bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed-methods, descriptive and observational cohort study examining feeding and growth patterns among low birthweight infants in India, Malawi and Tanzania: the LIFE study protocol
Authors: Vesel Linda , Spigel Lauren , Behera Jnanindra Nath , Bellad Roopa M , Das Leena , Dhaded Sangappa , Goudar Shivaprasad S , Guruprasad Gowdar , Misra Sujata , Panda Sanghamitra , Shamanur Latha G , Vernekar Sunil S , Hoffman Irving F , Mvalo Tisungane , Phiri Melda , Saidi Friday , Kisenge Rodrick , Manji Karim , Salim Nahya , Somji Sarah , Sudfeld Christopher R , Adair Linda , Caruso Bethany A , Duggan Christopher , Israel-Ballard Kiersten , Lee Anne CC , Martin Stephanie L , Mansen Kimberly L , North Krysten , Young Melissa , Benotti Emily , Marx Delaney Megan , Fishman Eliza , Fleming Katelyn , Henrich Natalie , Miller Kate , Subramanian Laura , Tuller Danielle E , Semrau Katherine EA
Published: December 2021

Introduction

Ending preventable deaths of newborns and children under 5 will not be possible without evidence-based strategies addressing the health and care of low birthweight (LBW, <2.5 kg) infants. The majority of LBW infants are born in low- and middle-income countries (LMICs) and account for more than 60%–80% of newborn deaths. Feeding promotion tailored to meet the nutritional needs of LBW infants in LMICs may serve a crucial role in curbing newborn mortality rates and promoting growth. The Low Birthweight Infant Feeding Exploration (LIFE) study aims to establish foundational knowledge regarding optimal feeding options for LBW infants in low-resource settings throughout infancy.

Methods and analysis

LIFE is a formative, multisite, observational cohort study involving 12 study facilities in India, Malawi and Tanzania, and using a convergent parallel, mixed-methods design. We assess feeding patterns, growth indicators, morbidity, mortality, child development and health system inputs that facilitate or hinder care and survival of LBW infants.

Ethics and dissemination

This study was approved by 11 ethics committees in India, Malawi, Tanzania and the USA. The results will be disseminated through peer-reviewed publications and presentations targeting the global and local research, clinical, programme implementation and policy communities.

Trial registration numbers

NCT04002908and CTRI/2019/02/017475.
Non-invasive ventilation in the palliative care of patients with chronic obstructive pulmonary disease: a scoping review protocol
Authors: Steindal Simen A , Hofsø Kristin , Aagaard Hanne , Mariussen Kari L , Andresen Brith , Christensen Vivi L , Heggdal Kristin , Karlsen Marte-Marie Wallander , Kvande Monica E , Kynø Nina Margrethe , Langerud Anne Kathrine , Ohnstad Mari O , Sørensen Kari , Larsen Marie Hamilton
Published: December 2021

Introduction

Patients with advanced chronic obstructive pulmonary disease (COPD) experience a great symptom burden. Breathlessness is a very frequently reported symptom that negatively affects all aspects of daily life and could lead to fear of dying. Non-invasive ventilation (NIV) could be an important palliative measure to manage breathlessness in patients with advanced COPD. We decided to conduct a scoping review to attain an overview of the existing research and to identify knowledge gaps. This scoping review aims to systematically map published studies on the use of NIV in the palliative care of COPD patients, including the perspectives and experiences of patients, families and healthcare professionals.

Methods and analysis

This scoping review will employ the framework of Arksey and O’Malley. The reporting will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A comprehensive and systematic search strategy will be developed in cooperation with an experienced librarian. Database searches will be conducted in AMED, PEDro, Embase, CINAHL, PsycInfo and MEDLINE in February 2021. Pairs of authors will independently assess studies’ eligibility and extract data using a standardised data-charting form. The data will be inductively summarised and organised thematically. The results will be discussed with an advisory board consisting of nurses and physicians from respiratory and intensive care units.

Ethics and dissemination

Approval for the workshop with the advisory board has been attained from the Norwegian Centre for Research Data (480222), and approval will be attained from the Personal Data Protection Officers of the participating hospitals. All advisory board participants will sign an informed written consent before participation. The results could contribute to developing the body of evidence on the use of NIV in the palliative care of COPD patients and serve to identify directions for future research.
Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review
Authors: Nyasulu Peter Suwirakwenda , Weyer Jacqueline , Tschopp Rea , Mihret Adane , Aseffa Abraham , Nuvor Samuel Victor , Tamuzi Jacques Lukenze , Nyakarahuka Luke , Helegbe Gideon Kofi , Ntinginya Nyanda Elias , Gebreyesus Melaku Tefera , Doumbia Seydou , Busse Reinhard , Drosten Christian
Published: December 2021

Objective

The objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control strategies in Africa.

Methods

We conducted a systematic scoping review following the Joanna Briggs methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. Medline, Embase, CINAHL (EBSCOHost), Scopus, Web of Science and rabies web conferences were used to search for peer-reviewed publications between January 1946 and May 2020. Two researchers reviewed the studies and extracted data based on author (year) and region, study design and data collection duration, participants/comparators, interventions, control conditions/exposures and outcomes (rabies mortality and morbidity) and key findings/gaps/challenges. The results were reported narratively using Arksey and O’Malley’s methodological framework.

Results

Electronic search yielded 2775 records, of which 43 studies were included. A total of 543 714 bite victims were censored through the included studies. Most of the victims were less than 15 years of age. The studies included rabies morbidity (21) and mortality (15) fluctuating in space and time across Africa depending on countries’ rabies prevention and control practices (16). Others were surveillance (nine studies); surveillance and prevention (five studies); management and control (seven studies); and surveillance, prevention and control (six studies). We found challenges in rabies reporting, existing dog vaccination programmes and post-exposure prophylaxis availability or compliance.

Conclusion

This study found challenges for dog rabies control and elimination in Africa and the need for a policy to drive the goal of zero dog-transmitted rabies to humans by 2030.

This is an open-access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build on this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated and the use is non-commercial (seehttp://creativecommons.org/licenses/by-nc/4.0/).
Scoping review protocol to understand the conceptualisation, implementation and practices of health promotion within the context of primary healthcare in Africa
Authors: Nkangu Miriam , Obegu Pamela , Asahngwa Constantine , Shiroya Veronica , Gobina Ronald , Agbaw-Ebai Fleur Pembe , Keboa Mark , Foretia Denis
Published: December 2021

Introduction

The ongoing COVID-19 pandemic has highlighted the importance of health promotion in empowering and sustaining communities, as well as the need to build resilient health systems and work collectively with other sectors to protect and promote health. The WHO has mainstreamed health promotion in the Global health agenda. However, the definition and practices of health promotion in Africa are not well understood and documented, with often, an interchangeable use of the concept of health promotion and health prevention. This scoping review is to explore how health promotion is defined and practised in Africa and identify gaps in its implementation within the framework of the Ottawa Charter.

Methods and analysis

The scoping review will employ the approach described by Arksey and O’Malley in 2005. The approach consists of five stages: (1) formulating the research questions, (2) identifying relevant studies, (3) selecting eligible studies, (4) charting the data and (5) collating, summarising and reporting the results. This protocol employed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review will apply the PRISMA extension for scoping reviews to present the results. The scoping review will adapt the five principles set forth in the Ottawa Charter to categorise the outcomes and uses its strategies to define the interventions. Data bases searched are Ovid Medline, Embase, Cochrane Library, CINAHL, SCOPUS, CABI, JBI Evidence Synthesis and grey literature. The database last searched was January 2021.

Ethics and dissemination

This review does not require ethics approval. Our dissemination strategy includes peer review publication, policy brief, presentation at conferences and relevant stakeholders.
Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review
Authors: Guijarro-Herráiz Marta Maria , Arias-Palencia Natalia María , Lucas- de la Cruz Lidia , Guijarro-Herráiz Beatriz , Notario-Pacheco Blanca , Palomo-Carrión Rocio , García-Klepzig Jose Luis , Solera-Martínez Montserrat
Published: December 2021

Introduction

The main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life.

Methods and analysis

The literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined.

Ethics and dissemination

In this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.

The results will be published in a peer-reviewed journal.
Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys: empirical evaluation using data of the EAT Addis study, Ethiopia
Authors: Shifraw Tigest , Selling Katarina , Worku Alemayehu , Berhane Hanna Yemane , Ekström Eva-Charlotte , Berhane Yemane
Published: December 2021

Objectives

The present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting.

Design

This study draws data from a community-based cross-sectional study conducted between July–August 2017 and January–February 2018 to account for seasonality in Addis Ababa, Ethiopia.

Setting

One hundred and sixteen districts were included in Addis Ababa, Ethiopia.

Participants

A total of 4914 women of reproductive age with children less than 5 years of age were participated in this study.

Primary and secondary outcome measures

Primary outcome measures included anthropometric indices. There were no secondary outcomes.

Results

The optimal cut-off points to identify overweight women of reproductive age were >87.5 cm for waist circumference (WC), >31.7 cm for neck circumference (NC) and >28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC.

Conclusions

Our result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible.
Expert elicitation on the relative importance of possible SARS-CoV-2 transmission routes and the effectiveness of mitigations
Authors: Freeman Alexandra LJ , Parker Simon , Noakes Catherine , Fitzgerald Shaun , Smyth Alexandra , Macbeth Ron , Spiegelhalter David , Rutter Harry
Published: December 2021

Objectives

To help people make decisions about the most effective mitigation measures against SARS-CoV-2 transmission in different scenarios, the likelihoods of transmission by different routes need to be quantified to some degree (however uncertain). These likelihoods need to be communicated in an appropriate way to illustrate the relative importance of different routes in different scenarios, the likely effectiveness of different mitigation measures along those routes, and the level of uncertainty in those estimates. In this study, a pragmatic expert elicitation was undertaken to supply the underlying quantitative values to produce such a communication tool.

Participants

Twenty-seven individual experts from five countries and many scientific disciplines provided estimates.

Outcome measures

Estimates of transmission parameters, assessments of the quality of the evidence, references to relevant literature, rationales for their estimates and sources of uncertainty.

Results and conclusion

The participants’ responses showed that there is still considerable disagreement among experts about the relative importance of different transmission pathways and the effectiveness of different mitigation measures due to a lack of empirical evidence. Despite these disagreements, when pooled, the majority views on each parameter formed an internally consistent set of estimates (for example, that transmission was more likely indoors than outdoors, and at closer range), which formed the basis of a visualisation to help individuals and organisations understand the factors that influence transmission and the potential benefits of different mitigation measures.
Continuity of care, measurement and association with hospital admission and mortality: a registry-based longitudinal cohort study
Authors: Hetlevik Øystein , Holmås Tor Helge , Monstad Karin
Published: December 2021

Objective

To assess whether continuity of care (COC) with a general practitioner (GP) is associated with mortality and hospital admissions for older patients We argue that the conventional continuity measure may overestimate these associations. To better reflect COC as a GP quality indicator, we present an alternative, service-based measure.

Design

Registry-based, population-level longitudinal cohort study.

Setting

Linked data from Norwegian administrative healthcare registries, including 3989 GPs.

Participants

757 873 patients aged 60–90 years with ≥2 contacts with a GP during 2016 and 2017.

Main outcome measure

All-cause emergency hospital admissions, emergency admissions for ambulatory care sensitive conditions, and mortality, in 2018.

Results

We assessed COC using the conventional usual provider of care index (UPCpatient) and an alternative/supplementary index (UPCGP list) based on the COC for all other patients enlisted with the same preferred GP.

For both indices, the mean index score was 0.78. Our model controls for demographic and socioeconomic characteristics, prior healthcare use and municipality-fixed effects. Overall, UPCGP listshows a much weaker association between COC and the outcomes. For both indices, there is a negative relationship between COC and hospital admissions. A 0.2-point increase in the index score would reduce admissions for ambulatory care sensitive conditions by 8.1% (CI 7.1% to 9.1%) versus merely 1.9% (0.2% to 3.5%) according to UPCpatientand UPCGP list, respectively. Using UPCGP list, we find that mortality is no longer associated with COC. There was greater evidence for an association between COC and all-cause admissions among patients with low education.

Conclusions

A continuity measure based on each patient’s contacts with own preferred GP may overestimate the importance of COC as a feature of the GP practice. An alternative, service-based measure of continuity could be suitable as a quality measure in primary healthcare. Facilitating continuity should be considered a health policy measure to reduce inequalities in health.
How community participation in water and sanitation interventions impacts human health, WASH infrastructure and service longevity in low-income and middle-income countries: a realist review
Authors: Nelson Sarah , Drabarek Dorothy , Jenkins Aaron , Negin Joel , Abimbola Seye
Published: December 2021

Objective

To understand how, and under what circumstances community participation in water and sanitation interventions impacts the availability of safe water and sanitation, a change in health status or behaviour and the longevity of water, sanitation and hygiene (WASH) resources and services.

Design

Realist review.

Data sources

PubMed, Web of Science and Scopus databases were used to identify papers from low-income and middle-income countries from 2010 to 2020.

Eligibility criteria for selecting studies

Criteria were developed for papers to be included. The contribution of each paper was assessed based on its relevance and rigour (eg, can it contribute to context, mechanism or outcome, and is the method used to generate that information credible).

Analysis

Inductive and deductive coding was used to generate context–mechanism–outcome configurations.

Results

73 studies conducted in 29 countries were included. We identified five mechanisms that explained the availability, change and longevity outcomes: (1) accountability (policies and procedures to hold communities responsible for their actions and outcomes of an intervention), (2) diffusion (spread of an idea or behaviour by innovators over time through communication among members of a community), (3) market (the interplay between demand and supply of a WASH service or resource), (4) ownership (a sense of possession and control of the WASH service or resource) and (5) shame (a feeling of disgust in one’s behaviour or actions). Contextual elements identified included community leadership and communication, technical skills and knowledge, resource access and dependency, committee activity such as the rules and management plans, location and the level of community participation.

Conclusions

The findings highlight five key mechanisms impacted by 19 contextual factors that explain the outcomes of community water and sanitation interventions. Policymakers, programme implementers and institutions should consider community dynamics, location, resources, committee activity and practices and nature of community participation, before introducing community water and sanitation interventions.
Professional decision making with digitalisation of patient contacts in a medical advice setting: a qualitative study of a pilot project with a chat programme in Sweden
Authors: Cajander Åsa , Hedström Gustaf , Leijon Sofia , Larusdottir Marta
Published: December 2021

Objectives

Patient e-services are increasingly launched globally to make healthcare more efficient and digitalised. One area that is digitalised is medical advice, where patients asynchronously chat with nurses and physicians, with patients having filled in a form with predefined questions before the chat. This study aimed to explore how occupational professionalism and the possibility of professional judgement are affected when clinical patient contact is digitalised. The study’s overall question concerns whether and how the scope of the healthcare staff’s professional judgement and occupational professionalism are affected by digitalisation.

Design and setting

A qualitative study of healthcare professionals working in a pilot project with a chat programme for patients in a medical advice setting in Sweden.

Participants and analysis

Contextual inquiries and 17 interviews with nurses (n=9) and physicians (n=8). The interviews were thematically analysed. The analysis was inductive and based on theories of decision making.

Results

Three themes emerged: (1) Predefined questions to patients not tailored for healthcare professionals’ work, (2) reduced trust in written communication and (3) reduced opportunity to obtain information through chat communication.

Conclusions

The results indicate that asynchronous chat with patients might reduce the opportunity for nurses and physicians to obtain and use professional knowledge and discretionary decision making. Furthermore, the system’s design increases uncertainty in assessments and decision making, which reduces the range of occupational professionalism.
POSNOC—POsitive Sentinel NOde: adjuvant therapy alone versus adjuvant therapy plus Clearance or axillary radiotherapy: a randomised controlled trial of axillary treatment in women with early-stage breast cancer who have metastases in one or two sentinel nodes
Authors: Goyal Amit , Mann G Bruce , Fallowfield Lesley , Duley Lelia , Reed Malcolm , Dodwell David , Coleman Robert E , Fakis Apostolos , Newcombe Robert , Jenkins Valerie , Whitham Diane , Childs Margaret , Whynes David , Keeley Vaughan , Ellis Ian , Fairbrother Patricia , Sadiq Shabina , Monson Kathryn , Montgomery Alan , Tan Wei , Vale Luke , Homer Tara , Badger Heath , Haines Rachel Helen , Lewis Mickey , Megias Daniel , Nabi Zohal , Singh Preetinder , Caraman Andrei , Miles Elizabeth
Published: December 2021

Introduction

ACOSOG-Z0011(Z11) trial showed that axillary node clearance (ANC) may be omitted in women with ≤2 positive nodes undergoing breast conserving surgery (BCS) and whole breast radiotherapy (RT). A confirmatory study is needed to clarify the role of axillary treatment in women with ≤2 macrometastases undergoing BCS and groups that were not included in Z11 for example, mastectomy and those with microscopic extranodal invasion. The primary objective of POsitive Sentinel NOde: adjuvant therapy alone versus adjuvant therapy plus Clearance or axillary radiotherapy (POSNOC) is to evaluate whether for women with breast cancer and 1 or 2 macrometastases, adjuvant therapy alone is non-inferior to adjuvant therapy plus axillary treatment, in terms of 5-year axillary recurrence.

Methods and analysis

POSNOC is a pragmatic, multicentre, non-inferiority, international trial with participants randomised in a 1:1 ratio. Women are eligible if they have T1/T2, unifocal or multifocal invasive breast cancer, and 1 or 2 macrometastases at sentinel node biopsy, with or without extranodal extension. In the intervention group women receive adjuvant therapy alone, in the standard care group they receive ANC or axillary RT. In both groups women receive adjuvant therapy, according to local guidelines. This includes systemic therapy and, if indicated, RT to breast or chest wall. The UK Radiotherapy Trials Quality Assurance Group manages the in-built radiotherapy quality assurance programme. Primary endpoint is 5-year axillary recurrence. Secondary outcomes are arm morbidity assessed by Lymphoedema and Breast Cancer Questionnaire and QuickDASH questionnaires; quality of life and anxiety as assessed with FACT B+4 and State/Trait Anxiety Inventory questionnaires, respectively; other oncological outcomes; economic evaluation using EQ-5D-5L. Target sample size is 1900. Primary analysis is per protocol. Recruitment started on 1 August 2014 and as of 9 June 2021, 1866 participants have been randomised.

Ethics and dissemination

Protocol was approved by the National Research Ethics Service Committee East Midlands—Nottingham 2 (REC reference: 13/EM/0459). Results will be submitted for publication in peer-reviewed journals.

Trial registration number

ISRCTN54765244;NCT0240168Cite Now
Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings
Authors: Das Pritimoy , Akhtar Zubair , Mah-E-Muneer Syeda , Islam Md Ariful , Rahman Mohammed Ziaur , Rahman Mustafizur , Rahman Mahmudur , Rahman Mahbubur , Billah Mallick Masum , Alamgir ASM , Flora Meerjady Sabrina , Shirin Tahmina , Banu Sayera , Chowdhury Fahmida
Published: December 2021

Objectives

To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.

Design

Hospital-based surveillance.

Setting

This study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.

Participants

In total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress.

Outcome measures

The outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson’s χ2test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death.

Results

COVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30–50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in <2 days of symptom onset due to critical illness (AOR: 4.7; 95% CI: 1.2 to 17.8) and hospital admission (AOR: 3.4; 95% CI: 1.2 to 9.8).

Conclusions

COVID-19 positivity was observed in more than one-third of patients with suspected COVID-19 attending selected hospitals. While managing such patients, the risk factors identified for higher death rates should be considered.
Characteristics of resident physicians accessing a specialised mental health service: a retrospective study
Authors: Braquehais María Dolores , Vargas-Cáceres Sebastián , Nieva Gemma , Mantilla Maria Fernanda , Ortega Germán , Valero Sergi , Ramos-Quiroga Jose Antonio , Bruguera Eugeni
Published: December 2021

Objectives

Little is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians.

Design

Retrospective observational study.

Setting

Medical records of the Galatea Care Programme for Sick Physicians.

Participants

1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018.

Primary and secondary outcome measures

Number of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation.

Results

Residents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001).

Conclusions

Residents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.
Quantifying clinic transfers among people living with HIV in the Western Cape, South Africa: a retrospective spatial analysis
Authors: Espinosa Dice Ana Lucia , Bengtson Angela M , Mwenda Kevin M , Colvin Christopher J , Lurie Mark N
Published: December 2021

Objectives

For persons living with HIV (PLWH) in long-term care, clinic transfers are common and influence sustained engagement in HIV care, as they are associated with significant time out-of-care, low CD4 count, and unsuppressed viral load on re-entry. Despite the geospatial nature of clinic transfers, there exist limited data on the geospatial trends of clinic transfers to guide intervention development. In this study, we investigate the geospatial characteristics and trends of clinic transfers among PLWH on antiretroviral therapy (ART) in the Western Cape Province of South Africa.

Design

Retrospective spatial analysis.

Setting

PLWH who initiated ART treatment between 2012 and 2016 in South Africa’s Western Cape Province were followed from ART initiation to their last visit prior to 2017. Deidentified electronic medical records from all public clinical, pharmacy, and laboratory visits in the Western Cape were linked across space and time using a unique patient identifier number.

Participants

4176 ART initiators in South Africa (68% women).

Methods

We defined a clinic transfer as any switch between health facilities that occurred on different days and measured the distance between facilities using geodesic distance. We constructed network flow maps to evaluate geospatial trends in clinic transfers over time, both for individuals’ first transfer and overall.

Results

Two-thirds of ART initiators transferred health facilities at least once during follow-up. Median distance between all clinic transfer origins and destinations among participants was 8.6 km. Participant transfers were heavily clustered around Cape Town. There was a positive association between time on ART and clinic transfer distance, both among participants’ first transfers and overall.

Conclusion

This study is among the first to examine geospatial trends in clinic transfers over time among PLWH. Our results make clear that clinic transfers are common and can cluster in urban areas, necessitating better integrated health information systems and HIV care.
Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review
Authors: Somerville Mari , Curran Janet A , Dol Justine , Boulos Leah , Saxinger Lynora , Doroshenko Alexander , Hastings Stephanie , Reynolds Bearach , Gallant Allyson J , Shin Hwayeon Danielle , Wong Helen , Crowther Daniel , Macdonald Marilyn , Martin-Misener Ruth , Comeau Jeannette , McCulloch Holly , Tricco Andrea C
Published: December 2021

Objectives

The four SARS-CoV-2 variants of concern (VOC; Alpha, Beta, Gamma and Delta) identified by May 2021 are highly transmissible, yet little is known about their impact on public health measures. We aimed to synthesise evidence related to public health measures and VOC.

Design

A rapid scoping review.

Data sources

On 11 May 2021, seven databases (MEDLINE, Embase, the Cochrane Database of Systematic Reviews, Central Register of Controlled Trials, Epistemonikos’ L-OVE on COVID-19, medRxiv, bioRxiv) were searched for terms related to VOC, public health measures, transmission and health systems. No limit was placed on date of publication.

Eligibility criteria

Studies were included if they reported on any of the four VOCs and public health measures, and were available in English. Only studies reporting on data collected after October 2020, when the first VOC was reported, were included.

Data extraction and synthesis

Titles, abstracts and full-text articles were screened by two independent reviewers. Data extraction was completed by two independent reviewers using a standardised form. Data synthesis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Results

Of the 37 included studies, the majority assessed the impact of Alpha (n=32) and were conducted in Europe (n=12) or the UK (n=9). Most were modelling studies (n=28) and preprints (n=28). The majority of studies reported on infection control measures (n=17), followed by modifying approaches to vaccines (n=13), physical distancing (n=6) and either mask wearing, testing or hand washing (n=2). Findings suggest an accelerated vaccine rollout is needed to mitigate the spread of VOC.

Conclusions

The increased severity of VOC requires proactive public health measures to control their spread. Further research is needed to strengthen the evidence for continued implementation of public health measures in conjunction with vaccine rollout. With no studies reporting on Delta, there is a need for further research on this and other emerging VOC on public health measures.
Parents’ experiences with a sick or injured child during the COVID-19 lockdown: an online survey in the Netherlands
Authors: Tan Chantal D , Lutgert Eveline K , Neill Sarah , Carter Rachel , Jones Ray B , Chynoweth Jade , Borensztajn Dorine M , Lakhanpaul Monica , Moll Henriette A
Published: December 2021

Objective

To assess the impact of the COVID-19 lockdown on parents’ health-seeking behaviour and care for a sick or injured child in the Netherlands.

Design and setting

An online survey on parents’ experiences with a sick or injured child during the COVID-19 lockdown periods was disseminated through social media.

Participants

Parents living in the Netherlands with a sick or injured child during the lockdown periods from March to June 2020 and from December 2020 to February 2021 were eligible to participate.

Outcome measures

Descriptive statistics and thematic analysis were used to analyse family and children’s characteristics, parents’ response to a sick or injured child, and the perceived impact of the lockdown on child’s severity of illness and treatment reported by parents. Analyses were stratified for children with and without chronic conditions.

Results

Of the 105 parents who completed the survey, 83% reported they would have sought medical help before lockdown compared with 88% who did seek help during lockdown for the same specific medical problem. Parents reported that changes in health services affected their child’s severity of illness (31%) and their treatment (39%), especially for children with chronic conditions. These changes included less availability of healthcare services and long waiting lists, which mostly led to worsening of the child’s illness. During lockdown, there was no change in health-seeking behaviour by parents of children with a chronic condition (N=51) compared with parents of children without a chronic condition.

Conclusion

Parents in the Netherlands who completed the survey were not deterred from seeking medical help for their sick or injured child during the COVID-19 lockdown periods. However, changes in health services affected child’s severity of illness and treatment, especially for children with chronic conditions.
Peripheral nerve blocks in advanced cancer pain: retrospective case series
Authors: Rouhento Erika Anna Sofia , Lehto Juho T , Kalliomäki Maija-Liisa
Published: December 2021

Objectives

Patients with cancer often suffer severe pain that is not relieved with systemic analgesics and requires further treatment options. This study aims to investigate whether peripheral nerve blocks are a feasible treatment option in patients with incurable cancer who suffer from severe pain.

Methods

All patients with advanced cancer who received a peripheral nerve block for the management of pain at the Tampere University Hospital between January 2015 and December 2018 were included in this retrospective study. The characteristics of the patients’ features of the nerve blocks, opioid dosing (daily morphine equivalent) before and after the blocks, and patient-reported pain relief following peripheral block were assessed from the medical records.

Results

Sixteen of the 17 patients included in this study received pain relief through a nerve block. Daily opioid dose was decreased with the block in 12 (71%) patients with a median change in daily morphine equivalent of −20 mg (IQR: −180 to 9). One infection of the catheter and two other transient adverse events occurred, but none was serious or fatal.

Conclusions

Peripheral nerve blocks seem safe and may provide considerable analgesia and decrease the need for opioids in patients with advanced cancer.
Comparing the efficacy and safety of the Skyflow device with those of the Solitaire FR stent in patients with acute ischemic stroke: a prospective, multicenter, randomized, non-inferiority clinical trial
Authors: Zhou Tengfei , Li Tianxiao , Zhu Liangfu , Li Zhaoshuo , Li Qiang , Bai Wei-xing , He Ying-kun , Liu Xiao , Guan Haitao , Long Youming , Liu Jinchao , Wei Liping , Nan Guangxian , Li Hongzhuang , Wen Changming , Zhang Yude , Qiao Hongyu , Han Jianfeng , Wang Shouchun , Gu Jianping , Cai Xueli , Liu Sheng , Zhao Zhenxin
Published: December 2021

Background

Mechanical thrombectomy is the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO) in the anterior circulation. This trial aimed to indicate whether Skyflow, a new thrombectomy device, could achieve the same safety and efficacy as Solitaire FR in the treatment of AIS.

Methods

This study was a prospective, multicenter, randomized, single blind, parallel, positive controlled, non-inferiority clinical trial. Patients with intracranial anterior circulation LVO within 8 hours from onset were included to receive thrombectomy treatment with either the Skyflow or Solitaire FR stent retriever. The primary endpoint was the rate of successful reperfusion (modified Treatment In Cerebral Infarction (mTICI) ≥2b) after the operation. The safety endpoints were the rate of symptomatic intracranial hemorrhage (sICH) and subarachnoid hemorrhage (SAH) at 24 hours after operation.

Results

A total of 95 and 97 patients were involved in the Skyflow group and Solitaire FR group, respectively. A successful reperfusion (mTICI ≥2b) was finally achieved in 84 (88.4%) patients in the Skyflow group and 80 (82.5%) patients in the Solitaire FR group. Skyflow was non-inferior to Solitaire FR in regard to the primary outcome, with the criterion of a non-inferiority margin of 12.5% (p=0.0002) after being adjusted for the combined center effect and the National Institutes of Health Stroke Scale (NIHSS) score. The rate of periprocedural sICH and SAH did not differ significantly between the two groups.

Conclusion

Endovascular thrombectomy with the Skyflow stent retriever was non-inferior to Solitaire FR with regard to successful reperfusion in AIS due to LVO (with a pre-specified non-inferiority margin of 12.5%).
Discussion on ‘
Tabelliscolex
(Cricocosmiidae: Palaeoscolecidomorpha) from the early Cambrian Chengjiang Biota and the evolution of seriation in Ecdysozoa’ by Shi
et al.
2021 (
JGS
, jgs2021-060)
Authors: Smith Martin Ross , Dhungana Alavya
Published: December 2021

Supplementary material:
Code necessary to reproduce analyses from the paper is available at
https://doi.org/10.6084/m9.figshare.16419522
Algorithms for Weighted Independent Transversals and Strong Colouring
Authors: Graf Alessandra , Harris David G. , Haxell Penny
Published: December 2021

An
independent transversal
(IT) in a graph with a given vertex partition is an independent set consisting of one vertex in each partition class. Several sufficient conditions are known for the existence of an IT in a given graph and vertex partition, which have been used over the years to solve many combinatorial problems. Some of these IT existence theorems have algorithmic proofs, but there remains a gap between the best existential bounds and the bounds obtainable by efficient algorithms.

Recently, Graf and Haxell (2018) described a new (deterministic) algorithm that asymptotically closes this gap, but there are limitations on its applicability. In this article, we develop a randomized algorithm that is much more widely applicable, and demonstrate its use by giving efficient algorithms for two problems concerning the strong chromatic number of graphs.
Deposited Layers as Negative Electrodes for Lithium Ion Batteries
Authors: Maca Josef , Libich Jiri , Kazda Tomas , Jasso Kamil , Cudek Pavel
Published: December 2021

The battery usage increases every year. The batteries help with development of mobility both from point of view of portable electronic and from view of goods and people transport in electromobility. One of the main parameters is gravimetric and volumetric capacity, which we are trying continually increase. One of the main ways is to change current used material by new ones with better parameters. One of possibilities is to use thin layer and so-called battery conversion principle. Electrodes works on conversion principle have usual higher capacities. The main disadvantage of such system is large volume change of electrode material due charging and discharging. This can be partly solved by special 3D structure which compensate the volume changes. This work focusses on preparing basic thin layer electrode by help of electrodeposition. The electrodes are then cycled against lithium.
Generating Innovative Solid Polymer Electrolyte Based on Melanin and Without Binder for High Energy Li Batteries
Authors: Shembel Elena , Polishchuk Yuliya , Kyrychenko Volodymyr , Redko Volodymyr , Blyuss Boris A , Pastushkin Tymofiy
Published: December 2021

The goal of this investigation is connected with wishes to use the melanin for formulating the solid polymer electrolyte without the binder for Li batteries. Nature and properties of solid polymer electrolyte of the Li batteries is an important factor for ensuring the properties of Li batteries. For successful optimization the properties of Li batteries the following list includes the important requirements for the polymer electrolyte: high conductivity in wide operating temperature, chemical stability and no ignition at under high temperature - even more than 1000C, low impedance of interface between electrode and solid polymer electrolyte, special design of system - the solid polymer electrolyte in porous structure of electrode. For developing the solid polymer electrolyte without the binder we fulfill this goal includes the melanin in the solid polymer electrolyte.
The Effect of Electrode Binders to Electrochemical Properties of Negative Electrode Materials
Authors: Zsigmond Andras , Libich Jiri
Published: December 2021

This paper deals with various types of electrode binders used in lithium-ion batteries. The electrode binders play important role in battery, the binders directly affect almost all aspect of electrode characteristics. As the one of the most import parameter is the electrode charge-discharge long term stability. The three binders have been tested in context of negative electrode in lithium-ion battery. The natural graphite has been chosen as an active electrode material. The natural graphite takes majority as negative electrode material on commercial market with lithium-ion batteries. The three kind of binders was established for testing: polyvinylidene fluoride (PVDF), styrene-butadiene rubber (SBR) and polyimide P84. The influence of these binders on charge-discharge stability are evaluated and described in this paper.
Surface Characteristics of TiO2 and Their Effect on Specific Capacity in Lithium and Sodium Systems
Authors: Globa Nataliya I. , Shmatok Yurii V. , Lisnycha Tatyana V. , Kirillov Sviatoslav A.
Published: December 2021

The paper presents the results of studies of nanosized titanium dioxide (TiO2) samples synthesized by alkaline hydrolysis. The surface properties of the samples were modified using high-temperature annealing. As a result, samples with a specific surface area of 31-203 m2/g were obtained. The specific capacity of TiO2 in lithium and sodium cells was determined. It is noted that the nature of the curves obtained, the specific capacity and its stability during cycling depend on the nature of the alkali metal cation and the surface properties of TiO2.
Chemical Changes During Cycling on the Surface of the Negative Electrode of Lead-Acid Batteries
Authors: Smejkal Jan , Chladil Ladislav
Published: December 2021

Our contribution deals with the study of surface processes and chemical composition on the surface of the negative electrode of a lead-acid battery during cycling at different speeds. Thin electrodes were created for the measurements. The negative electrode was analyzed at six SOC states (100 %, 80 %, 60 %, 40 %, 20 % and 0 % SOC). The proportion of individual elements on the surface of the negative electrode during cycling at 0.2 C, 0.3 C and 0.5 C was evaluated. Chemical changes occurring on the surface of the negative electrode during cycling of the lead-acid battery were measured using an X-ray diffractometer, and the presence of individual chemical elements on the surface of the electrode was evaluated using the Rietveld method. At higher cycling speeds, an increase in the material was observed, which did not convert during cycling, and higher cycling speeds caused a more significant material conversion near the negative electrode collector.