bluuebunny/crossref_metadata_2025 huggingface dataset:
Conjugative Transfer of Acute Hepatopancreatic Necrosis Disease-Causing pVA1-Type Plasmid Is Mediated by a Novel Self-Encoded Type IV Secretion System
Authors: Wang Dehao , Wang Liying , Bi Dexi , Song Jipeng , Wang Guohao , Gao Ye , Tang Kathy F. J. , Meng Fanzeng , Xie Jingmei , Zhang Fan , Huang Jie , Li Jianliang , Dong Xuan
Published: September 2022

The pathogenic pVA1-type plasmids that carry
pirAB
toxin genes are the genetic basis for
Vibrio
to cause acute hepatopancreatic necrosis disease (AHPND), a lethal shrimp disease posing an urgent threat to shrimp aquaculture. Emerging evidence also demonstrate the rapid spread of pVA1-type plasmids across
Vibrio
species.
Longitudinal Serological Surveillance for COVID-19 Antibodies after Infection and Vaccination
Authors: McGee Christopher , Shi Min , House John , Drude Anna , Gonzalez Gladys , Martin Negin , Chen Shih-Heng , Rogers Heidi , Njunge Alex , Hodge Xiomara , Mosley Brittany , George Margaret , Agrawal Ruhani , Wild Catherine , Smith Cynthia , Brown Audrey , Barber Lisa , Garantziotis Stavros
Published: September 2022

The COVID-19 pandemic continues to impact societies and health care systems worldwide and is continuously evolving. Immunity via vaccination or prior infection is the first and most important line of defense against COVID-19.
Clinical Laboratory Utility of a Humanized Antibody in Commercially Available Enzyme Immunoassays for Coccidioidomycosis
Authors: Grill Francisca J. , Jugler Collin , Kaleta Erin , Chen Qiang , Magee D. Mitchell , Grys Thomas E. , Lake Douglas F.
Published: September 2022

In southwestern and western regions of the United States, at least half a million diagnostic tests for coccidioidomycosis (valley fever) are run annually. Enzyme immunoassays (EIAs) are blood tests which require precise dilution of patient serum prior to testing.
Flavonoids for viral acute respiratory tract infections: protocol for a systematic review and meta-analysis of randomised controlled trials
Authors: Yao Jia , Zhao Jia , Wang Xianzhe , Yang Zhaojun , Lin Yuping , Sun Lu , Zhang Yuan , Lu Qiyun , Fan Guanjie
Published: September 2022

Introduction

Herbal and ‘natural’ products are a growing industry in today’s society because they reportedly help with numerous diseases and ailments. To date, there are some randomised controlled trials (RCTs) conducted on patients concerning the efficacy of flavonoids against viral acute respiratory tract infection (ARTI) showing inconsistent results. On this basis, we will summarise the available evidence to investigate the efficacy of flavonoids on viral ARTI by conducting a systematic review and meta-analysis.

Methods and analysis

This protocol has been registered. The systematic review and meta-analysis will be conducted by Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. RCTs comparing the flavonoids group with the control group for treating virus-induced ARTI will be included. RCTs published with relative outcomes will be searched through 12 databases. Data were searched from inception to 25 March 2022. Relevant literature search, data extraction and quality assessment will be performed by pairs of reviewers independently, and the third researcher will be involved in a discussion for disagreements. Stata V.16.0 software will be used for statistical analysis. Dichotomous data will use the ORs with 95% CIs. Continuous data will use the weighted mean difference with 95% CIs. Heterogeneity will be tested by χ2-based Cochran Q statistic and I2statistic. Sensitivity analyses and subgroup analyses will be used to observe the heterogeneity between included studies. The funnel plot, Egger’s test and Begg’s test will be used to judge the publication bias. A p<0.05 will be considered to indicate a statistically significant result.

Trail registration number

INPLASY202180107.
Determinants of responsiveness to multidisciplinary chronic pain management interventions: protocol for a systematic review and meta-analysis
Authors: Marttinen Maiju , Oura Petteri , Huttunen Merja , Vartiainen Pekka , Paananen Markus
Published: September 2022

Introduction

The current manuscript presents a protocol for a systematic review and meta-analysis of the evidence regarding the determinants of responsiveness to multidisciplinary management of chronic pain, with pain intensity, pain-related interference, physical functioning and health-related quality of life as the main outcomes, with consideration to multiple secondary outcomes.

Methods and analysis

To identify relevant studies, the Ovid MEDLINE, PubMed, Ovid PsycINFO, EBSCO CINAHL and Scopus databases will be searched for all studies exploring factors associated with responsiveness to multidisciplinary pain management from study inception to the present. Cohorts, case–control studies and randomised controlled trials will be included. Independent screening for eligible studies will be completed by a total of four researchers using defined criteria. Data extraction will be executed by two researchers. Study heterogeneity will be estimated using the I2index. A meta-analysis will be performed using random effects models. Publication bias will be evaluated by means of funnel plots and Egger’s test.

Ethics and dissemination

The proposed study does not involve collection of primary data. Therefore, no ethical approval is required. The results of the systematic review and meta-analysis will be presented in a peer-reviewed journal and at conferences.

PROSPERO registration number

CRD42021236424.
Patient-reported outcome measures to detect intentional, mixed, or unintentional non-adherence to medication: a systematic review
Authors: Fahrni Mathumalar Loganathan , Saman Kamaliah Md , Alkhoshaiban Ali Saleh , Naimat Faiza , Ramzan Farzan , Isa Khairil Anuar Md
Published: September 2022

Objective

To categorise patient-reported outcome measures (PROMs) into their propensity to detect intentional and/or unintentional non-adherence to medication, and synthesise their psychometric properties.

Design

Systematic review and regression analysis.

Eligibility

Medication adherence levels studied at primary, secondary and tertiary care settings. Self-reported measures with scoring methods were included. Studies without proxy measures were excluded.

Data sources

Using detailed searches with key concepts including questionnaires, reliability and validity, and restricted to English, MEDLINE, EMBASE, CINAHL, International Pharmaceutical Abstracts, and Cochrane Library were searched until 01 March 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA-2020) checklist was used.

Data analysis

Risk of bias was assessed via COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN-2018) guidelines. Narrative synthesis aided by graphical figures and statistical analyses.

Outcome measures

Process domains [behaviour (e.g., self-efficacy), barrier (e.g., impaired dexterity) or belief (e.g., perception)], and overall outcome domains of either intentional (I), unintentional (UI), or mixed non-adherence.

Results

Paper summarises evidence from 59 studies of PROMs, validated among patients aged 18–88 years in America, the United Kingdom, Europe, Middle East, and Australasia. PROMs detected outcome domains: intentional non-adherence, n=44 (I=491 criterion items), mixed intentionality, n=13 (I=79/UI=50), and unintentional, n=2 (UI=5). Process domains detected include belief (383 criterion items), barrier (192) and behaviour (165). Criterion validity assessment used proxy measures (biomarkers, e-monitors), and scoring was ordinal, dichotomised, or used Visual Analogue Scale. Heterogeneity was revealed across psychometric properties (consistency, construct, reliability, discrimination ability). Intentionality correlated positively with negative beliefs (r(57)=0.88) and barriers (r(57)=0.59). For every belief or barrier criterion-item, PROMs’ aptitude to detect intentional non-adherence increased by β=0.79 and β=0.34 units, respectively (R2=0.94). Primary care versus specialised care predicted intentional non-adherence (OR 1.9; CI 1.01 to 2.66).

Conclusions

Ten PROMs hadadequatepsychometric properties. Of the ten, eight PROMs were able to detect total, and two PROMs were able to detect partial intentionality to medication default. Fortification of patients’ knowledge and illness perception, as opposed to daily reminders alone, is most imperative at primary care levels.
Burn-out and relationship with the learning environment among psychiatry residents: a longitudinal study
Authors: Chew Qian Hui , Cleland Jennifer , Sim Kang
Published: September 2022

Objectives

Recent research suggests that burn-out is high and appears to be rooted in system-level factors including the local learning environment (LE). While most studies on this topic have been cross-sectional, our aim was to explore the relationship between burn-out and the LE over time within psychiatry residents. We hypothesised that burn-out is a significant predictor of learner perception of overall and all subdomains of LE within residents.

Design

This was a repeated measures questionnaire study.

Setting

We surveyed psychiatry residents in Singapore between January 2016 and December 2019.

Primary and secondary outcome measures

The Oldenburg Burnout Inventory and the Postgraduate Hospital Education Environment Measure (PHEEM) were used to assess burn-out and resident perception of the LE, respectively. Linear mixed modelling was used to examine changes in PHEEM scores over time while taking into account burn-out status.

Participants

Overall, 93 residents (response rate 89.4%) took part.

Results

The average difference between initial PHEEM total scores for residents with and without burn-out was significant (p<0.001). Burn-out status was a significant predictor of lower overall and all subdomain PHEEM scores at baseline (all p<0.001). PHEEM Teaching scores showed a significant increase over time for all residents regardless of burn-out status (p<0.05). However, PHEEM Total, Role Autonomy, Social Support scores did not change significantly over time or change significantly between residents with or without burn-out.

Conclusions

Perceptions of LE among psychiatry residents at baseline are inversely associated with burn-out status. That only the Teaching subdomain score increased over time could be accounted for by the fact that it is a more tangible and visible aspect of the LE compared with perceived role autonomy or social support subdomains. Our findings underscore the importance of attending to the well-being and improving the LE of our residents so as to optimise learning during training.
Study protocol for a pilot randomised controlled trial evaluating the effectiveness of oral trehalose on inflammatory factors, oxidative stress, nutritional and clinical status in traumatic head injury patients receiving enteral nutrition
Authors: Ghorbani Dehbalaei Moazzameh , Sahebkar Amirhossein , Safarian Mohammad , Khadem-Rezaiyan Majid , Rezaee Hamid , Naeini Fatemeh , Norouzy Abdolreza
Published: September 2022

Introduction

In traumatic brain injury (TBI) patients, inflammatory processes and oxidative stress have been linked to the development of neurodegenerative diseases, disability, increased rate of muscle catabolism, malnutrition, hospital stay and mortality. Previous in vitro and in vivo studies have shown that trehalose can decrease inflammatory and oxidative factors. Therefore, the present study was designed to evaluate the effect of oral trehalose consumption on this marker in critically ill TBI patients at intensive care unit (ICU).

Methods and analysis

This study is a pilot randomised, prospective and double-blind clinical trial. The study sample size is of 20 (10 patients in each group) TBI patients aged 18–65 years at ICU. Randomisation is performed by permuted block randomisation method. The allocation ratio is 1:1. An intervention group will receive 30 g of trehalose instead, as a part of the carbohydrate of daily bolus enteral feeding and the control group will receive standard isocaloric hospital bolus enteral feeding for 12 days. The inflammatory factors (C reactive protein, interleukin 6) and oxidative stress markers (glutathione, malondialdehyde, superoxide dismutase, pro-oxidant–antioxidant balance, total antioxidant capacity) will be measured at the baseline, at the 6th day, and at the end of the study (12th day). Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, Nutrition Risk in the Critically ill scores, 28-day mortality, anthropometric assessments and the clinical and nutritional status will be measured. Each patient’s nutritional needs will be calculated individually. The statistical analysis would be based on the intention to treat.

Ethics and dissemination

The vice-chancellor of the research centre of Mashhad University of Medical Sciences is sponsoring this study. IR.MUMS.MEDICAL.REC.1400.113.

Trial registration number

Iranian Registry of Clinical Trials (IRCT) Id: IRCT20210508051223N1, Registration date: 26 July 2021.
Study protocol for double-blind, randomised placebo-controlled trial evaluating semitendinosus function and morbidity following tendon harvesting for anterior cruciate ligament reconstruction augmented by platelet-rich plasma
Authors: du Moulin William , Kositsky Adam , Bourne Matthew N , Diamond Laura E , Tudor Francois , Vertullo Christopher , Saxby David J
Published: September 2022

Introduction

Anterior cruciate ligament (ACL) rupture is debilitating, often requiring surgical reconstruction. An ACL reconstruction (ACLR) using a tendon autograft harvested from the semitendinosus results in substantial injury to the donor muscle. Following ACLR, patients rarely return to their preinjury level of physical activity, are at elevated risk of secondary lower limb injuries and early onset knee osteoarthritis. To date, no randomised controlled trial has evaluated the efficacy of platelet-rich plasma (PRP) in aiding knee function and semitendinosus morphology of following ALCR.

Methods and analysis

This is a multicentre double-blind randomised placebo-controlled trial. Fifty-four ACLR patients aged 18–50 years will be randomised to receive either a single application of PRP (ACLR+) or placebo saline (ACLR) into the semitendinosus harvest zone at the time of surgery. All patients will undergo normal postoperative rehabilitation recommended by the attending orthopaedic surgeon or physiotherapist. The primary outcome measure is between-limb difference (ACLR compared with intact contralateral) in isometric knee flexor strength at 60o knee flexion, collected 10–12 months postsurgery. This primary outcome measure will be statistically compared between groups (ACLR+ and standard ACLR). Secondary outcome measures include bilateral assessments of hamstring muscle morphology via MRI, biomechanical and electromyographic parameters during an anticipated 45° running side-step cut and multidirectional hopping task and patient-reported outcomes questionaries. Additionally, patient-reported outcomes questionaries will be collected before (baseline) as well as immediately after surgery, and at 2–6 weeks, 3–4 months, 10–12 months and 22–24 months postsurgery 10–12 months following surgery.

Ethics and dissemination

Ethics approval has been granted by Griffith University Human Research Ethics Committee, Greenslopes Research and Ethics Committee, and Royal Brisbane & Women’s Hospital Human Research Ethics Committee. Results will be submitted for publication in a peer-reviewed medical journal.

Trial registration number

ACTRN12618000762257p.
Evaluating the effectiveness of email-based nudges to reduce postoperative opioid prescribing: study protocol of a randomised controlled trial
Authors: Kirkegaard Allison , Wagner Zachary , Mariano Louis T , Martinez Meghan C , Yan Xiaowei Sherry , Romanelli Robert J , Watkins Katherine E
Published: September 2022

Introduction

Surgical patients are commonly prescribed more opioids at discharge than needed to manage their postoperative pain. These excess opioids increase the risks of new persistent opioid use, opioid-induced ventilatory impairment and opioid diversion. This study tests the effectiveness of two behavioural nudges, one based on peer behaviour and one based on best practice guidelines, in reducing excessive postoperative opioid prescriptions.

Methods and analysis

The study will be conducted at 19 hospitals within a large healthcare delivery system in northern California, USA. Three surgical specialties (general surgery, orthopaedic surgery and obstetric/gynaecological surgery) at each hospital will be randomised either to a control group or to one of two active intervention arms. One intervention is grounded in the theory of injunctive norms, and provides feedback to surgeons on their postoperative opioid prescribing relative to prescribing guidelines endorsed by their institution. The other intervention draws from the theory of descriptive norms, and provides feedback similar to the first intervention but using peers’ behaviour rather than guidelines as the benchmark for the surgeon’s prescribing behaviour. The interventions will be delivered by a monthly email. Both interventions will be active for twelve months. The effects of each intervention relative to the control group and to each other will be tested using a four-level hierarchical model adjusted for multiple hypothesis testing.

Ethics and dissemination

Using behavioural nudges rather than rigid policy changes allows us to target excessive prescribing without preventing clinicians from using their clinical judgement to address patient pain. All study activities have been approved by the RAND Human Subjects Protection Committee (ID 2018-0988). Findings will be disseminated through conference presentations, peer-reviewed publications and social media accounts.

Trial registration number

NCT05070338.
Profiling the real-world management status of high-risk human papillomavirus infection: a protocol to establish a prospective cohort of high-risk human papillomavirus-infected women in Lueyang County, China
Authors: Yang Siyuan , Bai Li , Xu Wei , Zhang Ruoyi , Hu Dehua , Nie Yuxian , Xiang Rumei , Shi Qiuling
Published: September 2022

Introduction

Persistent infection with high-risk human papillomavirus (hrHPV) is the main cause of cervical cancer. Thus, the effective treatment against HPV represents an opportunity to reduce the incidence of cervical cancer. Although various treatments are effective in treating HPV infection, they still provide limited benefit in reducing the rate of cervical cancer due to the lack of implementation of a standardised protocol in many low/middle-income areas. This proposed cohort study aims to describe the status quo of treatment, attributions of the treatment decision-making process and potential factors influencing treatment decisions.

Methods and analysis

This is a mixed-method, 5-year prospective longitudinal study in Lueyang County, China, one of the areas with the highest cervical cancer incidence rates and lowest mean income in China. We will enrol women with hrHPV infection (at least one HPV type in the 13 high‐risk subtypes) diagnosed via a county-wide HPV infection and cervical cancer screening programme. The study procedures describe the treatment patterns and explore the potential influencing factors in treatment decision-making through questionnaires, laboratory examinations and in-depth interviews. All participants will be evaluated at baseline and at 6, 12, 24, 36, 48 and 60 months. The primary outcome is the treatment pattern, the type and duration of which will be described later. The secondary outcomes include guideline compliance and changes in the HPV infection status. The HPV impact profile, intimate relationship satisfaction, and costs within different management groups are also described and compared.

Ethics and dissemination

This study was reviewed, and all of the relevant approvals were obtained from the Ethics Committee of the Maternity Service Centre of Lueyang Maternal and Child Health Care Hospital (2021-001). The findings from this study will be disseminated through peer-reviewed publications, conference presentations and academic workshops.

Trial registration number

ChiCTR2100053757.
How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
Authors: Zhao Jiaying , Law Chi Kin , Kelly Matthew , Yiengprugsawan Vasoontara , Seubsman Sam-Ang , Sleigh Adrian
Published: September 2022

Objective

To examine the relationship between baseline union status (ie, including marriage and cohabitation) and mortality, paying attention to gender differentials, through an 11-year follow-up of a large cohort in Thailand.

Design

Cohort data from Thai Cohort Study (TCS) were linked official death records over an 11-year follow-up period.

Setting

Community-based adults in Thailand.

Participants

87 151 Thai adults participated in TCS cohort.

Method

Cox regression models measured longitudinal associations between union status and 11-year mortality.

Results

From 2005 (baseline) to 2016, persons who cohabited and lived with a partner, married persons but not living with a partner and separated/divorced/widowed people were more likely to die compared with those married and living together with a partner. Those who did not have good family support had a higher death risk than those having good family support.

Single or cohabiting women had higher risks of mortality than women who were married and living together with a partner throughout follow-up, while separated/divorced/widowed men had higher risks of mortality than counterpart males.

Conclusions

Our study reveals the protective effect of marriage and living together on mortality in Thailand, an understudied setting where institutionalisation of cohabitation is low leading to a limited mortality protection. Public policies for moderating mortality should thus be gender nuanced, culturally and institutionally specific. Also, we demonstrate that in settings such as Thailand, where marital status is not always defined in the same way as in western cultures, the need to measure cohabitation in locally relevant terms is important.
Street images classification according to COVID-19 risk in Lima, Peru: a convolutional neural networks feasibility analysis
Authors: Carrillo-Larco Rodrigo M , Castillo-Cara Manuel , Hernández Santa Cruz Jose Francisco
Published: September 2022

Objectives

During the COVID-19 pandemic, convolutional neural networks (CNNs) have been used in clinical medicine (eg, X-rays classification). Whether CNNs could inform the epidemiology of COVID-19 classifying street images according to COVID-19 risk is unknown, yet it could pinpoint high-risk places and relevant features of the built environment. In a feasibility study, we trained CNNs to classify the area surrounding bus stops (Lima, Peru) into moderate or extreme COVID-19 risk.

Design

CNN analysis based on images from bus stops and the surrounding area. We used transfer learning and updated the output layer of five CNNs: NASNetLarge, InceptionResNetV2, Xception, ResNet152V2 and ResNet101V2. We chose the best performing CNN, which was further tuned. We used GradCam to understand the classification process.

Setting

Bus stops from Lima, Peru. We used five images per bus stop.

Primary and secondary outcome measures

Bus stop images were classified according to COVID-19 risk into two labels: moderate or extreme.

Results

NASNetLarge outperformed the other CNNs except in the recall metric for the moderate label and in the precision metric for the extreme label; the ResNet152V2 performed better in these two metrics (85% vs 76% and 63% vs 60%, respectively). The NASNetLarge was further tuned. The best recall (75%) and F1 score (65%) for the extreme label were reached with data augmentation techniques. Areas close to buildings or with people were often classified as extreme risk.

Conclusions

This feasibility study showed that CNNs have the potential to classify street images according to levels of COVID-19 risk. In addition to applications in clinical medicine, CNNs and street images could advance the epidemiology of COVID-19 at the population level.
Research priority setting related to older adults: a scoping review to inform the Cochrane-Campbell Global Ageing Partnership work programme
Authors: Barbeau Victoria I , Madani Leen , Al Ameer Abdulah , Tanjong Ghogomu Elizabeth , Beecher Deirdre , Conde Monserrat , Howe Tracey E , Marcus Sue , Morley Richard , Nasser Mona , Smith Maureen , Thompson Coon Jo , Welch Vivian A
Published: September 2022

Objective

To explore and map the findings of prior research priority-setting initiatives related to improving the health and well-being of older adults.

Design

Scoping review.

Data sources

Searched MEDLINE, EMBASE, AgeLine, CINAHL and PsycINFO databases from January 2014 to 26 April 2021, and the James Lind Alliance top 10 priorities.

Eligibility criteria

We included primary studies reporting research priorities gathered from stakeholders that focused on ageing or the health of older adults (≥60 years). There were no restrictions by setting, but language was limited to English and French.

Data extraction and synthesis

We used a modified Reporting Guideline for Priority Setting of Health Research (REPRISE) guideline to assess the transparency of the reported methods. Population–intervention–control–outcome (PICO) priorities were categorised according to their associated International Classification of Health Interventions (ICHI) and International Classification of Functioning (ICF) outcomes. Broad research topics were categorised thematically.

Results

Sixty-four studies met our inclusion criteria. The studies gathered opinions from various stakeholder groups, including clinicians (n=56 studies) and older adults (n=35), and caregivers (n=24), with 75% of the initiatives involving multiple groups. None of the included priority-setting initiatives reported gathering opinions from stakeholders located in low-income or middle-income countries. Of the priorities extracted, 272 were identified as broad research topics, while 217 were identified as PICO priorities. PICO priorities that involved clinical outcomes (n=165 priorities) and interventions concerning health-related behaviours (n=59) were identified most often. Broad research topics on health services and systems were identified most often (n=60). Across all these included studies, the reporting of six REPRISE elements was deemed to be critically low.

Conclusion

Future priority setting initiatives should focus on documenting a more detailed methodology with all initiatives eliciting opinions from caregivers and older adults to ensure priorities reflect the opinions of all key stakeholder groups.
Evidence for stratified conflicts of interest policies in research contexts: a methodological review
Authors: Graham S Scott , Karnes Martha S , Jensen Jared T , Sharma Nandini , Barbour Joshua B , Majdik Zoltan P , Rousseau Justin F
Published: September 2022

Objectives

The purpose of this study was to conduct a methodological review of research on the effects of conflicts of interest (COIs) in research contexts.

Design

Methodological review.

Data sources

Ovid.

Eligibility criteria

Studies published between 1986 and 2021 conducting quantitative assessments of relationships between industry funding or COI and four target outcomes: positive study results, methodological biases, reporting quality and results–conclusions concordance.

Data extraction and synthesis

We assessed key facets of study design: our primary analysis identified whether studies stratified industry funding or COI variables by magnitude (ie, number of COI or disbursement amount), type (employment, travel fees, speaking fees) or if they assessed dichotomous variables (ie, conflict present or absent). Secondary analyses focused on target outcomes and available effects measures.

Results

Of the 167 articles included in this study, a substantial majority (98.2%) evaluated the effects of industry sponsorship. None evaluated associations between funding magnitude and outcomes of interest. Seven studies (4.3%) stratified industry funding based on the mechanism of disbursement or funder relationship to product (manufacturer or competitor). A fifth of the articles (19.8%) assessed the effects of author COI on target outcomes. None evaluated COI magnitude, and three studies (9.1%) stratified COI by disbursement type and/or reporting practices. Participation of an industry-employed author showed the most consistent effect on favourability of results across studies.

Conclusions

Substantial evidence demonstrates that industry funding and COI can bias biomedical research. Evidence-based policies are essential for mitigating the risks associated with COI. Although most policies stratify guidelines for managing COI, differentiating COIs based on the type of relationship or monetary value, this review shows that the available research has generally not been designed to assess the differential risks of COI types or magnitudes. Targeted research is necessary to establish an evidence base that can effectively inform policy to manage COI.
Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020–October 2021: a retrospective analysis of national surveillance data
Authors: Elimian Kelly , Yennan Sebastian , Musah Anwar , Cheshi Iliya Danladi , King Carina , Dunkwu Lauryn , Mohammed Ahmed Ladan , Ekeng Eme , Akande Oluwatosin Wuraola , Ayres Stephanie , Gandi Benjamin , Pembi Emmanuel , Saleh Fatima , Omar Ahmed Nasir , Crawford Emily , Olopha Olubunmi Omowumi , Nnaji Robinson , Muhammad Basheer , Luka-Lawal Rejoice , Ihueze Adachioma Chinonso , Olatunji David , Ojukwu Chidimma , Akinpelu Afolabi Muftau , Adaga Ene , Abubakar Yusuf , Nwadiuto Ifeoma , Ngishe Samuel , Alowooye Agnes Bosede , Nwogwugwu Peace Chinma , Kamaldeen Khadeejah , Abah Henry Nweke , Chukwuebuka Egbuna Hyacinth , Yusuff Hakeem Abiola , Mamadu Ibrahim , Mohammed Abbas Aliyu , Peter Sarah , Abbah Okpachi Christopher , Oladotun Popoola Michael , Oifoh Santino , Olugbile Micheal , Agogo Emmanuel , Ndodo Nnaemeka , Babatunde Olajumoke , Mba Nwando , Oladejo John , Ilori Elsie , Alfvén Tobias , Myles Puja , Ochu Chinwe Lucia , Ihekweazu Chikwe , Adetifa Ifedayo
Published: September 2022

Objectives

Nigeria reported an upsurge in cholera cases in October 2020, which then transitioned into a large, disseminated epidemic for most of 2021. This study aimed to describe the epidemiology, diagnostic performance of rapid diagnostic test (RDT) kits and the factors associated with mortality during the epidemic.

Design

A retrospective analysis of national surveillance data.

Setting

33 of 37 states (including the Federal Capital Territory) in Nigeria.

Participants

Persons who met cholera case definition (a person of any age with acute watery diarrhoea, with or without vomiting) between October 2020 and October 2021 within the Nigeria Centre for Disease Control surveillance data.

Outcome measures

Attack rate (AR; per 100 000 persons), case fatality rate (CFR; %) and accuracy of RDT performance compared with culture using area under the receiver operating characteristic curve (AUROC). Additionally, individual factors associated with cholera deaths and hospitalisation were presented as adjusted OR with 95% CIs.

Results

Overall, 93 598 cholera cases and 3298 deaths (CFR: 3.5%) were reported across 33 of 37 states in Nigeria within the study period. The proportions of cholera cases were higher in men aged 5–14 years and women aged 25–44 years. The overall AR was 46.5 per 100 000 persons. The North-West region recorded the highest AR with 102 per 100 000. Older age, male gender, residency in the North-Central region and severe dehydration significantly increased the odds of cholera deaths. The cholera RDT had excellent diagnostic accuracy (AUROC=0.91; 95% CI 0.87 to 0.96).

Conclusions

Cholera remains a serious public health threat in Nigeria with a high mortality rate. Thus, we recommend making RDT kits more widely accessible for improved surveillance and prompt case management across the country.
Process of youth engagement in school health promotion: a scoping review protocol
Authors: Kontak Julia C , Kirk Sara F
Published: September 2022

Introduction

School environments are an essential setting to shape and influence the health and well-being of students. Health promoting school (HPS) is a whole-school approach that strengthens and builds a safe and healthy school environment for students to learn and develop. A core component of HPS is the meaningful participation of youth. Despite promising outcomes arising from youth engagement in school health promotion, there is less known on the process of how students are involved in school health promotion and in what form. This scoping review will explore and map the different components of the student engagement process in school health promotion with specific focus on whole-school approaches like HPS.

Methods and analysis

We will follow scoping review guidelines employed by the Joanna Briggs Institute and Arksey and O’Malley’s framework. We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews to guide reporting. We will follow the PCC mnemonic (participant, concept and context) to develop eligibility criteria. Both published and unpublished literature will be included. Databases to be searched include: CINAHL, ERIC, MEDLINE, Scopus, ProQuest Dissertations & Theses Global databases and Google Scholar. Relevant organisational websites and sources identified by experts will also be reviewed. Two reviewers will screen the title, abstract and full text of the sourced articles. Data from included articles will be charted using a data charting tool. The socioecological model and Hart’s Ladder of Participation will be used to guide charting. Descriptive analysis will be conducted for quantitative data, and thematic analysis will be employed for qualitative data. Data will be displayed through tables and narrative descriptions.

Ethics and dissemination

No ethical approval is required for this study. To disseminate our work, we plan to develop an open-access publication, accompanied by a conference presentation and other knowledge translation products.
Who are the patients being offered the faecal immunochemical test in routine English general practice, and for what symptoms? A prospective descriptive study
Authors: Calanzani Natalia , Pannebakker Merel M , Tagg Max J , Walford Hugo , Holloway Peter , de Wit Niek , Hamilton Willie , Walter Fiona M
Published: September 2022

Objectives

The faecal immunochemical test (FIT) was introduced to triage patients with lower-risk symptoms of colorectal cancer (CRC) in English primary care in 2018. While there is growing evidence on its utility to triage patients in this setting, evidence is still limited on how official FIT guidance is being used, for which patients and for what symptoms. We aimed to investigate the use of FIT in primary care practice for lower-risk patients who did not immediately meet criteria for urgent referral.

Design

A prospective, descriptive study of symptomatic patients offered a FIT in primary care between January and June 2020.

Setting

East of England general practices.

Participants

Consenting patients (aged ≥40 years) who were seen by their general practitioners (GPs) with symptoms of possible CRC for whom a FIT was requested. We excluded patients receiving a FIT for asymptomatic screening purposes, or patients deemed by GPs as lacking capacity for informed consent. Data were obtained via patient questionnaire, medical and laboratory records.

Primary and secondary outcome measures

FIT results (10 µg Hb/g faeces defined a positive result); patient sociodemographic and clinical characteristics; patient-reported and GP-recorded symptoms, symptom severity and symptom agreement between patient and GP (% and kappa statistics).

Results

Complete data were available for 310 patients, median age 70 (IQR 61–77) years, 53% female and 23% FIT positive. Patients most commonly reported change in bowel habit (69%) and fatigue (57%), while GPs most commonly recorded abdominal pain (25%) and change in bowel habit (24%). Symptom agreement ranged from 44% (fatigue) to 80% (unexplained weight loss). Kappa agreement was universally low across symptoms.

Conclusion

Almost a quarter of this primary care cohort of symptomatic patients with FIT testing were found to be positive. However, there was low agreement between patient-reported and GP-recorded symptoms. This may impact cancer risk assessment and optimal patient management in primary care.
Cerebrovascular disease in sickle cell disease
Authors: Alakbarzade Vafa , Maduakor Chinedu , Khan Usman , Khandanpour Nader , Rhodes Elizabeth , Pereira Anthony C
Published: September 2022

Sickle cell disease (SCD) is the most common type of hereditary anaemia and genetic disorder worldwide. Cerebrovascular disease is one of its most devastating complications, with consequent increased morbidity and mortality. Current guidelines suggest that children and adults with SCD who develop acute ischaemic stroke should be transfused without delay. Those with acute ischaemic stroke aged over 18 years who present within 4.5 hours of symptom onset should be considered for intravenous thrombolysis; older patients with conventional vascular risk factors are the most likely to benefit. Endovascular thrombectomy should be considered carefully in adults with SCD as there are few data to guide how the prevalence of cerebral vasculopathy may confound the expected benefits or risks of intervention. We present a practical approach to cerebrovascular disease in sickle cell patients based on the available evidence and our experience.
What molecular imaging of cancer patients can teach us about COVID-19
Authors: Del Vecchio Silvana , Terlizzi Cristina , Pellegrino Sara , Altobelli Giovanna G. , Fonti Rosa
Published: September 2022

COVID-19 pandemic had a great impact on health systems and cancer care worldwide. Patients with cancer who develop COVID-19 are at high risk of severe outcomes and clarifying the determinants of such vulnerability of cancer patients would be of great clinical benefit. While the mechanisms of SARS-CoV-2 infection have been elucidated, the pathogenetic pathways leading to severe manifestations of the disease are largely unknown. Critical manifestations of COVID-19 mainly occur in elderly patients and in patients with serious comorbidities including cancer. Efforts to understand the intersection of pathways between severe manifestations of COVID-19 and cancer may shed light on the pathogenesis of critical illness in COVID-19 patients. Here, we will focus our attention on two major fields of potential intersection between COVID-19 and cancer, namely the dysfunction of immune system and the prothrombotic state that can occur in both COVID-19 and cancer patients, testing whether cancer imaging can provide clues to better understand such interactions.

Graphical abstract
On the Reconstruction of Geodesic Subspaces of ℝN
Authors: Fasy Brittany Terese , Komendarczyk Rafal , Majhi Sushovan , Wenk Carola
Published: September 2022

We consider the topological and geometric reconstruction of a geodesic subspace of [Formula: see text] both from the Čech and Vietoris-Rips filtrations on a finite, Hausdorff-close, Euclidean sample. Our reconstruction technique leverages the intrinsic length metric induced by the geodesics on the subspace. We consider the distortion and convexity radius as our sampling parameters for the reconstruction problem. For a geodesic subspace with finite distortion and positive convexity radius, we guarantee a correct computation of its homotopy and homology groups from the sample. This technique provides alternative sampling conditions to the existing and commonly used conditions based on weak feature size and [Formula: see text]–reach, and performs better under certain types of perturbations of the geodesic subspace. For geodesic subspaces of [Formula: see text], we also devise an algorithm to output a homotopy equivalent geometric complex that has a very small Hausdorff distance to the unknown underlying space.
Online Feature Selection Using Sparse Gradient
Authors: Banu N Nasrin , Kumar Radha Senthil
Published: September 2022

Feature Selection (FS) is an important preprocessing step in data analytics. It is used to select a subset of the original feature set such that the selected subset does not affect the classification performance significantly. Its objective is to remove irrelevant and redundant features from the original dataset. FS can be done either in offline mode or in online mode. The basic assumption in the former mode is that the entire dataset has been available for the FS algorithm; and the FS algorithm takes multiple epochs to select optimal feature subset that gives good accuracy. In contrast, the FS algorithms in online mode take input data one instance at a time and accumulate knowledge by learning each one of them. In online mode each instance of the original dataset is considered as training and testing sample as well. The offline FS algorithms require long time periods, if the data to be processed is large such as Big data. Whereas online FS algorithms will take only one epoch to learn the entire data and can produce the results swiftly which is highly desirable in the case of Big data. This paper deals with the online FS problem and provides a novel Feature Selection algorithm which uses the Sparse Gradient method to build a sparse classifier. In this proposed method, an online classifier is built and maintained throughout the learning process and feature weights, which are limited to a particular boundary limit, are reduced in a step by step decrement process. This method creates sparsity in the classifier. Effectively, the built classifier is used to select optimal feature subset from the incoming data. As this method reduces the weights in the classifier in step by step manner, only those important features which have value higher than the boundary survive from this repeated decrement process. The resultant optimal feature subset is formed using these non-zero weighted features. Most significantly, this particular method can be used with any learning algorithm. To show its applicability with different learning algorithms, various online feature selection models have been built using Learning Vector Quantization, Radial Basis Function Networks and Adaptive Resonance Theory MAP. In all these models, the proposed Sparse Gradient method is used. The encouraging results shows the effectiveness of the proposed method with different learning algorithms in medium and large sized benchmark datasets.
AN INSIGHT ON THE (2 + 1)-DIMENSIONAL FRACTAL NONLINEAR BOITI–LEON–MANNA–PEMPINELLI EQUATIONS
Authors: SUN JIANSHE
Published: September 2022

With the aid of a new fractal derivative, the nonlinear Boiti–Leon–Manna–Pempinelli equation (NBLMPE) with nonsmooth boundary is explored. The variational principle of the fractal NBLMPE is successfully established by fractal wave transformation (FWT) and fractal semi-inverse method (SIM) and strong minimum condition of fractal NBLMPE is proven with the fractal Weierstrass theorem. Based on the two-scale transformation method (TSTM) and homogeneous equilibrium method (HBM), soliton-like solutions for the [Formula: see text]-dimensional (SLS [Formula: see text]D) fractal NBLMPE are acquired. A powerful means of coupling HBM and TSTM to solve fractal differential equations is proposed.
EDITORIAL — SPECIAL ISSUE: MANAGING VALUES FOR INNOVATION
Authors: BREUER HENNING , LÜDEKE-FREUND FLORIAN , BESSANT JOHN
Published: September 2022

Although values in business have a long history, only recently has their pivotal role in innovation and its management become a topic attracting growing attention from both researchers and practitioners. Values-based innovation management is developing into a vibrant field of studies and practice with increasing relevance for innovation managers and entrepreneurs, providing a powerful toolbox of new methods and applications as well as having societal impact. We survey the state-of-the-art discussions in the field, including related concepts and methods and values-based approaches in areas such as innovation consulting and education, business modelling and entrepreneurship. As an introduction to the papers in IJIM’s Special Issue on Managing Values for Innovation, this editorial paper revisits and repositions some widespread assumptions about the nature, functions and potential of values in innovation contexts. We show to what extent values are an inevitable moment of innovation-related activities, requiring contributions from diverse stakeholders in normative, strategic and operational management dimensions. We illustrate their practicality to promote rather than handicap innovation and clarify their potential to change and assume different meanings rather than being static entities. The explanatory power of a values-based approach, its generative potential and its emancipatory impact motivate further research and development. Future avenues for research and development include impact management studies, attention to different levels of values and advancing the methodology and available tools to manage values for innovation in order to achieve more desirable outcomes.
Isomorphism extension properties in normal categories and normal duals
Authors: Rajan A. R. , Mathew Namitha Sara , Yu Bingjun
Published: September 2022

The normal categories associated with unit regular semigroups and various classes of strongly unit regular semigroups were described as [Formula: see text]-categories with appropriate isomorphism extension properties. The normal categories associated with unit regular semigroups have been characterized as weak [Formula: see text]-categories. The cases of [Formula: see text]-strongly unit regular, [Formula: see text]-strongly unit regular and strongly unit regular semigroups were characterized using corresponding forms of isomorphism extensions. It is shown that when a normal category satisfies one of these isomorphism extension properties, then its normal dual satisfies a corresponding isomorphism extension property. Further, we give a description of the extension isomorphisms in the dual [Formula: see text] in terms of extensions in [Formula: see text].
Stochastic P-Robust Approach to a Centralized Two-Stage DEA System with Resource Waste
Authors: Shakouri Rita , Salahi Maziar
Published: September 2022

Uncertain data and undesirable outputs are two challenging issues in traditional data envelopment analysis (DEA) models while dealing with the environmental efficiency estimation of decision-making units (DMUs). This study considers Stackelberg and the centralized game theory approach in a two-stage DEA model for evaluating DMUs in the presence of uncertainty and undesirable outputs simultaneously. To tackle the uncertainty, we apply the p-robust technique and assume that undesirable outputs are weakly disposable. The proposed fractional models are linearized using the Charnes and Cooper transformation. We utilize the new models for a real dataset drawn from 11 oil generation ports in the Persian Gulf region consisting of two stages: an oil production stage and a wastewater treatment stage. The results revealed that the managers should take different strategies in environmental efficiency evaluation including undesirable impacts and also efficiency improvement in increasing oil generation. Further, the empirical results showed that the stochastic p-robust approach for controlling the conservatism level leads to a more conservative solution, and policymakers could recognize the significant steps that should be followed to improve each oil generation unit’s environmental performance. Also, to show the reliability and accuracy of the results and the effect of the decision-maker’s preference, a detailed sensitivity analysis is performed.