bluuebunny/crossref_metadata_2025 huggingface dataset:
Pragmatism and Theology: Between Hasdai Crescas and Charles Peirce
Authors: Ochs Peter
Published: August 2022

The noted Jewish scholar Harry Wolfson (d. 1929) claimed in youthful writings that the fifteenth‐century rabbinic thinker and physicist, Hasdai Crescas, was a pragmatist. This essay introduces evidence that there are, indeed, significant analogies between elements of Hasdai Crescas’s critique of Aristotle and elements of Charles Peirce’s pragmatism. The essay concludes that Crescas’s primary work, Light of the Lord (Or Hashem), displays a unique analogue to classical American pragmatism, which analogue I label “rabbinic pragmatism” and classify as a subtype of “Jewish pragmatism.” The essay’s central hypothesis is that Crescas’s scientific reasoning is correlative to his Torah‐based reasoning. A second hypothesis is that the enabling conditions of this correlativity are the inquirer’s relation to God as author of Creation and of the Commandments (mitzvah). I argue that Crescas’s non‐finite mathematics (a potential source for Galileo) is correlative to his account of the non‐finite meanings of each Commandment so that each command displays fresh meanings in each new context of life.
Measuring the global research landscape on nonviolence (Ahiṃsā) over three decades (1991–2021)
Authors: Tyagi Sunil , Jain Lipi
Published: August 2022

This study employs bibliometric methods to measure the productivity of authors, organizations, and countries engaged in research on nonviolence according to preferred channels for dissemination, composition of collaborative teams, and overall research performance based on data drawn from the Elsevier Scopus database. The researchers identify three major developmental stages of nonviolence research over the course of three decades (1991–2021) and found that annual research productivity in nonviolence research has grown at a slow pace in stage 1 (1991–2000), at a moderate pace in stage 2 (2001–2010), and at a fast pace in stage 3 (2011–2021). Based on the keyword frequency and their co‐occurrence relationships, three major topical theme clusters emerged; the first theme cluster relates to religion and spirituality, the second theme cluster relates to nonviolence, peace, and conflict, and the third theme cluster relates to political tactics, law, and social movements. Authorship patterns in nonviolence research show a single authorship trend as most of the publications have been published by single authors (71.57%).
Heart transplantation in children and adults with Down syndrome: A single centre experience
Authors: Khoshbin Espeed , Khushnood Abbas , Reinhardt Zdenka , Parry Gareth , Schueler Stephan , Hasan Asif
Published: August 2022

Background

In recent years, rapid advances in cardiac surgery and changes in attitude towards patients with cognitive disability have led to these patients receiving cardiac transplantation.

Method

This is a retrospective report describing the experience of four patients with Down Syndrome who received heart transplantation in a single institution.

Results

Anthracycline‐induced cardiomyopathy was the most common cause of heart failure in this group (3/4). Two patients were bridged to transplantation, one by using a combination of extra‐corporeal membrane oxygenation and biventricular assist device and the other by using a durable implantable left ventricular assist device. All the four patients are alive with the longest surviving patient 17 years after transplantation. Against strong hypothetical predictions, we observed no propensity for the development of post‐transplant infections or lymphoproliferative disorders.

Conclusion

Down Syndrome should not be the sole contraindication to heart transplantation. The decision for transplantation should be on a case‐by‐case basis provided adequate social support is in place.
Cryotherapy in the paediatric airway: Indications, success and safety
Authors: Schramm Dirk , Freitag Nadine , Kötz Karsten , Iglesias‐Serrano Ignacio , Culebras‐Amigo Mario , Koblizek Vladimir , Pérez‐Tarazona Santiago , Cases Viedma Enrique , Srikanta JT , Durdik Peter , Darwiche Kaid , Rubak Sune , Stafler Patrick
Published: August 2022

Background and objective

Cryotherapy in interventional bronchoscopy is a new treatment modality, which has recently been made available for the paediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this study was to assess indications, success rates and complications of airway cryotherapy in children.

Methods

Bronchoscopists from medical centre performing cryotherapy in patients between 0 and 18 years were invited to participate in a prospective study based on an online questionnaire. Patient and participant data were collected between June 2020 and June 2021.

Results

A total of 69 cryotherapy procedures were performed in 57 patients a for three main indications: Biopsy (30), restoration of airway patency (23) and foreign body aspiration (16). The overall success rate was 93%, the remaining 7% were performed for foreign body removal and required a switch of technique. Restoration of airway patency was successfully applied in various pathologies, including mucus plugs, bronchial casts and post traumatic stenosis. The diagnostic yield of transbronchial biopsies was 96%. No severe complications were encountered; one pneumothorax following a cryobiopsy required a chest drain for 48 h. No child was admitted to intensive care or died from a procedural complication.

Conclusion

In this largest paediatric case collection to date, cryotherapy was safe and carried a high success rate. Cryobiopsy compares favourably to the widely used forceps biopsy and could replace it in the future. Paediatric bronchoscopists are encouraged to add cryotherapy to their armamentarium of airway interventions.
Would chronic mucus hypersecretion affect the clinical response to medications of COPD patients?
Authors: Ko Fanny Wai San , Hui David Shu Cheong
Published: August 2022

See related article
A case of giant dental calculus in a patient with centronuclear myopathy
Authors: Iwama Ryosuke , Nagai Hirokazu , Suzuki Naoki , Izumi Rumiko , Kumamoto Hiroyuki , Takahashi Tetsu
Published: August 2022

Introduction

Centronuclear myopathy is a hereditary congenital muscle disease. It is characterized by generalized muscle hypotonia from early childhood, elongated cacial appearance, mandibular undergroth, and dental malposition. In this report, we discuss the clinical course and management of a patient with centronuclearmyopathy, who developed a giant dental calculus in the floor of the mouth and underwent surgical excision.

Case Report

A 37‐year‐old Japanese man was referred to our hospital, and reported a swelling in the floor of the mouth. The patient affects centronuclear myopathy and has generalized muscle weakness. CT images showed a high‐density area in the floor of the mouth measuring 35 × 28 × 20 mm. The lesion was clinically diagnosed as giant dental calculus, and surgically removed.

Conclusion

We have experienced a case of giant dental calculus in a patient with centronuclear myopathy. In dental treatment, we must consider generalized muscle weakness.
ON THE SYNTAX OF VP DISLOCATION IN MANDARIN*
Authors: Jheng Wei‐Cherng Sam
Published: August 2022

By drawing on data of two types of VP dislocation in Mandarin, this paper argues that these two types represent a syntactic incarnation of XP‐split constructions providing an interesting argument for the conception of information structure starting in the numeration and multiple Spell‐Out of copies regulated by the checking of strong features over the course of a syntactic derivation. Building on Fanselow and Ćavar’s (2002) distributed deletion analysis, I show that Type 1 involves two autonomous nominals that form a nominal predicate structure in a VP, and the VP is copied and internally merged to a topic position, followed by multiple Spell‐Out of the copies whose information structural features are checked. In contrast, Type 2 is derived via base‐generation. I argue that the two types are derived employing the same set of operations in the computational system without extra postulations. Issues involved in dealing with Mandarin topic constructions are addressed.
The challenging estimation of trade elasticities: Tackling the inconclusive Eurozone evidence
Authors: Keil Sascha
Published: August 2022

This paper sheds light on serious methodological difficulties of employing the empiric export equation in order to derive long‐run trade elasticities. The unreliable estimated price coefficient (Kaldor paradox) and the potential presence of cointegration are identified as the most relevant points. It can be shown that difficulties are in part due to methodological issues. New empirical evidence, encompassing 11 Euro area countries and the timespan 1995–2021, has been obtained from different cointegration techniques. In almost all cases, a robust long‐run relationship was detected. Price competitiveness was consistently found to be a decisive determinant of European trade flows.
Inclusion of airway pressure release ventilation in the management of respiratory failure and refractory hypercapnia in a dog
Authors: Kovak Natalie , DeRosa Sage , Fischer Christiana , Murphy Kellyann , Wolf Jacob
Published: August 2022

Objective

To describe the use of airway pressure release ventilation (APRV) to relieve hypercapnia in a dog undergoing mechanical ventilation.

Case Summary

A 3‐month‐old male Shar‐Pei mix presented to the emergency department with suspected noncardiogenic pulmonary edema. Due to severe hypercapnia, mechanical ventilation was initiated. The hypercapnia failed to improve with conventional pressure control mechanical ventilation, bronchodilator administration, suctioning, or endotracheal tube replacement. The dog was transitioned to APRV and maintained in this mode for 36 hours. A modified APRV protocol in which inverse inspiratory to expiratory ratios ranged from 4.3:1 to 6.0:1 was utilized, resulting in a drastic improvement in the patient's hypercapnia. The patient eventually was transitioned off the ventilator, and no respiratory abnormalities have been noted at subsequent recheck examinations.

New or Unique Information Provided

This case documents the first use of APRV to relieve refractory hypercapnia in a dog undergoing mechanical ventilation and is one of the only recorded cases of using APRV for this purpose in the medical literature at large. APRV may be considered in cases of hypercapnia when traditional therapies fail, although caution is warranted as this mode of ventilation can also worsen hypercapnia.
Child life specialist practice and utilization across health care: a scoping review protocol
Authors: Rosenblatt Audrey , Pederson Renee , Davis-Sandfoss Tyler , Irwin Lauren , Mitsos Rebecca , Manworren Renee
Published: August 2022

Objective:

The objective of this review is to map the available evidence regarding the scope of child life specialist practice and utilization.

Introduction:

Child life specialists provide developmentally appropriate and emotion-focused supportive interventions that aim to build coping skills, enhance resilience, and mitigate traumatic experiences during health care encounters. Evidence of the care provided by a child life specialist is spread throughout health care literature. It is an emerging field that is aligned with a heightened focus on mental health and emotional safety. Evidence for the efficacy of child life specialists continues to grow.

Inclusion criteria:

Mapping the current evidence will capture the breadth of services provided by child life specialists. This scoping review will consider all evidence that reports on services provided by child life specialists, including across all quantitative and qualitative study designs, systematic reviews, and scoping reviews. The review will also include child life specialist workforce studies, such as child life specialist utilization, geographic availability, multidisciplinary team integration, and clinician-focused research. Case studies or narrative experiences outside of a qualitative research methodology, descriptions of program implementation, educational surveys, and quality improvement projects will be excluded from the scoping review.

Methods:

JBI methodology for scoping reviews will guide the review process. Literature published from 1980 to the present will be included. Databases to be searched include PubMed, Scopus, PsycINFO, and CINAHL. The search for unpublished evidence will include Google Scholar and OpenGrey. Extracted data will be presented in tabular format with accompanying narrative summary.
Influence of Off Gas Recirculation on the Intermediate Temperature SOFC With Partial Oxidation Reformer
Authors: Li Siyuan , Zhang Zhe , Li Guoxiang , Bai Shuzhan
Published: August 2022

Solid oxide fuel cell (SOFC) is a clean and efficient energy utilization technology. Partial oxidation reforming (POX) can be used to simplify the SOFC system structure, but its lower hydrogen production rate deteriorates the system performance. A wise method may be combining anode off gas recirculation (AOGR) and cathode off gas recirculation (COGR) with POX. Thus, their influence on the coupled system of intermediate temperature SOFC and POX is researched in detail in this paper. Results show that the reforming process gradually changes from exothermic to endothermic as AOGR rate increases. Meanwhile, its oxygen demand declines sharply and the process can even be self-sustained without external air input at the AOGR rate of 0.5 and 0.6. The application of AOGR can improve electrical efficiency by up to 51%, but at the expense of thermal efficiency. Excessive AOGR rates will result in decreased cell voltage and insufficient energy supply to the after-burner, so it should be restricted within a reasonable range and the best recommended value is 0.5. The application of COGR has little effect on fuel line parameters, so it causes little deterioration in electrical efficiency while improving thermal efficiency. Besides, the cell voltage is also insensitive to it. The combination of AOGR and COGR can obtain better fuel economy and larger cogeneration scale simultaneously at the cost of a tiny electrical output power, while an optimal balance between three efficiencies is also achieved.
Computational Fluid–Structure Interaction Analysis of Piston Pin Multiphase Elastohydrodynamic Lubrication With Unsteady Flow Channel Variation
Authors: Narumi Yudai , Ishimoto Jun , Kanayama Daisuke , Kuribara Hiroshi , Nakano Yoshikatsu
Published: August 2022

This research focuses on the multiphase oil film tribology between the piston pin and the connecting rod in an internal combustion engine and establishes a new computational approach for thin-film lubrication with unsteady flow channel variation. First, the pin and the connecting rod are considered as rigid bodies, and 3D numerical analysis of the cavitating lubricating oil flow is performed when combustion load is applied to the pin. We find that dynamic pressure does not increase around the connecting rod edge and that pressure is potentially insufficient to support the load. In the second numerical analysis, the pin and the connecting rod are considered to be elastically deformable structures, and coupled 3D multiphase fluid–structure interaction simulation is performed. The boundary lubrication area is detected using a statistical Greenwood–Tripp model as unevenness of the contacted metal surface. The results show that pressure distribution spreads more widely than in the result for rigid bodies and that the film was thicker as well. Also, the pin deformed like a bow, but the deformation of the connecting rod was quite small, suggesting a potential mechanical contact at the edge of the connecting rod with the pin. By comparison with an actual operationally used piston pin, we find that the fluid–structure coupled analysis qualitatively predicted the seizure location.
The Mnemosyne number and the rheology of remembrance
Authors: Jamali Safa , McKinley Gareth H.
Published: August 2022

The concept of a Deborah number is widely used in the study of viscoelastic materials to represent the ratio of a material relaxation time to the time scale of observation and to demarcate transitions between predominantly viscous or elastic material responses. However, this construct does not help quantify the importance of long transients and nonmonotonic stress jumps that are often observed in more complex time-varying systems. Many of these nonintuitive effects are lumped collectively under the term thixotropy; however, no proper nouns are associated with the key phenomena observed in such materials. Thixotropy arises from the ability of a complex structured fluid to remember its prior deformation history, so it is natural to name the dimensionless group representing such behavior with respect to the ability to remember. In Greek mythology, Mnemosyne was the mother of the nine Muses and the goddess of memory. We, thus, propose the definition of a Mnemosyne number as the dimensionless product of the thixotropic time scale and the imposed rate of deformation. The Mnemosyne number is, thus, a measure of the flow strength compared to the thixotropic time scale. Since long transient responses are endemic to thixotropic materials, one also needs to consider the duration of flow. The relevant dimensionless measure of this duration can be represented in terms of a mutation number, which compares the time scale of experiment/observation to the thixotropic time scale. Collating the mutation number and the Mnemosyne number, we can construct a general two-dimensional map that helps understand thixotropic behavior. We quantify these ideas using several of the simplest canonical thixotropic models available in the literature.
Strain Screening and Particle Formation: a Lysinibacillus boronitolerans for Self-Healing Concrete
Authors: Xu Jian-Miao , Lu Cheng , Wang Wei-Jie , Du Zi-Ye , Pan Jia-Jia , Cheng Feng , Wang Yuan-Shan , Liu Zhi-Qiang , Zheng Yu-Guo
Published: August 2022

The formation of calcium carbonate crystals in concrete by urease-producing bacteria is not understood fully. In this study, a
Lysinibacillus boronitolerans
strain with a high urease activity was isolated and used to analyze the counts and sizes of the crystals and the relationship with time.
mobileOG-db: a Manually Curated Database of Protein Families Mediating the Life Cycle of Bacterial Mobile Genetic Elements
Authors: Brown Connor L. , Mullet James , Hindi Fadi , Stoll James E. , Gupta Suraj , Choi Minyoung , Keenum Ishi , Vikesland Peter , Pruden Amy , Zhang Liqing
Published: August 2022

The analysis of bacterial mobile genetic elements (MGEs) in genomic data is a critical step toward profiling the root causes of antibiotic resistance, phenotypic or metabolic diversity, and the evolution of bacterial genera. Existing methods for MGE annotation pose high barriers of biological and computational expertise to properly harness.
A Novel Carrageenan Metabolic Pathway in Flavobacterium algicola
Authors: Jiang Chengcheng , Zhang Tianyu , Li Qiuyang , Jiang Hong , Mao Xiangzhao
Published: August 2022

Based on the premise that the specific carrageenan-based pathway involved in carrageenan use by
Flavobacterium algicola
has been identified, another pathway was further analyzed, and it involved two GH16_13 carrageenases. Among all the characterized carrageenases, the members of GH16_13 accounted for only a small portion.
Testosterone Promotes the Intestinal Replication and Dissemination of Coxsackievirus B3 in an Oral Inoculation Mouse Model
Authors: Dhalech Adeeba H. , Corn Caleb M. , Mangale Vrushali , Syed Fahim , Condotta Stephanie A. , Richer Martin J. , Robinson Christopher M.
Published: August 2022

Biological sex plays a significant role in the outcomes of various infections and diseases. The impact of sex hormones on the intestinal replication and dissemination of Coxsackievirus B3 remains poorly understood.
Atomic Structure of IglD Demonstrates Its Role as a Component of the Baseplate Complex of the
Francisella
Type VI Secretion System
Authors: Liu Xiaoyu , Clemens Daniel L. , Lee Bai-Yu , Yang Xue , Zhou Z. Hong , Horwitz Marcus A.
Published: August 2022

Francisella tularensis
is a facultatively intracellular Gram-negative bacterium that causes the serious and potentially fatal zoonotic illness, tularemia. Because of its extraordinarily high infectivity and mortality to humans, especially when inhaled,
F. tularensis
is considered a potential bioterrorism agent and is classified as a Tier 1 select agent.
Genome Sequences of 18 Salmonella enterica Serotype Hadar Strains Collected from Patients in the United States
Authors: Webb Hattie E. , Kim Justin Y. , Tagg Kaitlin A. , de la Cruz Fernando , Peñil-Celis Arancha , Tolar Beth , Ellison Zachary , Schwensohn Colin , Brandenburg Joshua , Nichols Megin , Folster Jason P.
Published: August 2022

Despite being linked to a number of recent poultry-associated outbreaks in the United States, few reference genomes are available for
Salmonella enterica
serotype Hadar. Here, we address this need by reporting 18
Salmonella
Hadar genomes from samples collected from patients in the United States between 2014 and 2020.
Genome-Resolved Metagenomics Informs the Functional Ecology of Uncultured Acidobacteria in Redox Oscillated
Sphagnum
Peat
Authors: Reji Linta , Zhang Xinning
Published: August 2022

Acidobacteria are among the most widespread and abundant members of the soil bacterial community, yet their ecophysiology remains largely underexplored. In acidic peat systems, Acidobacteria are thought to perform key biogeochemical functions, yet the mechanistic links between the phylogenetic and metabolic diversity within this phylum and peat carbon transformations remain unclear.
Comparison of the SARS-CoV-2 BD Veritor Nasal Antigen Test with Nasopharyngeal Reverse Transcription-PCR in Symptomatic Patients
Authors: Koga Paula , Maluf Maira , Nunes Fabiane , Campos Juliana , Gazarini Lívia , Borghoff Tatiane , Libanori Glaís , Martino Marinês
Published: August 2022

This study provides important and useful information, especially for diagnostic laboratories, since the results show that the BD Veritor system can provide a fast and safe point-of-care antigen diagnostic test for rapid detection of COVID-19 that has high sensitivity, reproducibility, and accuracy.
The Plant Homeodomain Protein Clp1 Regulates Fungal Development, Virulence, and Autophagy Homeostasis in Magnaporthe oryzae
Authors: Wang Jing , Huang Zhicheng , Huang Pengyun , Wang Qing , Li Yan , Liu Xiao-Hong , Lin Fu-Cheng , Lu Jianping
Published: August 2022

The fungal pathogen
Magnaporthe oryzae
causes serious diseases of grasses such as rice and wheat. Autophagy plays an indispensable role in the pathogenic process of
M. oryzae
.
Envelope Stress Activates Expression of the Twin Arginine Translocation (Tat) System in Salmonella
Authors: Rogers Alexandra R. , Turner Ezekeial E. , Johnson Deauna T. , Ellermeier Jeremy R.
Published: August 2022

Salmonella
species cause an array of diseases in a variety of hosts. This research is significant in showing induction of the Tat system as a defense against periplasmic stress. Understanding the underlying mechanism of this regulation broadens our understanding of the
Salmonella
stress response, which is critical to the ability of the organism to cause infection.
Neutron Polarization Observables in $$d(\vec {\gamma },\vec {n})p$$ at Low Energies of Interest to Astrophysics
Authors: Shilpashree S. P. , Shastri Venkataramana
Published: August 2022

A model-independent theoretical analysis of neutron polarization observables in $$d(\vec {\gamma },\vec {n})p$$ using circularly polarized photons at the range of energies of interest to Big Bang Nucleosynthesis is presented. An investigation of various spin dependent observables is carried out including the isoscalar multipole amplitudes $$M{{1}_{s}}$$ and $$E{{2}_{s}}.$$ It is suggested that the measurement of neutron polarization in the final state at near threshold energies will be very useful to assess the contribution of isoscalar amplitudes at range of energies of interest to Big Bang Nucleosynthesis.
Expression of CASC8 RNA in Human Pancreatic Cancer Cell Lines
Authors: Burenina O. Y. , Lazarevich N. L. , Kustova I. F. , Zatsepin T. S. , Rubtsova M. P. , Dontsova O. A.
Published: August 2022

A lot of long non-coding RNAs (lncRNAs) are expressed in human cells in a number of transcripts of different lengths and composition of exons. In case of cancer-associated lncRNAs, an actual task is to determine their specific isoforms, since each transcript can perform its own function in carcinogenesis and might have a unique expression profile in various types of tumors. For the first time, we analyzed the expression of CASC8 lncRNA in human pancreatic ductal adenocarcinoma cell lines and found an abundant isoform that was previously considered as the minor one in this type of cancer. We also revealed extremely high expression levels of all CASC8 transcripts in MIA PaCa-2 cells and, conversely, the lack of this lncRNA in PANC-1. This allows to use them as convenient models for further in vitro studies.
Spinal leptomeningeal hemangioblastomatosis occurring without craniospinal surgery in von Hippel-Lindau disease
Authors: De Jesus Orlando , Rosado-Philippi Julio
Published: August 2022

Hemangioblastomatosis represents an unusual and malignant leptomeningeal dissemination of hemangioblastoma (HB). It has been reported in patients with sporadic HB or von Hippel-Lindau (VHL) disease. Hemangioblastomatosis had been reported following resection of a primary HB lesion in all cases except one patient with a sporadic HB. We present a patient with VHL with several HBs at the brainstem, cerebellum, pituitary stalk and retina who developed spinal hemangioblastomatosis without previous craniospinal surgery. A whole spine MRI showed the spinal dissemination from the primary lesions. The patient received craniospinal radiotherapy due to the extensive spinal leptomeningeal dissemination and multiple HBs. MRI performed 12 months after the radiotherapy showed stability of the lesions.
Fusion-negative rhabdomyosarcoma with diffuse bony metastases and remarkable chemosensitivity
Authors: Kube Paige , Parisio Katie , Mangum David Spencer , Powell Jonathan
Published: August 2022

In this report, we describe the case of an adolescent male with an unusual case of fusion-negative, paratesticular alveolar rhabdomyosarcoma who presented with spontaneous tumour lysis syndrome and diffuse bony metastases throughout the axial and appendicular skeleton with additional significant bone marrow involvement. Both spontaneous tumour lysis syndrome and diffuse bony metastases are extremely unusual for rhabdomyosarcoma. On the backbone of standard vincristine, dactinomycin and cyclophosphamide (VAC) chemotherapy, the only local control was orchiectomy at 15 weeks, with no radiation administered due to the initially diffuse nature of the disease and rapid response to chemotherapy. Following 43 weeks of VAC, a year-long maintenance phase with pazopanib was given which was well tolerated. The patient remains in remission now 4 years after completion of therapy.
Managing the challenges associated with decreasing demand for COVID-19 vaccination in Central and West Asia
Authors: Bongers Alexander , Riggall Giovanna , Kokareva Larissa , Chin Brian
Published: August 2022

Since the first administration of COVID-19 vaccine in December 2020, countries have experienced a range of challenges at different phases of their COVID-19 vaccination programmes. Initially, with limited global COVID-19 vaccine supply, the WHO called for vaccine equity to ensure the most vulnerable people in every country globally had access to vaccine, and COVID-19 Vaccines Global Access was established to facilitate equitable access to COVID-19 vaccine. However, the aims of these initiatives were challenged as many countries secured earlier access to COVID-19 vaccine with direct agreements with manufacturers. During the early stages of COVID-19 vaccination programmes, the rate of vaccine uptake was determined by number of COVID-19 vaccines approved for use and the manufacturing capacity of the manufacturers of these vaccines. It is a very different situation in 2022, where COVID-19 vaccination coverage is no longer determined by access to supply and manufacturers are reducing or stopping production of vaccines completely. Uptake of COVID-19 vaccination in 2022 is dependent on complex issues like vaccine hesitancy. This paper focuses on the Central and West Asia region, where the authors have been supporting COVID-19 vaccination programmes across seven countries in this region. In this paper, we outline and describe the different phases of demand for COVID-19 vaccination as well as the risks and strategies to consider in each of these phases.
Biologically effective doses of 60–70Gy versus >70Gy of stereotactic body radiotherapy (SBRT) combined with chemotherapy in locally advanced pancreatic cancer: protocol of a single-centre, phase II clinical trial
Authors: Ye Yusheng , Zhu Xiaofei , Zhao Xianzhi , Jiang Lingong , Cao Yangsen , Zhang Huojun
Published: August 2022

Introduction

There is a paucity of studies about whether dose escalation of stereotactic body radiation therapy (SBRT) prolongs survival compared with de-escalation for patients with locally advanced pancreatic cancer (LAPC). Therefore, the aim of the study is to compare the survival benefits of biologically effective dose (BED10, α/β=10) of 60–70 Gy with those of BED10>70 Gy.

Methods and analysis

This study is a single-centre, phase II trial. Patients with LAPC are randomly allocated to receive SBRT with BED10of 60–70 Gy or >70 Gy in 5–6 fractions combined with gemcitabine plus albumin-bound paclitaxel. The primary outcome is progression-free survival. The secondary outcomes are adverse events, local control and overall survival.

Ethics and dissemination

The trial protocol has been approved by the Ethics committee of Shanghai Changhai Hospital. The ethics number is CHEC2020-100. Study results will be disseminated through peer-reviewed journals and released in related medical conferences.

Trial registration numbers

NCT04603586.
Factors Associated with the Magnitude Of acUpuncture treatment effectS (FAMOUS): a meta-epidemiological study of acupuncture randomised controlled trials
Authors: Gang Wei-Juan , Xiu Wen-Cui , Shi Lan-Jun , Zhou Qi , Jiao Rui-Min , Yang Ji-Wei , Shi Xiao-Shuang , Sun Xiao-Yue , Zeng Zhao , Witt Claudia M , Thabane Lehana , Song Ping , Yang Long-Hui , Guyatt Gordon , Zhang Zhi-Yun , Li Heng-Cong , Shi Jing-Tao , Chen An-Li , Qu Zheng-Yang , Zou Ling , Mou Dong-Xiao , Wang Xiao-Yu , Yu Qing-Quan , Chen Li-Zhen , Huang Yu-Ting , Pereira Tiago V , Chambers Jason , Ho Cameron , Bakaa Layla , Loniewski Kevin , Tong Kyle , Tong Jaryd , Dookie Jared E , Zhu Jie-wei , Hu Malini , Suk Yujin , Wu Kay , Lopes Luciane Cruz , White Julia , Buchan Tayler A , Mazzei Lauren Giustti , Alves Maíra Ramos , Moura Mariana Del Grossi , Bergamaschi Cristiane De Cássia , Meng Jing , Chan Cynthia , Sorrilha Flávia Blaseck , Jing Xiang-Hong , Zhang Yu-Qing
Published: August 2022

Objective

To identify factors and assess to what extent they impact the magnitude of the treatment effect of acupuncture therapies across therapeutic areas.

Data source

Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc, between 2015 and 2019.

Study selection

The inclusion criteria were trials with a total number of randomised patients larger than 100, at least one patient-important outcome and one of two sets of comparisons.

Data analysis

The potential independent variables were identified by reviewing relevant literature and consulting with experts. We conducted meta-regression analyses with standardised mean difference (SMD) as effect estimate for the dependent variable. The analyses included univariable meta-regression and multivariable meta-regression using a three-level robust mixed model.

Results

1304 effect estimates from 584 acupuncture randomised controlled trials (RCTs) were analysed. The multivariable analyses contained 15 independent variables . In the multivariable analysis, the following produced larger treatment effects of large magnitude (>0.4): quality of life (difference of adjusted SMDs 0.51, 95% CI 0.24 to 0.77), or pain (0.48, 95% CI 0.27 to 0.69), or function (0.41, 95% CI 0.21 to 0.61) vs major events. The following produced larger treatment effects of moderate magnitude (0.2–0.4): single-centred vs multicentred RCTs (0.38, 95% CI 0.10 to 0.66); penetration acupuncture vs non-penetration types of acupuncture (0.34, 95% CI 0.15 to 0.53); non-pain symptoms vs major events (0.32, 95% CI 0.12 to 0.52). The following produced larger treatment effects of small magnitude (<0.2): high vs low frequency treatment sessions (0.19, 95% CI 0.03 to 0.35); pain vs non-pain symptoms (0.16, 95% CI 0.04 to 0.27); unreported vs reported funding (0.12, 95% CI 0 to 0.25).

Conclusion

Patients, clinicians and policy-makers should consider penetrating over non-penetrating acupuncture and more frequent treatment sessions when feasible and acceptable. When designing future acupuncture RCTs, trialists should consider factors that impact acupuncture treatment effects.
How has the emergence of the Omicron SARS-CoV-2 variant of concern influenced worry, perceived risk and behaviour in the UK? A series of cross-sectional surveys
Authors: Smith Louise E , Potts Henry WW , Amlôt Richard , Fear Nicola T , Michie Susan , Rubin G James
Published: August 2022

Objectives

To investigate changes in beliefs and behaviours following news of the Omicron variant and changes to guidance understanding of Omicron-related guidance, and factors associated with engaging with protective behaviours.

Design

Series of cross-sectional surveys (1 November to 16 December 2021, five waves of data collection).

Setting

Online.

Participants

People living in England, aged 16 years or over (n=1622–1902 per wave).

Primary and secondary outcome measures

Levels of worry and perceived risk, and engagement with key behaviours (out-of-home activities, risky social mixing, wearing a face covering and testing uptake).

Results

Degree of worry and perceived risk of COVID-19 (to oneself and people in the UK) fluctuated over time, increasing slightly around the time of the announcement about Omicron (p<0.001). Understanding of rules in England was varied, ranging between 10.3% and 91.9%, with people overestimating the stringency of the new rules. Rates of wearing a face covering and testing increased over time (p<0.001). Meeting up with people from another household decreased around the time of the announcement of Omicron (29 November to 1 December), but then returned to previous levels (p=0.002). Associations with protective behaviours were investigated using regression analyses. There was no evidence for significant associations between out-of-home activity and worry or perceived risk (COVID-19 generally or Omicron-specific, p≥0.004; Bonferroni adjustment p<0.002 applied). Engaging in highest risk social mixing and always wearing a face covering were associated with worry and perceived risk about COVID-19 (p≤0.001). Always wearing a face covering in shops was associated with having heard more about Omicron (p<0.001).

Conclusions

Almost 2 years into the COVID-19 outbreak, the emergence of a novel variant of concern only slightly influenced worry and perceived risk. The main protective behaviour (wearing a face covering) promoted by new guidance showed significant re-uptake, but other protective behaviours showed little or no change.
Seropositivity of SARS-CoV-2 in an unvaccinated cohort in British Columbia, Canada: a cross-sectional survey with dried blood spot samples
Authors: Racey C Sarai , Booth Amy , Albert Arianne , Smith Laurie W , Krajden Mel , Murray Melanie C M , Côté Hélène C F , Gottschlich Anna , Goldfarb David M , Sadarangani Manish , Galea Liisa A M , Kaida Angela , Brotto Lori A , Ogilvie Gina S
Published: August 2022

Objectives

Gathering population-based data on prevalence of SARS-CoV-2 infection is vital to the public health response and planning. Current seroprevalence data in BC are limited with respect to considerations of how socioeconomic and demographic factors, such as age, sex, gender, income, identifying as a visibility minority and occupation, are related to SARS-CoV-2 antibody detection due to infection-acquired immunity. We aimed to estimate the SARS-CoV-2 seropositivity in a cohort of British Columbians, using at-home self-collected dried blood spot (DBS) samples.

Design

This cross-sectional study included online surveys that collected sociodemographic and COVID-19 vaccine receipt information, and an at-home DBS collection kit.

Setting

British Columbia (BC), Canada.

Participants

Eligible participants were aged 25–69 years and residents of BC.

Primary outcome measure

SARS-CoV-2 anti-spike IgG antibody detection in unvaccinated individuals. Adjusted incidence rate ratios (aIRR) explored factors associated with seropositivity.

Results

SARS-CoV-2 serology was performed on a total of 4048 unvaccinated participants 25–69 years of age who submitted DBS samples taken from November 2020 to June 2021. A total of 118 seropositive cases were identified, for an estimated overall seropositivity of 2.92% (95% CI 2.42% to 3.48%). Participants identifying as a visible minority had a higher seropositivity, 5.1% vs 2.6% (p=0.003), compared with non-visible minority participants. After adjustment by age and sex, identifying as a visible minority (aIRR=1.85, 95% CI 1.20 to 2.84) remained the only significant factor associated with SARS-CoV-2 antibody detection in this cohort of unvaccinated individuals.

Conclusions

SARS-CoV-2 seropositivity in the BC population due to infection-acquired immunity was low. Seropositivity indicated that among those unvaccinated, visible minority communities have been most impacted. Continued monitoring of SARS-CoV-2 serology due to both infection-acquired and vaccine-acquired immunity will be vital in public health planning and pandemic response.
Qualitative study exploring the well-being experiences of paediatric critical care consultants working in the UK during the COVID-19 pandemic
Authors: Butcher Isabelle , Saeed Sumayyah , Morrison Rachael , Donnelly Peter , Shaw Rachel
Published: August 2022

Objectives

The aim of this study was to examine the well-being experiences of consultants working in paediatric critical care (PCC) settings in the UK during the COVID-19 pandemic.

Design

Qualitative design using individual interviews and thematic analysis.

Setting

PCC.

Participants

Eleven medical consultants working in PCC in a range of PCC settings/transport teams in the UK from nine units participated. Participants ranged in years of experience as a consultant from four to 23 years.

Methods

A set of open semistructured questions were used to elicit information about participants’ experiences of workplace well-being. Interviews were audiorecorded and transcribed.

Findings

Thematic analysis identified six themes and data saturation was reached. These were as follows: (1) positive and negative impact of working during COVID-19, (2) job satisfaction and public scrutiny in the unique environment of PCC, (3) supporting the workforce through modified shift work, (4) perceptions of support and recognition offered from the hospital management, (5) successful coping strategies are personal and adaptive, and (6) importance of civility and good teamwork

Conclusion

Findings show that consultants’ well-being is challenged in a number of ways and that the solutions to the problem of burn-out are multifaceted. Action is required from individual consultants, clinical teams, hospital management and national regulatory bodies. Our work corroborates the recent General Medical Council report highlighting doctors’ core needs for well-being: autonomy, belonging, competence. Burn-out is a long-term problem, requiring sustainable solutions. Future research needs to develop and evaluate the effectiveness of evidence-based interventions to improve consultants’ well-being. Trials of effectiveness need to present evidence that will persuade hospital management to invest in their consultants’ well-being within the economic context of reduced budgets and limited PCC workforce.
Comparison of obstructive sleep apnoea prevalence and severity across WHO pulmonary hypertension groups
Authors: Simonson Joseph L , Pandya Dhwani , Khan Sara , Greenberg Harly E , Talwar Arunabh
Published: August 2022

Introduction

Pulmonary hypertension is classified into five groups in the WHO classification system. Patients with pulmonary hypertension often have comorbid obstructive sleep apnoea (OSA), yet the prevalence and severity of OSA in each of the WHO pulmonary hypertension groups have not been well established.

Methods

To compare the prevalence and severity of OSA between WHO pulmonary hypertension groups, we performed a retrospective cohort study, including patients who had polysomnography or a home sleep study and confirmed pulmonary hypertension on right heart catheterisation. The primary outcomes of OSA prevalence and severity were measured by median apnoea hypopnea index (AHI) or respiratory event index (REI) and were compared by WHO pulmonary hypertension group. Multivariable negative binomial regression was used to evaluate the association between the outcome of OSA severity by AHI or REI and WHO group.

Results

Among the cohort of 132 patients, OSA was common in all WHO pulmonary hypertension groups but was most common and most severe in WHO group II pulmonary hypertension. Median AHI or REI in WHO group II was 12.0 events/hour compared with 2.8 in group I, 3.7 in group III, 10.0 in group IV and 6.4 in group V. Multivariable negative binomial regression showed about a twofold increase in AHI or REI in WHO group II compared with WHO group I pulmonary hypertension.

Discussion

Our findings demonstrate that OSA deserves greater consideration as a treatable comorbidity that may affect pulmonary haemodynamics and quality of life in patients with pulmonary hypertension across all WHO groups.
Pressure–flow responses to exercise in aortic stenosis, mitral regurgitation and diastolic dysfunction
Authors: Andersen Mads J , Wolsk Emil , Bakkestrøm Rine , Christensen Nicolaj , Carter-Storch Rasmus , Omar Massar , Dahl Jordi S , Frederiksen Peter H , Borlaug Barry , Gustafsson Finn , Hassager Christian , Moller Jacob E
Published: August 2022

Background

Haemodynamic exercise testing is important for evaluating patients with dyspnoea on exertion and preserved ejection fraction. Despite very different pathologies, patients with pressure (aortic stenosis (AS)) and volume (mitral regurgitation (MR)) overload and diastolic dysfunction after recent acute myocardial infarction (AMI) reach similar filling pressure levels with exercise. The pressure–flow relationships (the association between change in cardiac output (∆CO) and change in pulmonary arterial wedge pressure (∆PAWP) may provide insight into haemodynamic adaptation to exercise in these groups.

Methods and results

One hundred sixty-eight subjects aged >50 years with a left ventricular ejection fraction of ≥50% underwent invasive exercise testing. They were enrolled in four different studies: AS (40 patients), AMI (52 patients), MR (43 patients) and 33 healthy subjects. Haemodynamic data were measured at rest, at 25 W, 75 W and at peak exercise. In all groups, PAWP increased with exercise. The greatest increase was observed in patients with AMI (from 12.7±3.9 mm Hg to 33.1±8.2 mm Hg, p<0.0001) and patients with AS (from 11.8±3.9 mm Hg to 31.4±6.1 mm Hg, p<0.0001), and the smallest was observed in healthy subjects (from 8.3±2.4 mm Hg to 21.1±7.5 mm Hg, p<0.0001). In all groups, the relative pressure increase was greatest at the beginning of the exercise. CO increased most in healthy patients (from 5.3±1.1 to 16.0±3.0 L/min, p<0.0001) and least in patients with AS (from 5.3±1.2 L/min to 12.4±2.6 L/min, p<0.0001). The pressure–flow relationships (∆PAWP/∆CO) and differed among groups (p=0.02). In all groups, the pressure–flow relationship was steepest in the initial phase of the exercise test. The AMI and AS groups (2.3±1.2 mm Hg/L/min and 3.0±1.3 mm Hg/L/min, AMI and AS, respectively) had the largest overall pressure–flow relationship; the healthy group had the smallest initially and at peak exercise (1.3±1.1 mm Hg/L/min) followed by MR group (1.9±1.4 mm Hg/L/min).

Conclusion

The pressure–flow relationship was steepest in the initial phase of the exercise test in all groups. The pressure–flow relationship differs between groups.

Trial registration numbers

NCT01974557,NCT01046838,NCT02961647andNCT02395107.
Temporal Trends and Disparities in Gastroenterology Care use before, during, and after COVID-19 Lockdown
Authors: Sanaka Harsha , Garg Rajat , Patel Vidhi , McMichael John , Macaron Carole
Published: August 2022

Socioeconomic disparities adversely affected healthcare use during COVID-19 lockdown. However, trends in these disparities post lockdown are unknown. Therefore, our aim was to study temporal trends and factors associated with gastroenterology healthcare access and disparities during and after COVID-19 lockdown. This cohort study consisted of patients receiving outpatient care in the Cleveland Clinic gastroenterology department between March 2020 and June 2020 and corresponding time periods in 2019 and 2021. Patient demographics and socioeconomic factors were extracted and analyzed. There were 47,031 patients (mean age 56.3±17.6 years, 61.9% female and 76.4% white) included. Patients ≥65 years sought healthcare less frequently during and after the lockdown (40.1% vs 34.8% vs 35.2% in 2019, 2020, and 2021 respectively). Missed visits (4.2% vs 10% vs 10.4%), tobacco (11.4% vs 15.9% vs 16.1%), alcohol (38.6% vs 45.5% vs 50.9%), and illicit drug use (3.5% vs 5.8% vs 10.7%) have steadily increased during and after the lockdown compared with prepandemic levels. Factors associated with reduced telehealth use were black race (OR 0.89, 95% CI 0.81 to 0.99), Hispanic race (OR 0.63, 95% CI 0.51 to 0.77)), Medicaid/other public insurance (OR 0.87, 95% CI 0.79 to 0.95)), unemployed status (OR 0.85, 95% CI 0.79 to 0.92)), and non-English/Spanish speakers (OR 0.66, 95% CI 0.46 to 0.94)). In conclusion, socioeconomic and ethnic disparities persist in healthcare use even a year after the onset of the COVID-19 pandemic. There is an alarming increase in missed visits and substance abuse. Therefore, efforts should be targeted on improving healthcare access for these aforementioned vulnerable groups.