bluuebunny/crossref_metadata_2025 huggingface dataset:
Salt tolerance in relation to elemental concentrations in leaf cell vacuoles and chloroplasts of a C4 monocotyledonous halophyte
Authors: Oi Takao , Clode Peta L , Taniguchi Mitsutaka , Colmer Timothy D , Kotula Lukasz
Published: February 2022

Halophytes accumulate and sequester high concentrations of salt in vacuoles while maintaining lower levels of salt in the cytoplasm. The current data on cellular and subcellular partitioning of salt in halophytes are, however, limited to only a few dicotyledonous C3 species. Using cryo‐scanning electron microscopy X‐ray microanalysis, we assessed the concentrations of Na, Cl, K, Ca, Mg, P and S in various cell types within the leaf‐blades of a monocotyledonous C4 halophyte, Rhodes grass (Chloris gayana). We also linked, for the first time, elemental concentrations in chloroplasts of mesophyll and bundle sheath cells to their ultrastructure and photosynthetic performance of plants grown in nonsaline and saline (200 mM NaCl) conditions. Na and Cl accumulated to the highest levels in xylem parenchyma and epidermal cells, but were maintained at lower concentrations in photosynthetically active mesophyll and bundle sheath cells. Concentrations of Na and Cl in chloroplasts of mesophyll and bundle sheath cells were lower than in their respective vacuoles. No ultrastructural changes were observed in either mesophyll or bundle sheath chloroplasts, and photosynthetic activity was maintained in saline conditions. Salinity tolerance in Rhodes grass is related to specific cellular Na and Cl distributions in leaf tissues, and the ability to regulate Na and Cl concentrations in chloroplasts.
One and done? Exploring linkages between households' intended adaptations to climate‐induced floods
Authors: Noll Brayton , Filatova Tatiana , Need Ariana
Published: February 2022

As climate change increases the probability and severity of natural hazards, the need for coordinated adaptation at all levels of society intensifies. Governmental‐level adaptation measures are essential, but insufficient in the face of growing risks, necessitating complementary action from households. Apprehending the drivers of household adaptation is critical if governments are to stimulate protective behavior effectively. While past work has focused on the behavioral drivers of household adaptation, little attention has been paid to understanding the relationships between adaptation measures themselves—both previously undergone and additionally (planned) intended adaptation(s). Using survey data (N = 4,688) from four countries—the United States, China, Indonesia, and the Netherlands—we utilize protection motivation theory to account for the behavioral drivers of household adaptation to the most devastating climate‐driven hazard: flooding. We analyze how past and additionally intended adaptations involving structural modification to one's home affect household behavior. We find that both prior adaptations and additionally intended adaptation have a positive effect on intending a specific adaptation. Further, we note that once links between adaptations are accounted for, the effect that worry has on motivating specific actions, substantially lessens. This suggests that while threat appraisal is important in initially determining if households intend to adapt, it is households' adaptive capacity that determines how. Our analysis reveals that household structural modifications may be nonmarginal. This could indicate that past action and intention to pursue one action trigger intentions for other adaptations, a finding with implications for estimating the speed and scope of household adaptation diffusion.
Who am I and what do my peers think: How do gender identity and peer norms relate to other‐gender friendships
Authors: Andrews Naomi C. Z. , Cook Rachel E. , Martin Carol Lynn
Published: February 2022

Though there is increasing awareness of the potential benefits of other‐gender interactions and friendships, there has been little research examining the factors that might act as barriers or promoters of such friendships. Our goal was to explore both individual‐level factors (i.e., gender identity) and indicators of the social environment (i.e., perceived peer norms) that might relate to other‐gender friendships. Sixth graders (N = 396, 47% girls; 65% White) nominated friends in their classrooms, reported their similarity to both own‐ and other‐gender peers and reported on perceived peer norms related to other‐gender interaction. Results indicated that, in general, feeling similar to other‐gender youth was associated with more other‐gender friends. Positive peer norms (e.g., heightened respect) but not negative norms (e.g., teasing) also were associated with more other‐gender friends. Findings have implications for the importance of broadening our understanding of friendship homophily to consider gendered interests/similarities in addition to gender category. Further, the promotion of positive peer norms over negative ones might be an effective means of intervention to promote other‐gender friendships.
Evaluation of geriatric trauma in dogs with moderate to severe injury (6169 cases): A VetCOT registry study
Authors: Young Anda A. , Cooper Edward , Yaxley Page , Habing Greg
Published: February 2022

Objective

To examine geriatric classification as a predictor of survival in moderate to severely injured dogs denoted by animal trauma triage (ATT) scores ≥3 or modified Glasgow Coma Scale (mGCS) scores ≤14.

Design

Retrospective observational cohort study utilizing data collected between September 2013 and May 2019 with follow‐up until death or hospital discharge.

Setting

Thirty‐one trauma centers including university teaching hospitals and private referral centers.

Animals

A total of 6169 dogs entered into the Veterinary Committee on Trauma Registry with complete data entry including age, weight, outcome, mGCS (≤14), and/or ATT (≥3).

Interventions

None.

Measurements and Main Results

The effect of geriatric classification on survival was estimated using shared‐frailty cox proportional hazard models. Model 1 dependent variables: death despite intervention or euthanasia due to grave prognosis. Model 2 dependent variables: death by euthanasia due to financial influence or combined influence of finances and grave prognosis. Model 3 evaluated interactions between geriatric classification and moderate versus severe trauma. The shared‐frailty models controlled for contributing site as a random effect and other confounding variables, including trauma severity. Model 1: geriatrics had a significantly increased hazard risk (HR) for death (HR = 1.48, P < 0.0001). Model 2: geriatrics had an insignificant increased HR for death (HR = 1.34, P = 0.08). Model 3: geriatrics demonstrated significantly increased mortality risk with moderate level trauma. Additional Model 1 variables independently associated with mortality include ATT perfusion, neurologic, respiratory subscores, mGCS motor subscore, weight, and spinal trauma. Additional Model 2 variables independently associated with mortality include ATT perfusion subscore and neuter status. In general, statistical differences between cohorts were found with regard to lactate, PCV, total protein, and glucose.

Conclusions

Among moderately injured dogs who experienced death despite intervention or euthanasia due to grave prognosis, mortality risk is significantly higher in geriatrics as compared to nongeriatrics.
Collaborative practices with parents and primary caregivers in pediatric occupational therapy: a scoping review protocol
Authors: Lage Carla Ribeiro , Wright Shelley , de Souza Monteiro Rafaelle Gracine , Boshoff Kobie
Published: February 2022

Objective:

This scoping review aims to identify and describe the available literature on current collaborative practices with parents and primary caregivers in pediatric occupational therapy. The review will also explore the definition of collaborative practices and the therapeutic approaches employed in the literature.

Introduction:

The family-centered approach in occupational therapy has proven effective in supporting families’ education about their child's condition, as well as intervention strategies. One of the pillars of this approach is parent-therapist collaboration. Collaborative practices enable shared decision-making and mutual engagement between families and professionals. The literature has shown inconsistencies in the definitions, language, and implementation of collaborative practices and family-centered literature. Such inconsistencies have been hindering the transition from traditional service delivery to a family-centered approach.

Inclusion criteria:

This review will include studies investigating collaborative practices in pediatric occupational therapy. Accepted studies must include a description of the therapeutic practices undertaken and an explanation of how the collaboration between parents and/or primary caregivers and professionals occurred. All pediatric occupational therapy areas will be considered for inclusion, including practices with other disciplines. However, studies including only adolescents or using child-centered interventions exclusively will be excluded.

Methods:

The search will employ indexed terms and keywords in seven databases (MEDLINE, PsyclNFO, ERIC, Embase, OTseeker, Scopus, and ProQuest Central). Eligible sources must be written in English, and will not be limited to date range or location. Data will be extracted, charted, and descriptively analyzed by four reviewers based on JBI recommendations. Study findings will be presented and mapped in tables and diagrams to address the study aims.
Rapid reviews and the methodological rigor of evidence synthesis: a JBI position statement
Authors: Tricco Andrea C. , Khalil Hanan , Holly Cheryl , Feyissa Garumma , Godfrey Christina , Evans Catrin , Sawchuck Diane , Sudhakar Morankar , Asahngwa Constantine , Stannard Daphne , Abdulahi Misra , Bonnano Laura , Aromataris Edoardo , McInerney Patricia , Wilson Rosemary , Pang Dong , Wang Zhiwen , Cardoso Ana Filipa , Peters Micah D.J. , Marnie Casey , Barker Timothy , Pollock Danielle , McArthur Alexa , Munn Zachary
Published: February 2022

The demand for rapid reviews has exploded in recent years. A rapid review is an approach to evidence synthesis that provides timely information to decision-makers (eg, health care planners, providers, policymakers, patients) by simplifying the evidence synthesis process. A rapid review is particularly appealing for urgent decisions. JBI is a world-renowned international collaboration for evidence synthesis and implementation methodologies. The principles for JBI evidence synthesis include comprehensiveness, rigor, transparency, and a focus on applicability to clinical practice. As such, JBI has not yet endorsed a specific approach for rapid reviews. In this paper, we compare rapid reviews versus other types of evidence synthesis, provide a range of rapid evidence products, outline how to appraise the quality of rapid reviews, and present the JBI position on rapid reviews. JBI Collaborating Centers conduct rapid reviews for decision-makers in specific circumstances, such as limited time or funding constraints. A standardized approach is not used for these cases;instead, the evidence synthesis methods are tailored to the needs of the decision-maker. The urgent need to deliver timely evidence to decision-makers poses challenges to JBI's mission to produce high-quality, trustworthy evidence. However, JBI recognizes the value of rapid reviews as part of the evidence synthesis ecosystem. As such, it is recommended that rapid reviews be conducted with the same methodological rigor and transparency expected of JBI reviews. Most importantly, transparency is essential, and the rapid review should clearly report where any simplification in the steps of the evidence synthesis process has been taken.
Clasificación del riesgo de lavado de activos y financiación del terrorismo en Colombia en 2019
Authors: Rangel Quiñonez Henry Sebastián , Barrera Gómez Gilma , Gómez Sánchez Oscar Mauricio
Published: February 2022

El lavado de activos y el financiamiento del terrorismo son actividades ilícitas que perjudican el crecimiento y la estabilidad económica de un país; estos delitos están relacionado con el aumento de la pobreza y la violencia por lo que su control debe ser riguroso. La presente investigación diseña un modelo de segmentación basado en el factor jurisdicción que permite identificar las ciudades de mayor exposición al riesgo del Lavado de Activos y Financiación del Terrorismo (LAFT) en Colombia. Para dar cumplimiento a lo anterior, se recolecta la información disponible para 1122 municipios del país, proveniente de fuentes externas como la Fiscalía General de la Nación, el Observatorio de Drogas de Colombia e Indepaz. Los resultados reflejan que el 85% de los municipios son clasificados como riesgo bajo, 15% como riesgo medio y menos del 1% como riesgo alto en lavado de activos
Optimized Joint Coordinate System Achieves Clinically Meaningful Kinematics of the Tibiofemoral Joint as Compared to the International Society of Biomechanics (ISB) Recommendation
Authors: Haudenschild Anne , Hull Maury
Published: February 2022

Quantification of clinically meaningful tibiofemoral motions requires a coordinate system where motions are free from kinematic crosstalk errors. The objectives were to 1) develop an algorithm for assigning an optimized joint coordinate system (OPT JCS) that minimizes kinematic crosstalk errors based on a kinematic model of the tibiofemoral joint, 2) determine tibiofemoral kinematics of the native (i.e. healthy) knee during deep knee bend using OPT JCS and a coordinate system recommended by the International Society of Biomechanics (ISB JCS), and 3) determine whether OPT JCS significantly reduces kinematic crosstalk errors compared to ISB JCS. A novel algorithm was developed for assigning a patient-specific, OPT JCS based on a two rotational degree-of-freedom kinematic model, which included flexion-extension and internal-external tibial rotation axes. Single-plane fluoroscopic images of native knees of 13 subjects performing deep knee bend were analyzed to show that tibiofemoral kinematics using OPT-JCS fell within the physiological range of motion in all six degrees of freedom. Internal rotation of the tibia with respect to the femur averaged 11 deg and off-axis motions were minimal as expected based on biomechanical constraints. In contrast, off-axis motions for ISB JCS were non-physiologic; maximum valgus rotation was 12 deg, maximum posterior translation was 12 mm, and maximum distraction translation was 28 mm. Hence, an optimized JCS achieved clinically meaningful kinematics by significantly reducing kinematic crosstalk errors compared to the ISB recommendation and is the more suitable coordinate system for evaluating tibiofemoral joint function.
Fault Diagnosis of Bearings Using Recurrences and Artificial Intelligence Techniques
Authors: Sharma Aditya
Published: February 2022

Rolling element bearings are one of the most common mechanical components used in a wide variety of rotating systems. The performance of these systems is closely associated with the health of bearings. In this study, a nonlinear time series analysis method, i.e., recurrence analysis is utilized to assess the health of bearings using time domain data. The recurrence analysis acquires the quantitative measures from the recurrence plots and provides an insight to the system under investigations. Experiments are performed to generate the vibration data from the healthy and faulty bearing. Eight recurrence quantitative analysis measures and five time-domain measures are used for the investigations. Three artificial intelligence techniques: rotation forest, artificial neural network, and support vector machine are employed to quantify the diagnosis performance. Results highlight the ability of recurrence analysis to identify the health state of the bearing at the early stage and superior diagnosis accuracy of the proposed methodology.
High-energy photoelectron spectroscopy of 6H-SiC wafer with Cr Kα excitation
Authors: Deleuze Pierre-Marie , Artyushkova Kateryna , Martinez Eugénie , Renault Olivier
Published: February 2022

A C-terminated SiC wafer was analyzed by high-energy photoelectron spectroscopy using monochromatic Cr Kα (5414.8 eV) radiation. The data include a survey scan and high-resolution spectra of Si 1s, Si 2s, Si 2p, C 1s, and O 1s core levels.
Does Complex Training Enhance Vertical Jump Performance and Muscle Power in Elite Male Volleyball Players?
Authors: Berriel Guilherme P. , Cardoso Ananda S. , Costa Rochelle R. , Rosa Rodrigo G. , Oliveira Henrique B. , Kruel Luiz Fernando M. , Peyré-Tartaruga Leonardo A.
Published: February 2022

Purpose: The authors aimed to compare the effects of 4 weeks jump versus complex training methods on lower limb muscle power and maximal isokinetic torque of knee extensors and flexors in elite male volleyball players. Methods: Sixteen male volleyball players were allocated into 2 groups, jump training (n = 8; 27.0 [5.7] y, 94.3 [7.6] kg) and complex training (with induction of postactivation performance enhancement, n = 8; 26.6 [3.6] y, 94.2 [6.3] kg). All individuals performed jump training 2 sessions/wk, and the complex group received induction training with postactivation performance enhancement and jump training. Results: After 4 weeks, an increase in countermovement jump height (jump: 49.0 [1.2] to 52.7 [2.1] cm and complex: 49.2 [1.1] to 53.3 [1.9] cm; P = .009) and power (jump: 29.5 [1.1] to 34.3 [1.4] W and complex: 30.4 [0.9] to 34.4 [1.08] W; P = .001) was observed without significant differences between groups and without significant group × time interaction (P > .05). Also, no significant difference was observed between and within groups for the isokinetic peak torque at low speeds (60 and 180°s), although total muscle work and knee extensor/flexor ratio increased from pretraining to posttraining at 300° seconds similarly in both groups. Conclusion: The findings indicate that jump performance and power, knee extensor/flexor ratio, and total muscle work increased after 4 weeks of jump and complex training. However, the inclusion of heavy resistance stimulus did not elicit any additional improvements in the vertical jump performance and isokinetic strength of elite volleyball players.
Community-acquired fungal pyelonephritis with renal infarction and gangrene of the colon: an uncommon diagnosis
Authors: Samuel Stephen Varghese , George Tarun K , Gopinathan Vikram Raj , Abraham O C
Published: February 2022

A 54-year-old male farmer with a history of long-standing uncontrolled type 2 diabetes mellitus (HbA1c 10.8) presented with a 3-week history of fever, intermittent vomiting, malaise and left flank pain for which he was treated with broad-spectrum antibiotics and oral antifungals forCandidaisolated from urine culture. CT of the abdomen revealed predominant involvement of the left kidney and retroperitoneal structures. Nephrectomy was performed due to worsening abdominal pain and features of bowel perforation found on imaging. Pus culture from the necrotic kidney grew aseptate fungal hyphae, and the histopathological examination was suggestive of zygomycosis. He received amphotericin B postoperatively, but his condition deteriorated and he succumbed to nosocomial gram-negative septicaemia.
Lactic acidosis and multisystem organ failure following ibuprofen overdose requiring haemodialysis
Authors: Pollack Blythe E , Barbaro Ryan P , Selewski David T , Carlton Erin F
Published: February 2022

A 17-year-old man was admitted to the paediatric intensive care unit 2 hours following an intentional ingestion of unknown substances. In the first 23 hours of hospitalisation, lactate levels remained elevated at 2–4 mmol/L, during the 24th hour, he developed lactic acidosis with lactate levels increasing from 4 to 16 mmol/L. His neurological status declined, requiring orotracheal intubation. Central and arterial access were obtained, and vasoactive infusions were initiated for haemodynamic support. Due to increasing lactate levels (maximum level >24 mmol/L) and haemodynamic instability, a dialysis line was inserted, and continuous renal replacement therapy (CRRT) was initiated. The lactic acidosis resolved over 10 hours. Serum ibuprofen level subsequently resulted at 841 µg/mL (reference range 10–50). Few reported cases discuss the sequela of large quantity ibuprofen ingestion leading to severe lactic acidosis and multiorgan system failure. Early intervention with CRRT may reverse acidosis, stabilise haemodynamics and halt secondary organ failure.
ALK-positive anaplastic large cell lymphoma of skeletal muscle masquerading as soft tissue sarcoma
Authors: Gupta Deepika , Vishwajeet Vikarn , Ramzan Mohammed , Elhence Poonam Abhay
Published: February 2022

Anaplastic large cell lymphoma (ALCL) is a subtype of T cell non-Hodgkin’s lymphoma and can present as an extranodal disease. Primary ALCL of skeletal muscle is rare. We report a case of ALK-positive ALCL involving the left thigh and anterior chest wall in a 12-year-old male child. The fine needle aspiration cytology from the lesion showed cellular smears with singly scattered and occasional clusters of large pleomorphic atypical cells. A diagnosis of poorly differentiated malignant neoplasm was rendered. On core biopsy, the histomorphological features posed a diagnostic challenge with a myriad of morphological mimickers. The diagnosis was established by excluding specific entities by relevant immunostains and confirming the diagnosis by strong expression of CD30 and ALK on immunohistochemistry. Fluorescence in-situ hybridisation confirmed the characteristic t(2:5) translocation. Presentation of ALCL with skeletal muscle involvement is uncommon, and the diagnosis relies on broadening the diagnostic possibilities and judicious use of immunohistochemical markers.
Usefulness of renal diffusion-weighted magnetic resonance imaging for early diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome
Authors: Kawai Honami , Suzuki Yoshio , Shiojiri Toshiaki
Published: February 2022

A teenage girl presented with fever after aspirin use. Examination revealed no organ-specific symptoms. The serum creatinine level and urine analysis findings were normal. The drug lymphocyte stimulation test was positive for aspirin. Diffusion-weighted magnetic resonance imaging (DW-MRI) revealed hyperintensity in both kidneys although serum creatinine was only mildly elevated. A subsequent kidney biopsy confirmed acute interstitial nephritis (AIN). She later developed uveitis and the final diagnosis was tubulointerstitial nephritis and uveitis (TINU) syndrome, possibly triggered by aspirin, requiring systemic and topical corticosteroid therapies. TINU syndrome should be considered in young patients with fever of unknown origin and a history of nonsteroidal anti-inflammatory drug use. This is the first reported case suggesting the usefulness of DW-MRI, which is safe for children without exposure to ionising radiation, in detecting early-stage AIN before apparent kidney impairment.
Middle turbinate angiofibroma in an adolescent boy
Authors: Hassan Mohamed Faizal , Nagi Kezevino , Saxena Sunil Kumar , Srinivas Bheemanathi Hanuman
Published: February 2022

Bleeding nasal mass in adolescent boys has customarily been attributed to Juvenile nasopharyngeal angiofibroma. However, little is known regarding the extranasopharyngeal origin of angiofibroma, as highlighted in this case report of a 15-year-old boy who presented with recurrent epistaxis and nasal obstruction. On constructing a working diagnosis of nasal haemangioma, the patient was taken up for endoscopic excision under general anaesthesia. Intraoperative endoscopic findings and histopathological examination revealed the diagnosis of middle turbinate angiofibroma, which is an extremely rare extranasopharyngeal angiofibroma. Consequently, this represents the third described case of a juvenile angiofibroma arising from the middle turbinate.
Management of postpartum haemorrhage in a patient with Klippel-Trènaunay syndrome
Authors: Benson Emily , Chen Huigen , Nakhosteen Ali , Yoong Wai
Published: February 2022

Klippel-Trènaunay syndrome is a rare congenital disorder characterised by vascular malformations, which may be exacerbated during pregnancy and pose considerable thromboembolic and haemorrhagic risk for obstetric patients. We report on a patient with this syndrome who underwent elective caesarean section which was indicated due to previous obstetric anal sphincter injury. We describe her multidisciplinary preoperative planning and successful management of major postpartum haemorrhage with uterine compression sutures and intrauterine balloon tamponade (‘uterine sandwich’).
Rare case of renal Ewing sarcoma presenting as ectopic Cushing syndrome in a 12-year-old girl
Authors: Karguppikar Madhura Bharat , Oza Chirantap Markand , Khadilkar Vaman , Khadilkar Anuradha
Published: February 2022

We present a 12-year-old girl with recent onset weight gain and purple striae over the abdomen. Examination revealed her to be hypertensive. On evaluation for Cushing syndrome (CS), her cortisol and adrenocorticotropic hormone (ACTH) were found to be high. MRI brain showed a suspicious lesion (thought to be pituitary microadenoma). Inferior petrosal sinus sampling was not conclusive of pituitary source of ACTH. High dose dexamethasone suppression test confirmed an ectopic source of ACTH secretion and CT scan revealed a mass in the right kidney which was laparoscopically excised. Histopathology and immunohistochemistry confirmed Ewing sarcoma. Our case highlights the rare presentation of renal Ewing sarcoma (RES) as CS. To the best of our knowledge, this is only the second case report of RES/primitive neuroectodermal tumour of the kidney presenting as CS in paediatric age group and first with a concomitant pituitary incidentaloma.
Augmented-reality telementoring for leg fasciotomy: a proof-of-concept study
Authors: McPherson John , Kennedy C , Slobogean G , Hilsden R , Talbot M
Published: February 2022

Background

Prolonged field care is required when casualty evacuation to a surgical facility is delayed by distance, weather or tactical constraints. This situation can occur in both civilian and military environments. In these circumstances, there are no established treatment options for extremity compartment syndrome. Telementoring by a surgeon may enable the local clinician to perform a fasciotomy to decompress the affected compartments.

Methods

Six military clinicians were asked to perform a two-incision leg fasciotomy in synthetic models under the guidance of an orthopaedic surgeon located 380 km away. Communication occurred through commercially available software and smartglasses, which also allowed the surgeon to send augmented-reality graphics to the operators. Two blinded surgeons evaluated the specimens according to objective criteria. Control specimens were added to ensure the integrity of the evaluation process.

Results

The six study participants were military physician assistants who had extensive clinical experience but had never performed a fasciotomy. The average duration of the procedure was 53 min. All six procedures were completed without major errors: release of all four compartments was achieved through full-length incisions in the skin and fascia. The only surgical complication was a laceration of the saphenous vein. All three control specimens were correctly assessed by the evaluators. None of the participants experienced adverse effects from wearing the smartglasses. Four dropped calls occurred, but the connection was re-established in all cases.

Conclusion

All six surgical procedures were completed successfully. We attribute the dropped calls to a mismatch between the size of the graphic files and the available bandwidth. A better technical understanding of the software by the mentoring surgeon would have avoided this problem. Important considerations for future research and practice include protocols for dropped communications, surgical skills training for the operators and communication training for the surgeons.
Potential effect of real-world junk food and sugar-sweetened beverage taxes on population health, health system costs and greenhouse gas emissions in New Zealand: a modelling study
Authors: Grout Leah , Mizdrak Anja , Nghiem Nhung , Jones Amanda C , Blakely Tony , Ni Mhurchu Cliona , Cleghorn Christine
Published: February 2022

Poor diet is a major risk factor for excess weight gain and obesity-related diseases, including cardiovascular diseases, type 2 diabetes mellitus, osteoarthritis and several cancers. This paper aims to assess the potential impacts of real-world food and beverage taxes on change in dietary risk factors, health gains (in quality-adjusted life years (QALYs)), health system costs and greenhouse gas (GHG) emissions as if they had all been implemented in New Zealand (NZ). Ten taxes or tax packages were modelled. A proportional multistate life table model was used to predict resultant QALYs and costs over the remaining lifespan of the NZ population alive in 2011, as well as GHG emissions. QALYs ranged from 12.5 (95% uncertainty interval (UI) 10.2 to 15.0; 3% discount rate) per 1000 population for the import tax on sugar-sweetened beverages (SSB) in Palau to 143 (95% UI 118 to 171) per 1000 population for the excise duties on saturated fat, chocolate and sweets in Denmark, while health expenditure savings ranged from 2011 NZ$245 (95% UI 188 to 310; 2020 US$185) per capita to NZ$2770 (95% UI 2140 to 3480; US$2100) per capita, respectively. The modelled taxes resulted in decreases in GHG emissions from baseline diets, ranging from −0.2% for the tax on SSB in Barbados to −2.8% for Denmark’s tax package. There is strong evidence for the implementation of food and beverage tax packages in NZ or similar high-income settings.
Impact of cancer diagnoses on the outcomes of patients with COVID-19: a systematic review and meta-analysis
Authors: Han Shuting , Zhuang Qingyuan , Chiang Jianbang , Tan Sze Huey , Chua Gail Wan Ying , Xie Conghua , Chua Melvin L K , Soon Yu Yang , Yang Valerie Shiwen
Published: February 2022

Background

The COVID-19 has caused significant mortality and morbidity across the globe. Patients with cancer are especially vulnerable given their immunocompromised state. We aimed to determine the proportion of COVID-19 patients with cancer, their severity and mortality outcomes through a systematic review and meta-analysis (MA).

Methods

Systematic review was performed through online databases, PubMed, Medline and Google Scholar, with keywords listed in the Methods section (1 November 2019–31 December 2020). Studies with clinical outcomes of at least 10 COVID-19 patients and at least one with a diagnosis of cancer were included. The studies for MA were assessed with PRISMA guidelines and appraised with Newcastle-Ottawa Scale. The data were pooled using a random-effects model using STATA software. The main outcomes were planned before data collection, including proportion of patients with cancer among COVID-19 populations, relative risk (RR) of severe outcomes and death of patients with cancer compared with general COVID-19 patients.

Results

We identified 57 case series (63 413 patients), with 230 patients with cancer with individual patient data (IPD). We found that the pooled proportion of cancer among COVID-19 patients was 0.04 (95% CI 0.03 to 0.05, I2=97.69%, p<0.001). The pooled RR of death was 1.44 (95% CI 1.19 to 1.76) between patients with cancer and the general population with COVID-19 infection. The pooled RR of severe outcome was 1.49 (95% CI 1.18 to 1.87) between cancer and general COVID-19 patients. The presence of lung cancer and stage IV cancer did not result in significantly increased RR of severe outcome. Among the available IPD, only age and gender were associated with severe outcomes.

Conclusion

Patients with cancer were at a higher risk of severe and death outcomes from COVID-19 infection as compared with general COVID-19 populations. Limitations of this study include publication bias. A collaborative effort is required for a more complete database.
Determinants of HIV infection among children born from mothers on prevention of mother to child transmission programme of HIV in southern Ethiopia: a case–control study
Authors: Hussen Rehima , Zenebe Wagaye Alemu , Mamo Tizalegn Tesfaye , Shaka Mohammed Feyisso
Published: February 2022

Objective

This study was aimed to identify determinants of HIV infection among children born from mothers on the prevention of mother to child transmission (PMTCT) programme in Southern Ethiopia. It was designed to explore the main contributors to the considerable transmission rate of HIV from mother to child.

Setting and design

A multicentre facility-based unmatched case–control study was conducted using 27 health facilities providing PMTCT service in Southern Ethiopia.

Participants

Out of 307 (62 cases and 245 controls) expected to participate in this study, a total of 290 mother–child pairs of 58 cases and 232 controls have completed the interview. Cases were children born to mothers on PMTCT programme and with DNA PCR or antibody HIV positive test result at ≤24 months of age. Controls were children born to mothers on PMTCT programme and with DNA PCR or antibody HIV negative test result at ≤24 months of age.

Result

Data were collected from the mother and record and analysed using SPSS V.20. Logistic regression analysis was done for statistical association and the significance of association was declared at a p value of <0.05. Rural residence (adjusted OR (AOR): 4.15, 95% CI: (1.57 to 10.97)), knowing serostatus during current pregnancy (AOR: 5.11, 95% CI: (1.33 to 19.69)), home delivery (AOR: 6.00, 95% CI: (2.310 to 15.593)), poor partner involvement (AOR: 5.95, 95% CI: 1.91 to 18.53)), poor adherence, late enrolment of the child for ARV prophylaxis (AOR: 4.89, 95% CI: 1.34 to 17.88)), mixed breastfeeding practice (AOR: 10.36, 95% CI: (3.10 to 34.60)) and failure to be on cotrimoxazole therapy (AOR: 7.56, 95% CI: 2.07 to 27.61)) were factors significantly associated with MTCT.

Conclusion

The finding implies that more needs to be done on rural residents, strengthening screening for HIV before pregnancy, encouraging male involvement, early enrolment of child for ARV prophylaxis, avoiding mixed breast feeding and putting newborn on cotrimoxazole therapy.
Transformation of identity in substance use as a pathway to recovery and the potential of treatment for hepatitis C: a systematic review protocol
Authors: Donaldson Sarah R , Radley Andrew , Dillon John F
Published: February 2022

Introduction

Hepatitis C virus (HCV) is a strongly stigmatised disease as it is framed within the context of injecting substance use. HCV provides the identity of ‘dirty’ or ‘junky’, with perceptions by others being beyond the control of the individual. People who experience problematic substance use are often viewed as being outside acceptable social behaviours, thus viewed as having tainted identities or second-class citizens. It is suggested that to recover from substance use, people should move towards social networks where substance use is not the norm and there is greater recovery support. The social identity model of recovery advocates that the mechanism to do this is by developing a new identity. It is unclear what catalysts provide this change in identity. This systematic review aims to describe actions, interventions and treatments that provide the opportunity for new identities and considers evidence that supports the hypothesis that curing HCV with direct acting antivirals may provide this opportunity.

Methods and analysis

Methods are informed by the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement. Seven electronic peer-reviewed and four grey literature sources were identified and preliminary searches have been conducted. The inclusion and exclusion criteria are broad to capture activities that result in a change in identity, recovery from substance use, quality of life, life satisfaction or the opportunity for the individual to reclaim their place in society (citizenship). Qualitative and quantitative literature are eligible. Papers will be assessed against standardised criteria and checked independently and in duplicate. A narrative synthesis of the findings will be reported, structured around intervention type, population context and outcomes.

Ethics and dissemination

This systematic review will be based on studies that have already been conducted and therefore no ethical approvals are required. The resulting findings will be submitted to an international peer-reviewed journal and disseminated at relevant research conferences.

PROSPERO registration number

CRD42020209447.
Conceptualising centres of excellence: a scoping review of global evidence
Authors: Manyazewal Tsegahun , Woldeamanuel Yimtubezinash , Oppenheim Claire , Hailu Asrat , Giday Mirutse , Medhin Girmay , Belete Anteneh , Yimer Getnet , Collins Asha , Makonnen Eyasu , Fekadu Abebaw
Published: February 2022

Objective

Globally, interest in excellence has grown exponentially, with public and private institutions shifting their attention from meeting targets to achieving excellence. Centres of Excellence (CoEs) are standing at the forefront of healthcare, research and innovations responding to the world’s most complex problems. However, their potential is hindered by conceptual ambiguity. We conducted a global synthesis of the evidence to conceptualise CoEs.

Design

Scoping review, following Arksey and O’Malley’s framework and methodological enhancement by Levac et al and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Data sources

PubMed, Scopus, CINAHL, Google Scholar and the Google engine until 1 January 2021.

Eligibility

Articles that describe CoE as the main theme.

Results

The search resulted in 52 161 potential publications, with 78 articles met the eligibility criteria. The 78 articles were from 33 countries, of which 35 were from the USA, 3 each from Nigeria, South Africa, Spain and India, and 2 each from Ethiopia, Canada, Russia, Colombia, Sweden, Greece and Peru. The rest 17 were from various countries. The articles involved six thematic areas—healthcare, education, research, industry, information technology and general concepts on CoE. The analysis documented success stories of using the brand ‘CoE’—an inﬂuential brand to stimulate best practices. We identified 12 essential foundations of CoE—specialised expertise; infrastructure; innovation; high-impact research; quality service; accreditation or standards; leadership; organisational structure; strategy; collaboration and partnership; sustainable funding or financial mechanisms; and entrepreneurship.

Conclusions

CoEs have significant scientific, political, economic and social impacts. However, there are inconsistent use and self-designation of the brand without approval by an independent, external process of evaluation and with high ambiguity between ‘CoEs’ and the ordinary ‘institutions’ or ‘centres’. A comprehensive framework is needed to guide and inspire an institution as a CoE and to help government and funding institutions shape and oversee CoEs.
Stakeholders’ views of supporting asthma management in schools with a school-based asthma programme for primary school children: a qualitative study in Malaysia
Authors: Ramdzan Siti Nurkamilla , Khoo Ee Ming , Liew Su May , Cunningham Steve , Pinnock Hilary
Published: February 2022

Objective

The WHO Global School Health Initiative aimed to improve child and community health through health promotion programmes in schools, though most focus on preventing communicable disease. Despite WHO recommendations, no asthma programme is included in the Malaysian national school health service guideline. Therefore, we aimed to explore the views of school staff, healthcare professionals and policy-makers about the challenges of managing asthma in schools and the potential of a school asthma programme for primary school children.

Design

A focus group and individual interview qualitative study using purposive sampling of participants to obtain diverse views. Data collection was guided by piloted semistructured topic guides. The focus groups and interviews were audiorecorded, transcribed verbatim and analysed using inductive thematic analysis. We completed data collection once data saturation was reached.

Setting

Stakeholders in education and health sectors in Malaysia.

Participants

Fifty-two participants (40 school staff, 9 healthcare professionals and 3 policy-makers) contributed to nine focus groups and eleven individual interviews.

Results

School staff had limited awareness of asthma and what to do in emergencies. There was no guidance on asthma management in government schools, and teachers were unclear about their role in school children’s health. These uncertainties led to delays in the treatment of asthma symptoms/attacks, and suggestions that an asthma education programme and a school plan would improve asthma care. Perceived challenges in conducting school health programmes included a busy school schedule and poor parental participation. A tailored asthma programme in partnerships with schools could facilitate the programme’s adoption and implementation.

Conclusions

Identifying and addressing issues and challenges specific to the school and wider community could facilitate the delivery of a school asthma programme in line with the WHO School Health Initiative. Clarity over national policy on the roles and responsibilities of school staff could support implementation and guide appropriate and prompt response to asthma emergencies in schools.
Effect of sedation with inhaled anaesthetics on cognitive and psychiatric outcomes in critically ill adults: a systematic review protocol
Authors: Cuninghame Sean , Gorsky Kevin , Francoeur Conall , Withington Davinia , Burry Lisa , Jerath Angela , Slessarev Marat
Published: February 2022

Introduction

The COVID-19 pandemic has renewed interest in the use of inhaled anaesthetics for sedation of ventilated critically ill patients. Preliminary data show that inhaled anaesthetics reduce lung inflammation, time to extubation and intensive care unit length of stay compared with intravenous sedatives. However, the impact of inhaled anaesthetics on cognitive and psychiatric outcomes is not well described in this setting. Randomised controlled trials are underway to establish if inhaled anaesthetics affect these and other patient and health system outcomes. Our aim is to summarise the known effects of inhaled sedatives on cognitive and psychiatric outcomes.

Methods and analysis

In this systematic review, we will use MEDLINE, EMBASE, and PsycINFO to identify studies from 1970 to 2021 that assessed cognitive and psychiatric outcomes in critically ill adult patients sedated with inhaled anaesthetics. We will include case series, observational and cohort studies and randomised controlled trials. We will exclude case studies due to the heterogeneity of reporting in these studies. For randomised controlled trials comparing inhaled to intravenous sedation, we will report cognitive and psychiatric outcomes for both study arms. Studies will be selected based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data will be extracted using a standardised data extraction tool by two independent reviewers. Studies will be assessed for bias using the Cochrane risk of bias tool for randomised controlled trials, or the Newcastle-Ottawa Scale for cohort and case–control studies. Findings will be reported according to outcome and descriptive statistics will be used to illustrate findings in a narrative fashion.

Ethics and dissemination

The systematic review uses published data and therefore does not require ethics approval. Results will be disseminated via publication in peer-reviewed journals and presentation at conferences related to the field.

PROSPERO registration number

CRD42021236455.
Atrial fibrillation (AF) pilot screening programme in primary care in Ireland: an implementation study protocol
Authors: Callanan Aileen , Quinlan Diarmuid , O'Sullivan Susanne , Bradley Colin P , Kearney Patricia M , Murphy Aileen , Buckley Claire Mary
Published: February 2022

Introduction

Atrial fibrillation (AF) is a major risk factor for stroke. There is a fivefold increase in stroke risk in the presence of AF. The irregular beating of the heart enables blood stasis which allows clots to form. These can migrate to the brain causing a stroke. AF is common and its incidence increases with age. AF is often asymptomatic and early detection enables effective preventive treatment reducing stroke risk by up to two-thirds.

Stroke contributes significantly to morbidity and mortality globally. In Ireland, it is the leading cause of acquired disability and second leading cause of death. The cost associated with stroke is significant. Stroke risk increases with age and is a public health priority.

Internationally, there is consensus among experts that AF screening is valuable. In Ireland, the National Cardiovascular Policy recommended establishing a screening programme. However, there are many ways to screen for AF including pulse palpation, mobile ECG devices, 12-lead ECG and personal health monitoring devices.

This study aims to investigate the acceptability, feasibility and impact of AF screening in primary care using a handheld mobile ECG device.

Methods and analysis

General practitioners (GPs) and practice nurses in the South of Ireland will opportunistically screen patients aged ≥65 years for AF at routine consultation using a handheld one-lead ECG device, KardiaMobile. This study will screen up to 4000 patients. Blood pressure and smoking status will be checked concurrently. A mixed-method evaluation will be undertaken including a partial economic evaluation. Anonymised data will be collected from participating practices and qualitative interviews will be conducted with GP, nurse and patient participants.

Ethics and dissemination

Ethical approval has been granted by the Clinical Research Ethics Committee in University College Cork. Dissemination will involve publication in peer-reviewed journals and presentation at national and international conferences.