problems, this study contributes to network DEA by introducing a novel enhanced Russell graph (ERG) efficiency measure for evaluating the general two-stage series network structures. Then, the proposed model is extended into the general multi-stage series network structures. This study also describes the managerial and economic implications of measuring the efficiency score of the multi-stage DMUs and provides two numerical and empirical examples for illustrating the use of our proposed model.
Poisson size-biased Lindley distribution and its applications
Authors: Dar Showkat Ahmad , Hassan Anwar , Ahmad Peer Bilal
Published: December 2021

In this paper, a new model for count data is introduced by compounding the Poisson distribution with size-biased three-parameter Lindley distribution. Statistical properties, such as reliability, hazard rate, reverse hazard rate, Mills ratio, moments, shewness, kurtosis, moment genrating function, probability generating function and order statistics, have been discussed. Moreover, the collective risk model is discussed by considering the proposed distrubution as the primary distribution and the expoential and Erlang distributions as the secondary ones. Parameter estimation is done using maximum likelihood estimation (MLE). Finally a real dataset is discussed to demonstrate the suitability and applicability of the proposed distribution in modeling count dataset.
Structural, Electronic and Magnetic Properties of CaSe Doped with 3d (V, Cr and Mn)
Authors: Daoudi Youcef , Mazouz Hadj Moulay Ahmed , Lagoun Brahim , Benghia Ali
Published: December 2021

We report first-principles investigation on structural, electronic and magnetic properties of 3d transition metal element-doped rock-salt calcium selenide Ca[Formula: see text]TMxSe (TM = V, Cr and Mn) at concentrations [Formula: see text] = 0.0625, 0.125 and 0.25. We performed the calculations in the framework of the density functional theory (DFT) using the full-potential linearized augmented plane waves plus local orbitals (FP-LAPW+lo) method within the Wu–Cohen generalized gradient approximation (WC-GGA) for the structural optimization and the Tran–Blaha modified Becke–Johnson (TBmBJ) potential for the electronic and the magnetic properties. The computed spin-polarized band structures and densities of states show that Ca[Formula: see text]CrxSe compounds at all studied concentrations are half-metallic ferromagnets with a complete spin polarization of 100% at Fermi-level while the Ca[Formula: see text]VxSe and Ca[Formula: see text]MnxSe are ferromagnetic semiconductors. The total magnetic moments for Ca[Formula: see text]VxSe, Ca[Formula: see text]CrxSe, and Ca[Formula: see text]MnxSe show the integer values of 3[Formula: see text][Formula: see text], 4[Formula: see text][Formula: see text], and 5[Formula: see text][Formula: see text], respectively, with a major contribution of transition metal elements (TM) in the total magnetization. Also, we reported the calculated exchange constants [Formula: see text] and [Formula: see text] and the band edge spin splitting of the valence ([Formula: see text]) and conduction ([Formula: see text]) bands. The ferromagnetism of these compounds is due to the super-exchange and the double-exchange mechanisms in addition to the strong p–d exchange interaction. Therefore, the predicted results indicate that the diluted Ca[Formula: see text]TMxSe (TM = V, Cr, Mn) compounds are suitable candidates for a possible application in the field of spintronic technology.
A New Method for Sound Generation Based on Digital Sound Reconstruction
Authors: Mayrhofer Dominik , Kaltenbacher Manfred
Published: December 2021

In this paper, we consider the general idea of Digital Sound Reconstruction (DSR) and analyze its inherent limitations. Based on this discussion, a new method which we call Advanced Digital Sound Reconstruction (ADSR) is introduced and analyzed in detail. This method aims to overcome the problems of classical DSR by introducing shutter gates and focuses on sound generation in the low-frequency domain. Combining the idea of classical DSR with a redirection mechanism leads to a gain of 20[Formula: see text]dB per decade regarding the sound pressure for decreasing frequency values. We present multiple array designs and possible embodiments for ADSR as well as an in depth view of excitation and optimization approaches. Finally, numerical investigations are used in order to demonstrate the potential of ADSR especially in the mid- to low-frequency range.