bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and presentation of an objective risk stratification tool for healthcare workers when dealing with the COVID-19 pandemic in the UK: risk modelling based on hospitalisation and mortality statistics compared with epidemiological data
Authors: Strain W David , Jankowski Janusz , Davies Angharad P , English Peter , Friedman Ellis , McKeown Helena , Sethi Su , Rao Mala
Published: September 2021

Objectives

Healthcare workers have greater exposure to SARS-CoV-2 and an estimated 2.5-fold increased risk of contracting COVID-19 than the general population. We wished to explore the predictive role of basic demographics to establish a simple tool that could help risk stratify healthcare workers.

Setting

We undertook a review of the published literature (including multiple search strategies in MEDLINE with PubMed interface) and critically assessed early reports on preprint servers. We explored the relative risk of mortality from readily available demographics to identify the population at the highest risk.

Results

The published studies specifically assessing the risk of healthcare workers had limited demographics available; therefore, we explored the general population in the literature.Clinician demographics: Mortality increased with increasing age from 50 years onwards. Male sex at birth, and people of black and minority ethnicity groups had higher susceptibility to both hospitalisation and mortality.Comorbid disease. Vascular disease, renal disease, diabetes and chronic pulmonary disease further increased risk.Risk stratification tool: A risk stratification tool was compiled using a white female aged <50 years with no comorbidities as a reference. A point allocated to risk factors was associated with an approximate doubling in risk. This tool provides numerical support for healthcare workers when determining which team members should be allocated to patient facing clinical duties compared with remote supportive roles.

Conclusions

We generated a tool that provides a framework for objective risk stratification of doctors and healthcare professionals during the COVID-19 pandemic, without requiring disclosure of information that an individual may not wish to share with their direct line manager during the risk assessment process. This tool has been made freely available through the British Medical Association website and is widely used in the National Health Service and other external organisations.
Perceived barriers to care for migrant children and young people with mental health problems and/or neurodevelopmental differences in high-income countries: a meta-ethnography
Authors: Place Vanessa , Nabb Benjamin , Gubi Ester , Assel Karima , Åhlén Johan , Hagström Ana , Bäärnhielm Sofie , Dalman Christina , Hollander Anna-Clara
Published: September 2021

Objectives

To develop conceptual understanding of perceived barriers to seeking care for migrant children and young people (aged 0–25 years) with mental health problems and/or neurodevelopmental differences in high-income countries.

Design

Qualitative evidence synthesis using meta-ethnography methodology. We searched four electronic databases (Medline, PsycINFO, Global Health and Web of Science) from inception to July 2019 for qualitative studies exploring barriers to care (as perceived by migrant communities and service providers) for migrant children and young people in high-income countries with neurodevelopmental differences and/or mental health problems. The quality of included studies was explored systematically using a quality assessment tool.

Results

We screened 753 unique citations and 101 full texts, and 30 studies met our inclusion criteria. We developed 16 themes representing perceived barriers to care on the supply and demand side of the care-seeking process. Barriers included: stigma; fear and mistrust of services; lack of information on mental health and service providers lacking cultural responsiveness. Themes were incorporated into Levesqueet al’s conceptual framework of patient-centred access to healthcare, creating a version of the framework specific to migrant children and young people’s mental health and neurodevelopmental differences.

Conclusions

This is the first qualitative evidence synthesis on barriers to care for mental health problems and/or neurodevelopmental differences in migrant children and young people in high-income countries. We present an adapted conceptual framework that will help professionals and policy-makers to visualise the complex nature of barriers to care, and assist in improving practice and designing interventions to overcome them. Similar barriers were identified across study participants and migrant populations. While many barriers were also similar to those for children and young people in general populations, migrant families faced further, specific barriers to care. Interventions targeting multiple barriers may be required to ensure migrant families reach care.
Quick-Wee versus bladder stimulation to collect midstream urine from precontinent infants under 1 year of age: a study protocol for a randomised controlled trial (ES.Stimquick.U)
Authors: Marchal Sarah , Janicot Jade , Salicis Julie , Demonchy Diane , Herisse Anne-Laure , Olla Marco , Rancurel Anne , Haas Hervé , Bérard Etienne , Bréaud Jean , Bernardor Julie , Ribet Chloé , Freyssinet Emma , Donzeau Dominique , Desmontils Jonathan , Schori-Fortier Clara , Fontas Eric , Tran Antoine
Published: September 2021

Introduction

Urinary tract infections occur in around 1%–4% of boys and 3%–8% of girls under 2 years old. Diagnosis is difficult because of non-specific symptoms and the risk of urine analysis contamination depending on the sampling method used for precontinent infants. The American Academy of Pediatrics recommend transurethral catheterisation and suprapubic aspiration because of a low contamination rate but these techniques are invasive. On the other hand, while the National Institute for Health and Care Excellence advocate clean catch urine for its minimal invasiveness and acceptable contamination rate, it is difficult to accomplish in precontinent infants. Two recent methods have been described: the Quick-Wee method by Kaufmanet al(suprapubic stimulation with cold saline-soaked gauze); and bladder stimulation by Herreroset althen by Tranet al(pubic tapping alternating with lumbar massage). This study aims to compare the effectiveness in collecting midstream urine by bladder stimulation vs the Quick-Wee method in infants under 1 year, before walking.

Methods and analysis

This study is a multicentre randomised controlled trial of 230 infants under 1 year and before walking who need urine analysis, conducted in four paediatric emergency departments in France. Patients will be randomised into two groups: bladder stimulation and Quick-Wee method.

The primary endpoint will be the success rate of voiding at least 2 mL of urine in less than 5 min.

Secondary outcomes are the time to collect at least 2 mL of urine, comfort, quality of urine and the risk factors associated with failure of the two techniques.

Ethics and dissemination

The study protocol was approved by the French national ethic committee (consultative committee of the protection of persons). The results of the study will be published in a peer-reviewed journal.

Trial registration number

Clinical Trials Registry -NCT04587999.

Date and protocol version identifier

October 2020, V.1.
Impact of a cancer diagnosis on the income of adult cancer survivors: a scoping review protocol
Authors: El Adam Shiraz , Bentley Colene , McQuarrie Lisa , Teckle Paulos , Peacock Stuart
Published: September 2021

Introduction

While the socioeconomic impact of a cancer diagnosis on cancer survivors has gained some attention in the literature, to our knowledge, a review of the evidence on changes in income due to cancer has yet to be undertaken. In this paper, we describe a scoping review protocol to review the evidence on the effect of a cancer diagnosis on the income of individuals diagnosed with cancer during adulthood (≥18 years). The purpose is to summarise existing evidence, identify gaps in current research and highlight priority areas for future research.

Methods and analysis

This study will follow the methodological framework for conducting scoping reviews by the Joanna Briggs Institute In collaboration with a health science librarian, we developed a search strategy to be performed in Ovid MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Econ-Literature and Evidence-Based Medicine Reviews. This scoping review will search the scientific literature published in English from 1 January 2000 to 31 December 2020. Studies that measured the impact of cancer on income of adults will be eligible for inclusion. Studies exclusively focused on employment outcomes (eg, return to work, unemployment, productivity loss), financial expenditures, childhood cancer survivors and/or the caregivers of cancer survivors will be excluded. Three independent reviewers will conduct screening and extract data. Descriptive information will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews.

Ethics and dissemination

This scoping review will analyse data from publicly available materials and thus does not require ethics approval. Results from this review will be disseminated through a peer-reviewed publication and/or conference presentation with the potential to identify gaps in the literature, suggest strategies for standardised terminology and provide directions for future research.
Impact of bed height on the biomechanics of healthcare professionals during chest compressions on the neonate: a descriptive pilot study
Authors: Parent-Nichols Jennifer , Perez Julia , Witherell Brittany , McWilliam Paula , Halamek Louis P , Kent Nancy , Varnum Wendy , Yamada Nicole K
Published: September 2021

Objectives

The biomechanics of the healthcare professionals (HCPs) performing the life-saving intervention of chest compressions in the neonatal population is poorly understood. The aim of this pilot study was to describe the variations in body position at a self-selected and a predetermined bed height during neonatal chest compressions. Measures of joint angles, time to postural sway and number of postural adjustments were chosen as indices for the stability of the HCP’s position.

Setting

Data were collected at a simulation-based research centre in which the patient care environment was replicated.

Participants

HCPs with varying roles working in the neonatal intensive care unit and holding a current Neonatal Resuscitation Program Provider certification were recruited for this study.

Interventions

Fifteen HCPs performed two trials of chest compressions, each lasting 2 min, at a predetermined bed height and a self-selected bed height. Trials were video recorded, capturing upper and lower body movements. Videos were analysed for time to postural sway and number of postural adjustments. Joint angles were measured at the start and end of each trial.

Results

A statistically significant difference was found between the two bed height conditions for number of postural adjustments (p=0.02). While not statistically significant, time postural sway was increased in the choice bed height condition (85 s) compared with the predetermined bed height (45 s). After 30 s of chest compressions, mean shoulder and knee angles were smaller for choice bed height (p=0.03, 95% CI Lower=−12.14, Upper=−0.68 and p=0.05, 95% CI Lower=3.43, Upper=0.01, respectively). After 1 min and 45 s of chest compressions, mean wrist angles were smaller in the choice bed height condition (p=0.01, 95% CI Lower=−9.20, Upper=−1.22), stride length decreased between the 30 s and 1 min 45 s marks of the chest compressions in the predetermined height condition (p=0.02).
Prevalence and related factors of hyperuricaemia in Shanghai adult women of different ages: a multicentre and cross-sectional study
Authors: Tao Min , Ma Xiaoyan , Pi Xiaoling , Shi Yingfeng , Tang Lunxian , Hu Yan , Chen Hui , Zhou Xun , Du Lin , Chi Yongbin , Zhuang Shougang , Liu Na
Published: September 2021

Objective

Women in different age phases have different metabolism and hormone levels that influence the production and excretion of uric acid. We aimed to investigate the prevalence and related factors of hyperuricaemia among women in various age phases.

Study design

Observational, cross-sectional study.

Setting

Data were obtained from women at three health check-up centres in Shanghai.

Participants

Adult women from three health check-up centres were recruited. Exclusion criteria were individuals with pregnancy, cancer, incomplete information. Finally, 11 601 participants were enrolled.

Results

The prevalence rates of hyperuricaemia of total subjects were 11.15% (95% CIs 10.57% to 11.72%). The prevalence of hyperuricaemia in 18–29, 30–39, 40–49, 50–59, 60–69 and ≥70 years old was 6.41% (95% CI 4.97% to 7.86%), 5.63% (4.71% to 6.55%), 6.02% (5.01%% to 7.03%), 11.51% (10.19% to 12.82%), 16.49% (15.03% to 17.95%) and 23.98% (21.56% to 26.40%), respectively. Compared with 18–29 years old, the ORs for hyperuricaemia in other age phases were 0.870 (95% CI 0.647 to 1.170, p=0.357), 0.935 (0.693 to 1.261, p=0.659), 1.898 (1.444 to 2.493, p<0.001), 2.882 (2.216 to 3.748, p<0.001) and 4.602 (3.497 to 6.056, p<0.001), respectively. During the 18–29 years old, the related factors for hyperuricaemia were obesity and dyslipidaemia. During the 30–59 years old, the related factors were obesity, dyslipidaemia, hypertension and chronic kidney disease (CKD). Over the 60 years old, the occurrence of hyperuricaemia was mainly affected by obesity, dyslipidaemia and CKD, while hypertension cannot be an impact factor for hyperuricaemia independently of obesity and dyslipidaemia.

Conclusion

After 50 years old, the prevalence of hyperuricaemia in Shanghai women has increased significantly and reaches the peak after 70. Obesity and dyslipidaemia are two main related factors for hyperuricaemia during all ages, while diabetes mellitus and nephrolithiasis have no relationship with hyperuricaemia throughout. CKD is an independent impact factor for hyperuricaemia after 30 years old.
Determinants of physicians’ online medical services uptake: a cross-sectional study applying social ecosystem theory
Authors: Peng Xueqing , Li Zhiguang , Zhang Chi , Liu Rui , Jiang Yongzhi , Chen Jiayu , Qi Zixin , Ge Jinjin , Zhao Shiqi , Zhou Meng , You Hua
Published: September 2021

Objective

To investigate the determinants of willingness and practice of physicians’ online medical services (OMS) uptake based on social ecosystem theory, so as to formulate OMS development strategies.

Design

Cross-sectional survey.

Setting

Research was conducted in two comprehensive hospitals and two community hospitals in Jiangsu, China, and the data were gathered from 1 June to 31 June 2020.

Participants

With multistage sampling, 707 physicians were enrolled in this study.

Outcome measure

Descriptive statistics were reported for the basic characteristics. χ2test, Mann-Whitney U test and Spearman’s correlation analysis were used to perform univariate analysis. Linear regression and logistic regression were employed to examine the determinants of physicians’ OMS uptake willingness and actual uptake, respectively.

Results

The mean score of the physicians’ OMS uptake willingness was 17.33 (range 5–25), with an SD of 4.39, and 53.3% of them reported having conducted OMS. In the micro system, factors positively associated with willingness included holding administrative positions (b=1.03, p<0.05), OMS-related awareness (b=1.32, p<0.001) and OMS-related skills (b=4.88, p<0.001); the determinants of actual uptake included holding administrative positions (OR=2.89, 95% CI 1.59 to 5.28, p<0.01), OMS-related awareness (OR=1.90, 95% CI 1.22 to 2.96, p<0.01), OMS-related skills (OR=2.25, 95% CI 1.35 to 3.74, p<0.01) and working years (OR=2.44, 95% CI 1.66 to 3.59, p<0.001). In the meso system, the hospital’s incentive mechanisms (b=0.78, p<0.05) were correlated with willingness; hospital advocated for OMS (OR=2.34, 95% CI 1.21 to 4.52, p<0.05), colleagues’ experiences (OR=3.81, 95% CI 2.25 to 6.45, p<0.001) and patients’ consultations (OR=2.93, 95% CI 2.02 to 4.25, p<0.001) were determinants of actual uptake. In the macro system, laws and policies were correlated with willingness (b=0.73, p<0.05) and actual uptake (OR=1.98, 95% CI 1.31 to 2.99, p<0.01); media orientation was also associated with willingness (b=0.74, p<0.05).

Conclusion

Multiple determinants influence physicians’ OMS application. Comprehensive OMS promotion strategies should be put forward from multidimensional perspectives including the micro, meso and macro levels.
Protocol for implementation of the ‘AusPROM’ recommendations for elective surgery patients: a mixed-methods cohort study
Authors: Morris Meg E , Brusco Natasha , Woods Jeffrey , Myles Paul S , Hodge Anita , Jones Cathy , Lloyd Damien , Rovtar Vincent , Clifford Amanda , Atkinson Victoria
Published: September 2021

Introduction

Incorporating patient-reported outcome measures (PROMs) into usual care in hospitals can improve safety and quality. Gaps exist in electronic PROM (ePROM) implementation recommendations, including for elective surgery. The aims are to: (1) understand barriers and enablers to ePROM implementation in hospitals and develop Australian ePROM implementation recommendations (AusPROM); (2) test the feasibility and acceptability of the Quality of Recovery 15 item short-form (QoR-15) PROM for elective surgery patients applying the AusPROM and (3) establish if the QoR-15 PROM has concurrent validity with the EQ-5D-5L.

Methods and analysis

Phase I will identify staff barriers and facilitators for the implementation of the AusPROM recommendations using a Delphi technique. Phase II will determine QoR-15 acceptability for elective surgery patients across four pilot hospitals, using the AusPROM recommendations. For phase II, in addition to a consumer focus group, patients will complete brief acceptability surveys, incorporating the QoR-15, in the week prior to surgery, in the week following surgery and 4 weeks postsurgery. The primary endpoint will be 4 weeks postsurgery. Phase III will be the national implementation of the AusPROM (29 hospitals) and the concurrent validity of the QoR-15 and generic EQ-5D-5L. This protocol adopts the Guidelines for Inclusion of Patient-Reported Outcomes in Clinical Trials Protocols guidelines.

Ethics and dissemination

The results will be disseminated via public forums, conferences and peer-reviewed journals. Ethics approval: La Trobe University (HEC20479).

Trial registration number

ACTRN12621000298819 (Phase I and II) and ACTRN12621000969864 (Phase III)
BREAST trial study protocol: evaluation of a non-invasive technique for breast reconstruction in a multicentre, randomised controlled trial
Authors: Schop Sander S J , Hommes Juliette E , Krastev Todor K , Derks Daniëlle , Larsen Mikko , Rakhorst HInne , Schmidbauer Ute , Smit Jan Maerten , Tan Tik , Wehrens Kim , de Wit Thijs , van der Hulst Rene R W J , Piatkowski de Grzymala Andrzej A
Published: September 2021

Introduction

Pioneers have shown that it is possible to reconstruct a full breast using just autologous fat harvested by liposuction or autologous fat transfer (AFT). This study describes the first multicentre randomised study protocol to thoroughly investigate the effectiveness of AFT to reconstruct full breasts following mastectomy procedures (primarily and delayed).

Methods and analysis

This study is designed as a multicentre, randomised controlled clinical superiority trial with a 1:1 allocation ratio. A total of 196 patients (98 patients per treatment arm) are aimed to be included. Patients who wish to undergo breast reconstruction with either one of the two techniques are randomly allocated into the AFT group (intervention) or the tissue-expander/prosthesis group (control). The primary outcome measure for the quality of life is measured by the validated BREAST-Q questionnaire.

Ethics and dissemination

Approval for this study was obtained from the medical ethics committee of Maastricht University Medical Centre/Maastricht University; the trial has been registered at ClinicalTrials.gov. The results of this randomised controlled trial will be presented at scientific meetings as abstracts for poster or oral presentations and published in peer-reviewed journals.

Trial status

Enrolment into the trial has started in October 2015. Data collection and data analysis are expected to be completed in December 2021.

Trial registration number

NCT02339779.
COVID outcome prediction in the emergency department (COPE): using retrospective Dutch hospital data to develop simple and valid models for predicting mortality and need for intensive care unit admission in patients who present at the emergency department with suspected COVID-19
Authors: van Klaveren David , Rekkas Alexandros , Alsma Jelmer , Verdonschot Rob J C G , Koning Dick T J J , Kamps Marlijn J A , Dormans Tom , Stassen Robert , Weijer Sebastiaan , Arnold Klaas-Sierk , Tomlow Benjamin , de Geus Hilde R H , van Bruchem-Visser Rozemarijn L , Miedema Jelle R , Verbon Annelies , van Nood Els , Kent David M , Schuit Stephanie C E , Lingsma Hester
Published: September 2021

Objectives

Develop simple and valid models for predicting mortality and need for intensive care unit (ICU) admission in patients who present at the emergency department (ED) with suspected COVID-19.

Design

Retrospective.

Setting

Secondary care in four large Dutch hospitals.

Participants

Patients who presented at the ED and were admitted to hospital with suspected COVID-19. We used 5831 first-wave patients who presented between March and August 2020 for model development and 3252 second-wave patients who presented between September and December 2020 for model validation.

Outcome measures

We developed separate logistic regression models for in-hospital death and for need for ICU admission, both within 28 days after hospital admission. Based on prior literature, we considered quickly and objectively obtainable patient characteristics, vital parameters and blood test values as predictors. We assessed model performance by the area under the receiver operating characteristic curve (AUC) and by calibration plots.

Results

Of 5831 first-wave patients, 629 (10.8%) died within 28 days after admission. ICU admission was fully recorded for 2633 first-wave patients in 2 hospitals, with 214 (8.1%) ICU admissions within 28 days. A simple model—COVID outcome prediction in the emergency department (COPE)—with age, respiratory rate, C reactive protein, lactate dehydrogenase, albumin and urea captured most of the ability to predict death. COPE was well calibrated and showed good discrimination for mortality in second-wave patients (AUC in four hospitals: 0.82 (95% CI 0.78 to 0.86); 0.82 (95% CI 0.74 to 0.90); 0.79 (95% CI 0.70 to 0.88); 0.83 (95% CI 0.79 to 0.86)). COPE was also able to identify patients at high risk of needing ICU admission in second-wave patients (AUC in two hospitals: 0.84 (95% CI 0.78 to 0.90); 0.81 (95% CI 0.66 to 0.95)).

Conclusions

COPE is a simple tool that is well able to predict mortality and need for ICU admission in patients who present to the ED with suspected COVID-19 and may help patients and doctors in decision making.
Association among emotional and behavioural problems, sexual minority status and suicidal behaviours in adolescents: a cross-sectional study from Guangdong Province in China
Authors: Li Wenyan , Guo Lan , Zhang Sheng , Wang Wanxin , Chen Xiaoliang , Li Qian , Lu Ciyong
Published: September 2021

Objectives

This study was conducted to estimate whether emotional and behavioural problems mediate the association between sexual minority status and suicidal behaviour among Chinese adolescents. We also tested whether such mediation is moderated by the sex assigned at birth.

Design

Cross-sectional observational study.

Setting

A secondary analysis of the cross-sectional data collected from 7th-grade to 12th-grade students in junior high schools (n=36), senior high schools (n=24) and vocational high schools (n=12) in six cities of Guangdong Province, China. A multistage, stratified cluster, random sampling method was used in the 2019 School-based Chinese Adolescents Health Survey.

Participants

A total of 16 663 students aged 11–20 years.

Outcome measures

Two main psychological and mental health outcomes: (1) self-reported version of the Strengths and Difficulties Questionnaire to measure emotional and behavioural problems; and (2) presence of suicidal ideation and suicide attempts in the past 12 months.

Results

Emotional and behavioural problems (peer problems, emotional problems, conduct problems and hyperactivity) partially mediated the effects of sexual minority status on suicidal ideation (indirect effect=0.020, 95% CI 0.015 to 0.025) and suicide attempts (indirect effect=0.012, 95% CI 0.009 to 0.016), accounting for 18.18% and 14.46% of the total effect, respectively. Further moderated mediation analyses revealed a greater risk of suicidality among sexual minority girls.

Conclusions

Emotional and behavioural problems partially explained the increased risk of suicidality among sexual minority adolescents, and appreciably higher among sexual minority girls than boys. To prevent subsequent suicidality, the risks of emotional and behavioural problems in sexual minority adolescents should be identified at an early stage and reduced by means of preventive measures.
Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations
Authors: Braeuninger-Weimer Kathrin Louise , Anjarwalla Naffis , McGregor Alison H , Roberts Lisa , Sell Philip , Pincus Tamar
Published: September 2021

Objective

This study aimed to explore the perceptions of orthopaedic clinicians about consultations for people with persistent musculoskeletal low back pain (PMLBP) in which surgery is not recommended. Surgery is not recommended for the majority of PMLBP consulting in secondary care settings.

Setting

Secondary care sector in the UK.

Participants

Semi-structured qualitative interviews were conducted with 24 orthopaedic team clinicians from 17 different hospitals in the UK and Ireland. Interviews explored clinicians’ perceptions of the challenges in consultations where surgery is not indicated. Interviews were transcribed verbatim and analysed using thematic analysis.

Results

Two meta-themes, Difficulties and Enablers, each consisting of several subthemes were identified. Difficulties included challenges around the choice of appropriate terminology and labels for PMLBP, managing patients’ expectations, working with mentally vulnerable patients and explaining imaging findings. Enablers included early management of expectations, use of routine imaging, triaging, access to direct referral elsewhere, including other non-surgical practitioners in the team, training to improve communication skills and understanding of psychological issues.

Conclusion

The findings highlight clinicians’ perceived need for concordance in messages delivered across the care pathway and training of orthopaedic clinicians to deliver effective reassurance and address patients’ needs in circumstances where surgery is not indicated.
Cancer symptom experience and help-seeking behaviour during the COVID-19 pandemic in the UK: a cross-sectional population survey
Authors: Quinn-Scoggins Harriet D , Cannings-John Rebecca , Moriarty Yvonne , Whitelock Victoria , Whitaker Katriina L , Grozeva Detelina , Hughes Jacqueline , Townson Julia , Osborne Kirstie , Goddard Mark , McCutchan Grace M , Waller Jo , Robling Michael , Hepburn Julie , Moore Graham , Gjini Ardiana , Brain Kate
Published: September 2021

Objectives

To understand self-reported potential cancer symptom help-seeking behaviours and attitudes during the first 6 months (March–August 2020) of the UK COVID-19 pandemic.

Design

UK population-based survey conducted during August and September 2020. Correlates of help-seeking behaviour were modelled using logistic regression in participants reporting potential cancer symptoms during the previous 6 months. Qualitative telephone interviews with a purposeful subsample of participants, analysed thematically.

Setting

Online UK wide survey.

Participants

7543 adults recruited via Cancer Research UK online panel provider (Dynata) and HealthWise Wales (a national register of ‘research ready’ participants) supplemented with social media (Facebook and Twitter) recruitment. 30 participants were also interviewed.

Main outcome measures

Survey measures included experiences of 15 potential cancer symptoms, help-seeking behaviour, barriers and prompts to help-seeking.

Results

Of 3025 (40.1%) participants who experienced a potential cancer symptom, 44.8% (1355/3025) had not contacted their general practitioner (GP). Odds of help-seeking were higher among participants with disability (adjusted OR (aOR)=1.38, 95% CI 1.11 to 1.71) and who experienced more symptoms (aOR=1.68, 95% CI 1.56 to 1.82), and lower among those who perceived COVID-19 as the cause of symptom(s) (aOR=0.36, 95% CI 0.25 to 0.52). Barriers included worries about wasting the doctor’s time (1158/7543, 15.4%), putting strain on healthcare services (945, 12.6%) and not wanting to make a fuss (907, 12.0%). Interviewees reported reluctance to contact the GP due to concerns about COVID-19 and fear of attending hospitals, and described putting their health concerns on hold.

Conclusions

Many people avoided healthcare services despite experiencing potential cancer symptoms during the COVID-19 pandemic. Alongside current help-seeking campaigns, well-timed and appropriate nationally coordinated campaigns should signal that services are open safely for those with unusual or persistent symptoms.

Trial registration number

ISRCTN17782018.
Insights into the association of ACEIs/ARBs use and COVID-19 prognosis: a multistate modelling study of nationwide hospital surveillance data from Belgium
Authors: Peñalvo José L. , Genbrugge Els , Mertens Elly , Sagastume Diana , van der Sande Marianne A B , Widdowson Marc-Alain , Van Beckhoven Dominique
Published: September 2021

Objectives

The widespread use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) by patients with chronic conditions raised early concerns on the potential exacerbation of COVID-19 severity and fatality. Previous studies addressing this question have used standard methods that may lead to biased estimates when analysing hospital data because of the presence of competing events and event-related dependency. We investigated the association of ACEIs/ARBs’ use with COVID-19 disease outcomes using time-to-event data in a multistate setting to account for competing events and minimise bias.

Setting

Nationwide surveillance data from 119 Belgian hospitals.

Participants

Medical records of 10 866 patients hospitalised from 14 March 2020to 14 June 2020 with a confirmed SARS-CoV-19 infection and information about ACEIs/ARBs’ use.

Primary outcome measure

Multistate, multivariate Cox-Markov models were used to estimate the hazards of patients transitioning through health states from admission to discharge or death, along with transition probabilities calculated by combining the baseline cumulative hazard and regression coefficients.

Results

After accounting for potential confounders, there was no discernable association between ACEIs/ARBs’ use and transfer to intensive care unit (ICU). Contrastingly, for patients without ICU transfer, ACEIs/ARBs’ use was associated with a modest increase in recovery (HR 1.07, 95% CI 1.01 to 1.13, p=0.027) and reduction in fatality (HR 0.83, 95% CI 0.75 to 0.93, p=0.001) transitions. For patients transferred to ICU admission, no evidence of an association between ACEIs/ARBs’ use and recovery (HR 1.16, 95% CI 0.97 to 1.38, p=0.098) or in-hospital death (HR 0.91, 95% CI 0.73 to 1.12, p=0.381) was observed. Male gender and older age were significantly associated with higher risk of ICU admission or death. Chronic cardiometabolic comorbidities were also associated with less recovery.

Conclusions

For the first time, a multistate model was used to address magnitude and direction of the association of ACEIs/ARBs’ use on COVID-19 progression. By minimising bias, this study provided a robust indication of a protective, although modest, association with recovery and survival.
Perceptions of experts on key injury risk factors in alpine ski racing as a function of stakeholder role and associated level of competition
Authors: Kiers Kirsten , Kröll Josef , Mitterbauer Gerald , Scherr Johannes , Spörri Jörg
Published: September 2021

Objectives

(1) To update experts’ priorities of perceived key injury risk factors in alpine ski racing based on a framework and list derived 10 years ago, (2) to identify additionally emerging risk factors since then and (3) to compile a list with countermeasure suggestions.

Methods

A sample of 532 expert stakeholders (athletes, coaches, team medical staff, Ski Racing Suppliers (SRS) and International Ski Federation (FIS) representatives) from the World Cup (WC), European Cup (EC) and FIS-race level participated in a cross-sectional online survey. Experts were asked to name those risk factors with the highest believed impact on injury risk and rank them according to their current priority from a predefined list. In addition, experts were encouraged to name additional (not listed) risk factors and to suggest countermeasures.

Results

Regardless of stakeholder role and competition level, snow-related factors appeared to have the highest perceived priority. However, WC athletes’ and coaches’ perceptions were also related to equipment, while at the EC and FIS-race level fatigue and physical fitness-related factors were considered important. Athletes’ perceptions were largely in agreement with SRS (ie, snow-related and equipment-related factors). At the same time, while coaches, team medical staff and FIS representatives additionally emphasised fatigue and physical fitness-related factors.

Conclusion

Experts’ perceptions on key injury risk factors in alpine ski racing depend on the stakeholder role and differ between the competition levels. Thus, to develop effective prevention measures and to successfully implement them, all relevant stakeholders should be given a voice, and prevention efforts should be targeted to the specific level.
Clinical characteristics of non-radiographic versus radiographic axial spondyloarthritis in Asia and non-radiographic axial spondyloarthritis in other regions: results of the cross-sectional ASAS-COMOSPA study
Authors: Kishimoto Mitsumasa , Ono Keisuke , Fukui Sho , Kawaai Satoshi , Deshpande Gautam A , Yoshida Kazuki , Ichikawa Naomi , Kaneko Yuko , Kawasaki Taku , Matsui Kazuo , Morita Mitsuhro , Tada Kurisu , Takizawa Naoho , Tamura Naoto , Taniguchi Atsuo , Taniguchi Yoshinori , Tsuji Shigeyoshi , Okada Masato , Kobayashi Shigeto , Komagata Yoshinori , López-Medina Clementina , Molto Anna , van der Heijde Desirée , Dougados Maxime , Tomita Tetsuya , Kaname Shinya
Published: September 2021

Objectives

To delineate characteristics of non-radiographic axial spondyloarthritis (nr-axSpA) in Asia versus non-Asian regions, and compare radiographic axSpA (r-axSpA) with nr-axSpA within Asia.

Methods

Data were collected from the Assessment of SpondyloArthritis international Society-COMOrbidities in SPondyloArthritis database. Categorising patients by region, we compared clinical characteristics between nr-axSpA from Asia vs elsewhere (Europe, the Americas and Africa). Within Asians, we additionally compared patient characteristics of those with nr-axSpA versus r-axSpA.

Results

Among 3984 SpA cases, 1094 were from Asian countries. Of 780 axSpA patients in Asia, 112 (14.4%) had nr-axSpA, less than in non-Asian countries (486/1997, 24.3%). Nr-axSpA patients in Asia were predominantly male (75.9% vs 47.1%), younger at onset (22.8 vs 27.8 years) and diagnosis (27.2 vs 34.5 years), and experienced less diagnostic delay (1.9 vs 2.9 years) compared with nr-axSpA in non-Asian countries. Nr-axSpA in Asia exhibited higher human leucocyte antigens-B27 prevalence (90.6% vs 61.9%), fewer peripheral SpA features (53.6% vs 66.3%) and similar extra-articular and comorbid disease rates compared with those with nr-axSpA in non-Asian countries. Disease activity, functional impairment and MRI sacroiliitis were less in nr-axSpA in Asia, with higher rates of non-steroidal anti-inflammatory drug response and less methotrexate and biological disease-modifying antirheumatic drugs use. Within Asia, r-axSpA showed higher disease activity and structural damage compared with nr-axSpA, with no differences in other features.

Conclusion

Among axSpA, lower frequency of nr-axSpA was observed in Asia. Our results offer an opportunity to better understand clinical characteristics and optimise diagnostic strategies, such as ensuring access and availability of MRI resources for accurate diagnosis of nr-axSpA in Asia.
A core set of risk factors in individuals at risk of rheumatoid arthritis: a systematic literature review informing the EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis
Authors: Mankia Kulveer , Siddle Heidi , Di Matteo Andrea , Alpízar-Rodríguez Deshiré , Kerry Joel , Kerschbaumer Andreas , Aletaha Daniel , Emery Paul
Published: September 2021

Background

There is significant interest in determining risk factors in individuals at risk of rheumatoid arthritis (RA). A core set of risk factors for clinical arthritis development has not been defined.

Methods

A literature search and systematic literature review (SLR) was conducted to identify risk factors in individuals at risk of RA using Medline, Embase, PubMed and Central databases.

Results

3854 articles were identified by the literature search. After screening of titles, 138 abstracts were reviewed and 96 articles finally included. Fifty-three articles included data on risk factors including autoantibodies, subclinical inflammation on imaging, clinical features, serum and cellular biomarkers and genetic markers. Risk factors were dependent on the at-risk population. There was good evidence for serum anticitrullinated protein antibodies (ACPA) levels, as risk factors for arthritis in all at-risk populations (n=13 articles). Subclinical inflammation on ultrasound (n=12) and MRI (n=6) was reported as a risk factor in multiple studies in at-risk individuals with musculoskeletal (MSK) symptoms and undifferentiated arthritis (UA). Clinical features were reported as a risk factor in at-risk individuals with MSK symptoms and UA (n=13). Other risk factors, including serum and cellular markers were less frequently reported.

Conclusions

Risk factors for arthritis development in RA are specific to the at-risk population. Serum ACPA confers risk in all populations; subclinical inflammation on imaging and clinical features confer risk in at-risk individuals with MSK symptoms. This SLR informed the EULAR taskforce for points to consider on conducting clinical trials and studies in individuals at risk of RA.
Efficient one-pot synthesis of 4-hydroxy-2H chromene by heterogeneously catalyzed ZnO NP and mesoporous aluminosilicate catalysts in solvent free condition
Authors: Mahato Birendra Nath , Krithiga T. , Kumar J. Aravind , Yogalakshmi G.
Published: September 2021

4-Hydroxy-2H chromenes are fused benzopyran rings, an important class of biologically active compounds that are widely used as antibacterial, antiviral, antitumor, and anticancer agents. In this paper, we report the synthesis of 4-hydroxy-2H chromenes using two catalysts: (i) ZnO nanoparticles and (ii) mesoporous ZnO/AlSBA-15(7). The ZnO nanoparticle catalyst was prepared using leaf extract, and ZnO/AlSBA-15(7) catalysts were prepared by a wet chemical route. All catalysts were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), Fourier transform infrared (FTIR) spectroscopy, and N2 sorption techniques. The catalytic activity of the synthesized catalyst was evaluated in a one-pot reaction using aromatic aldehyde and coumarin and was found to have a maximum yield of 81% at 80 °C, with a catalyst dose of 10 mmol %, and in a time limit of 4 h.
Pulse-shape discrimination against low-energy Ar-39 beta decays in liquid argon with 4.5 tonne-years of DEAP-3600 data
Authors: Adhikari P. , Ajaj R. , Alpízar-Venegas M. , Amaudruz P.-A. , Auty D. J. , Batygov M. , Beltran B. , Benmansour H. , Bina C. E. , Bonatt J. , Bonivento W. , Boulay M. G. , Broerman B. , Bueno J. F. , Burghardt P. M. , Butcher A. , Cadeddu M. , Cai B. , Cárdenas-Montes M. , Cavuoti S. , Chen M. , Chen Y. , Cleveland B. T. , Corning J. M. , Cranshaw D. , Daugherty S. , DelGobbo P. , Dering K. , DiGioseffo J. , Di Stefano P. , Doria L. , Duncan F. A. , Dunford M. , Ellingwood E. , Erlandson A. , Farahani S. S. , Fatemighomi N. , Fiorillo G. , Florian S. , Flower T. , Ford R. J. , Gagnon R. , Gallacher D. , García Abia P. , Garg S. , Giampa P. , Goeldi D. , Golovko V. , Gorel P. , Graham K. , Grant D. R. , Grobov A. , Hallin A. L. , Hamstra M. , Harvey P. J. , Hearns C. , Hugues T. , Ilyasov A. , Joy A. , Jigmeddorj B. , Jillings C. J. , Kamaev O. , Kaur G. , Kemp A. , Kochanek I. , Kuźniak M. , Lai M. , Langrock S. , Lehnert B. , Leonhardt A. , Levashko N. , Li X. , Lidgard J. , Lindner T. , Lissia M. , Lock J. , Longo G. , Machulin I. , McDonald A. B. , McElroy T. , McGinn T. , McLaughlin J. B. , Mehdiyev R. , Mielnichuk C. , Monroe J. , Nadeau P. , Nantais C. , Ng C. , Noble A. J. , O’Dwyer E. , Oliviéro G. , Ouellet C. , Pal S. , Pasuthip P. , Peeters S. J. M. , Perry M. , Pesudo V. , Picciau E. , Piro M.-C. , Pollmann T. R. , Rand E. T. , Rethmeier C. , Retière F. , Rodríguez-García I. , Roszkowski L. , Ruhland J. B. , Sánchez-García E. , Santorelli R. , Sinclair D. , Skensved P. , Smith B. , Smith N. J. T. , Sonley T. , Soukup J. , Stainforth R. , Stone C. , Strickland V. , Stringer M. , Sur B. , Tang J. , Vázquez-Jáuregui E. , Viel S. , Walding J. , Waqar M. , Ward M. , Westerdale S. , Willis J. , Zuñiga-Reyes A. ,   DEAP Collaboration
Published: September 2021

The DEAP-3600 detector searches for the scintillation signal from dark matter particles scattering on a 3.3 tonne liquid argon target. The largest background comes from $$^{39}\text{ Ar }$$

39

Ar

beta decays and is suppressed using pulse-shape discrimination (PSD). We use two types of PSD estimator: the prompt-fraction, which considers the fraction of the scintillation signal in a narrow and a wide time window around the event peak, and the log-likelihood-ratio, which compares the observed photon arrival times to a signal and a background model. We furthermore use two algorithms to determine the number of photons detected at a given time: (1) simply dividing the charge of each PMT pulse by the mean single-photoelectron charge, and (2) a likelihood analysis that considers the probability to detect a certain number of photons at a given time, based on a model for the scintillation pulse shape and for afterpulsing in the light detectors. The prompt-fraction performs approximately as well as the log-likelihood-ratio PSD algorithm if the photon detection times are not biased by detector effects. We explain this result using a model for the information carried by scintillation photons as a function of the time when they are detected.
Resonance enhancement of neutrino oscillations due to transition magnetic moments
Authors: Chukhnova A. V. , Lobanov A. E.
Published: September 2021

We prove that a resonance enhancement of neutrino oscillations in magnetic field is possible due to transition magnetic moments and demonstrate that this resonance is strictly connected to the neutrino polarization. To study the main properties of this resonance, we obtain the probabilities of transitions between neutrino states with definite flavor and helicity in inhomogeneous electromagnetic field in the adiabatic approximation. Since the resonance is present only when the adiabaticity condition is fulfilled, we also obtain and discuss this condition.
Revisiting geodesic observers in cosmology
Authors: Vachon Geneviève , Vanderwee Robert , Faraoni Valerio
Published: September 2021

Geodesic observers in cosmology are revisited. The coordinates based on freely falling observers introduced by Gautreau in de Sitter and Einstein-de Sitter spaces (and, previously, by Gautreau and Hoffmann in Schwarzschild space) are extended to general FLRW universes. We identify situations in which the relation between geodesic and comoving coordinates can be expressed explicitly in terms of elementary functions. In general, geodesic coordinates in cosmology turn out to be rather cumbersome and limited to the region below the apparent horizon.
Future prospects for the minimal supersymmetric standard model
Authors: AbdusSalam Shehu , Barzani Safura S. , Noormandipour Mohammadreza
Published: September 2021

Experimental collaborations for the large hadron collider conducted various searches for supersymmetry. In the absence of signals, lower limits were put on sparticle masses but usually within frameworks with (over-)simplifications relative to the entire indications by supersymmetry models. For complementing current interpretations of experimental bounds, we introduce a 30-parameter version of the R-parity conserving Minimal Supersymmetric Standard Model (MSSM-30). Using a sample of the MSSM-30 which are in harmony with cold dark matter, flavor and precision electroweak constraints, we explicitly show the prospects for assessing neutralino candidate dark matter in contrast to future searches for supersymmetry. The MSSM-30-parameter regions that are beyond reach to dark matter direct detection experiments could be probed by future hadron–hadron colliders.
Study on the existence of the transportation particle tracking model in the interactive medium
Authors: El-Hadidy Mohamed Abd Allah , Alzulaibani Alaa A.
Published: September 2021

This paper assumes that the particle jumps randomly (Guassian jumps) from one point to another along one of the imaginary lines inside the interactive medium. Since this study was done in the space, we consider that the position of the particle at any time [Formula: see text] has a multivariate distribution. The random waiting time of the particle for each Gaussian jump depends on its length. An identical set of programed nanosensors (with unit speed) were used to track this particle. Each line has a sensor that starts the tracking process from the origin. The existence of the necessary conditions which give the optimal search plan and the minimum expected value of the particle detection has been proven. This study is supported by a numerical example.
Composition analysis of AU–AG and AU–CU solid solution alloys by Friedel’s periodic spherical oscillation model
Authors: Hong Hai-Lian , Yang Chi-Hsin , Wang Kun-Chieh , Gao Hao , Yan Hui-Xian
Published: September 2021

In this work, a two-nearest-neighbor structure model, named the 3-1 model, of the face-centered cubic (FCC) solid solution alloy is found based on the Cowley short-range order parameter and the Friedel’s periodic spherical oscillated (FPSO) model. The proposed 3-1 model has high symmetry, high density, and large separation. The model error between the 3-1 model and the standard spherical periodic model is only 0.004 nm. Besides, the chemical composition formula of the present model is applied to analyze the common grade compositions of various alloys. This work shows that the 3-1 model has universality in mature industrial grades of Au–Ag and Au–Cu alloys, and provides a simplified method to design the composition of alloys.