bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Faith‐Placed Health Education Service on Bowel Cancer Screening in Mosques in East London
Authors: Waqar Salman , Yerrakalva Dharani , Duffy Thomas E. , Chambers Jake , Ali Zohra , Thomas Paul , Cook Caroline , Alam Sufia , Khagram Leena , Quaife Samantha , Duffy Stephen W.
Published: August 2024

Background

Bowel cancer screening using faecal immunochemical testing is provided in the United Kingdom with the aim of reducing mortality from colorectal cancer. However, there are low participant rates among ethnic minorities across the United Kingdom. Faith‐placed interventions have the potential to improve screening rates among such populations, but studies examining their effectiveness are scarce.

Methods

We delivered a presentation on bowel cancer screening to 204 Muslims in seven mosques in East London (intervention group). All participants completed a questionnaire regarding attitudes, perceptions and knowledge of bowel cancer screening before and after the presentation. Concurrently, we administered the questionnaire to 72 subjects attending a mosque that did not receive the presentation (comparison group).

Results

The intervention group showed a greater willingness to do the test (90% vs. 67%, p < 0.001) and to recommend it to others (96% vs. 74%, p < 0.001), ability to complete the test by themselves (94% vs. 56%, p < 0.001) and confidence in noticing symptoms (78% vs. 32%, p < 0.001) after the presentation compared to before. There was a significant difference between the intervention group post‐presentation and the comparison group on intention to do the test (90% vs. 79%, p = 0.02), recommending it to others (96% vs. 83%, p < 0.001), and confidence in their ability to complete the test by themselves (94% vs. 63%, p < 0.001).

Conclusion

A culture‐sensitive, faith‐placed health education intervention delivered in mosques can substantially improve knowledge of bowel cancer screening and increase the intention to participate in the screening programme.

Patient or Public Contribution

The intervention presentation was developed using insights from four public involvement sessions with four to six members representative of the East London Muslim community. The sessions sought attendees’ thoughts on appropriate ways to approach the intervention design for their community and asked for their views on the acceptability, appropriateness of messaging, format/design and likely impact of the presentation. Their views were then utilised to improve the presentation.
Processing, microstructure, and mechanical properties of chopped SiC fibers reinforced ZrB2–hBN–based composites
Authors: Zou Ji , Zhao Guanlin , Liang Huayue , Liu Jingjing , Ji Wei , Wang Weimin , Fu Zhengyi
Published: August 2024

This study selected ZrB2–hBN ceramics as the matrix for low‐cost second‐generation SiC fibers, due to their low modulus and ability to be sintered at relatively low temperatures. The resulting composites, which contained up to 30 wt.% short‐chopped SiCf, were consolidated using reactive spark plasma sintering at 1550 and 1700°C under 50 MPa for 5 min. Without needing to prepare interfaces on the SiCf surfaces, fiber pullout, strengthening, and toughening during the fracture process were realized. By constructing the volatility phase diagram for the fiber, the microstructural changes that occurred on the fiber surfaces during sintering were successfully illustrated. Mechanical properties of ZrB2–hBN ceramics with 10 wt.% SiCf sintered at 1550°C still showed considerable improvements, including an elastic modulus of 187 GPa, a flexural strength of 337 ± 16 MPa, and a fracture toughness of 4.12 ± 0.25 MPa m1/2, increases of 12.6%, 61.2%, and 118%, respectively, compared to the counterparts without adding chopped fibers. Variations in these properties were linked to the matrix porosity and SiCf pullout behaviors, which were subsequently analyzed using the He–Hutchinson model.
A passage through India: The biotic ferry model supports the build‐up of Indo‐Australian biodiversity of an ancient soil arthropod clade
Authors: Manivannan Maya , Gurung Nehal , Edgecombe Gregory D. , Joshi Jahnavi
Published: August 2024

Aim

Scutigeromorpha is a globally distributed, ancient group of centipedes with at least 400 million years of evolutionary history. We assess the biogeographic history of the order, with a particular focus on the Peninsular Indian Plate (PIP), a Gondwanan fragment. We hypothesize that continental vicariance explains the disjunct distribution of extant scutigeromorphs, that PIP scutigeromorphs are of ancient Gondwanan origins, and that East Gondwana vicariance explains the diversification of the subfamily Thereuoneminae into its Asian and Australian clades.

Location

Global.

Taxa

Centipedes, Scutigeromorpha.

Methods

We use a novel molecular dataset sampled across the PIP and a global sequence database representing the geographic distribution of all families and subfamilies. We employ molecular phylogenetic analyses on two mitochondrial and three nuclear markers, molecular species delimitation and ancestral range estimation to reconstruct biogeographic history.

Results

Ancestral scutigeromorphs were likely widely distributed across Gondwana and diverged prior to any continental vicariance. Their subsequent biogeography is shaped by continental vicariance, long‐distance dispersal and jump dispersal, indicating an ability to colonize areas far from their ancestral range. The PIP emerged as the ancestral range of Thereuoneminae, which started diversifying during the Cretaceous Period. Subsequent in‐situ diversification within the PIP and dispersals into Asia, Australia and the Pacific Islands best explained the extant distribution of Thereuoneminae, more so than East Gondwana vicariance.

Main Conclusions

The in‐situ diversification of PIP species and their ancient divergence suggest they represent Gondwanan relicts in a landmass whose biota is primarily dispersal‐driven. A single dispersal event from the PIP generated most of the extant diversity in Australia, another Gondwanan fragment. Furthermore, the discovery of 11 putative species from the PIP and the Andaman Islands, five times more than was known, highlights the Wallacean and Linnean shortfalls in tropical Asia.
How well do connectivity tools agree over the full life cycle? A case study of Irish Sea plaice Pleuronectes platessaLinnaeus, 1758
Authors: Geffen Audrey J. , Nash Richard D. M. , Fox Clive J.
Published: August 2024

Adult plaice in the Irish Sea have distinct traits that reflect the spawning locations that could suggest a number of different populations. However, do connectivity pathways support this concept? Different tools are directed at measuring exchange or connectivity between different life‐history stages, and the challenge is to integrate the signals to obtain full life‐cycle estimates. Collectively, the different methods reveal stable connectivity between known spawning and nursery grounds, with sufficient exchange to maintain a single population with weak genetic structure.
Veterans' use of inpatient and outpatient palliative care: The national landscape
Authors: Kaufman Brystana G. , Woolson Sandra , Stanwyck Catherine , Burns Madison , Dennis Paul , Ma Jessica , Feder Shelli , Thorpe Joshua M. , Hastings S. Nicole , Bekelman David B. , Van Houtven Courtney H.
Published: August 2024

Background

Palliative care improves the quality of life for people with life‐limiting conditions, which are common among older adults. Despite the Veterans Health Administration (VA) outpatient palliative care expansion, most research has focused on inpatient palliative care. This study aimed to compare veteran characteristics and hospice use for palliative care users across care settings (inpatient vs. outpatient) and dose (number of palliative care encounters).

Methods

This national cohort included veterans with any VA palliative care encounters from 2014 through 2017. We used VA and Medicare administrative data (2010–2017) to describe veteran demographics, socioeconomic status, life‐limiting conditions, frailty, and palliative care utilization. Specialty palliative care encounters were identified using clinic stop codes (353, 351) and current procedural terminology codes (99241–99245).

Results

Of 120,249 unique veterans with specialty palliative care over 4 years, 67.8% had palliative care only in the inpatient setting (n = 81,523) and 32.2% had at least one palliative care encounter in the outpatient setting (n = 38,726), with or without an inpatient palliative care encounter. Outpatient versus inpatient palliative care users were more likely to have cancer and less likely to have high frailty, but sociodemographic factors including rurality and housing instability were similar. Duration of hospice use was similar between inpatient (median = 37 days; IQR = 11, 112) and outpatient (median = 44 days; IQR = 14, 118) palliative care users, and shorter among those with only one palliative care encounter (median = 18 days; IQR = 5, 64).

Conclusions

This national evaluation provides novel insights into the care setting and dose of VA specialty palliative care for veterans. Among veterans with palliative care use, one‐third received at least some palliative care in the outpatient care setting. Differences between veterans with inpatient and outpatient use motivate the need for further research to understand how care settings and number of palliative care encounters impact outcomes for veterans and older adults.
Commensal Attraction: Eating Together as a Social Tool
Authors: Neuman Nicklas
Published: August 2024

Social and human sciences have demonstrated again and again how commensality—the practice of eating together—has substantial implications, across time and place, for how social life is configured. Closely related phenomena have also been explored in biologically oriented sciences focused on human behavior. Yet, there is still little dialogue between these and the mainstream social science analysis of food and eating, despite their shared interests in the role played by food and eating in the organization of social life. The paper strengthens this dialogue and proposes that eating together be analyzed as a social tool: an innovation for the organization of complex behavior. More precisely, the proposition is that the habitual, routinized, and ritualized communal eating we see today developed into a social tool for exercising a diverse set of biologically evolved social traits. Through in‐depth analyses of food sharing, meal sharing, and feasting, I propose three distinct propositions of commensality as a social tool: social coordination of needs (mainly nutritional); social order and complex interaction (primarily conversations); and the symbolic display of stratified social relations. Understanding communal eating as a social tool thus opens up for a unified theory to explain seemingly disparate social phenomena, such as the underlying sociality displayed through different meal arrangements. For a thorough understanding of this, intensified conversations across the borders of scientific paradigms are required. Commensality is a social tool that satisfies both the social and biological appetites.
Performance of the IMMY® sona Aspergillus lateral flow assay for the detection of galactomannan in tracheal aspirate samples from Brazilian patients with COVID‐19‐associated pulmonary aspergillosis: Cross‐sectional and systematic review of literature
Authors: dos Santos Arthur Pereira , Amorim Bárbara Casella , da Silva Danielle Gomes , de Rodrigues Dality Keffelen Barros , da Costa Marques Ana Paula , Gasparoto Antonio Luiz Dal Bello , da Costa Alvarenga de Brito Eliana , Fava Wellington Santos , de Oliveira Caroline Tieppo Flores , Canassa Ana Luiza , Gonçalves Crhistinne Cavalheiro Maymone , Grande Antonio Jose , de Souza Carvalho Melhem Marcia , Paniago Anamaria Mello Miranda , Volpe‐Chaves Cláudia Elizabeth , Venturini James
Published: August 2024

During the COVID‐19 pandemic, many patients in intensive care units (ICUs) were affected by invasive fungal infections, including aspergillosis, contributing to a high mortality rate. Diagnosing proven COVID‐19‐associated pulmonary aspergillosis (CAPA) requires clinical and radiological evaluations, along with laboratory testing of bronchoalveolar lavage samples or lung biopsies. However, these procedures and equipment are often inaccessible in developing countries or regions with limited resources, including Brazil. Consequently, alternative diagnostic methods, such as measuring Aspergillus galactomannan (GM) in tracheal aspirate (TA), have been explored for CAPA diagnosis. Nonetheless, research on the efficacy of TA‐based diagnostic tests is limited. This study aimed to assess the performance of the IMMY® Sona Aspergillus lateral flow assay (LFA) for GM detection in TA samples from 60 ICU patients with suspected CAPA at two tertiary hospitals in Campo Grande, Brazil. The ELISA method (Platelia Aspergillus AG, Bio‐Rad®) was used to detect Aspergillus GM in TA samples, serving as the microbiological criterion and reference test. Fifteen patients (12.4%) were identified as having possible CAPA. The overall accuracy of LFA was 94%, and the tests demonstrated an agreement of 93.1% (Cohen's kappa of 0.83). Based on our findings, the LFA for Aspergillus GM detection in TA samples exhibited excellent performance, proving to be a valuable diagnostic tool for potential CAPA. In a systematic review, two studies were included, and the meta‐analysis revealed pooled estimates provided a sensitivity of 86% (95% CI, 80%–91%) and specificity of 93% (95% CI, 86%–97%). The diagnostic odds ratio (DOR) for identification of Aspergillus using LFA was 103.38 (95% CI, 38.03–281.03). Despite its lower sensitivity compared to our study, the LFA appears to be a promising diagnostic option for CAPA, particularly in suspected cases that have not received antifungal therapy. This enables timely antifungal treatment and could reduce mortality rates in regions where bronchoscopy is unavailable or limited.
The transmembrane domain of the rice small protein OsS1Fa1 is responsible for subcellular localization and drought tolerance
Authors: Kwak J. S. , Lee K. H. , Min W. K. , Lee S. J. , Song J. T. , Seo H. S.
Published: August 2024

OsS1Fa1, a homologue of spinach S1Fa, is a small protein in rice that contains four distinct conserved motifs and participates in drought tolerance. However, the biological functions of these conserved motifs have not been characterized to date. Therefore, we investigated the roles of these conserved domains in the localization and cellular function of OsS1Fa1.

We analysed the subcellular localization of OsS1Fa1 using confocal laser scanning microscopy (CLSM), following particle bombardment and bacterial infiltration. An E. coli in vivo reconstituted sumoylation assay was conducted to investigate sumoylation of OsS1Fa1. We characterized the function of the transmembrane domain of OsS1Fa1 in drought tolerance using transgenic Arabidopsis plants.

Fluorescence analysis showed that OsS1Fa1 localized to the nuclear and cytoplasmic membranes. Mutation and cell fractionation analyses revealed that the membrane localization domain determined the subcellular localization of OsS1Fa1. The rice homologue OsS1Fa2 and Arabidopsis orthologs AtS1Fa1, AtS1Fa2, and AtS1Fa3 also exhibited similar localization patterns as OsS1Fa1. Sumoylation analysis demonstrated that OsS1Fa1 was conjugated with the small ubiquitin‐related modifier (SUMO). Transgenic analysis showed that overexpression of OsS1Fa1(TMm1), a mutant form of the transmembrane domain of OsS1Fa1, in Arabidopsis did not enhance drought stress tolerance, whereas OsS1Fa1 overexpression improved the drought tolerance of transgenic Arabidopsis.

Our data indicate that rice and Arabidopsis S1Fa1 proteins localize in the nuclear and cytoplasmic membranes, and that transmembrane domain determines subcellular localization and plays an important role in drought stress tolerance.
Sustainability risk management: Exploring the role of artificial intelligence capabilities through an information‐processing lens
Authors: Kong Kai Yuan , Yuen Kum Fai
Published: August 2024

The global sustainability movement is reshaping the operational requirements and managerial approaches of maritime firms, resulting in the emergence of unprecedented and complex risks in the sector. This has driven maritime firms to leverage digital tools, such as artificial intelligence (AI) capabilities, to enhance their sustainability risk management (SRM) endeavors. Drawing on the organizational information‐processing theory (OIPT), this study proposes four AI capabilities: customer value proposition, key process optimization, key resource optimization, and societal good. It examines their influence on sustainability‐related knowledge management capabilities (SKMC), stakeholder engagement, and SRM. A survey questionnaire was used to gather responses from 157 maritime professionals across various sectors of the industry, providing empirical data for analysis. Employing structural equation modeling, the findings reveal that AI capabilities can improve SKMC. These findings enhance existing literature by using OIPT concepts to investigate the interplay among the constructs that lead to better SRM in maritime firms. Furthermore, the study offers managerial guidance by providing insights into AI capabilities that maritime firms should incorporate into their operations, fostering best practices to effectively manage sustainability risks and ensure the firm's long‐term survival.
Shared sanitation facilities and risk of respiratory virus transmission in resource‐poor settings: A COVID‐19 modeling case study
Authors: Hayashi Michael A. L. , Simon Sophia M. , Zou Kaiyue , Van Wyk Hannah , Zahid Mondal Hasan , Eisenberg Joseph N. S. , Freeman Matthew C.
Published: August 2024

Water supply and sanitation are essential household services frequently shared in resource‐poor settings. Shared sanitation can increase the risk of enteric pathogen transmission due to suboptimal cleanliness of facilities used by large numbers of individuals. It also can potentially increase the risk of respiratory disease transmission. As sanitation is an essential need, shared sanitation facilities may act as important respiratory pathogen transmission venues even with strict control measures such as stay‐at‐home recommendations in place. This analysis explores how behavioral and infrastructural conditions surrounding shared sanitation may individually and interactively influence respiratory pathogen transmission. We developed an individual‐based community transmission model using COVID‐19 as a motivating example parameterized from empirical literature to explore how transmission in shared latrines interacts with transmission at the community level. We explored mitigation strategies, including infrastructural and behavioral interventions. Our review of empirical literature confirms that shared sanitation venues in resource‐poor settings are relatively small with poor ventilation and high use patterns. In these contexts, shared sanitation facilities may act as strong drivers of respiratory disease transmission, especially in areas reliant on shared facilities. Decreasing dependence on shared latrines was most effective at attenuating sanitation‐associated transmission. Improvements to latrine ventilation and handwashing behavior were also able to decrease transmission. The type and order of interventions are important in successfully attenuating disease risk, with infrastructural and engineering controls being most effective when administered first, followed by behavioral controls after successful attenuation of sufficient alternate transmission routes. Beyond COVID‐19, our modeling framework can be extended to address water, sanitation, and hygiene measures targeted at a range of environmentally mediated infectious diseases.
Translationally controlled tumor protein interacts with TaCIPK23 to positively regulate wheat resistance to Puccinia triticina
Authors: Ma Nan , Sun Tianjie , Liu Gang , Wang Qian , Liu Chunji , Liu Na , Han Shengfang , Zhen Wenchao , Hou Chunyan , Wang Dongmei
Published: August 2024

Hypersensitive response‐programmed cell death (HR‐PCD) regulated by Ca2+ signal is considered the major regulator of resistance against Puccinia triticina (Pt.) infection in wheat. In this study, the bread wheat variety Thatcher and its near‐isogenic line with the leaf rust resistance locus Lr26 were infected with the Pt. race 260 to obtain the compatible and incompatible combinations, respectively. The expression of translationally controlled tumor protein (TaTCTP) was upregulated upon infection with Pt., through a Ca2+‐dependent mechanism in the incompatible combination. The knockdown of TaTCTP markedly increased the area of dying cell and the number of Pt. haustorial mother cells (HMCs) at the infection sites, whereas plants overexpressing the gene exhibited enhanced resistance. The interaction between TaTCTP and calcineurin B‐like protein‐interacting protein kinase 23 (TaCIPK23) was also investigated, and the interaction was found occurred in the endoplasmic reticulum. TaCIPK23 phosphorylated TaTCTP in vitro. The expression of a phospho‐mimic TaTCTP mutant in Nicotiana benthamiana promoted HR‐like cell death. Silencing TaCIPK23 or TaCIPK23/TaTCTP co‐silencing resulted in the same results as silencing TaTCTP. This suggested that TaTCTP is a novel phosphorylation target of TaCIPK23, and both participate in the resistance of wheat to Pt. in the same pathway.
Link splitting deformation of colored Khovanov–Rozansky homology
Authors: Hogancamp Matthew , Rose David E. V. , Wedrich Paul
Published: August 2024

We introduce a multiparameter deformation of the triply‐graded Khovanov–Rozansky homology of links colored by one‐column Young diagrams, generalizing the “‐ified” link homology of Gorsky–Hogancamp and work of Cautis–Lauda–Sussan. For each link component, the natural set of deformation parameters corresponds to interpolation coordinates on the Hilbert scheme of the plane. We extend our deformed link homology theory to braids by introducing a monoidal dg 2‐category of curved complexes of type A singular Soergel bimodules. Using this framework, we promote to the curved setting the categorical colored skein relation from our recent joint work and also the notion of splitting map for the colored full twists on two strands. As applications, we compute the invariants of colored Hopf links in terms of ideals generated by Haiman determinants and use these results to establish general link splitting properties for our deformed, colored, triply‐graded link homology. Informed by this, we formulate several conjectures that have implications for the relation between (colored) Khovanov–Rozansky homology and Hilbert schemes.
Interrelation between Doping Dependencies of the Spin Susceptibility and Electronic Structure in Cuprates
Authors: Kuz’min V. I. , Korshunov M. M. , Nikolaev S. V. , Ovchinnikova T. M. , Ovchinnikov S. G.
Published: August 2024

We calculate electronic structure and spin susceptibility dependencies on doping within the framework of a cluster perturbation theory for strongly correlated electronic systems. The change in the susceptibility with increasing doping is qualitatively consistent with the experimental data on resonant inelastic X-ray scattering and inelastic neutron scattering, as well as with the results of the calculations within the quantum Monte Carlo method.
Tumour masquerading juvenile angiofibroma in a female; unveiling glomangiopericytoma-a rare sinonasal histopathology
Authors: Lakshmanan Jijitha , Ramasamy Karthikeyan , Alexander Arun , Ganesan Sivaraman
Published: August 2024

Sinonasal tumours of varying histology are not unusual in otolaryngology surgical practice. Juvenile angiofibroma (JAs) are vascular tumours usually occurring in adolescent male population; but rare in females. But similar clinical and radiological presentations are possible in females inducing strong suspicion of JA which needs to be ruled out by detailed evaluation. Here we present a case of a young female in her 20s who presented with a bleeding nasal mass which was finally diagnosed as sinonasal glomangiopericytoma which is a very rare sinonasal tumour. Tumours resembling JA do present in the female population but rarely turn out to be JA. A strong index of suspicion along with a handful of special blood investigations to rule out androgen insensitivity syndrome is mandatory.
IgG4-related disease presenting with gastric outlet obstruction
Authors: Masterman Benjamin , Zhang Yve , Pauling John D , Zeino Zeino
Published: August 2024

A woman in her 20s presented with 6 weeks of fever, persistent vomiting and 28% loss of body weight. Symptoms were refractory to treatment with antiemetics and broad spectrum antibiotics.

Further investigation via oesophageogastroduedenoscopy revealed a large gastric ulcer and pyloric stricture, causing gastric outlet obstruction (GOO). Biopsies of the stomach and duodenum showed plasma cell infiltration with a large proportion being IgG4 positive.

Treatment with methylprednisolone, and later prednisolone, quickly improved inflammatory markers and symptoms. Balloon dilatation of the pyloric stricture also improved vomiting, allowing eventual re-establishment of oral nutrition. The patient made a full recovery with maintenance treatment on mycophenolate mofetil.

IgG4-related disease (IgG4-RD) is a multisystem disorder with unpredictable presentation. The case highlights diagnostic challenges in IgG4-RD and identifies it as a rare differential in upper gastrointestinal symptoms. To our knowledge this is the first published case of IgG4-RD in the duodenum causing GOO.
Challenging chest pain: salmonella myopericarditis
Authors: Van Ochten Natalie , deQuillfeldt Natalie P , Edward Justin A , Meyer Marita , Bollinger Daniel , Le Preston , Frasca Katherine , Garcia Rivera Mirian V , Moudgal Anita N , Rogers Kevin
Published: August 2024

Salmonellainfections have been associated with cardiovascular complications, including myocarditis and myopericarditis. This presentation ofSalmonellamyopericarditis highlights key clinical features to aid in diagnosis and the importance of prompt treatment with antibiotics, colchicine and non-steroidal anti-inflammatory drugs (NSAIDs).
What characteristics of clinical decision support system implementations lead to adoption for regular use? A scoping review
Authors: Hill Adele , Morrissey Dylan , Marsh William
Published: August 2024

Introduction

Digital healthcare innovation has yielded many prototype clinical decision support (CDS) systems, however, few are fully adopted into practice, despite successful research outcomes. We aimed to explore the characteristics of implementations in clinical practice to inform future innovation.

Methods

Web of Science, Trip Database, PubMed, NHS Digital and the BMA website were searched for examples of CDS systems in May 2022 and updated in June 2023. Papers were included if they reported on a CDS giving pathway advice to a clinician, adopted into regular clinical practice and had sufficient published information for analysis. Examples were excluded if they were only used in a research setting or intended for patients. Articles found in citation searches were assessed alongside a detailed hand search of the grey literature to gather all available information, including commercial information. Examples were excluded if there was insufficient information for analysis. The normalisation process theory (NPT) framework informed analysis.

Results

22 implemented CDS projects were included, with 53 related publications or sources of information (40 peer-reviewed publications and 13 alternative sources). NPT framework analysis indicated organisational support was paramount to successful adoption of CDS. Ensuring that workflows were optimised for patient care alongside iterative, mixed-methods implementation was key to engaging clinicians.

Conclusion

Extensive searches revealed few examples of CDS available for analysis, highlighting the implementation gap between research and healthcare innovation. Lessons from included projects include the need for organisational support, an underpinning mixed-methods implementation strategy and an iterative approach to address clinician feedback.
Prognostic prediction models for treatment experienced people living with HIV: a protocol for systematic review and meta-analysis
Authors: Wu Xinsheng , Chen Yuanyi , Lu Zhen , Wang Junfeng , Zou Huachun
Published: August 2024

Introduction

Despite the favourable efficacy of antiretroviral therapy (ART), HIV/AIDS continues to impose significant disease burdens worldwide. This study aims to systematically review published prognostic prediction models for survival outcomes of treatment experienced people living with HIV (TE-PLHIV), to describe their characteristics, compare their performance and assess the risk of bias and real-world clinical utility.

Methods and analysis

Studies will be identified through a comprehensive search in PubMed, EMBASE, Scopus, the Cochrane Library, and OpenGrey databases. Two reviewers will independently conduct a selection of eligible studies, data extraction and critical appraisal. Included studies will be systematically summarised using appropriate tools designed for prognostic prediction modelling studies. Where applicable, evidence will be summarised with meta-analyses.

Ethics and dissemination

Ethical approval is not required because only available published data will be analysed. The results of this work will be published in a peer-reviewed journal.

Systematic review registration

PROSPERO registration number CRD42023412118.
Maternal modifiable factors and risk of congenital heart defects: systematic review and causality assessment
Authors: Gomersall Judith C , Moore Vivienne M , Fernandez Renae C , Giles Lynne C , Grzeskowiak Luke E , Davies Michael J , Rumbold Alice R
Published: August 2024

Objective

Primary prevention strategies are critical to reduce the global burden of congenital heart defects (CHDs); this requires robust knowledge of causal agents. We aimed to review associations between CHDs and maternal advanced age, obesity, diabetes, hypertension, smoking and alcohol consumption and assess the causal nature of the associations.

Design

Systematic review of reviews with application of a Bradford Hill criteria score-based causal assessment system.

Data sources

We searched PubMed, Embase and Episteminokos (January 1990–April 2023).

Eligibility criteria

Systematic reviews of original epidemiological studies reporting association (relative risk) between one or more of the above maternal factors and CHDs overall (any type) in subsequent offspring.

Data extraction and synthesis

Two independent reviewers selected eligible reviews, assessed the risk of bias and assigned the strength of evidence for causality.

Results

There was strong evidence of a causal relationship between CHDs and maternal obesity (prepregnancy and early pregnancy) and pre-existing diabetes (six of seven Bradford Hill criteria met). For pre-existing hypertension (strength and biological gradient not met), and advanced age (strength, consistency and biological gradient not met), causal evidence was moderate. Evidence for the causal contribution of gestational diabetes, gestational hypertension, smoking and alcohol consumption was weak (strength, consistency, temporality and biological gradient not met).

Conclusions

CHDs can be reduced with stronger action to reduce maternal obesity and pre-existing diabetes prevalence. Investigating environmental exposures that have received limited attention, such as air pollutants and chemical exposures, is important to further inform prevention.
Self-management interventions among community-dwelling older adults with type 2 diabetes mellitus: a scoping review protocol
Authors: Mehrotra Shashank , Bhattacharjya Sutanuka , Shetty Ranjitha S
Published: August 2024

Background

Globally, the number of older adults is increasing rapidly; simultaneously, there is an epidemiological shift toward chronic diseases. One such chronic disease is type 2 diabetes mellitus (DM) which is caused either by the inability to produce insulin or due to the ineffective use of insulin. In recent years, self-management programmes for chronic conditions have gained importance, especially among occupational therapists. Though there is an increasing focus on ‘self-management interventions’ among older adults, there is still a lack of such interventions for older adults with type 2 DM in low- or middle-income countries (LMICs).

Objectives

Summarise the existing literature on self-management intervention programmes for community-dwelling older adults with type 2 DM; identify the principles, practices and criteria that define a self-management intervention programme for community-dwelling older adults with type 2 DM in LMICs.

Methods

This present study will be a scoping review, combining quantitative and qualitative literature with a parallel results convergent synthesis design. The synthesis applies to analysing existing principles and practices that influence the selection and application of ‘diabetes self-management intervention’ among older adults in community settings with type 2 DM in LMICs.

Ethics and dissemination

As a secondary analysis, this scoping review does not require ethics approval. The final review results will be submitted for publication in a peer-reviewed journal in the rehabilitation, diabetes, occupational therapy or health promotion-related fields. Other dissemination strategies may be an oral presentation at international conferences or through various social media networks.
Pilot qualitative exploration of the impact of community asset mapping within the undergraduate psychiatry curriculum at an Irish medical school
Authors: Edwards Gareth , Moore Leona , Russell Vincent
Published: August 2024

Introduction

Providing an effective response to global health disparities requires that future doctors are better prepared to embrace a public health ethos. Asset-based approaches see people and communities as coproducers of health and well-being and have begun to influence healthcare policy and the training of health professionals. However, to date, there is scant research in this area within undergraduate medical education.

Objectives

To explore: (1) whether an asset-mapping assignment enhances medical students’ experience and understanding of psychiatry. (2) The extent to which asset mapping promotes engagement of students with the clinical teams and communities in which they are placed, as perceived by students, clinical tutors and other team members.

Design

Using a qualitative case study approach, semistructured interviews were completed with 16 students, 8 psychiatry tutors and 3 multidisciplinary team members (MDTMs) to explore their experiences of the initiative. Interview transcripts were thematically analysed, based on the study aims.

Setting

This research was carried out at Ireland’s largest medical school, among undergraduate medical students following a 6-week psychiatry clerkship.

Intervention

Students completed a team-based assignment to elicit information on community assets from patients and presented an asset map to their host clinical team at the end of the clerkship.

Results

We identified three over-arching themes within the data: (a) connecting the individual patient with the community; (b) relationship building; and (c) pedagogical challenges and rewards. Students found the asset-mapping assignment not only challenging but also rewarding and supported its retention within the curriculum. Tutors were predominantly positive, but some felt that the social focus diluted students’ professional identity. MDTMs welcomed the initiative and wished to be more involved.

Conclusion

Our findings suggest that community asset mapping offers added value within the undergraduate medical curriculum, sensitising students to the importance of exploring patient-perceived community assets.
Safety of herbal medicine in the postpartum period of a Korean Medicine hospital and postpartum care centre: protocol of a registry study (SAFEHERE-PC)
Authors: Kim Anna , Kim Young Eun , Seo Sumin , Kim Sungha , Cho Eunbyul , Kang Yu-Jeong , Kim Moonsun , Lee Eunhee , Son Mi Ju
Published: August 2024

Introduction

Herbal medicines (HMs) are commonly used during the postpartum period in South Korea. However, the safety concerns associated with these medicines remain unresolved. This study aims to establish a registry of patients receiving HM treatment during the postpartum period and collect clinical data on treatments and adverse reactions to build evidence evaluating the safety of HM use.

Methods and analysis

This study will use a prospective observational registry, including patients admitted to the obstetrics and gynaecology department of the Woosuk University Korean Medicine Hospital’s postpartum care centre. A total of 1000 eligible patients visiting the Korean medicine hospital to recover from various postchildbirth symptoms and opting for HM treatment will be enrolled in the registry. For safety assessment, demographic information, medical history, adverse events (AEs) and treatment details, including HM prescription and concomitant medication usage, will be collected throughout the patient’s hospitalisation period at the postpartum care centre for analysis. Adverse reactions will be monitored daily during hospitalisation, and collected AEs will be analysed for causality using the WHO Uppsala Monitoring Centre causality assessment and the Naranjo Algorithm Score.

Ethics and dissemination

This study was approved by the Institutional Review Board of Woosuk University Korean Medicine Medical Center (WSOH IRB H2311-03-01). The results will be published in peer-reviewed journals or disseminated through conference presentations.

Trial registration number

KCT0009060.
Study protocol for the ROLEX-DUO randomised placebo-controlled trial: ROmosozumab Loaded with EXercise – DUal effects on bone and muscle in postmenopausal Osteoporosis and Osteopenia
Authors: Kumar Shejil , Beck Belinda R , Nery Liza , Byth Karen , Elhindi James , Wood Cameron , Fuller Oliver K , Clifton-Bligh Roderick J , Girgis Christian M
Published: August 2024

Introduction

Novel strategies are needed to address the rising burden of osteoporosis and fragility fractures. High-intensity resistance and impact (HiRIT) exercise has shown benefit in improving bone density in postmenopausal women with osteoporosis/osteopenia. Whether HiRIT can enhance the therapeutic effects of osteoporosis pharmacotherapy has not been established. ROLEX-DUO is a randomised controlled trial designed to assess the efficacy of romosozumab on various bone and muscle outcomes in combination with different exercise interventions in women with postmenopausal osteoporosis/osteopenia.

Methods and analysis

ROLEX-DUO is an 8-month randomised placebo-controlled trial conducted at two tertiary referral centres for patients with osteoporosis/osteopenia in Sydney, New South Wales, Australia. The study is implementing the combination of romosozumab or placebo with different forms of exercise in postmenopausal women with osteoporosis/osteopenia without recent fragility fracture (n=102). Eligible women will be randomised 1:1:1 into one of three groups: (1) romosozumab with supervised HiRIT, (2) romosozumab with unsupervised low-intensity exercise or (3) placebo with unsupervised low-intensity exercise. Co-primary outcomes are the mean percentage change in lumbar spine bone mineral density (BMD), and mean change in five times sit-to-stand test performance (seconds) at 8 months. Secondary/exploratory outcomes include BMD changes at the femoral neck, total hip and distal radius, three-dimensional dual-energy X-ray absorptiometry (DXA) hip outcomes, DXA-derived lean and fat mass, serum markers of bone turnover (procollagen type 1 peptide, C-telopeptide of type 1 collagen) and bone biomarkers (dickkopf-1), serum extracellular vesicle analyses, 36-Item Short Form Survey (SF-36) quality-of-life scores, Menopause-Specific Quality Of Life (MENQOL) Questionnaire menopause symptom burden scores, number of falls and fractures. Mixed-effects models will be performed to compare longitudinal outcome results between groups using intention-to-treat analysis.

Ethics and dissemination

The trial was approved by the Northern Sydney Local Health District Human Research Ethics Committee (2022/ETH01794, protocol V.8, dated 03 July 2024). Participants will provide written informed consent prior to inclusion. Findings will be disseminated via peer-reviewed journals, scientific conferences and summary reports to funding bodies.

Trial registration number

ACTRN12623000867695.
Community-engaged randomised controlled trial to disseminate COVID-19 vaccine-related information and increase uptake among Black individuals in two US cities with rheumatic conditions
Authors: Sirek Greta , Erickson Daniel , Muhammad Lutfiyya N , Losina Elena , Chandler Mia T , Son Mary Beth , Crespo-Bosque Monica , York Michael , Jean-Jacques Muriel , Milaeger Holly , Pillai Neil , Roberson Tonya , Chung Anh , Shramuk Maxwell , Osaghae Eseosa , Williams Jessica , Ojikutu Bisola O , Dhand Amar , Ramsey-Goldman Rosalind , Feldman Candace H
Published: August 2024

Introduction

Inequities in COVID-19 infection and vaccine uptake among historically marginalised racial and ethnic groups in the USA persist. Individuals with rheumatic conditions, especially those who are immunocompromised, are especially vulnerable to severe infection, with significant racialised inequities in infection outcomes and in vaccine uptake. Structural racism, historical injustices and misinformation engender racial and ethnic inequities in vaccine uptake. The Popular Opinion Lleader (POL) model, a community-based intervention that trains trusted community leaders to disseminate health information to their social network members (eg, friends, family and neighbours), has been shown to reduce stigma and improve care-seeking behaviours.

Methods and analysis

This is a community-based cluster randomised controlled trial led by a team of community and academic partners to compare the efficacy of training POLs with rheumatic or musculoskeletal conditions using a curriculum embedded with a racial justice vs a biomedical framework to increase COVID-19 vaccine uptake and reduce vaccine hesitancy. This trial began recruitment in February 2024 in Boston, Massachusetts and Chicago, Illinois, USA. Eligible POLs are English-speaking adults who identify as Black and/or of African descent, have a diagnosis of a rheumatic or musculoskeletal condition and have received >=1 COVID-19 vaccine after 31 August 2022. POLs will be randomised to a 6-module virtual educational training; the COVID-19 and vaccine-related content will be the same for both groups however the framing for arm 1 will be with a racial justice lens and for arm 2, a biomedical preventative care-focused lens. Following the training, POLs will disseminate the information they learned to 12–16 social network members who have not received the most recent COVID-19 vaccine, over 4 weeks. The trial’s primary outcome is social network member COVID-19 vaccine uptake, which will be compared between intervention arms.

Ethics and dissemination

This trial has ethical approval in the USA. This has been approved by the Mass General Brigham Institutional Review Board (IRB, 2023P000686), the Northwestern University IRB (STU00219053), the Boston University/Boston Medical Center IRB (H-43857) and the Boston Children’s Hospital IRB (P00045404). Results will be published in a publicly accessible peer-reviewed journal.

Trial registration number

NCT05822219.
Defining non-inferiority margins in randomised controlled surgical trials: a protocol for a systematic review
Authors: Kuemmerli Christoph , Gallagher Iain J , Skipworth Richard , Laird Barry
Published: August 2024

Background

The reporting of randomised controlled non-inferiority (NI) drug trials is poor with less than 50% of published trials reporting a justification of the NI margin. This is despite the introduction of the Consolidated Standards of Reporting Trials (CONSORT) extension on reporting of NI and equivalence in randomised trials. It is critical to set the appropriate NI margin as this choice dictates the conclusions of the trial. Methods to estimate the margin are heterogeneous but generally based on clinical judgement and statistical reasoning, and hence tailored to each clinical situation. Yet an appraisal of NI in clinical trials has not been undertaken. Therefore the aim of this systematic review is to assess the reporting and methodological quality of defining the NI margin. Surgical NI trials have been chosen as our prototype to assess this.

Methods

We will conduct a systematic review of published randomised controlled trials in abdominal surgery that use an NI design. Key eligibility criteria will be: surgical intervention in at least one trial arm; adult patients and a sample size of 100 or more. Ovid MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials will be searched from inception until the date of the search. Identified studies will be assessed for reporting according to the CONSORT recommendations. The outcomes are the description of the methods for defining the NI margin, and the robustness of the NI margin estimation. The latter will be based on simulations using alternative assumptions for model parameters. The results of the simulation will be compared with the trial authors’ conclusions.

Anticipated results

The review will describe and appraise the design and reporting of surgical NI trials including shortcomings thereof and allow a comparison with pharmaceutical trials. These findings will inform researchers on the appropriate design and pitfalls when conducting surgical randomised controlled trials with an NI design and promote thorough and standardised reporting of study findings.

Ethics and dissemination

Ethical approval is not required and any changes to the protocol will be communicated via the registration platform. The final manuscript will be submitted to a journal for publication and the findings will be disseminated through conference presentations to inform researchers and the public.
Private sector business interactions with bereaved people: UK Commission on Bereavement secondary analysis
Authors: Crooks Jodie , Warren Rachel , Hudson Briony
Published: August 2024

Objectives

Evidence suggests that 61% of adults who were bereaved in the past 5 years had difficulties with at least one practical or administrative task following bereavement. We aimed to explore individual’s experiences of interacting with private sector businesses following a bereavement.

Methods

Qualitative secondary analysis of data collected via an online survey within the UK Commission on Bereavement. Data from 1133 survey respondents was extracted verbatim, and thematic analysis was carried out. Participants were adults who had experienced a bereavement within the past 5 years and lived in the UK. They were eligible to take part in the survey.

Results

Three core themes were developed: (1) needs of bereaved people outside of ‘business as usual’, (2) admin burden while grieving and (3) the impact and experience of organisational failures. The results of this secondary analysis outline that bereaved individuals often struggle with several points of interaction with private businesses, including facing resistance when making initial contact, insensitive or non-empathetic interactions, facing unrealistic timelines for administrative tasks that are not then returned by the business, and difficulty understanding and completing paperwork. Participants emphasised the difficulty in navigating this while in the initial period following a bereavement.

Conclusions

People experiencing a bereavement experience a high degree of mental load and emotional burden linked with interacting with private businesses following a bereavement. Given that this forms only one element of a person’s whole bereavement experience, it is important that changes to policy and practice are made to allow a simple, positive experience for bereaved customers.