bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse event reviews in healthcare: what matters to patients and their family? A qualitative study exploring the perspective of patients and family
Authors: McQueen Jean M , Gibson Kyle R , Manson Moira , Francis Morag
Published: May 2022

Objectives

Explore what ‘good’ patient and family involvement in healthcare adverse event reviews may involve.

Design

Data was collected using semi-structured telephone interviews. Interview transcripts were analysed using an inductive thematic approach.

Setting

NHS Scotland.

Participants

19 interviews were conducted with patients who had experienced an adverse event during the provision of their healthcare or their family member.

Results

Four key themes were derived from these interviews: trauma, communication, learning and litigation.

Conclusions

There are many advantages of actively involving patients and their families in adverse event reviews. An open, collaborative, person-centred approach which listens to, and involves, patients and their families is perceived to lead to improved outcomes. For the patient and their family, it can help with reconciliation following a traumatic event and help restore their faith in the healthcare system. For the health service, listening and involving people will likely enhance learning with subsequent improvements in healthcare provision with reduction in risk of similar events occurring for other patients. This study suggests eight recommendations for involving patients and families in adverse event reviews using the APICCTHS model (table 3) which includes an apology, person-centred inclusive communication, closing the loop, timeliness, putting patients and families at the heart of the review with appropriate support for staff involved. Communicating in a compassionate manner could also decrease litigation claims following an adverse event.
Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study
Authors: Mruts Kalayu Brhane , Tessema Gizachew Assefa , Dunne Jennifer , Gebremedhin Amanuel Tesfay , Scott Jane , Pereira Gavin F
Published: May 2022

Objective

This study examined the association between family planning counselling receipt during the 12 months preceding the survey and postpartum modern contraceptive uptake in Ethiopia. We hypothesised that receiving family planning counselling either within the community setting by a field health worker or at a health facility by a healthcare attendant during the 12 months preceding the survey improves postpartum modern contraceptive uptake.

Design

We used a cross-sectional study of the Ethiopian Demographic and Health Survey conducted in 2016.

Setting

Ethiopia.

Participants

A total of 1650 women who gave birth during the 12 months and had contact with service delivery points during the 12 months preceding the survey.

Primary outcome

A weighted modified Poisson regression model was used to estimate an adjusted relative risk (RR) of postpartum modern contraceptives.

Results

Approximately half (48%) of the women have missed the opportunity to receive family planning counselling at the health service contact points during the 12 months preceding the survey. The postpartum modern contraceptive uptake was 27%. Two hundred forty-two (30%) and 204 (24%) of the counselled and not counselled women used postpartum modern contraceptive methods, respectively. Compared with women who did not receive counselling for family planning, women who received counselling had higher contraceptive uptake (RR 1.32, 95% CI 1.04 to 1.67).

Conclusion

Significant numbers of women have missed the opportunity of receiving family planning counselling during contact with health service delivery points. Modern contraceptive uptake among postpartum women was low in Ethiopia. Despite this, our findings revealed that family planning counselling was associated with improved postpartum modern contraceptive uptake.
Nationwide population-based study of poisoning-induced out-of-hospital cardiac arrest in South Korea
Authors: Park Gihun , Ahn Chiwon , Kim Jae Hwan
Published: May 2022

Objective

To evaluate the characteristics of poisoning-induced out-of-hospital cardiac arrest (pOHCA) and the factors influencing survival to discharge and good neurological outcomes using a nationwide, population-based database.

Design

Nationwide, retrospective, population-based cohort study.

Setting and participants

This study included adult patients who had experienced pOHCA and those who had not (non-pOHCA patients) in South Korea from January 2008 to December 2018.

Outcome measures

The primary outcome was survival to discharge, and the secondary outcome was a good neurological outcome.

Methods

The basic characteristics of pOHCA and non-pOHCA patients were analysed by descriptive analysis. Logistic regression analysis was conducted for related variables, including pOHCA.

Results

A total of 173 190 patients were included, and 3582 patients (2.1%) were in the pOHCA group. Some of the pOHCA patients were young (58.2±17.8 vs 69.0±15.5, p<0.001), a few of their cardiac arrests were witnessed (12.8% vs 45.1%, p<0.001), a few were resuscitated by bystanders (8.2% vs 14.8%, p<0.001) and they had low shockable rhythm rates (1.2% vs 8.8%, p<0.001). They showed significantly lower survival to discharge and poorer neurological outcomes than non-pOHCA patients (survival to discharge, 3.7% vs 6.2%, p<0.001; good neurological outcomes, 1.3% vs 3.2%, p<0.001). There were no significant differences between pOHCA and non-pOHCA patients in terms of the adjusted ORs for survival to discharge (adjusted OR 0.608; 95% CI 0.86 to 1.27) and good neurological outcomes (adjusted OR 1.03; 95% CI 0.73 to 1.42).

Conclusion

This study shows that apparent aetiology of OHCA caused by poison, did not influence survival to discharge and good neurological outcomes. Furthermore, pOHCA occurs in younger patients and has fewer witnesses and shockable rhythms. pOHCA did not influence survival to discharge and good neurological outcomes. Also, pesticides and gases were the most frequent substances causing pOHCA in South Korea.
Establishing the reference interval for pulse oxygen saturation in neonates at high altitudes: protocol for a multicentre, open, cross-sectional study
Authors: Wang Bo , Liu Chongde , Yao Yanli , Lu Zhihui , Yu Rong , CaiRen Zhuoma , Wang Zhixiu , Liu Runwu , Wu Yazhen , Yu Zhangbin
Published: May 2022

Introduction

Establishing the reference interval for pulse oxygen saturation (SpO2) is essential for sensitively identifying neonatal hypoxaemia due to various causes. However, the reference interval for high altitudes has not yet been established, and existing studies have many limitations. This study will aim to establish the reference interval for various high altitudes and determine whether preductal and postductal measurements at the same altitude vary.

Methods and analysis

This is a multicentre, open, cross-sectional study, which will begin in February 2022. Approximately 2000 healthy full-term singleton neonates will be recruited from six hospitals (altitude ≥2000 m) in Qinghai Province, China. The participating hospitals will use a uniform pulse oximeter type. The measurements will be performed between 24 hours after birth and discharge. During the measurement, the neonate will be awake and quiet. Preductal and postductal measurements will be performed. The measurement time, site and results will be recorded and input, along with the collected basic information, into the perinatal cloud database. We will carry out strict quality control for basic information collection, measurement and data filing. We will perform descriptive statistics on the distribution range of the collected data, determine the lower limit value of the reference interval for each hospital and the corresponding altitude, perform curve fitting for the lower limit value, use the altitude as a covariate for the function corresponding to the fitted curve, establish the prediction equation and ultimately determine the reference intervals of each high altitude location.

Ethics and dissemination

Our protocol has been approved by the Medical Ethics Committee of all participating hospitals. We will publish our study results in academic conferences and peer-reviewed public journals.

Trial registration number

NCT05115721.
Advance care planning in amyotrophic lateral sclerosis (ALS): study protocol for a qualitative longitudinal study with persons with ALS and their family carers
Authors: Vandenbogaerde Isabel , Miranda Rose , De Bleecker Jan L , Carduff Emma , van der Heide Agnes , Van den Block Lieve , Deliens Luc , De Vleminck Aline
Published: May 2022

Introduction

Amyotrophic lateral sclerosis (ALS) is an incurable motor neuron degenerative disease that has rapid progression and is associated with cognitive impairment. For people with ALS (pALS) and their family carers, advance care planning (ACP) is beneficial, as it can lead to feelings of control/relief and refusal of unwanted treatments. However, evidence concerning the experiences and preferences regarding ACP of pALS and their family carers, especially when their symptoms progress, is scarce. This article describes the protocol for a qualitative longitudinal study that aims to explore: (1) the experiences with ACP and the preferences for future care and treatment of pALS and their family carers and (2) how these experiences and preferences change over time.

Methods and analysis

A qualitative, longitudinal, multiperspective design. A total of eight to nine dyads (pALS and their family carers) will be recruited, and semistructured interviews administered every 3 months over a 9-month period. Qualitative longitudinal analysis involves content analysis via in-depth reading, followed by a two-step timeline method to describe changes in experiences and preferences within and across participants.

Ethics and dissemination

This protocol has been approved by the central ethical committee of the University Hospital of Brussels, and local ethical committees of the other participating hospitals (B.U.N. B1432020000128). The results will be disseminated via the research group’s (endoflifecare.be) website, social media and newsletter and via presentations at national and international scientific conferences.
Treatment of Hidradenitis Suppurativa Evaluation Study (THESEUS): protocol for a prospective cohort study
Authors: Bates Janine , Stanton Helen , Cannings-John Rebecca , Thomas Kim Suzanne , Leighton Paul , Howells Laura M , Rodrigues Jeremy , Howes Rachel , Collier Fiona , Harris Ceri , Gibbons Angela , Thomas-Jones Emma , Hood Kerenza , Ingram John R
Published: May 2022

Background

Hidradenitis suppurativa (HS) is a chronic, painful, inflammatory skin disease with estimates of prevalence in the European population of 1%–2%. Despite being a relatively common condition, the evidence base for management of HS is limited. European and North American management guidelines rely on consensus for many aspects of treatment and within the UK variations in management of HS have been identified. The HS James Lind Alliance Priority Setting Partnership (PSP) published a top 10 list of future HS research priorities including both medical and surgical interventions. The aims of the THESEUS study are to inform the design of future HS randomised controlled trials (RCTs) and to understand how HS treatments are currently used. THESEUS incorporates several HS PSP research priorities, including investigation of oral and surgical treatments. Core outcome domains have been established by the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC) and THESEUS is designed to validate instruments to measure the domains.

Methods and analysis

The THESEUS study is a prospective observational cohort study. Participants, adults with active HS of any severity, will be asked to select one of five HS treatment options that is appropriate for their HS care. Participants will be allocated to their chosen treatment intervention and followed for a period of up to 12 months. Outcomes will be assessed at 3-monthly intervals using HISTORIC core outcome instruments. Video recordings of the surgical and laser operations will provide informational and training videos for future trials. Nested mixed-methods studies will characterise the interventions in clinical practice, understand facilitators and barriers to recruitment into future HS RCTs and examine patients’ and clinicians’ perspectives on HS treatment choices.

Trial registration number

ISRCTN69985145.
Uncovering the effects of gender affirming hormone therapy on skeletal muscle and epigenetics: protocol for a prospective matched cohort study in transgender individuals (the GAME study)
Authors: Jones Patrice R , Voisin Sarah , Nolan Brendan J , Landen Shanie , Jacques Macsue , Newell Beau , Zwickl Sav , Cook Teddy , Wong Alex , Ginger Ariel , Palmer Andrew , Garnham Andrew , Alvarez-Romero Javier , Mohandas Namitha , Seale Kirsten , Cheung Ada , Eynon Nir
Published: May 2022

Introduction

Gender affirming hormone therapy (GAHT) is increasingly used by transgender individuals and leads to shifts in sex hormone levels. Skeletal muscle is highly responsive to hormone activity, with limited data on the effects of GAHT on different human tissues. Here, we present the protocol for the GAME study (the effects ofGenderAffirming hormone therapy on skeletalMuscle training andEpigenetics), which aims to uncover the effects of GAHT on skeletal muscle ‘omic’ profiles (methylomics, transcriptomics, proteomics, metabolomics) and markers of skeletal muscle health and fitness.

Methods and analysis

This study is a prospective age-matched cohort study in transgender adults commencing GAHT (n=80) and age-matched individuals not commencing GAHT (n=80), conducted at Austin Health and Victoria University in Victoria, Australia. Assessments will take place prior to beginning GAHT and 6 and 12 months into therapies in adults commencing GAHT. Age-matched individuals will be assessed at the same time points. Assessments will be divided over three examination days, involving (1) aerobic fitness tests, (2) muscle strength assessments and (3) collection of blood and muscle samples, as well as body composition measurements. Standardised diets, fitness watches and questionnaires will be used to control for key confounders in analyses. Primary outcomes are changes in aerobic fitness and muscle strength, as well as changes in skeletal muscle DNA methylation and gene expression profiles. Secondary outcomes include changes in skeletal muscle characteristics, proteomics, body composition and blood markers. Linear mixed models will be used to assess changes in outcomes, while accounting for repeated measures within participants and adjusting for known confounders.

Ethics and dissemination

The Austin Health Human Research Ethics Committee (HREC) and Victoria University HREC granted approval for this study (HREC/77146/Austin-2021). Findings from this project will be published in open-access, peer-reviewed journals and presented to scientific and public audiences.

Trial registration number

ACTRN12621001415897; Pre-results.
Genetics Adviser: a protocol for a mixed-methods randomised controlled trial evaluating a digital platform for genetics service delivery
Authors: Shickh Salma , Hirjikaka Daena , Clausen Marc , Kodida Rita , Mighton Chloe , Reble Emma , Sam Jordan , Panchal Seema , Aronson Melyssa , Graham Tracy , Armel Susan Randall , Glogowski Emily , Elser Christine , Eisen Andrea , Carroll June C , Shuman Cheryl , Seto Emily , Baxter Nancy N , Scheer Adena , Shastri-Estrada Serena , Feldman Geoff , Thorpe Kevin E , Schrader Kasmintan A , Lerner-Ellis Jordan , Kim Raymond H , Faghfoury Hanna , Bombard Yvonne
Published: May 2022

Introduction

The high demand for genetic tests and limited supply of genetics professionals has created a need for alternative service delivery models. Digital tools are increasingly being used to support multiple points in the genetic testing journey; however, none are transferable across multiple clinical specialties and settings nor do they encompass the entire trajectory of the journey. We aim to evaluate the effectiveness of the Genetics Adviser, an interactive, patient-facing, online digital health tool that delivers pre-test counselling, provides support during the waiting period for results, and returns results with post-test counselling, encompassing the entire patient genetic testing journey.

Methods and analysis

We will compare the Genetics Adviser paired with a brief genetic counselling session to genetic counselling alone in a randomised controlled trial. One hundred and forty patients who previously received uninformative genetic test results for their personal and family history of cancer will be recruited from familial cancer clinics in Toronto and offered all clinically significant results from genomic sequencing. Participants randomised into the intervention arm will use the Genetics Adviser to learn about genomic sequencing, receive pre-test counselling, support during the waiting period and results, supplemented with brief counselling from a genetic counsellor. Participants in the control arm will receive standard pre-test and post-test counselling for genomic sequencing from a genetic counsellor. Our primary outcome is decisional conflict following pre-test counselling from the Genetics Adviser+genetic counsellor or counsellor alone. Secondary outcomes include: knowledge, satisfaction with decision-making, anxiety, quality of life, psychological impact of results, empowerment, acceptability and economic impact for patients and the health system. A subset of patients will be interviewed to assess user experience.

Ethics and dissemination

This study has been approved by Clinical Trials Ontario Streamlined Research Ethics Review System (REB#20–035). Results will be shared through stakeholder workshops, national and international conferences and peer-reviewed journals.

Trial registration number

NCT04725565.
Atrial cardiomyopathy in patients with ischaemic stroke: a cross-sectional and prospective cohort study—the COAST study
Authors: Larsen Bjørn Strøier , Aplin Mark , Høst Nis , Dominguez Helena , Christensen Hanne , Christensen Louisa Marguerite , Havsteen Inger , Prescott Eva , Jensen Gorm Boje , Vejlstrup Niels , Bertelsen Litten , Sajadieh Ahmad
Published: May 2022

Introduction

Despite workup for the aetiology of ischaemic stroke, about 25% of cases remain unexplained. Paroxysmal atrial fibrillation is typically suspected but often not detected. Even if atrial fibrillation (AF) is detected, the quantitative threshold of clinically relevant AF remains unclear. Emerging evidence suggests that left atrial (LA) functional and structural abnormalities may convey a risk of ischaemic stroke in which AF is only one of several features. These abnormalities have been termed ‘atrial cardiomyopathy’. This study uses cardiac magnetic resonance (CMR) to evaluate atrial cardiomyopathy among patients with stroke of undetermined aetiology compared with those with an attributable mechanism and controls without established cardiovascular disease.

Methods and analysis

This cross-sectional and prospective cohort study included 100 patients with recent ischaemic stroke and 50 controls with no established cardiovascular disease. The study will assess LA structural and functional abnormalities with CMR. Inclusion began in March 2019, and follow-up is planned to be complete in January 2023. There are two scheduled follow-ups: (1) 18 months after individual inclusion, counting from the index diagnostic MRI of the brain, (2) end of study follow-up at 18 months after inclusion of the last patient, assessing the incidence of recurrent ischaemic stroke, AF and cardiovascular death. The primary endpoint is the extent of CMR-assessed atrial fibrosis in the LA at baseline. The study is powered to detect a difference of 6% fibrosis between stroke of undetermined aetiology and stroke of known mechanism with a SD of 9%, a significance level of 0.05, and power of 80%.

Ethics and dissemination

This study has been approved by the Danish National Committee on Health Research Ethics (H-18055313). All participants in the study signed informed consent. Results from the study will be published in peer-reviewed journals regardless of the outcome.

Trial registration number

NCT03830983.
Cross-sectional study of the relationship between women’s representation among editors and peer reviewers in journals of the British Medical Journal Publishing Group
Authors: Pinho-Gomes Ana-Catarina , Vassallo Amy , Woodward Mark , Peters Sanne
Published: May 2022

Objectives

To investigate whether there is an association between women’s representation as peer reviewers and editors of medical journals.

Methods

In this cross-sectional study, the gender of editors and peer reviewers of journals of the British Medical Journal Publishing Group (BMJ-PG) in 2020 was determined based on given names. Trends over time were analysed for the BMJ between 2009 and 2017.

Results

Overall, this study included 47 of the 74 journals in the BMJ-PG. Women accounted for 30.2% of the 42 539 peer reviewers, with marked variation from 8% to 50%. Women represented 33.4% of the 555 editors, including 19.2% of the 52 editors-in-chief. There was a moderate positive correlation between the percentage of women as editors and as reviewers (Spearman correlation coefficient 0.590; p<0.0001). The percentage of women as editors, excluding editors-in-chief, was higher when the editor-in-chief was a woman than a man (53.3% vs 29.2%, respectively; p<0.0001). Likewise, the percentage of women as peer reviewers was higher in journals that had a woman as editor-in-chief in comparison with a man (32.0% vs 26.4%, respectively; p<0.0001). There was a slight increase in the percentage of women as peer reviewers from 27.3% in 2009 to 29.7% in 2017 in the BMJ.

Conclusions

Women account for less than one in three peer reviewers of medical journals. Women’s representation as peer reviewers is higher in journals with higher percentage of women as editors or with a woman as editor-in-chief. It is, thus, imperative to address the persisting gender gap at all levels of the publishing system.
Online synchronous chat counselling for young people aged 12–25: a mixed methods systematic review protocol
Authors: Tibbs Maria , O'Reilly Aileen , Dwan O'Reilly Maeve , Fitzgerald Amanda
Published: May 2022

Introduction

Youth mental health is a global issue, with 75% of many serious mental health difficulties emerging before the age of 25. An increase in the popularity of online counselling for young people’s mental health has been seen in recent years, due to their accessibility, cost-effectiveness and reduced stigmatising effects. Online synchronous chat counselling consists of real-time, text-based, one-to-one chats with a mental health professional and/or trained volunteer. Literature to date examining the effectiveness of these interventions has been limited, and little is known about their design features, their acceptance, effectiveness and the therapeutic processes that contribute to their working.

Methods and analysis

A mixed-methods systematic review of the literature will be conducted. PsycINFO MEDLINE, CINAHL, Web of Science and relevant grey literature will be searched for peer-reviewed, English language studies between January 1995 and June 2021. Backward and forward reference checking will be conducted. Quality of included articles will be examined using the Mixed Methods Appraisal Tool and a combination of the TIDieR checklist and a prepopulated data table will be used for extraction. A mixed methods review adopting a convergent-integrated design will be employed. Quantitative data will be transformed and analysed simultaneously alongside qualitative data using narrative synthesis.

Ethics and dissemination

The research does not require ethical approval. Findings will be disseminated through peer-reviewed publications, academic conference presentations, academic social media and invited workshops, webinars and seminars.

PROSPERO registration number

CRD42021256016.
Protocol of a mixed-method randomised controlled pilot study evaluating a wilderness programme for adolescent and young adult cancer survivors: the WAYA study
Authors: Jong Miek C , Mulder Eric , Kristoffersen Agnete E , Stub Trine , Dahlqvist Heléne , Viitasara Eija , Lown E Anne , Schats Winnie , Jong Mats
Published: May 2022

Introduction

The majority of childhood, adolescent and young adult (AYA) cancer survivors suffer from long-term and late effects such as fatigue, psychological distress or comorbid diseases. Effective health promotion strategies are needed to support the health of this vulnerable group. This protocol provides a methodological description of a study that aims to examine the feasibility and safety of performing a randomised clinical trial (RCT) on a wilderness programme that is developed to support the health of AYA cancer survivors.

Methods and analysis

The pilot RCT study has a mixed-method design, including quantitative and qualitative evaluations. Participants are AYAs, aged 16–39 years, that have been diagnosed with cancer during childhood, adolescence or young adulthood. A total of 40 participants will be randomly assigned to a wilderness programme (n=20) or a holiday programme (n=20). Both arms include participation in an 8-day summer programme, followed by a 4-day programme 3 months later. Primary outcomes are feasibility and safety parameters such as time to recruitment, willingness to be randomised, programme adherence and adverse effects. Secondary outcomes include self-reported health such as self-esteem, quality of life, self-efficacy and lived experiences. Descriptive statistics will be used to analyse outcomes and explore indications of differences between the programmes. Interviews are analysed by directed content analysis and hermeneutic phenomenology. A convergent parallel mixed-method analysis design will be applied to integrate quantitative and qualitative data. Results of this feasibility study will inform the preparation for a larger RCT with AYA cancer survivors.

Ethics and dissemination

The study protocol is approved by the Swedish Ethical Review Authority (reference: 2020-00239). This study will be performed between January 2021 and December 2023. Results will be published in international peer-reviewed journals, presented at conferences and disseminated to participants, cancer societies, healthcare professionals and outdoor instructors.

Trial registration number

NCT04761042.
Study protocol for CELLAR (COVID-related Eating Limitations and Latent dietary effects in the Atlantic Region): population-based observational study to monitor dietary intakes and purchasing during COVID-19 in four Atlantic Canadian provinces
Authors: Mah Catherine L , Foster Karen , Jago Emily , Hajizadeh Mohammad , Luongo Gabriella , Taylor Nathan , Fuller Daniel , Yi Yanqing , Esan Olukorede T , Lukic Ryan , Clarke Maria , Wranik Wiesława Dominika , Brimblecombe Julie Kay , Peeters Anna
Published: May 2022

Introduction

Poor diet is a leading preventable risk for the global burden of non-communicable disease. Robust measurement is needed to determine the effect of COVID-19 on dietary intakes and consumer purchasing, given the widespread changes to consumer food environments and economic precarity. The research objectives are as follows: (1) describe dietary intakes of foods, beverages and nutrients of concern during the COVID-19 pandemic; (2) quantify change in diet during COVID-19 as compared with prepandemic, previously captured in the provincial samples of the population-representative 2015 Canadian Community Health Survey-Nutrition and (3) examine how household purchasing practices predict dietary intakes during COVID-19.

Methods and analyses

Observational study of diet, using a population-based stratified probability sampling strategy allocated via dual-frame (landline and cellphone) calls to random-digit dialled numbers, followed by age-sex group quotas. The base population comprises the four provinces of the Atlantic region of Canada, jurisdictions with an excess burden of pre-existing dietary risk, compared with the rest of Canada. Our aim is n=1000 to obtain reliable estimates at a regional level to describe intakes and compare with prepandemic baseline. Data collection entails 12 weeks participation: (1) enrolment with sociodemographics (key dietary risk predictors such as age, sex, gender, pre-COVID-19 income, employment, household composition, receipt of economic relief, rural residence); (2) two 24hour diet recalls using the online ASA-24 Canada 2018 tool; and (3) online uploads of household food purchase receipts over the 12 weeks enrolled. Participation incentives will be offered.

Ethics and dissemination

This research protocol received funding from the Canadian Institutes of Health Research (FRN VR5 172691) and ethics review approval from the Dalhousie University Research Ethics Board. Study protocol and instruments and a de-identified dataset will be made publicly available. We will submit the findings to peer-reviewed journals, as well as conferences geared towards scientific and decision-maker audiences.
Rationale and design of the CORE (COrticosteroids REvised) study: protocol
Authors: Stam Suzanne P , Vulto Annet , Vos Michel J , Kerstens Michiel N , Rutgers Abraham , Kema Ido , Touw Daan J , Bakker Stephan JL , van Beek André P
Published: May 2022

Introduction

Corticosteroids are an important pillar in many anti-inflammatory and immunosuppressive treatment regimens and are available in natural and synthetic forms, which are considered equipotent if clinical bioequivalence data are used. Current clinical bioequivalence data are however based on animal studies or studies with subjective endpoints. Furthermore, advancement in steroid physiology with regard to metabolism, intracellular handling and receptor activation have not yet been incorporated. Therefore, this study aims to re-examine the clinical bioequivalence and dose effects of the most widely used synthetic corticosteroids, prednisolone and dexamethasone.

Methods and analysis

In this double-blind, randomised cross-over clinical trial, 24 healthy male and female volunteers aged 18–75 years, will be included. All volunteers will randomly receive either first a daily dose of 7.5 mg prednisolone for 1 week, immediately followed by a daily dose of 30 mg prednisolone for 1 week, or first a presumed clinical bioequivalent dose of 1.125 mg dexamethasone per day, immediately followed by 4.5 mg of dexamethasone per day for 1 week. After a wash-out period of 4–8 weeks, the other treatment will be applied. The primary study endpoint is the difference in free cortisol excretion in 24 hours urine. Secondary endpoints will include differences in immunological parameters, blood pressure and metabolic measurements.

Ethics and dissemination

This study has been approved by the Medical Ethics Committee of the University Medical Center Groningen (METC 2020.398). The results of this study will be submitted for publication in peer-reviewed journals.

Trial registration number

ClinicalTrials.gov (Identifier: NCT04733144), and in the Dutch trial registry (NL9138).
Research on microstructure and interface bonding of high volume fraction SiCp/Al composite
Authors: Zhang Zhenggui , Cai Jiaxin , Wang Quanzhao
Published: May 2022

Taking the high volume fraction SiCp/6061Al-based composite material prepared by the powder metallurgy method under different sintering temperatures and holding times as the research object, the microstructure and interface actions are investigated by X-ray diffractometer, scanning electron microscope, transmission electron microscope, etc. The results show that as the sintering temperature increases, the interface reaction between SiC and Al intensifies, producing brittle phase Al4C3 and MgAl2O4 and MgO interface products. The nucleation and growth of Al4C3 are controlled by the sintering temperature and time. When preparing large-size workpieces with high volume fraction SiCp/6061Al-based composite materials, the sintering temperature should be controlled below [Formula: see text]C, and the holding time should not exceed 24 h.
Triple-band terahertz metamaterial absorber using the nesting structure of two pairs of splitting arcs
Authors: Zhang Sijian , Lai Shengxiong , Lu Liming , Yang Zhuchuang , Wang Kun , Feng Sen , Wu Yangkuan , Zhu Huaxin , Wang Ben-Xin
Published: May 2022

This paper presents the design of triple-band terahertz metamaterial absorber, whose surface structure is a nested-type metallic pattern composed of two pairs of splitting arcs, of which the inner two splitting arcs have the same but smaller size, while the outer two possess the same but larger dimension. The surface patterned structure can strongly interact with the incident terahertz beam, resulting in three narrow-band and discrete resonance peaks having higher than 94% absorption rates. Near-field patterns of the three absorption peaks are discussed to insight into the physical mechanism of these peaks, it is revealed that the first two absorption peaks result from the dipole resonance of the inner two splitting arcs and outer pair of splitting arcs, respectively, while the last absorption peak is caused by surface propagation resonance of the surface patterned resonator. The effect of structure parameters, including the sizes of splitting arcs and the spacing between two pairs of splitting arcs, on the absorption properties, is further analyzed. The absorber suggested here could provide guidance for the design of multiple-band metamaterial absorbers, and could find great application prospects in terahertz technology-related areas.
Evolving Deep Neural Networks with Cultural Algorithms for Real-Time Industrial Applications
Authors: Waris Faisal , Reynolds Robert G. , Lee Joonho
Published: May 2022

The goal of this paper is to investigate the applicability of evolutionary algorithms to the design of real-time industrial controllers. Present-day “deep learning” (DL) is firmly established as a useful tool for addressing many practical problems. This has spurred the development of neural architecture search (NAS) methods in order to automate the model search activity. CATNeuro is a NAS algorithm based on the graph evolution concept devised by Neuroevolution of Augmenting Topologies (NEAT) but propelled by cultural algorithm (CA) as the evolutionary driver. The CA is a network-based, stochastic optimization framework inspired by problem solving in human cultures. Knowledge distribution (KD) across the network of graph models is a key to problem solving success in CAT systems. Two alternative mechanisms for KD across the network are employed. One supports cooperation (CATNeuro) in the network and the other competition (WM). To test the viability of each configuration prior to use in the industrial setting, they were applied to the design of a real-time controller for a two-dimensional fighting game. While both were able to beat the AI program that came with the fighting game, the cooperative method performed statistically better. As a result, it was used to track the motion of a trailer (in lateral and vertical directions) using a camera mounted on the tractor vehicle towing the trailer. In this second real-time application (trailer motion), the CATNeuro configuration was compared to the original NEAT (elitist) method of evolution. CATNeuro is found to perform statistically better than NEAT in many aspects of the design including model training loss, model parameter size, and overall model structure consistency. In both scenarios, the performance improvements were attributed to the increased model diversity due to the interaction of CA knowledge sources both cooperatively and competitively.
Efficient Federated Matrix Factorization Against Inference Attacks
Authors: Chai Di , Wang Leye , Chen Kai , Yang Qiang
Published: May 2022

Recommender systems typically require the revelation of users’ ratings to the recommender server, which will subsequently use these ratings to provide personalized services. However, such revelations make users vulnerable to a broader set of inference attacks, allowing the recommender server to learn users’ private attributes, e.g., age and gender. Therefore, in this paper, we propose an efficient federated matrix factorization method that protects users against inference attacks. The key idea is that we obfuscate one user’s rating to another such that the private attribute leakage is minimized under the given distortion budget, which bounds the recommending loss and overhead of system efficiency. During the obfuscation, we apply differential privacy to control the information leakage between the users. We also adopt homomorphic encryption to protect the intermediate results during training. Our framework is implemented and tested on real-world datasets. The result shows that our method can reduce up to 16.7% of inference attack accuracy compared to using no privacy protections.
FHIR: Reducing Friction in the Exchange of Healthcare Data
Authors: Agnew James , Helland Pat , Cole Adam
Published: May 2022

With the full clout of the Centers for Medicare and Medicaid Services currently being brought to bear on healthcare providers to meet high standards for patient data interoperability and accessibility, it would be easy to assume the only reason this goal wasn't accomplished long ago is simply a lack of will. Interoperable data? How hard can that be? Much harder than you think, it turns out. To dig into why this is the case, we asked Pat Helland, a principal architect at Salesforce, to speak with James Agnew (CTO) and Adam Cole (senior solutions architect) of Smile CDR, a Toronto, Ontario-based provider of a leading platform used by healthcare organizations to achieve FHIR (Fast Healthcare Interoperability Resources) compliance. They discuss the efforts and misadventures witnessed along the way to a time where it no longer seems inconceivable for healthcare providers to exchange patient records.
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Authors: Golmaryami Marjan , Taheri Rahim , Pooranian Zahra , Shojafar Mohammad , Xiao Pei
Published: May 2022

In recent years, malware detection has become an active research topic in the area of Internet of Things (IoT) security. The principle is to exploit knowledge from large quantities of continuously generated malware. Existing algorithms practise available malware features for IoT devices and lack real-time prediction behaviours. More research is thus required on malware detection to cope with real-time misclassification of the input IoT data. Motivated by this, in this article, we propose an adversarial self-supervised architecture for detecting malware in IoT networks, SETTI, considering samples of IoT network traffic that may not be labeled. In the SETTI architecture, we design
three
self-supervised attack techniques, namely,
Self-MDS
,
GSelf-MDS,
and
ASelf-MDS
. The Self-MDS method considers the IoT input data and the adversarial sample generation in real-time. The GSelf-MDS builds a generative adversarial network model to generate adversarial samples in the self-supervised structure. Finally, ASelf-MDS utilises
three
well-known perturbation sample techniques to develop adversarial malware and inject it over the self-supervised architecture. Also, we apply a defence method to mitigate these attacks, namely,
adversarial self-supervised training,
to protect the malware detection architecture against injecting the malicious samples. To validate the attack and defence algorithms, we conduct experiments on two recent IoT datasets: IoT23 and NBIoT. Comparison of the results shows that in the IoT23 dataset, the Self-MDS method has the most damaging consequences from the attacker’s point of view by reducing the accuracy rate from 98% to 74%. In the NBIoT dataset, the ASelf-MDS method is the most devastating algorithm that can plunge the accuracy rate from 98% to 77%.
Electrochemical Redox Behaviors of Sulfur Mustard at Different Platinum Electrodes
Authors: Yang Yulin , Sun Jie , Li Jigang , Zhou Tian , Wei Shouping
Published: May 2022

A bare platinum (Pt) plate electrode, two composite Pt electrodes of Pt/polypyrrole/glassy carbon electrode (Pt/pPy/GCE) and Pt nanoparticles/CeO2 microspheres/GCE (Pt NPs/CeO2/GCE) were prepared to investigate the electrochemical redox behaviors of sulfur mustard (HD). Cyclic voltammetry (CV) measurements revealed two irreversible oxidation peaks and an irreversible reduction peak. All three Pt electrodes had two oxidation peaks at 1.02 V (vs. saturated calomel electrode (SCE)) and 1.26 V (vs. SCE), indicating the formation of bis(2-chloroethyl) sulfoxide and bis(2-chloroethyl) sulfone on all the electrode surfaces. The reduction peak at 1.16 V (vs. SCE) attributed to the cleaving of HD was observed on both Pt/pPy/GCE and Pt NPs/CeO2/GCE, but not on the bare Pt-plate electrode, which revealed that Pt/pPy and Pt NPs/CeO2 materials were more conducive for catalyzing degradation of HD. Fourier transform infrared (FT-IR) and high performance liquid chromatography-mass spectrometry (HPLC-MS) measurements were taken, which further supported the presence of sulfoxide, sulfone, hydroxyl structure, and 2,2′-sulfonyldi[ethanol]. Furthermore, this work proposes the integral redox process of HD on Pt NPs/CeO2.
Differential effects of acute versus chronic dietary fructose consumption on metabolic responses in FVB/N mice
Authors: Strober Jordan W. , Fernandez Sully , Ye Honggang , Brady Matthew J.
Published: May 2022

Increased human consumption of high-fructose corn syrup has been linked to the marked increase in obesity and metabolic syndrome. Previous studies on the rapid effects of a high-fructose diet in mice have largely been confined to the C57BL/6 strains. In the current study, the FVB/N strain of mice that are resistant to diet-induced weight gain were used and fed a control or high-fructose diet for 48 h or for 12 wk. Many of the previously reported changes that occurred upon high-fructose feeding for 48 h in C57BL/6 mice were recapitulated in the FVB/N mice. However, the acute increases in fructolytic and lipogenic gene expression were completely lost during the 12-wk dietary intervention protocol. Furthermore, there was no significant weight gain in FVB/N mice fed a high-fructose diet for 12 wk, despite an overall increase in caloric consumption and an increase in average epididymal adipocyte cell size. These findings may be in part explained by a commensurate increase in energy expenditure and in carbohydrate utilization in high-fructose-fed animals. Overall, these findings demonstrate that FVB/N mice are a suitable model for the study of the effects of dietary intervention on metabolic and molecular parameters. Furthermore, the rapid changes in hepatic gene expression that have been widely reported were not sustained over a longer time course. Compensatory changes in energy expenditure and utilization may be in part responsible for the differences obtained between acute and chronic high-fructose feeding protocols.
Faster early rate of force development in warmer muscle: an in vivo exploration of fascicle dynamics and muscle-tendon mechanical properties
Authors: Mornas Adèle , Racinais Sébastien , Brocherie Franck , Alhammoud Marine , Hager Robin , Desmedt Yanis , Guilhem Gaël
Published: May 2022

Although heat exposure has been shown to increase the skeletal rate of force development (RFD), the underlying processes remain unknown. This study investigated the effect of heat on gastrocnemius medialis (GM) muscle-tendon properties and interactions. Sixteen subjects performed electrically evoked and voluntary contractions combined with ultrafast ultrasound under thermoneutral [control (CON): 25.8 ± 1.8°C, core temperature 37.0 ± 0.3°C, muscle temperature 34.0 ± 1.1°C] and passive heat exposure [hot (HOT): 47.4 ± 1.8°C, core temperature 38.4 ± 0.3°C, muscle temperature 37.0 ± 0.8°C] conditions. Maximal voluntary force changes did not reach statistical significance (−5.0 ± 11.3%, P = 0.052) whereas voluntary activation significantly decreased (−4.6 ± 8.7%, P = 0.038) in HOT. Heat exposure significantly increased voluntary RFD before 100 ms from contraction onset (+48.2 ± 62.7%; P = 0.013), without further changes after 100 ms. GM fascicle dynamics during electrically evoked and voluntary contractions remained unchanged between conditions. Joint velocity at a given force was higher in HOT (+7.1 ± 6.6%; P = 0.004) but the fascicle force-velocity relationship remained unchanged. Passive muscle stiffness and active tendon stiffness were lower in HOT than CON ( P ≤ 0.030). This study showed that heat-induced increases in early voluntary RFD may not be attributed to changes in contractile properties. Late voluntary RFD was unaltered, possibly due to decreased soft tissues’ stiffness in heat. Further investigations are required to explore the influence of neural drive and motor unit recruitment in the enhancement of explosive strength elicited by heat exposure.
Construction of a New 3D Cu(II) Compound with Photocatalytic Activity and Therapeutic Effect on Ventriculitis
Authors: Chen Xingzhao , Mao Qing
Published: May 2022

A new Cu(II) compound, that is {[Cu(L)(ClO4)(H2O)(CH3CN)](ClO4)}n (1, L is 4-(furan-2-yl)-2,6-bis(pyridin-2-yl)pyridine), was solvothermally synthesized and structurally characterized. It features a 0D isolated unit, and these 0D isolated units are further hydrogen-bonded into a 3D supramolecular framework. The framework of 1 can be stable up to 284°C, and the optical band gap of 1 is 3.71 eV. Under the irradiation of ultraviolet light, complex 1 as a photocatalyst exhibits high activity for methylene blue (MB) degradation in the water solution. The above compound’s inhibitory activity on the inflammatory cytokines releasing was tested through exploiting ELISA detection. The real time RT-PCR was conducted to assess the compound’s suppression on the expression of bacterial survival gene.
Potential of a Nonperennial Tributary Integrated with Solar Energy for Rural Electrification: A Case Study of Ikukwa Village in Tanzania
Authors: Mwakitalima Isaka J , Rizwan Mohammad , Kumar Narendra
Published: May 2022

This study evaluates the hydropower potential in the design of a micro-hydro/solar photovoltaic hybrid system with battery energy storage for increasing the access to electricity in Ikukwa Village in Mbeya Region of Tanzania. Usually, hybridized hydropower schemes are designed from perennial streams for the provision of electricity. This study incorporates the run-of-the river (COE) power scheme, which originates from the untapped potential of nonperennial hydro-energy source and the use of traditional approach of data measurements for Ikata tributary to design hybrid system. The system is optimized by the minimization of the total net present cost (NPC) and cost of energy (COE) using the soft computing method of Hybrid Optimization of Multiple Energy Resources (HOMER) software and artificial intelligent (AI) techniques. AI optimization techniques such as particle swarm optimization (PSO), grey wolf optimization (GWO), and GWO-PSO hybrid (GWO-PSOHD) algorithms have been employed for further optimal results. The data for solar radiation and the tributary have been obtained from the National Aeronautics and Space Administration (NASA) and traditional methods of measurements, respectively. The estimated maximum water flow rate and head are 2.943 m3/s and 13 m, respectively. In the same period, the approximated theoretical power potential of the tributary is found to be 375 kW. Total NPCs obtained from HOMER, PSO, GWO, and GWO-PSOHD methods are $ 141, 397.76, $ 95 167.21, $ 92 472.82, and $ 91,854.10, respectively. Similarly, the optimal results of COE from HOMER, PSO, GWO, and GWO-PSOHD approaches are $ 0.1818/kWh, $ 0.1185/kWh, $ 0.1182/kWh, and $ 0.1181/kWh, respectively. Comparatively, PSO implementation has indicated the greatest energy cost, while the cost acquired by GWO-PSOHD is the lowest for all aforementioned AI optimization techniques. The tributary under study has a high potential of diversification of energy sources for rural electrification in the area of study and other parts of the world with comparable conditions.