bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of combination treatment of double plasma molecular adsorption system and low volume plasma exchange for patients with hepatitis B virus related acute-on-chronic liver failure: a multicentre randomised controlled clinical trial
Authors: Xu Wenxiong , Li Yangmei , Wang Lu , Gao Hongbo , Chen Jinjun , Yuan Jing , Ouyang Yi , Gao Yufeng , Li Jianguo , Li Xuejun , Peng Liang
Published: December 2021

Introduction

Hepatitis B virus (HBV) related acute-on-chronic liver failure (ACLF) is still a common type of liver failure in China. Therefore, we conduct this multicentre, non-blinded, randomised controlled clinical trial to investigate the efficacy and safety of combination treatment of double plasma molecular adsorption system (DPMAS) and low volume plasma exchange (PE) for patients with HBV related ACLF.

Methods and analysis

A total of 200 patients with HBV related ACLF in the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou Eighth People’s Hospital, Nanfang Hospital of Southern Medical University, The Third People’s Hospital of Shenzhen, Xiangya Hospital of Central South University and The First Affiliated Hospital of Anhui Medical University, will be recruited into this trial. Eligible patients will undergo randomisation at a 1:1 ratio to two arms: the control group and the trial group. Patients in control group will receive comprehensive internal medical treatment. Patients in trial group will receive treatment of DPMAS and sequential low volume PE for three times, and comprehensive internal medical treatment. Clinical safety will be assessed by the analysis of adverse events (AEs) and laboratory tests. The primary efficacy outcome will be the incidence of unfavored events including death, liver transplantation and treatment abandonment. The secondary efficacy outcome will be the model for end-stage liver disease score variation. All evaluations will be performed at baseline, and 4, 8, 12, 24, 36, 48 weeks after enrolment. All AEs will be reported as soon as they are noted during the entire study procedure.

Ethics and dissemination

This study was approved by Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University (approval no. (2020)02-173-01). The results and conclusions of this clinical trial will be published at academic conferences or in journals.

Trial registration number

NCT04597164.
Randomised controlled trial to investigate optimal antithrombotic therapy in patients with non-valvular atrial fibrillation undergoing percutaneous coronary intervention: a study protocol of the OPTIMA-AF trial
Authors: Sotomi Yohei , Kozuma Ken , Kashiwabara Kosuke , Higuchi Yoshiharu , Ando Kenji , Morino Yoshihiro , Ako Junya , Tanabe Kengo , Muramatsu Takashi , Nakazawa Gaku , Hikoso Shungo , Sakata Yasushi
Published: December 2021

Introduction

The optimal antithrombotic strategy for patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) is uncertain. For patients with non-AF, many trials are now evaluating short 1-month dual antiplatelet therapy. In patients with AF undergoing PCI, in contrast, short dual therapy (P2Y12 inhibitor +direct oral anticoagulant (DOAC)) has not yet been evaluated.

Methods and analysis

The OPTIMA-AF trial (OPTIMAl antiplatelet therapy in combination with direct oral anticoagulants in patients with non-valvular Atrial Fibrillation undergoing percutaneous coronary intervention with everolimus-eluting stent) is an investigator-initiated, open-label, nationwide, multicentre, prospective, randomised controlled trial. The primary objective is to compare the efficacy and safety of short dual therapy (1-month DOAC +P2Y12 inhibitor followed by DOAC monotherapy) against long dual therapy (12-month DOAC +P2Y12 inhibitor followed by DOAC monotherapy) in the treatment of AF subjects undergoing PCI. The primary efficacy endpoint is a composite of death or thromboembolic events (myocardial infarction, definite stent thrombosis, stroke or systemic embolism) at 365 days; and the primary safety endpoint is bleeding (International Society on Thrombosis and Haemostasis major or clinically relevant non-major bleeding) at 365 days. This trial is intended to show the non-inferiority of short dual therapy versus long dual therapy in terms of the primary efficacy endpoint and show superiority in terms of the primary safety endpoint. A total of 1090 subjects will be randomised in a 1:1 ratio at approximately 60 sites.

Ethics and dissemination

This study received approval from the Certified Review Board of Osaka University (a certified research ethics committee by the Japanese Clinical Research Act). The findings will be disseminated through peer-reviewed publications and conference presentations.

Trial registration number

Japan Registry of Clinical Trials: jRCTs051190053; Pre-results.
Construct validity of a clinically correlated knee osteoarthritis ultrasonographic scale: a cross-sectional observational study
Authors: Mortada Mohamed , Dawa Ghada A , Amer Youmna A
Published: December 2021

Objectives

To assess the validity of a novel ultrasonographic scale for knee osteoarthritis (KOA) and its relation with the degree of pain and clinical features.

Design

A cross-sectional observational study including 245 patients with knee pain who fulfilled the American College of Rheumatology criteria for KOA. All patients were subjected to clinical assessment Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) scale, global visual analogue scale (VAS) and functional assessment through the use of Health Assessment Questionnaire-II (HAQ-II). Ultrasonographic assessment was conducted following ZAGAZIG scale comprising five domains: one for degenerative features (one-third of total score) and the other four for inflammatory features (two-thirds of score).

Results

There were positive correlations between ZAGAZIG score and all WOMAC subscales (pain, stiffness and function) (r=0.71, p=0.00; r=0.62, p=0.00; r=0.70, p=0.00, respectively).

Moreover, there was a strong positive correlation between ZAGAZIG scale and both VAS and HAQ-II (r=0.82, p=0.00 and r=0.67, p=0.00). At cut-off point of >5, total US score distinguishes between patients with KOA with no or mild pain and those with moderate pain (87.2 sensitivity and 87.2 specificity). At cut-off point of 7, total score of ZAGAZIG scale distinguishes between patients with KOA with moderate pain and those with severe pain (94.5 sensitivity and 42.5 specificity).

Conclusion

ZAGAZIG scale constitutes a validated tool for KOA assessment. ZAGAZIG scale correlated with WOMAC subscales (pain, stiffness and function), VAS and HAQ.
Effect of repetitive transcranial magnetic stimulation on patients with severe depression: a study protocol for systematic review and meta-analysis of randomised clinical trials
Authors: Han Fang , Tao Shuai , Liang Shanshan , Li Danyang , Me Yutong , Fan Hongyu , Wu Hao , Zhang Gaofeng
Published: December 2021

Introduction

Depression is characterised by easy recurrence, high disability and high burden, and antidepressant therapy is the standard treatment. However, its treatment effect on patients with severe depressive disorder has been unsatisfactory. Previous studies have shown that repetitive transcranial magnetic stimulation (rTMS), as a neurotherapy, can effectively mitigate the severity of depressive symptoms. Yet, more evidence is still required for TMS to treat severe depression. This study will be the first systematic review of the efficacy and tolerability of TMS for treating severe depression. We expect it to guide future clinical practice of TMS for the treatment of psychiatric disorders.

Methods and analysis

We will search for the randomised controlled trial (RCT) involving rTMS for treating depression in eight electronic databases, including PubMed, Web of Science, EMBASE, the Cochrane Library and Wanfang Database, from publication up to September 2021. We will define Improvement in depressive symptoms, the difference between pretreatment (baseline) and post-treatment as the primary outcomes. The difference between pretreatment and post-treatment changes in resting state fMRI will be regarded as the secondary outcomes. Quality assessment of the included articles will be independently performed according to the Cochrane Risk of Bias tool.

Ethics and dissemination

Ethical approval is not essential because there is no need to collect individual patient data. And this study will be published in a peer-reviewed journal.

Trial registration number

CRD42020211460.
Lockdown and non-COVID-19 deaths: cause-specific mortality during the first wave of the 2020 pandemic in Norway: a population-based register study
Authors: Raknes Guttorm , Strøm Marianne Sørlie , Sulo Gerhard , Øverland Simon , Roelants Mathieu , Juliusson Petur Benedikt
Published: December 2021

Objective

To explore the potential impact of the first wave of COVID-19 pandemic on all cause and cause-specific mortality in Norway.

Design

Population-based register study.

Setting

The Norwegian cause of Death Registry and the National Population Register of Norway.

Participants

All recorded deaths in Norway from March to May from 2010 to 2020.

Main outcome measures

Rate (per 100 000) of all-cause mortality and causes of death in the European Shortlist for Causes of Death from March to May 2020. The rates were age standardised and adjusted to a 100% register coverage and compared with a 95% prediction interval (PI) from linear regression based on corresponding rates for 2010–2019.

Results

113 710 deaths were included, of which 10 226 were from 2020. We did not observe any deviation from predicted total mortality. There were fewer than predicted deaths from chronic lower respiratory diseases excluding asthma (11.4, 95% PI 11.8 to 15.2) and from other non-ischaemic, non-rheumatic heart diseases (13.9, 95% PI 14.5 to 20.2). The death rates were higher than predicted for Alzheimer’s disease (7.3, 95% PI 5.5 to 7.3) and diabetes mellitus (4.1, 95% PI 2.1 to 3.4).

Conclusions

There was no significant difference in the frequency of the major causes of death in the first wave of the 2020 COVID-19 pandemic in Norway compared with corresponding periods 2010–2019. There was an increase in diabetes mellitus and Alzheimer’s deaths. Reduced mortality due to some heart and lung conditions may be linked to infection control measures.
Protocol for thiamine and folic acid in the treatment of cognitive impairment in maintenance haemodialysis patients: a prospective, randomised, placebo-controlled, double-blind, multicentre study
Authors: Lu Renhua , Gu Le-Yi , Zhang Weiming , Guo Yongping , Zang Xiujuan , Zhou Yan , Yu Ling , Pan Shuting , Pang Huihua , Liu Shang , Xie Kewei , Li Ping , Zeng Xiaojun , Lu Yifei
Published: December 2021

Introduction

Cognitive impairment (CI) is the common complications in maintenance haemodialysis (MHD) patients. Recently, the pathogenesis of CI has been discussed and oxidative stress is one of the main mechanisms in these patients. Thiamine and folic acid, which play an important role in relieving the production of reactive oxygen species, reducing homocysteine levels, improving oxidative stress in the nervous system. In pilot study, cognitive function was significantly improved in the group with thiamine and folic supplementation. Based on this result, we hypothesise that thiamine combined with folic acid supplementation may improve cognitive function in patients with MHD.

Methods and analysis

In this prospective, randomised, placebo-controlled, double-blind, multicentre study, we will enrol patients undergoing haemodialysis who has the Montreal Cognitive Assessment score lower than 26 to treatment group (thiamine 90 mg/day combined with folic acid 30 mg/day) or control group (thiamine placebo 90 mg/day combined with folic acid placebo 30 mg/day). All subjects will be followed up for 96 weeks. The primary endpoint is the comparison of Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) score between treatment group and control group at 96 weeks of follow-up. The secondary endpoints include serum thiamine, folate, homocysteine levels, cranial functional MRI and survival. The central randomisation method will be adopted and the principles of placebo-controlled, double-blind randomised control will be followed. The comparisons among ADAS-Cog scores and other secondary endpoints over time within subjects is conducted by using repeated measure analysis of variance (ANOVA) or generalised estimating equations (GEE). Pairwise t-test with Bonferroni adjustment is performed for multiple comparisons. On the other hand, for comparisons between treatment and control group, simple one-way ANOVA, GEE or Wilcoxon rank sum test is used. The χ2method is used for statistical analysis of the categorical data. Kaplan-Meier survival curve is used for survival analysis. A p<0.05 is considered statistically significant difference.

Ethics and dissemination

This trial has been approved by Shanghai Jiao Tong University School of Medicine, Renji Hospital Ethics Committee (KY2019-199). After publication of study results, trial report will be published in peer-reviewed journals and/or in national or international conferences.

Trial registration number

ChiCTR2000029297.
Realist evaluation of Autism ServiCe Delivery (RE-ASCeD): which diagnostic pathways work best, for whom and in what context? Findings from a rapid realist review
Authors: Abrahamson Vanessa , Zhang Wenjing , Wilson Patricia M , Farr William , Reddy Venkat , Parr Jeremy , Peckham Anna , Male Ian
Published: December 2021

Objectives

Waiting times in the UK for an autism diagnostic assessment have increased rapidly in the last 5 years. This review explored research (including ‘grey’ literature) to uncover the current evidence base about autism diagnostic pathways and what works best, for whom and in what circumstances, to deliver high quality and timely diagnosis.

Design

We performed a Rapid Realist Review consistent with recognised standards for realist syntheses. We collected 129 grey literature and policy/guidelines and 220 articles from seven databases (January 2011–December 2019). We developed programme theories of how, why and in what contexts an intervention worked, based on cross comparison and synthesis of evidence. The focus was on identifying factors that contributed to a clearly defined intervention (the diagnostic pathway), associated with specific outcomes (high quality and timely), within specific parameters (Autism diagnostic services in Paediatric and Child & Adolescent Mental Health services in the UK). Our Expert Stakeholder Group, including representatives from local parent forums, national advocacy groups and clinicians, was integral to the process.

Results

Based on 45 relevant articles, we identified 7 programme theories that were integral to the process of diagnostic service delivery. Four were related to the clinical pathway: initial recognition of possible autism; referral and triaging; diagnostic model; and providing feedback to parents. Three programme theories were pertinent to all stages of the referral and diagnostic process: working in partnership with families; interagency working; and training, service evaluation and development.

Conclusions

This theory informed review of childhood autism diagnostic pathways identified important aspects that may contribute to efficient, high quality and family-friendly service delivery. The programme theories will be further tested through a national survey of current practice and in-depth longitudinal case studies of exemplar services.

Trial registration number

NCT04422483.
Physician’s use of sickness certification guidelines: a nationwide survey of 13 750 physicians in different types of clinics in Sweden
Authors: Svärd Veronica , Alexanderson Kristina
Published: December 2021

Objectives

To explore physicians’ experiences of using the national sickness certification guidelines introduced in 2007 and the types of information they used, in general and in different types of clinics.

Design

Cross-sectional survey.

Setting

Most physicians working in Sweden in 2017.

Participants

A questionnaire was sent to 34 718 physicians; 54% responded. Analyses were based on answers from the 13 750 physicians who had sick leave cases.

Outcome measures

To what extent the guidelines were used and what type of information from them that was used.

Results

Ten years after the sickness certification guidelines were introduced in Sweden, half of the physicians used them at least once a month. About 40% of physicians in primary healthcare and occupational health services used the guidelines every week. The type of information used varied; 53% used recommendations about duration and 29% about degree of sick leave. Using information about function and activity/work capacity, respectively, was more common within primary healthcare (37% and 38%), psychiatry (42% and 42%), and occupational health services (35% and 41%), and less common in surgery and orthopaedic clinics (12% and 12%) who more often used information about duration (48% and 53%). Moreover, 10% stated that the guidelines were very, and 24% fairly problematic to apply. Half (47%) stated that the guidelines facilitated their contacts with patients and 29% that they improved quality in their management of sick leave cases. More non-specialists, compared with specialists, found that the guidelines facilitated contacts with patients (OR 3.28, 95% CI 3.04 to 3.55).

Conclusions

The majority of the physicians used the sickness certification guidelines, although this varied with type of clinic. Half stated that the guidelines facilitated patient contacts. Yet, some found it problematic to apply the guidelines. Further development of the guidelines is warranted as well as more knowledge about them among physicians.
Illness prevalence and symptoms in youth floorball players: a one-season prospective cohort study involving 471 players
Authors: Perera Nirmala Kanthi Panagodage , Waldén Markus , Lindblom Hanna , Åkerlund Ida , Sonesson Sofi , Hägglund Martin
Published: December 2021

Objective

To describe weekly illness prevalence and illness symptoms by sex in youth floorball players during one season.

Design

Prospective cohort study.

Setting

Players who were registered to play community level floorball during the 2017–2018 season (26 weeks) in two provinces in southern Sweden.

Participants

471 youth players aged 12–17 years. Mean (SD) age for 329 male players 13.3 (1.0) years and 142 female players 13.7 (1.5) years.

Primary and secondary outcome measures

Weekly self-reported illness prevalence and illness symptoms according to the 2020 International Olympic Committee’s consensus recommendations.

Results

61% of youth floorball players reported at least one illness week during the season, with an average weekly illness prevalence of 12% (95% CI 10.8% to 12.3%). The prevalence was slightly higher among females (13%, 95% CI 11.6% to 14.3%) than males (11%, 95% CI 9.9% to 11.7%), prevalence rate ratio 1.20 (95% CI 1.05 to 1.37, p=0.009). In total, 49% (53% male, 43% female) of illness reports indicated that the player could not participate in floorball (time loss), with a mean (SD) absence of 2.0 (1.7) days per illness week. Fever (30%), sore throat (16%) and cough (14%) were the most common symptoms. Female players more often reported difficulty in breathing/tight airways and fainting, and male players more often reported coughing, feeling tired/feverish and headache. Illness prevalence was highest in the peak winter months (late January/February) reaching 15%–18% during this period.

Conclusions

Our novel findings of the illness prevalence and symptoms in youth floorball may help direct prevention strategies. Athletes, coaches, parents and support personnel need to be educated about risk mitigation strategies.

Trial registration number

NCT03309904.
Women’s conceptual knowledge about breast cancer screening and overdiagnosis in Norway: a cross-sectional study
Authors: Tsuruda Kaitlyn M , Veierød Marit B , Houssami Nehmat , Waade Gunvor G , Mangerud Gunhild , Hofvind Solveig
Published: December 2021

Objective

To investigate conceptual knowledge about mammographic screening among Norwegian women.

Design

We administered a cross-sectional, web-based survey. We used multiple-choice questions and a grading rubric published by a research group from Australia.

Setting

Our Norwegian-language survey was open from April to June 2020 and targeted women aged 45–74 years.

Participants

2033 women completed our questionnaire. We excluded 13 women outside the target age range and 128 women with incomplete data. Responses from 1892 women were included in the final study sample.

Primary and secondary outcome measures

The questionnaire focused on women’s knowledge about the breast cancer mortality reduction, false positive results and overdiagnosis associated with mammographic screening. The primary outcome was the mean number of marks assigned in each of the three themes and overall. There were three potential marks for questions about breast cancer mortality, one for false positives and six for overdiagnosis.

Results

Most women (91.7%) correctly reported that screened women are less likely to die of breast cancer than non-screened women. 39.7% of women reported having heard of a ‘false positive screening result’ and 86.2% identified the term’s definition; 51.3% of women had heard of ‘overdiagnosis’ and 14.8% identified the term’s definition. The mean score was 2.59 of 3 for questions about breast cancer mortality benefit and 0.93 of 1 for the question about false positive screening results. It was 2.23 of 6 for questions about overdiagnosis.

Conclusions

Most participants correctly answered questions about the breast cancer mortality benefit and false positive results associated with screening. The proportion of correct responses to questions about overdiagnosis was modest, indicating that conceptual knowledge about overdiagnosis was lower. Qualitative studies that can obtain in-depth information about women’s understanding of overdiagnosis may help improve Norwegian-language information about this challenging topic.
Physical comorbidity and use of healthcare services in people with schizophrenia: protocol for a systematic review
Authors: Salvador Robert Mercè , Porras-Segovia Alejandro , Peñuelas-Calvo Inmaculada , Baca-Garcia Enrique
Published: December 2021

Introduction

People with schizophrenia die about 15–20 years earlier than the general population. A constellation of factors contributes to this gap in life expectancy: side effects of psychotropic drugs, unhealthy lifestyles (inactivity, unhealthy diet) and inequality in the provision of healthcare services. This is a topic of main importance, which requires constant update and synthesis of the literature. The aim of this review is to explore the evidence of physical comorbidity and use of healthcare services in people with schizophrenia.

Methods and analysis

We will conduct a systematic literature search in the databases PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO and Cochrane Library, Proquest Health Research Premium Collection, in order to identify studies that answer to our research question: Are patients with schizophrenia different from the non-psychiatric population in terms of physical comorbidity and use of healthcare services? Two authors will independently review the studies and extract the data.

Ethics and dissemination

This study does not include human or animal subjects. Thus, ethics considerations are not applicable. Dissemination plans include publications in peer-reviewed journals and discussion of results in psychiatric congresses.

PROSPERO registration number

CRD42020139972.
Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
Authors: Brünahl Christian A , Klotz Susanne G R , Dybowski Christoph , Albrecht Rebecca , Höink Johanna , Fisch Margit , Ketels Gesche , Löwe Bernd
Published: December 2021

Objective

To explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS).

Design

Prospective non-randomised controlled pilot study.

Setting

Tertiary care facility with a specialised interdisciplinary outpatient clinic for patients with CPPS.

Participants

A total of 311 patients was approached; 60 participated. 36 patients were included in the intervention group (mean age ±SD 48.6 years±14.8; 52.8% female) and 24 in the control group (mean age ±SD 50.6 years±14.5; 58.3% female). Fourteen participants were lost to follow-up.

Interventions

Participants were non-randomly allocated to the intervention group with two consecutive treatment modules (physiotherapy and cognitive behavioural therapy) with a duration of 9 weeks each or to the control group (treatment as usual).

Main outcome measures

Feasibility was operationalised in terms of delivering and evaluating the therapeutic combination. Regarding eligibility as the first aspect of feasibility, willingness to participate, dropout and satisfaction were assessed; for the second aspect, standardised self-report questionnaires measuring health-related quality of life, depression severity and pain were applied.

Results

Although eligibility and willingness-to-participate rates were low, satisfaction of the participants in the intervention group was high and dropout rates were low. Results indicated a small and non-significant intervention effect in health-related quality of life and significant effects regarding depression severity and pain.

Conclusions

The combination of physiotherapy and psychotherapy for patients with CPPS seems to be feasible and potentially promising with regard to effect. However, a subsequent fully powered randomised controlled trial is needed.

Trial registration number

German Clinical Trials Register (DRKS00009976) and ISRCTN (ISRCTN43221600).
Content validity of Scoliosis Research Society questionnaire-22 revised (SRS-22r) for adolescents with idiopathic scoliosis: protocol for a qualitative study exploring patient’s and practitioner’s perspectives
Authors: Alamrani Samia , Gardner Adrian , Falla Deborah , Russell Emily , Rushton Alison B , Heneghan Nicola R
Published: December 2021

Introduction

Content validity is the most important measurement property for any patient-reported outcome measure (PROM). It being the extent that the PROM measures important concepts that are relevant to the population of interest. Adolescent with idiopathic scoliosis (AIS) is the most common spinal deformity in paediatric populations, with the Scoliosis Research Society questionnaire-22 revised (SRS-22r) a commonly used PROMof quality of life. In the absence of existing evidence, a content validity study for SRS-22r is needed to confirm its suitability for AIS. Thus, this study aims to investigate the content validity of SRS-22r for AIS. A secondary aim is to explore healthcare professional (HCP) perspectives of the barriers and facilitators to using outcome measures in AIS.

Methods and analysis

Qualitative study reported according to COnsolidated criteria for Reporting Qualitative Studies. A purposive sample of AIS (n=10–15, Cobb angle >25°, aged 10–18 years) will be recruited for online semi-structured interviews. A convenience sample (n=10–12) of HCP with clinical and/or research experience in AIS will be recruited for a focus group discussion. Topic guides and age-relevant documents are informed by existing evidence and developed using a framework of concept elicitation and cognitive debriefing. Audio-recordings will be transcribed verbatim, coded, analysed and synthesised using interpretive phenomenology analysis. Themes that generated from the analysis will be used as codes that will then be mapped to the SRS-22r contents.

Ethics and dissemination

The Health Research Authority and Health and Care Research Wales approval have been granted (IRAS 289888). Study findings will be disseminated through publications in peer-reviewed journals and conference presentations.
Evaluation of the prevalence of non-diabetic eye disease detected at first screen from a single region diabetic retinopathy screening program: a cross-sectional cohort study in Auckland, New Zealand
Authors: Ramachandran Nishanthan , Schmiedel Ole , Vaghefi Ehsan , Hill Sophie , Wilson Graham , Squirrell David
Published: December 2021

Objectives

To evaluate the prevalence of incidental non-diabetic ocular comorbidities detected at first screen in a large diabetic retinopathy (DR) screening programme.

Design

Cross-sectional cohort study.

Setting

Single large metropolitan diabetic eye screening programme in Auckland, New Zealand.

Participants

Twenty-two thousand seven hundred and seventy-one participants who attended screening from September 2008 to August 2018.

Results

Hypertensive retinopathy (HTR) was observed in 14.2% (3236/22 771) participants. Drusen were present in 14.0% participants under the age of 55 years, increasing to 20.5% in those 55 years and older. The prevalence of neovascular age-related macular degeneration (AMD) was 0.5% in participants aged<55 years, 2.4% in participants aged 55–75 years and 16% in participants aged>75 years. Retinal vein occlusion and retinal arterial embolus were prevalent in 0.7% and 0.02%, respectively, in participants aged<55 years, increasing to 2.2% and 0.4%, respectively, in those >75 years. Cataracts were common being present in 37.1% of participants over the age of 75 years. Only 386 individuals (1.7%) were labelled as glaucoma suspects. Geographic atrophy, epiretinal membrane, choroidal nevi and posterior capsular opacification had an increased prevalence in older individuals.

Conclusions

Our data suggest that AMD, HTR and cataracts are routinely detected during DR screening. The incorporation of the detection of these ocular comorbidities during DR screening provide opportunities for patients to modify risk factors (smoking cessation and diet for AMD, blood pressure for HTR) and allow access to cataract surgery.
PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
Authors: Vad Rune , Larsen Tobias Malte , Kildegaard Helene , Brabrand Mikkel , Lundager Forberg Jakob , Ekelund Ulf , Pottegard Anton , Lassen Annmarie Touborg
Published: December 2021

Objectives

Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED).

Design and setting

We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (>200 ms) and normal PR interval (120–200 ms).

Participants and results

We included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%).

Conclusion

PR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients.
Examining the double burden of malnutrition for preschool children and women of reproductive age in low-income and middle-income countries: a scoping review protocol
Authors: Were Jason Mulimba , Stranges Saverio , Sharma Ishor , Vargas-Gonzalez Juan Camilo , Campbell M. Karen
Published: December 2021

Introduction

The majority of the populations in low-income and middle-income countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its aetiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regard to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM.

Methods

A comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations and Thesis Global. Additionally, searches in other government and institutional sources (WHO website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full-text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Ethics and dissemination

Ethical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.
Impact of carbapenem resistance on mortality in patients infected withEnterobacteriaceae: a systematic review and meta-analysis
Authors: Zhou Ruyin , Fang Xiangming , Zhang Jinjin , Zheng Xiaodong , Shangguan Shuangyue , Chen Shibo , Shen Yingbo , Liu Zhihai , Li Juan , Zhang Rong , Shen Jianzhong , Walsh Timothy R , Wang Yang
Published: December 2021

Objectives

To provide a comprehensive assessment of the impact of carbapenem resistance on mortality among patients infected withEnterobacteriaceaeand to explore the source of heterogeneity across studies.

Design

This systematic review was conducted following the guidelines of Cochrane Guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Data sources

We conducted a systematic literature search of the PubMed, Embase, Web of Science and Cochrane Library databases to identify relevant studies published between 1 January 1994 and 30 August 2020.

Eligibility criteria

We included primary observational studies published in English that reported the mortality outcomes for hospitalised patients with confirmed infections due to carbapenem-resistantEnterobacteriaceae(CRE) and carbapenem-susceptibleEnterobacteriaceae(CSE). Studies with no comparison group or with a comparison group of patients infected with unconfirmed CSE were excluded.

Data extraction and synthesis

Data extraction and assessment of risk bias were conducted independently by two reviewers. The pooled relative risk and risk difference were calculated as effect measures with 95% CIs using a random effects model. The heterogeneity across studies was assessed by Q-statistic and I2measures.

Results

Of 10 304 studies initially identified, 50 studies were included in the meta-analyses. The results of the meta-analyses showed that carbapenem resistance has a significant positive effect on the probability of death for patients infected withEnterobacteriaceaefor any type of mortality outcome. The results of the stratified analysis and meta-regression suggested that the effect of carbapenem resistance on the risk of death varied by infection type, sample size and year of publication.

Conclusions

Our results suggested that patients with CRE infection still face a greater risk of death than patients with CSE infection do, and an urgent need to develop new antibiotics and appropriate treatments to reduce the risk of death.

PROSPERO registration number

CRD42020176808.
Association of elder abuse, crime victimhood and perceived neighbourhood safety with major depression among older adults in India: a cross-sectional study using data from the LASI baseline survey (2017–2018)
Authors: Muhammad T , Meher Trupti , Sekher T V
Published: December 2021

Objective

The study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations.

Design

A cross-sectional study was conducted using a large survey data.

Setting and participants

The study used data from the Longitudinal Ageing Study in India wave 1 (2017–2018). The effective sample size was 31 464 older adults (aged 60 years or older).

Primary and secondary outcome measures

The outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives.

Results

5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse.

Conclusions

Healthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.
Use of rating of perceived exertion during anterior cruciate ligament reconstruction and knee osteoarthritis rehabilitation: a scoping review protocol
Authors: Germano Maciel Daniel , Cerqueira Mikhail Santos , Brito Vieira Wouber Hérickson de
Published: December 2021

Introduction

Anterior cruciate ligament (ACL) tear and knee osteoarthritis (KOA) are the most prevalent musculoskeletal disorders of the knee. Rehabilitation with progressive resistance training is recommended for both disorders. Rating of perceived exertion (RPE) is widely used to prescribe, monitor, and control exercise load. However, the lack of detailed methodological description and variability in the use of RPE may hinder its validity. This scoping review summarises methodological aspects of the use of RPE in resistance exercises during ACL reconstruction and KOA rehabilitation. We also aim to identify possible methodological issues related to the use of RPE and provide recommendations for future studies.

Methods and analysis

This scoping review protocol was developed following the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews. The search will be conducted in Medline/PubMed, Embase, CINAHL, PEDro, Central and SPORTDiscus databases. The terms “anterior cruciate ligament rehabilitation”, “knee osteoarthritis” and “resistance exercise” and their synonymous will be used isolated and combined (boolean operators AND/OR/NOT). Two reviewers will independently conduct title and abstract screening and evaluate full texts of potentially eligible articles. Data related to study design, sample, intervention characteristics and RPE outcomes will be extracted, summarised and qualitatively analysed.

Ethics and dissemination

The proposed scoping review does not require ethical approval since it will synthesise information from publicly available studies. Regarding dissemination activities, results will be submitted for publication in a scientific journal and presented at conferences in the field.
Using synthetic climate datasets for geotechnical and geoenvironmental design problems
Authors: Bashir Rashid , Sahi Muhammad A.N. , Sharma Jitendra
Published: December 2021

Location-specific climate datasets are required for the design and evaluation of a number of civil engineering projects. It requires huge effort to compile a multi-year quality-controlled climate dataset. In this paper, a method of generating simulated daily climate variables of interest from readily available climate normal using the general-purpose weather generator SIMETAW is presented. The accuracy of this method is assessed by comparing the climate datasets generated using SIMETAW with the recorded historical climate datasets for nine different sites across Canada with climates ranging from semi-arid to pre-humid. This comparison was done using visual presentations as well as statistical analyses of the two datasets. It was found that the multi-year daily climate datasets generated by SIMETAW using just 12 monthly climate normal values are fairly similar to the recorded historical climate datasets. The usefulness of SIMETAW-generated climate datasets was demonstrated by using them in numerical simulations of three different design problems, namely, infiltration into soils, swelling potential of an expansive soil, and soil cover design. From the results of these numerical simulations, it is concluded that the SIMETAW-generated multi-year daily climate datasets are satisfactory for use in the geotechnical and geoenvironmental problems of the kind simulated herein.
Post-fire early successional vegetation buffers surface microclimate and increases survival of planted conifer seedlings in the southwestern United States
Authors: Crockett Joseph L. , Hurteau Matthew D.
Published: December 2021

Climate change and fire exclusion have increased the flammability of western United States forests, leading to forest cover loss when wildfires occur under severe weather conditions. Increasingly large high-severity burn patches limit natural regeneration because of dispersal distance, increasing the chance of conversion to non-forest. Post-fire planting can overcome dispersal limitations, yet warmer and drier post-fire conditions can still reduce survival. We examined how two shrub species with different structures affect below-shrub microclimate and survival rates of planted tree seedlings (Pinus ponderosa Lawson & C. Lawson, Pinus edulis Engelm., Pinus strobiformis Engelm., Pseudotsuga menziesii (Mirb.) Franco) following a high-severity fire in northern New Mexico. We expected that Gambel oak (Querus gambelii Nutt.), with its denser canopy, would buffer below-shrub climate causing higher survival rates of planted seedlings more than the lower canopy density New Mexico locust (Robinia neomexicana A. Gray). Seedlings planted under Gambel oak had survival rates 10% to 35% greater than those planted under New Mexico locust. Higher light availability beneath New Mexico locust corresponded to higher temperatures, lower humidity, and higher vapor pressure deficit, impacting the mortality of planted tree seedlings. These results indicate that by waiting for post-fire shrub establishment, selective use of shrubs can buffer microclimate and increase post-fire planting success in the southwestern United States.
Muons as a tool for background rejection in imaging atmospheric Cherenkov telescope arrays
Authors: Olivera-Nieto L. , Mitchell A. M. W. , Bernlöhr K. , Hinton J. A.
Published: December 2021

The presence of muons in air-showers initiated by cosmic ray protons and nuclei is well established as a powerful tool to separate such showers from those initiated by gamma rays. However, so far this approach has been fully exploited only for ground level particle detecting arrays. We explore the feasibility of using Cherenkov light from muons as a background rejection tool for imaging atmospheric Cherenkov telescope arrays at the highest energies. We adopt an analytical model of the Cherenkov light from individual muons to allow rapid simulation of a large number of showers in a hybrid mode. This allows us to explore the very high background rejection power regime at acceptable cost in terms of computing time. We show that for very large ($$\gtrsim 20$$

≳
20

 m mirror diameter) telescopes, efficient identification of muon light can potentially lead to background rejection levels up to 10$$^{-5}$$

-
5

whilst retaining high efficiency for gamma rays. While many challenges remain in the effective exploitation of the muon Cherenkov light in the data analysis for imaging Cherenkov telescope arrays, our study indicates that for arrays containing at least one large telescope, this is a very worthwhile endeavor.
DFT with Universal Test Set for All Missing Gate Faults in Reversible Circuits
Authors: Mondal Joyati , Kole Dipak Kumar , Rahaman Hafizur , Das Debesh Kumar , Bhattacharya Bhargab B.
Published: December 2021

The design of reversible logic circuits has received considerable attention in recent times for their potential use in implementing quantum computers. A fault model, namely, the Missing-Gate Fault (MGF) model, has been found to be more suitable for modeling defects in quantum circuits as compared to the classical fault models used for testing conventional CMOS circuits. In this paper, we propose two design-for-testability techniques with universal test set to detect MGFs in a reversible circuit. In these techniques, an [Formula: see text] reversible circuit implemented with [Formula: see text]-CNOT gates is transformed to a testable design with addition of two extra inputs lines and some additional gates, which uses a universal test set of size [Formula: see text] to detect the MGFs. The proposed DFT techniques are compared with earlier works and it has been shown that these techniques outperform the earlier techniques with respect to quantum cost overhead and percentage detection of the different MGFs.
Traversable wormhole solutions in f(R,T) gravity with three novel shape functions
Authors: Godani Nisha
Published: December 2021

Morris and Thorne [Am. J. Phys. 56 (1988) 395] developed wormhole solutions in General Relativity which requires the dissatisfaction of null energy condition at the throat. The current scenario of the universe has been explained by using the background of modified gravity and it has inspired the researchers to explore the wormhole solutions in modified versions of gravity. In this paper, the [Formula: see text] theory of gravity proposed by Harko et al. [Phys. Rev. D 84 (2011) 024020] is taken to investigate traversable wormhole solutions. These solutions have been developed in three cases. In each case, the shape function is derived, its characteristics are studied and the embedding surface is constructed. Further, in each case, the wormhole solutions are constructed and energy conditions are tested to know about the matter sustaining the wormhole geometries.