bluuebunny/crossref_metadata_2025 huggingface dataset:
Trust towards nurses who care for haemodialysis patients: a cross‐sectional study
Authors: Ahmadpour Behnaz , Ghafourifard Mansour , Ghahramanian Akram
Published: December 2019

Background

Trust is widely acknowledged as the main component of relationships between patients and nurses.

Aims

Considering the importance of building trust in the patient–nurse relationship especially in vulnerable patients such as patients undergoing haemodialysis, this study was carried out to assess the trust of these patients towards nurses in the haemodialysis unit and to explore its relationship with some characteristics of the patients.

Methods

In this cross‐sectional study, a total of 180 patients undergoing maintenance haemodialysis were selected using random sampling method. Data were collected by trust in nurses (TNS) scale. The collected data were analysed by SPSS (ver.21) software using anova, independent t‐test and Pearson’s correlation coefficient.

Results

The mean score of patients' trust in nurses was 23.82, showing a high level of trust towards nurses. The lowest score (with a mean score of 4.17) was related to the providing of accurate information by nurses about the disease. Pearson's correlation coefficient indicated a positive significant relationship between the age and patient's trust (r = 0.17, p > 0.05), and there was a negative relationship between the mean score of trust and the mean of interdialytic weight gain (r = 0.57, p > 0.05).

Conclusions

Although the patient trust towards nurses was high in this study, there were some deficiencies in certain items especially in the provision of information and education to the patients. Education of specialised courses for nurses and empowering them to provide a high quality care to the patients on dialysis could help to increase the patents' trust.
Mechanistic and methodological perspectives on the impact of intense interval training on post‐exercise metabolism
Authors: Moniz Sara C. , Islam Hashim , Hazell Tom J.
Published: December 2019

The post‐exercise recovery period is associated with an elevated metabolism known as excess post‐exercise oxygen consumption (EPOC). The relationship between exercise duration and EPOC magnitude is thought to be linear whereas the relationship between EPOC magnitude and exercise intensity is thought to be exponential. Accordingly, near‐maximal and supramaximal protocols such as high‐intensity interval training (HIIT) and sprint interval training (SIT) protocols have been hypothesized to produce greater EPOC magnitudes than submaximal moderate‐intensity continuous training (MICT). This review updates previous reviews by focusing on the impact of HIIT and SIT on EPOC. Research to date suggests small differences in EPOC post‐HIIT compared to MICT in the immediate (<1 hour) recovery period, but greater EPOC values post‐HIIT when examined over 24 hours. Conversely, differences in EPOC post‐SIT are more pronounced, as SIT tends to produce a larger EPOC vs MICT at all time points. We discuss potential mechanisms that may drive the EPOC response to interval training (eg, glycogen resynthesis, mitochondrial uncoupling, and protein turnover among others) and also consider the role of EPOC as one of the potential contributors to fat loss following HIIT/SIT interventions. Lastly, we highlight a number of methodological shortcomings related to the measurement of EPOC following HIIT and SIT.
Formation and metamorphism of sedimentary rocks beneath the Dingxi Basin: Record of the evolution from subduction to collision in the North Qilian Orogen
Authors: Wang Bin , Wang Wei‐(RZ) , Tian Zuoling , Wei Chunjing , Zhao Yue
Published: December 2019

The North Qilian Orogen (NQO) in northwest China underwent oceanic subduction and subsequent continental collision. Metasedimentary rocks from a deep borehole in the Dingxi Basin, NQO, contain garnet, biotite, plagioclase, quartz and minor cummingtonite and chlorite in the matrix, with inclusions of kyanite and staurolite in garnet. The mineral textures and compositions define clockwise pressure–temperature evolution with peak conditions of ~10.5 kbar and ~670°C, followed by isothermal decompression down to ~6.5 kbar. Age and Hf isotope data of detrital zircon support the formation of the sedimentary protolith in an arc setting at ~460 Ma, and the age and rare earth element characteristics of metamorphic monazite reflect exhumation at ~425 Ma. These results indicate a complete cycle of deposition–burial–exhumation for the sedimentary rocks, and directly constrain the continental collision process in NQO to yield a geotherm of ~21°C/km and to culminate before 425 Ma.
West Nile virus activity in United States blood donors and optimizing detection strategies: 2014‐2018
Authors: Groves Jamel A. , Foster Gregory A. , Dodd Roger Y. , Stramer Susan L.
Published: December 2019

BACKGROUND

Rare transfusion‐transmitted West Nile virus (WNV) cases usually occur due to gaps in testing involving converting to more sensitive nucleic acid testing (NAT) formats (referred to as triggering). Using data from 2014 to 2018, we investigated a strategy used to increase detection early in the triggering period and reviewed its yield as the individual donation (ID)‐NAT geographic area was decreased.

METHODS

Mini‐pool–NAT transitioned to ID‐NAT following triggering based on one WNV NAT–reactive donation (having an elevated signal, repeat reactive, or in an area with WNV ongoing activity). ID‐NAT–triggered geographic areas included an entire state (2014‐2017) or collections within a 50‐mile radius of the triggering donor's residential zip code (2018). During the MP‐ to ID‐NAT transition, donation samples were retrieved and tested by ID‐NAT for those with results not yet released (referred to as in‐process testing). Reactive sample confirmation was performed by repeat NAT of an independent sample or antibody testing.

RESULTS

ID‐NAT included 3.2 million donations of more than 25 million tested year‐round, resulting in 684 confirmed positives; all confirmed‐positive donations occurred from June to December (0.64/10,000). Overall, 52% (358/684) required ID‐NAT for detection, including 68 (19%) antibody negatives. Ten of 19 (53%) identified in‐process were ID‐NAT–only detectable, including four antibody negatives, or approximately 1 per year (2.8% of ID‐NAT–only detectable). With reduced triggering geography, 12 of 19 (63%) were not identified (including 6/10 ID‐NAT–only detectable, and 2/4 ID‐NAT–only detectable/antibody negative).

CONCLUSION

WNV NAT's utility is between June–December; however, abandoning testing outside of this time may increase risk. While in‐process testing identified approximately one ID‐NAT–only detectable (antibody‐negative) donation per year, reducing the geographic triggered area decreased its effectiveness.
Mechanical comparison of two small interlocking nails in torsion using a feline bone surrogate
Authors: Marturello Danielle M. , von Pfeil Dirsko J. F. , Déjardin Loïc M.
Published: December 2019

Objective

To compare the torsional behavior of two small angle‐stable interlocking nails (I‐Loc and Targon) with that of locking compression plates (LCP). To evaluate the effect of implant removal on the torsional strength of feline bone surrogates.

Study design

Experimental.

Sample population

Fracture gap constructs and intact explanted bone surrogates.

Methods

Fracture gap constructs were stabilized with one of six implants (I‐Loc 3 and 4, Targon 2.5 and 3.0, LCP 2.0 and 2.4) and then cyclically tested in torsion (n = 4/group). To simulate implant removal, intact surrogates with implant‐specific pilot holes were then twisted to failure (n = 4/group). Torsional compliance (TC; °/Nm), angular deformation (AD; °), and failure torque (FT; Nm) were statistically compared (P < .05).

Results

The I‐Loc 4 had the smallest TC and AD of all constructs (P < .05). The largest TC (P < .05) was seen with the LCP 2.0. The Targon 2.5 had the largest AD (P < .05) secondary to locking interface slippage. Targon surrogates FT were the lowest of all groups (P < .05). Conversely, there was no difference between the FT of the I‐Loc, LCP, and intact surrogates (P > .05).

Conclusion

We showed that I‐Loc nails provided greater torsional stability than size‐matched Targon nails and LCPs. Conversely, Targon 2.5 locking interface slippage may jeopardize that construct's stability. Furthermore, the significantly reduced bone surrogate torsional strength provided evidence that the large Targon bolt holes increased the risk of postexplantation iatrogenic fracture.

Clinical significance

Our results provide evidence to conclude that the small I‐Loc nails may be valid alternatives to other osteosynthesis options for feline fracture repair.
Zoonoses and potential zoonoses of bears
Authors: Di Salvo Andrew R. , Chomel Bruno B.
Published: December 2019

Captive and free‐ranging wild bears can carry and transmit several zoonotic pathogens. A review of nearly 90 years of scientific publications concerning confirmed and potential zoonotic diseases that can be present in any of the eight species of bears in the world was conducted. The findings were organized amongst the following disease sections: bacterial, viral, protozoal, mycotic, helminth and arthropod‐borne. The most commonly reported pathogens of concern were of parasitic (Trichinella, Toxoplasma) and bacterial (Francisella, Brucella) origin.
Analysis of Clumped-Pebble Shape on Thermal Radiation and Conduction in Nuclear Beds by Subcell Radiation Model
Authors: Wu Hao , Gui Nan , Yang Xingtuan , Tu Jiyuan , Jiang Shengyao
Published: December 2019

The core of high-temperature gas-cooled reactor is a dense pebble bed of random packing filled with monosized fuel spheres. Subcell radiation model (SCM) is a generic analytical approach to calculate effective thermal conductivity (ETC) of thermal radiation. For the packed bed of monosized spheres operated in various conditions, it is proven that the SCM is still applicable in the particle size ranges of 1.2–60 mm and temperature ranges of 0–1200 °C. Based on the SCM, radiation-to-conduction ratio ξ is presented and radiation becomes an essential part at ξ>0.1 for the accurate evaluation. For the beds of nonoverlapping clumped-sphere particles, the model combining with discrete element method (DEM) and SCM is presented to study the heat transfer behaviors, including effects of particle shape, emissivity distribution and pebble flow with transient heat transfer. For the experimental nuclear pebble beds, the results of SCM are in good agreement with the empirical correlation and accord well with the experimental data under high temperature range.
An Articulated Closed Kinematic Chain Planar Robotic Leg for High-Speed Locomotion
Authors: Liu Yujiong , Ben-Tzvi Pinhas
Published: December 2019

This paper presents the design, dynamic modeling, and integration of a single degree of freedom (DOF) robotic leg mechanism intended for tailed quadruped locomotion. The design employs a lightweight six-bar linkage that couples the hip and knee flexion/extension joints mechanically, requiring only a single degree of actuation. By utilizing a parametric optimization, a unique topological arrangement is achieved that results in a foot trajectory that is well suited for dynamic gaits including trot-running, bounding, and galloping. Furthermore, a singular perturbation is introduced to the hybrid dynamic framework to address the lack of robust methods that provide a solution for the differential algebraic equations (DAEs) that characterize closed kinematic chain (CKC) structures as well as the hybrid nature of legged locomotion. By approximating the system dynamics as ordinary differential equations (ODEs) and asymptotically driving the constraint error to zero, CKCs can adopt existing real-time model-based/model-predictive/hybrid-control frameworks. The dynamic model is verified through simulations and the foot trajectory was experimentally validated. Preliminary open-loop planar running demonstrated speeds up to 3.2 m/s. These advantages, accompanied by low-integration costs, warrant this leg as a robust, effective platform for future tailed quadruped research.
A Novel Method to Simultaneously Identify Temperature-Dependent Thermal Properties and Verification
Authors: Pan Weizhen , Yi Fajun , Zhuo Lijun , Meng Songhe
Published: December 2019

A novel method for the identification of thermal conductivity and specific heat capacity simultaneously by solving inverse heat transfer problems (IHTPs) is proposed. The present method uses a new iterative format of the Levenberg–Marquardt method (LMM) and guarantees global convergence by implementing the subsection identification method. Both simulation and real experiments are conducted to prove the validity and practicability of the proposed method. The thermal properties in simulation and real experiments are identified, respectively, by the proposed method. In the simulation experiments, random errors are added into temperature data to survey the effect of measurement errors on the identification; and the deviations of the results are also compared to that in a published literature to show the superiority of the proposed method. The numerical results illustrate that the identification is accurate and stable. And the identification results of the real experiment are compared with measured ones, proving the practicability of the method.
Experimental Investigation of Heat Transfer Enhancement of Shell and Tube Heat Exchanger Using SnO2-Water and Ag-Water Nanofluids
Authors: Sridhar S. V. , Karuppasamy R. , Sivakumar G. D.
Published: December 2019

In this investigation, the performance of the shell and tube heat exchanger operated with tin nanoparticles-water (SnO2-W) and silver nanoparticles-water (Ag-W) nanofluids was experimentally analyzed. SnO2-W and Ag-W nanofluids were prepared without any surface medication of nanoparticles. The effects of volume concentrations of nanoparticles on thermal conductivity, viscosity, heat transfer coefficient, fiction factor, Nusselt number, and pressure drop were analyzed. The results showed that thermal conductivity of nanofluids increased by 29% and 39% while adding 0.1 wt% of SnO2 and Ag nanoparticles, respectively, due to the unique intrinsic property of the nanoparticles. Further, the convective heat transfer coefficient was enhanced because of improvement of thermal conductivity of the two phase mixture and friction factor increased due to the increases of viscosity and density of nanofluids. Moreover, Ag nanofluid showed superior pressure drop compared to SnO2 nanofluid owing to the improvement of thermophysical properties of nanofluid.
Dorsal-ventral patterned neural cyst from human pluripotent stem cells in a neurogenic niche
Authors: Zheng Y. , Xue X. , Resto-Irizarry A. M. , Li Z. , Shao Y. , Zheng Y. , Zhao G. , Fu J.
Published: December 2019

A human neural tube development model with proper dorsal-ventral patterning is accomplished using stem cells.
Caveolin-1–derived peptide limits development of pulmonary fibrosis
Authors: Marudamuthu Amarnath Satheesh , Bhandary Yashodhar Prabhakar , Fan Liang , Radhakrishnan Vijay , MacKenzie BreAnne , Maier Esther , Shetty Shwetha Kumari , Nagaraja M.R. , Gopu Venkadesaperumal , Tiwari Nivedita , Zhang Yajie , Watts Alan B. , Williams Robert O. , Criner Gerald J , Bolla Sudhir , Marchetti Nathaniel , Idell Steven , Shetty Sreerama
Published: December 2019

CSP7, a caveolin-1–derived peptide, targets injured alveolar epithelial cells and activated lung fibroblasts to mitigate pulmonary fibrosis.
Dementia is not synonymous with Alzheimer’s disease
Authors: Jack Clifford R. , Holtzman David M. , Sperling Reisa
Published: December 2019

Alzheimer’s disease is defined by its pathology, amyloid plaques, and neurofibrillary tau tangles, not by the clinical syndrome of dementia.
Distinct neural mechanisms for the prosocial and rewarding properties of MDMA
Authors: Heifets Boris D. , Salgado Juliana S. , Taylor Madison D. , Hoerbelt Paul , Cardozo Pinto Daniel F. , Steinberg Elizabeth E. , Walsh Jessica J. , Sze Ji Y. , Malenka Robert C.
Published: December 2019

MDMA, which has both therapeutic and abuse potential, engages a brain region–specific serotonergic pathway to produce its prosocial effect.
PD-1H (VISTA)–mediated suppression of autoimmunity in systemic and cutaneous lupus erythematosus
Authors: Han Xue , Vesely Matthew D. , Yang Wendy , Sanmamed Miguel F. , Badri Ti , Alawa Jude , López-Giráldez Francesc , Gaule Patricia , Lee Sang Won , Zhang Jian-Ping , Nie Xinxin , Nassar Ala , Boto Agedi , Flies Dallas B. , Zheng Linghua , Kim Tae Kon , Moeckel Gilbert W. , McNiff Jennifer M. , Chen Lieping
Published: December 2019

PD-1H (VISTA) is immunosuppressive during lupus progression and could be targeted by an agonistic antibody for therapy.
A recombinant platform for flavivirus vaccines and diagnostics using chimeras of a new insect-specific virus
Authors: Hobson-Peters Jody , Harrison Jessica J. , Watterson Daniel , Hazlewood Jessamine E. , Vet Laura J. , Newton Natalee D. , Warrilow David , Colmant Agathe M. G. , Taylor Carmel , Huang Bixing , Piyasena Thisun B. H. , Chow Weng Kong , Setoh Yin Xiang , Tang Bing , Nakayama Eri , Yan Kexin , Amarilla Alberto A. , Wheatley Sarah , Moore Peter R. , Finger Mitchell , Kurucz Nina , Modhiran Naphak , Young Paul R. , Khromykh Alexander A. , Bielefeldt-Ohmann Helle , Suhrbier Andreas , Hall Roy A.
Published: December 2019

Insect-specific Binjari virus facilitates the production of chimeric virus particles of flavivirus pathogens for diagnostics and vaccines.
Method Comparison of the ImmuView L. pneumophila and
L. longbeachae
Urinary Antigen Test with the BinaxNOW
Legionella
Urinary Antigen Card for Detection of Legionella pneumophila Serogroup 1 Antigen in Urine
Authors: Badoux Paul , Kracht-Kosten Lianne , Herpers Bjorn , Euser Sjoerd
Published: December 2019

We compared the clinical performance of the ImmuView
L. pneumophila
and
L. longbeachae
urinary antigen test (SSI Diagnostica A/S, Hillerød, Denmark) to that of the BinaxNOW
Legionella
urinary antigen card (Binax; Abbott, Lake Buff, IL) using urine specimens from patients suspected of having pneumonia. In total, 100 frozen urine samples (derived from 50
Legionella
cases and 50 noncases) were analyzed with both tests, as were 200 nonfrozen prospectively collected samples.
Nature of Cretaceous dolerite dikes with two distinct trends in the Damodar Valley, eastern India: Constraints on their linkage to mantle plumes and large igneous provinces from 40Ar/39Ar geochronology and geochemistry
Authors: Srivastava Rajesh K. , Wang Fei , Shi Wenbei , Sinha Anup K. , Buchan Kenneth L.
Published: December 2019

Two distinct sets of Cretaceous dolerite dikes intrude the Chhotanagpur gneissic complex of eastern India, mostly within the Damodar Valley Gondwanan sedimentary basins. One dike set trends NNE to ENE, whereas the other set, which includes the prominent Salma dike, trends NW to NNW. One dike from each set in the Raniganj Basin was dated using the 40Ar/39Ar method in order to resolve a controversy concerning the emplacement age of the Salma dike. The NE-trending dike yielded a plateau age of 70.5 ± 0.9 Ma, whereas the NNW-trending Salma dike is much older, with a plateau age of 116.0 ± 1.4 Ma. These results demonstrate that the Salma dike was emplaced at ca. 116 Ma and not at ca. 65 Ma, as suggested in an earlier study. Geochemical characteristics of the two dikes are also distinct and indicate that they belong to previously identified high-Ti and low-Ti dolerite groups, respectively. The observed geochemical characteristics of both dike sets are comparable with the geochemistry of basalts of the Kerguelen Plateau, Bunbury Island, and Rajmahal Group I and suggest a connection to mantle plumes. The new age data presented herein indicate that these two magmatic episodes in the eastern Indian Shield were related to the ca. 120–100 Ma Kerguelen mantle plume and its associated Greater Kerguelen large igneous province and the ca. 70–65 Ma Réunion plume and its associated Deccan large igneous province, respectively.
Surgical outcomes of centripetal non-fovea-sparing internal limiting membrane peeling for myopic foveoschisis with and without foveal detachment: a follow-up of at least 3 years
Authors: Peng Kai-Ling , Kung Ya-Hsin , Hsu Chia-Ming , Chang Shu-Ping , Tseng Pei-Lin , Wu Tsung-Tien
Published: December 2019

Background

We evaluated the surgical outcomes of vitrectomy with non-fovea-sparing internal limiting membrane (ILM) peeling for myopic foveoschisis with a follow-up of at least 3 years.

Methods

In this retrospective study, 32 consecutive eyes with high myopia with or without foveal detachment underwent vitrectomy and centripetal, non-fovea-sparing ILM peeling with gas tamponade for myopic foveoschisis. Outcome measures were visual acuity (VA) and optical coherence tomography findings.

Results

Mean axial length was 29.39±1.92 mm; mean follow-up was 42.66 (±8.29) months. Foveoschisis and foveal detachment completely resolved in all eyes postoperatively. Mean central foveal thickness (CFT) improved significantly from 631.88±191.72 to 232.65±69.67 µm, and mean best-corrected visual acuity improved significantly from 0.90 (Snellen equivalent (SE), 20/160)±0.43 logarithm of minimum angle of resolution (logMAR) to 0.43 (SE, 20/54)±0.29 logMAR (both p<0.001; two-tailed, paired t-test). Eyes with foveal detachment (n=10) at baseline had thicker preoperative CFT (737.8±239.83 vs 583.73±147.78 µm; p=0.033) but thinner postoperative CFT (188.20±31.52 vs 252.86±73.29 µm; p=0.012). Eyes without foveal detachment at baseline had significantly better postoperative VA (0.33 (SE, 20/43)±0.18 vs 0.65 (SE, 20/86)±0.37 logMAR; p=0.002). No macular hole or other complications occurred during follow-up.

Conclusion

Centripetal, non-fovea-sparing ILM peeling with gas tamponade may achieve myopic foveoschisis resolution and vision improvement without macular hole formation during at least 3-year follow-up.
Effect of non-invasive intranasal neurostimulation on tear volume, dryness and ocular pain
Authors: Farhangi Monika , Cheng Anny Mansim , Baksh Brandon , Sarantopoulos Constantine D , Felix Elizabeth R , Levitt Roy C , Galor Anat
Published: December 2019

Purpose

To evaluate the effect of one TrueTear session on change in tear volume and symptoms of dryness and ocular pain.

Methods

Retrospective interventional case series of patients seen in a dry eye clinic. Seventy-five individuals underwent an ocular surface examination and one session of neurostimulation. Outcome measures included objective change in tear volume measured via phenol red test, and subjective change in sensations of dryness and ocular pain measured on a 0–10 Numerical Rating Scale.

Results

The mean age of the 75 individuals was 59±13 years, and the majority were male (73%). Intranasal neurostimulation increased tear volume (mean 13.40±8.00 mm, p<0.0005) and reduced intensities of dryness (mean −2.85±2.79, p<0.0005) and ocular pain (mean −1.48±2.41, p<0.0005 for both). However, these effects were independent of one another as change in symptom report did not correlate with change in tear volume (r=−0.13, p=0.25 for dryness; r=0.07, p=0.56 for pain). In a multivariable model, the strongest predictors for increased tear volume were lower baseline tear volume (standardised beta (β)=−0.50, p<0.0005) and absence of an autoimmune disease (β=−0.36, p=0.001) (R
2
=0.30). The strongest predictors for reduced dryness and pain scores were lower baseline dryness and ocular pain scores. No complications related to neurostimulation were noted.

Conclusion

Intranasal neurostimulation increased tear volume and reduced intensities of dryness and ocular pain, independently of one another.
Key factors for overcoming psychological insulin resistance: an examination of patient perspectives through content analysis
Authors: Stuckey Heather , Fisher Lawrence , Polonsky William H , Hessler Danielle , Snoek Frank J , Tang Tricia S , Hermanns Norbert , Mundet-Tuduri Xavier , da Silva Maria Elizabeth Rossi , Sturt Jackie , Okazaki Kentaro , Cao Dachuang , Hadjiyianni Irene , Ivanova Jasmina I , Desai Urvi , Perez-Nieves Magaly
Published: December 2019

Objective

To understand participant perceptions about insulin and identify key behaviors of healthcare professionals (HCPs) that motivated initially reluctant adults from seven countries (n=40) who had type 2 diabetes (T2D) to start insulin treatment.

Research design and methods

Telephone interviews were conducted with a subset of participants from an international investigation of adults with T2D who were reluctant to start insulin (EMOTION). Questions related to: (a) participants’ thoughts about insulin before and after initiation; (b) reasons behind responses on the survey that were either ‘not helpful at all’ or ‘helped a lot’; (c) actions their HCP may have taken to help start insulin treatment; and (d) advice they would give to others in a similar situation of starting insulin. Responses were coded by two independent reviewers (kappa 0.992).

Results

Starting insulin treatment was perceived as a negative experience that would be painful and would lead down a ‘slippery slope’ to complications. HCPs engaged in four primary behaviors that helped with insulin acceptance: (1) showed the insulin pen/needle and demonstrated the injection process; (2) explained how insulin could help with diabetes control and reduce risk of complications; (3) used collaborative communication style; and (4) offered support and willingness to answer questions so that participants would not be ‘on their own’. Following initiation, most participants noted that insulin was not ‘as bad as they thought’ and recommended insulin to other adults with T2D.

Conclusions

Based on these themes, two actionable strategies are suggested for HCPs to help people with psychological insulin resistance: (1) demonstrate the injection process and discuss negative perceptions of insulin as well as potential benefits; (2) offer autonomy in a person-centred collaborative approach, but provide support and accessibility to address concerns. These findings help HCPs to better understand ways in which they can engage reluctant people with T2D with specific strategies.
Current state of science in machine learning methods for automatic infant pain evaluation using facial expression information: study protocol of a systematic review and meta-analysis
Authors: Cheng Dan , Liu Dianbo , Philpotts Lisa Liang , Turner Dana P , Houle Timothy T , Chen Lucy , Zhang Miaomiao , Yang Jianjun , Zhang Wei , Deng Hao
Published: December 2019

Introduction

Infants can experience pain similar to adults, and improperly controlled pain stimuli could have a long-term adverse impact on their cognitive and neurological function development. The biggest challenge of achieving good infant pain control is obtaining objective pain assessment when direct communication is lacking. For years, computer scientists have developed many different facial expression-centred machine learning (ML) methods for automatic infant pain assessment. Many of these ML algorithms showed rather satisfactory performance and have demonstrated good potential to be further enhanced for implementation in real-world clinical settings. To date, there is no prior research that has systematically summarised and compared the performance of these ML algorithms. Our proposed meta-analysis will provide the first comprehensive evidence on this topic to guide further ML algorithm development and clinical implementation.

Methods and analysis

We will search four major public electronic medical and computer science databases including Web of Science, PubMed, Embase and IEEE Xplore Digital Library from January 2008 to present. All the articles will be imported into the Covidence platform for study eligibility screening and inclusion. Study-level extracted data will be stored in the Systematic Review Data Repository online platform. The primary outcome will be the prediction accuracy of the ML model. The secondary outcomes will be model utility measures including generalisability, interpretability and computational efficiency. All extracted outcome data will be imported into RevMan V.5.2.1 software and R V3.3.2 for analysis. Risk of bias will be summarised using the latest Prediction Model Study Risk of Bias Assessment Tool.

Ethics and dissemination

This systematic review and meta-analysis will only use study-level data from public databases, thus formal ethical approval is not required. The results will be disseminated in the form of an official publication in a peer-reviewed journal and/or presentation at relevant conferences.

PROSPERO registration number

CRD42019118784.
Systematic review and meta-analysis of the prognosis and prognostic factors of interstitial pneumonia with autoimmune features
Authors: Kamiya Hiroyuki , Panlaqui Ogee Mer
Published: December 2019

Objective

To clarify the prognosis and prognostic factors of interstitial pneumonia with autoimmune features (IPAF) in comparison to idiopathic pulmonary fibrosis (IPF), the most common idiopathic interstitial pneumonia, and connective tissue disease-associated interstitial pneumonia (CTD-IP).

Design

A systematic review and meta-analysis.

Data sources

Electronic databases such as Medline and Embase were searched from 2015 through 6 September 2019.

Eligibility criteria for selecting studies

Primary studies that comparatively investigated the prognosis or prognostic factors of IPAF were eligible.

Data extraction and analysis

Two reviewers extracted relevant data and assessed the risk of bias independently. A meta-analysis was conducted using a random-effects model. The quality of presented evidence was assessed by the Grades of Recommendation, Assessment, Development, and Evaluation system.

Results

Out of a total of 656 records retrieved, 12 studies were reviewed. The clinical features of IPAF were diverse between studies, which included a radiological and/or pathological usual interstitial pneumonia (UIP) pattern of between 0% and 73.8%. All studies contained some risk of bias. There was no significant difference of all-cause mortality between IPAF-UIP and IPF in all studies, although the prognosis of IPAF in contrast to IPF or CTD-IP varied between studies depending on the proportion of UIP pattern. Among the potential prognostic factors identified, age was significantly associated with all-cause mortality of IPAF by a pooled analysis of univariate results with a hazard ratio (HR) of 1.06 (95% confidence interval (CI) 1.04 to 1.07). The adjusted effect of age was also significant in all studies. The quality of presented evidence was deemed as very low.

Conclusion

There was no significant difference of all-cause mortality between IPAF-UIP and IPF. Age was deemed as a prognostic factor for all-cause mortality of IPAF. The findings should be interpreted cautiously due to the low quality of the presented evidence.

PROSPERO registration number

CRD42018115870.
Assessing the performance of the Asian/Pacific islander identification algorithm to infer Hmong ethnicity from electronic health records in California
Authors: Ly May Ying N , Kim Katherine K , Stewart Susan L
Published: December 2019

Objective

This study assesses the performance of the North American Association of Central Cancer Registries Asian/Pacific Islander Identification Algorithm (NAPIIA) to infer Hmong ethnicity.

Design and setting

Analyses of electronic health records (EHRs) from 1 January 2011 to 1 October 2015. The NAPIIA was applied to the EHR data, and self-reported Hmong ethnicity from a questionnaire was used as the gold standard. Sensitivity, specificity, positive (PPV) and negative predictive values (NPVs) were calculated comparing the source data ethnicity inferred by the algorithm with the self-reported ethnicity from the questionnaire.

Participants

EHRs indicating Hmong, Chinese, Vietnamese and Korean ethnicity who met the original study inclusion criteria were analysed.

Results

The NAPIIA had a sensitivity of 78%, a specificity of 99.9%, a PPV of 96% and an NPV of 99%. The prevalence of Hmong population in the sample was 3.9%.

Conclusion

The high sensitivity of the NAPIIA indicates its effectiveness in detecting Hmong ethnicity. The applicability of the NAPIIA to a multitude of Asian subgroups can advance Asian health disparity research by enabling researchers to disaggregate Asian data and unmask health challenges of different Asian subgroups.
Safety and efficacy of perioperative benzodiazepine administration: study protocol for a systematic review and meta-analysis
Authors: Spence Jessica , Young Jack , Alhazzani Waleed , Whitlock Richard , D'Aragon Frédérick , Um Kevin , Mazer David , Beaver Chris , Jacobsohn Eric , Belley-Cote Emilie
Published: December 2019

Introduction

Perioperative benzodiazepines are used because of their anxiolytic, sedative and amnestic effects. Evidence has demonstrated an association of benzodiazepines with adverse neuropsychiatric effects. Nonetheless, because of their potential benefits, perioperative benzodiazepines continue to be used routinely. We seek to evaluate the body of evidence of the risks and benefits of benzodiazepine use during the perioperative period.

Methods and analysis

We will search Cochrane CENTRAL, MEDLINE, EMBASE, PsychINFO, CINAHL and Web of Science from inception to March 2019 for randomised controlled trials (RCTs) and observational studies evaluating the administration of benzodiazepine medications as compared with all other medications (or nothing) in patients undergoing cardiac and non-cardiac surgery. We will exclude studies assessing the use of benzodiazepines for procedural sedation or day surgery. We will examine the impact of giving these medications before, during and after surgery. Outcomes of interest include the incidence of delirium, duration of delirium, postprocedure cognitive change, the incidence of intraoperative awareness, patient satisfaction/quality of life/quality of recovery, length-of-stay (LOS) in the intensive care unit (ICU), hospital LOS and in-hospital mortality.

Reviewers will screen references and assess eligibility using predefined criteria independently and in duplicate. Two reviewers will independently collect data using prepiloted forms. We will present results separately for RCTs and observational studies. We will pool data using a random effect model and present results as relative risk with 95% CIs for dichotomous outcomes and mean difference with 95% CI for continuous outcomes. We will pool adjusted ORs for observational studies. We will assess risk of bias for individual studies using the Cochrane Collaboration tool for RCTs. For observational studies, we will use tools designed by the Clinical Advances through Research and Information Translation group. Quality of evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

This systematic review involves no patient contact and no interaction with healthcare providers or systems. As such, we did not seek ethics board approval. We will disseminate the findings of our systematic review through the presentation at peer-reviewed conferences and by seeking publication in a peer-reviewed journal.

PROSPERO registration number

CRD42019128144
Quality evaluation of community pharmacy blood pressure (BP) screening services: an English cross-sectional survey with geospatial analysis
Authors: Barrett Ravina , Hodgkinson James
Published: December 2019

Objectives

The primary objective was to assess the accuracy (calibration and validation status) of digital blood pressure (BP) monitors used within community pharmacy in England and the secondary objectives were to assess the overall quality of the BP service by assessing service prevalence, service utilisation and other in-service considerations.

Design

A cross-sectional survey.

Setting

Primary-care retail-pharmacies.

Participants

500 pharmacies that contribute to government dispensing-data were invited by post to complete the survey. Private contractors were excluded.

Interventions

We conducted a questionnaire survey with a follow-up (September 2018 to December 2018).

Results

109 responses were received. 61% (n=66) of responding pharmacies provided a free BP check to their patients. 40 (61%) pharmacies used recommended validated clinical metres, 6 (9%) had failed validation and 20 (30%) provided too little information to enable us to determine their monitor’s status.

Conclusions

Responding pharmacies were able to provide useful BP monitoring services to their patients, though quality enhancements need to be implemented. Majority of pharmacies use validated BP monitors, however, there was a lack of range of cuff sizes, variation in replacement and calibration of monitors and apparent absence of such practice in a minority of pharmacies alongside variation in training standards. We noted higher frequency of BP screening in the most deprived postcodes.

We recommend in-service redesign and delivery improvements, and suggest professional bodies and researchers work together to create clearer frameworks for front-line practitioners, creating appropriate incentives to facilitate this service redesign.

Funders and policy setters should consider the value added to the National Health Service and other healthcare agencies of such screening by pharmacy providers both nationally and internationally. It has the potential to reduce complications of undiagnosed hypertension and the medicines burden that it creates. Future work should examine the impact of pharmacist-led BP screening on patients.
Evidence-based occupational health and safety interventions: a comprehensive overview of reviews
Authors: Teufer Birgit , Ebenberger Agnes , Affengruber Lisa , Kien Christina , Klerings Irma , Szelag Monika , Grillich Ludwig , Griebler Ursula
Published: December 2019

Objectives

Occupational injuries and diseases are a huge public health problem and cause extensive suffering and loss of productivity. Nevertheless, many occupational health and safety (OHS) guidelines are still not based on the best available evidence. In the last decade, numerous systematic reviews on behavioural, relational and mixed interventions to reduce occupational injuries and diseases have been carried out, but a comprehensive synopsis is yet missing. The aim of this overview of reviews is to provide a comprehensive basis to inform evidence-based decision-making about interventions in the field of OHS.

Methods

We conducted an overview of reviews. We searched MEDLINE (Ovid), the Cochrane Library (Wiley), epistemonikos.org and Scopus (Elsevier) for relevant systematic reviews published between January 2008 and June 2018. Two authors independently screened abstracts and full-text publications and determined the risk of bias of the included systematic reviews with the ROBIS (Risk of Bias in Systematic Reviews) tool.

Results

We screened 2287 abstracts and 200 full-texts for eligibility. Finally, we included 25 systematic reviews with a low risk of bias for data synthesis and analysis. We identified systematic reviews on the prevention of occupational injuries, musculoskeletal, skin and lung diseases, occupational hearing impairment and interventions without specific target diseases. Several interventions led to consistently positive results on individual diseases; other interventions did not show any effects, or the studies are contradictory. We provide detailed results on all included interventions.

Discussion

To our knowledge, this is the first comprehensive overview of behavioural, relational and mixed interventions and their effectiveness in preventing occupational injuries and diseases. It provides policymakers with an important basis for making evidence-based decisions on interventions in this field.

PROSPERO registration number

CRD42018100341
Acute kidney injury electronic alerts: mixed methods Normalisation Process Theory evaluation of their implementation into secondary care in England
Authors: Scott Jason , Finch Tracy , Bevan Mark , Maniatopoulos Gregory , Gibbins Chris , Yates Bryan , Kilimangalam Narayanan , Sheerin Neil , Kanagasundaram Nigel Suren
Published: December 2019

Objective

Around one in five emergency hospital admissions are affected by acute kidney injury (AKI). To address poor quality of care in relation to AKI, electronic alerts (e-alerts) are mandated across primary and secondary care in England and Wales. Evidence of the benefit of AKI e-alerts remains conflicting, with at least some uncertainty explained by poor or unclear implementation. The objective of this study was to identify factors relating to implementation, using Normalisation Process Theory (NPT), which promote or inhibit use of AKI e-alerts in secondary care.

Design

Mixed methods combining qualitative (observations, semi-structured interviews) and quantitative (survey) methods.

Setting and participants

Three secondary care hospitals in North East England, representing two distinct AKI e-alerting systems. Observations (>44 hours) were conducted in Emergency Assessment Units (EAUs). Semi-structured interviews were conducted with clinicians (n=29) from EAUs, vascular or general surgery or care of the elderly. Qualitative data were supplemented by Normalization MeAsure Development (NoMAD) surveys (n=101).

Analysis

Qualitative data were analysed using the NPT framework, with quantitative data analysed descriptively and using χ2 and Wilcoxon signed-rank test for differences in current and future normalisation.

Results

Participants reported familiarity with the AKI e-alerts but that the e-alerts would become more normalised in the future (p<0.001). No single NPT mechanism led to current (un)successful implementation of the e-alerts, but analysis of the underlying subconstructs identified several mechanisms indicative of successful normalisation (internalisation, legitimation) or unsuccessful normalisation (initiation, differentiation, skill set workability, systematisation).

Conclusions

Clinicians recognised the value and importance of AKI e-alerts in their practice, although this was not sufficient for the e-alerts to be routinely engaged with by clinicians. To further normalise the use of AKI e-alerts, there is a need for tailored training on use of the e-alerts and routine feedback to clinicians on the impact that e-alerts have on patient outcomes.
Current tools available for investigating vaccine hesitancy: a scoping review protocol
Authors: Oduwole Elizabeth O , Pienaar Elizabeth D , Mahomed Hassan , Wiysonge Charles Shey
Published: December 2019

Introduction

Vaccine hesitancy, defined as the delay in acceptance or refusal of vaccination despite availability of vaccination services is responsible in part for suboptimal levels of vaccination coverage worldwide. The WHO recommends that countries incorporate plans to measure and address vaccine hesitancy into their immunisation programmes. This requires that governments and health institutions be able to detect concerns about vaccination in the population and monitor changes in vaccination behaviours. To do this effectively, tools to detect and measure vaccine hesitancy are required. The purpose of this scoping review is to give a broad overview of currently available vaccine hesitancy measuring tools and present a summary of their nature, similarities and differences.

Methods and analysis

The review will be conducted using the framework for scoping review proffered by Arksey and O’Malley. It will comply with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews’ guidelines. The broader research question of this review is: what vaccine hesitancy measuring tools are currently available?

Search strategies will be developed using controlled vocabulary and selected keywords. PubMed, Web of Science, Scopus and reference lists of relevant publications will be searched. Titles and abstracts will be independently screened by two authors and data from full-text articles meeting the inclusion criteria will be extracted independently by two authors using a pretested data charting form. Discrepancies will be resolved by discussion and consensus. Results will be presented using descriptive statistics such as percentages, tables, charts and flow diagrams as appropriate. Narrative analysis will be used to summarise the findings of the review.

Ethics and dissemination

Ethics approval is not required for the review. It will be submitted as part of a doctoral thesis, presented at conferences and published in a peer-reviewed journal.

Trial registration number

https://osf.io/x8fjk/
Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
Authors: Jokanovic Natali , Aslani Parisa , Carter Sophie , Duong Mai , Gnjidic Danijela , Jansen Jesse , Le Couteur David , Hilmer Sarah
Published: December 2019

Objective

To develop information leaflets for older inpatients and/or their carers to support deprescribing of antipsychotics, benzodiazepines/Z-drugs and proton pump inhibitors (PPIs).

Design

An iterative mixed-methods approach involving face-to-face user testing and semi-structured interviews was performed over three rounds with consumers and hospital health professionals.

Setting

Sydney, New South Wales, Australia.

Participants

Thirty-seven consumers (or their carers) aged 65 years or older admitted to hospital in the previous 5 years and taking at least one regular medicine (not the medicine tested) completed user testing. Health professionals included a convenience sample of seven pharmacists and five doctors.

Methods

The antipsychotic leaflet was tested in round 1 (consumers, n=10) and revised and retested in round 2 (consumers, n=9; health professionals, n=5). Findings from rounds 1 and 2 informed the design of the benzodiazepine/Z-drug and PPI leaflets tested in round 3 (benzodiazepine/Z-drug consumers, n=9; health professionals, n=7; PPI consumers, n=9). Findings from round 3 informed the final design of all leaflets. Consumer user testing involved 12–13 questions to evaluate consumers’ ability to locate and understand information in the leaflet. Usability by health professionals was assessed using the System Usability Scale (SUS).

Results

At least 80% of consumers correctly found and understood the deprescribing information in the leaflets (9 of 12 information points in round 1 (antipsychotic); 10 of 12 in round 2; 12 of 13 (benzodiazepine/Z-drug) and 11 of 12 (PPI) in round 3). Consumers perceived the leaflets to be informative, well-designed and useful aids for ongoing medication management. The SUS scores obtained from health professionals were 91.0±3.8 for the antipsychotic leaflet and 86.4±6.6 for the benzodiazepine/Z-drug leaflet, indicating excellent usability.

Conclusions

Understandable and easy-to-use consumer information leaflets were developed and tested by consumers and health professionals. The feasibility and utility of these leaflets to support deprescribing at transitions of care should be explored in clinical practice.