bluuebunny/crossref_metadata_2025 huggingface dataset:
Porcine Deltacoronavirus Enters Porcine IPI-2I Intestinal Epithelial Cells via Macropinocytosis and Clathrin-Mediated Endocytosis Dependent on pH and Dynamin
Authors: Fang Puxian , Zhang Jiansong , Zhang Huichang , Xia Sijin , Ren Jie , Tian Liyuan , Bai Dongcheng , Fang Liurong , Xiao Shaobo
Published: September 2021

An emerging enteropathogenic coronavirus, PDCoV, has the potential for cross-species transmission, attracting extensive attenuation. Characterizing the detailed process of PDCoV entry into cells will deepen our understanding of the viral infection and pathogenesis and provide clues for therapeutic intervention against PDCoV.
Virome of Bat-Infesting Arthropods: Highly Divergent Viruses in Different Vectors
Authors: Xu Ziqian , Feng Yun , Chen Xinxin , Shi Mang , Fu Shihong , Yang Weihong , Liu William J. , Gao George F. , Liang Guodong
Published: September 2021

Bats are reservoirs of many important viral pathogens. To evaluate whether bat-parasitic blood-sucking arthropods participate in the circulation of these important viruses, it is necessary to conduct unbiased virome studies on these arthropods.
Candida albicans
ENT2
Contributes to Efficient Endocytosis, Cell Wall Integrity, Filamentation, and Virulence
Authors: Rollenhagen Christiane , Agyeman Harrison , Eszterhas Susan , Lee Samuel A.
Published: September 2021

The opportunistic fungal pathogen
Candida albicans
is an important cause of invasive infections in hospitalized patients and a source of considerable morbidity and mortality. Despite its clinical importance, we still need to improve our ability to diagnose and treat this common pathogen.
Serological Assays for Assessing Postvaccination SARS-CoV-2 Antibody Response
Authors: Mahmoud Sally A. , Ganesan Subhashini , Naik Shivaraj , Bissar Safaa , Zamel Isra Al , Warren KN , Zaher Walid A. , Khan Gulfaraz
Published: September 2021

Commercial serological assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now widely available. This study adds new knowledge regarding the optimization of these assays for evaluating postvaccination antibodies status.
What work is required to implement and sustain the National Surgical Quality Improvement Program (NSQIP)? A qualitative study of NSQIP implementation in Alberta, Canada
Authors: Schroeder Dawn , Luig Thea , Beesoon Sanjay , Robert Jill , Campbell-Scherer Denise , Brindle Mary
Published: September 2021

Objectives

Hospitals introducing the National Surgical Quality Improvement Program (NSQIP) face implementation challenges. To understand the work of embedding NSQIP into routine practice, we explored interactions between contextual factors and the work among implementation teams at the individual, team and organisational level to illuminate how to support and sustain NSQIP implementation.

Design

Qualitative interpretative study using thematic analysis.

Setting

Five contextually diverse hospital sites in Alberta, Canada, for in-depth interviewing and four additional hospitals for observation of NSQIP meetings.

Participants

9 Surgeon and Anaesthesiologist Champions; 6 Surgical Clinical Reviewers; 4 Directors and 1 Surgical Site Manager; 3 Operating Room Managers; 3 Quality Improvement Consultants; 1 Surgeon and 1 Provincial NSQIP Lead.

Methods

To capture context, process and the dynamic interplay between the two, we integrated the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT) to guide data collection and analysis. 28 individual semi-structured interviews with key informants and observations with field notes of 10 NSQIP meetings were conducted. Data were coded deductively and inductively and analysed thematically.

Results

Key findings informed by CFIR describe the impact of Provincial Collaboratives, leadership support and resources to support NSQIP work. Key findings illuminated by NPT highlight how teams overcame mistrust in NSQIP through relationship building, creating formative spaces to inform collective understandings of NSQIP and inviting feedback from professional groups to cocreate quality improvement solutions. This approach led to increased engagement with NSQIP data and encouraged shifts in conversations within and between nursing and physician groups from problems to solutions based.

Conclusions

The work the teams did to implement and sustain NSQIP highlights the need for time and resources to develop shared understandings of work processes, reorganise themselves to work together and understand how to help others in the surgical community interpret and value using NSQIP to improve care.
Effect of food insecurity on mental health of patients with tuberculosis in Southwest Ethiopia: a prospective cohort study
Authors: Soboka Matiwos , Tesfaye Markos , Adorjan Kristina , Krahl Wolfgang , Tesfaye Elias , Yitayih Yimenu , Strobl Ralf , Grill Eva
Published: September 2021

Objective

The objective of this study is to investigate the effect of food insecurity on the mental health of patients with tuberculosis (TB) in Ethiopia.

Design

A prospective cohort study.

Setting

Health centres and hospitals located in Jimma zone, Southwest Ethiopia.

Participants

Patients with TB who had recently been diagnosed with TB and started directly observed treatment in the selected 26 health institutions from October 2017 to October 2018. A total of 268 patients were followed for 6 months and data were collected at recruitment and two follow-up visits (at 2 and 6 months). Patients with multidrug-resistant TB were not included in the study.

Main outcome measures

Mental distress was measured by the Self-Reporting Questionnaire-20 while food insecurity was assessed by using the Household Food Insecurity Access Scale.

Results

A total of 268 patients were recruited and there was no lost to follow-up. The prevalence of food insecurity at baseline, first and second follow-up was 49.3%, 45.9% and 39.6%, respectively. Of these, 28.0% of them reported severe food insecurity at baseline which declined to 23.5% at the end of the sixth month. Likewise, the prevalence of mental distress at baseline was 61.2% but declined to 22.0% at the second follow-up. At baseline, 77.3% of patients with mental distress reported severe food insecurity but declined to 46.0% at second follow-up. In the final model, severe food insecurity (OR 4.7, 95% CI 2.4 to 9.4) and being a government employee (adjusted odds ratio (aOR) 0.3, 95% CI 0.1 to 0.9) were associated with mental distress.

Conclusion

In this study, food insecurity was associated with mental distress over the course of follow-up. Likewise, there is a high prevalence of food insecurity and mental distress among patients with TB on treatment. Therefore, early assessment and interventions for food insecurity may improve the mental health of patients with TB on treatment.
Lay and healthcare providers’ experiences to inform future of respectful maternal and newborn care in Tanzania and Malawi: an Appreciative Inquiry
Authors: Mdoe Paschal , Mills Tracey A , Chasweka Robert , Nsemwa Livuka , Petross Chisomo , Laisser Rose , Chimwaza Angela , Lavender Tina
Published: September 2021

Objectives

Disrespectful care, which remains prevalent in low and middle-income countries (LMICs), acts as a barrier to women accessing skilled birth attendance, compromising care when services are available. Building on what was positive in facilities, we aimed to explore lay and healthcare providers’ experience of respectful care to inform future interventions.

Setting

Five maternity facilities in Mwanza Tanzania and Lilongwe Malawi.

Participants

94 participants in Malawi (N=46) and Tanzania (N=48) including 24 women birthing live baby within the previous 12 months; 22 family members and 48 healthcare providers who regularly provided maternity care in the included facilities

Design

The study was guided by Appreciative Inquiry (AI). Semistructured, one-to-one interviews were conducted between January and December 2019. Interviews were audio-recorded, translated where necessary, transcribed verbatim, and analysed using the framework approach.

Results

Four main themes describing participants positive experience and their vision of respectful care were identified: (1) empathic healthcare provider–woman interactions including friendly welcome and courteous language, well-timed appropriate care and information sharing, (2) an enabling environment, characterised by improvement of physical environment, the use of screens, curtains and wall partitions for privacy, availability of equipment and provision of incentives to staff, (3) supportive leadership demonstrated by the commitment of the government and facility leaders to provision of respectful care, ensuring availability of guidelines and policies, supportive supervision, reflective discussion and paying staff salaries timely, (4) providers’ attitudes and behaviours characterised by professional values through readiness, compassionate communication and commitment.

Conclusion

The positive experiences of service users, families and healthcare providers provided insight into key drivers of respectful care in facilities in Tanzania and Malawi. Interventions targeting improved environment and privacy, healthcare provider communication and developing positive leadership structures in facilities could provide the basis for sustained improvement in respectful and dignified maternal and newborn care in LMICs.
Sick leave and return to work for patients with anxiety and depression: a longitudinal study of trajectories before, during and after work-focused treatment
Authors: Sandin Kenneth , Anyan Frederick , Osnes Kåre , Gunnarsdatter Hole Gjengedal Ragne , Risberg Leversen Jonas Sigurd , Endresen Reme Silje , Hjemdal Odin
Published: September 2021

Objectives

Sick leave due to anxiety and depression is a heterogeneous process constituting a pressing public health issue. This longitudinal study aimed to identify sick leave trajectories among patients before, during and after work-focused treatment, in all 29.5 months. We then aimed to determine the background and clinical characteristics of these trajectory groups.

Methods

Background and clinical data were collected by patient self-report (N=619) in an observational study in a specialised mental healthcare clinic. Sick leave was recorded from national registry data. A latent growth mixture model identified trajectories. Multinomial logistic regression determined differences in background characteristics while a one-way analysis of variance (ANOVA) identified clinical differences.

Results

We identified three trajectories: The ‘Resilient’ group (47.7%) had low sick leave throughout the period. The two other groups (‘Recovery’, 31.8% and ‘High risk’, 20.5%) had similar pretreatment trajectories: lower sick leave one year prior which increased to high sick leave at the start of treatment. After treatment, the ‘Recovery’ group made an almost full return to work while the ‘High risk’ group remained at high sick leave. The two groups with high sick leave had more women and higher age compared with the ‘Resilient’ group. All groups had similar clinical scores at the start of treatment, but the ‘High risk’ groups had residual depressive symptoms at the end of treatment. Effect sizes for anxiety and depression were moderate or large for all groups, (Cohen’sd=0.74–1.81), and 87.2% of the total sample were fully working one year after treatment.

Conclusion

We found three subgroups with distinctly different trajectories. Female gender and higher age were associated with high sick leave at the start of treatment, while residual depressive symptoms at the end of treatment predicted continued sick leave. The study points to the possibility of improving patient outcomes in the future by stratifying and tailoring treatment to patient characteristics.
Birhan maternal and child health cohort: a study protocol
Authors: Chan Grace J , Hunegnaw Bezawit Mesfin , Van Wickle Kimiko , Mohammed Yahya , Hunegnaw Mesfin , Bekele Chalachew , Goddard Frederick G B , Tadesse Fisseha , Bekele Delayehu
Published: September 2021

Introduction

Reliable estimates on maternal and child morbidity and mortality are essential for health programmes and policies. Data are needed in populations, which have the highest burden of disease but also have the least evidence and research, to design and evaluate health interventions to prevent illnesses and deaths that occur worldwide each year.

Methods and analysis

The Birhan Maternal and Child Health cohort is an open prospective pregnancy and birth cohort nested within the Birhan Health and Demographic Surveillance System. An estimated 2500 pregnant women are enrolled each year and followed through pregnancy, birth and the postpartum period. Newborns are followed through 2 years of life to assess growth and development. Baseline medical data, signs and symptoms, laboratory test results, anthropometrics and pregnancy and birth outcomes (stillbirth, preterm birth, low birth weight) are collected from both home and health facility visits. We will calculate the period prevalence and incidence of primary morbidity and mortality outcomes.

Ethics and dissemination

The cohort has received ethical approval. Findings will be disseminated at scientific conferences, peer-reviewed journals and to relevant stakeholders including the Ministry of Health.
Virtual reality for relatives of ICU patients to improve psychological sequelae: study protocol for a multicentre, randomised controlled trial
Authors: Vlake Johan H , van Bommel Jasper , Wils Evert-Jan , Korevaar Tim , Hellemons Merel E , Klijn Eva , Schut Anna FC , Labout Joost AM , Van Bavel Marten P , van Mol Margo MC , Gommers Diederik , van Genderen Michel E
Published: September 2021

Introduction

Intensive care unit (ICU) admission of a relative might lead to psychological distress and complicated grief (post-intensive care syndrome–family; PICS-F). Evidence suggests that increased distress during ICU stay increases risk of PICS-F, resulting in difficulty returning to their normal lives after the ICU experience. Effective interventions to improve PICS-F are currently lacking. In the present trial, we hypothesised that information provision using ICU-specific Virtual Reality for Family members/relatives (ICU-VR-F) may improve understanding of the ICU and subsequently improve psychological well-being and quality of life in relatives of patients admitted to the ICU.

Methods and analysis

This multicentre, clustered randomised controlled trial will be conducted from January to December 2021 in the mixed medical-surgical ICUs of four hospitals in Rotterdam, the Netherlands. We aim to include adult relatives of 160 ICU patients with an expected ICU length of stay over 72 hours. Participants will be randomised clustered per patient in a 1:1 ratio to either the intervention or control group. Participants allocated to the intervention group will receive ICU-VR-F, an information video that can be watched in VR, while the control group will receive usual care. Initiation of ICU-VR-F will be during their hospital visit unless participants cannot visit the hospital due to COVID-19 regulations, then VR can be watched digitally at home. The primary objective is to study the effect of ICU-VR-F on psychological well-being and quality of life up to 6 months after the patients’ ICU discharge. The secondary outcome is the degree of understanding of ICU treatment and ICU modalities.

Ethics and dissemination

The Medical Ethics Committee of the Erasmus Medical Centre, Rotterdam, the Netherlands, approved the study and local approval was obtained from each participating centre (NL73670.078.20). Our findings will be disseminated by presentation of the results at (inter)national conferences and publication in scientific, peer-reviewed journals.

Trial registration number

Netherlands Trial Register (TrialRegister.nl, NL9220).
Protocol for the Stimulating β3-Adrenergic Receptors for Peripheral Artery Disease (STAR-PAD) trial: a double-blinded, randomised, placebo-controlled study evaluating the effects of mirabegron on functional performance in patients with peripheral arterial disease
Authors: Bubb Kristen J , Harmer Jason A , Finemore Meghan , Aitken Sarah Joy , Ali Zara S , Billot Laurent , Chow Clara , Golledge Jonathan , Mister Rebecca , Gray Michael P , Grieve Stuart M , Hamburg Naomi , Keech Anthony C , Patel Sanjay , Puttaswamy Vikram , Figtree Gemma A
Published: September 2021

Introduction

There is currently only one approved medication effective at improving walking distance in people with intermittent claudication. Preclinical data suggest that the β3-adrenergic receptor agonist (mirabegron) could be repurposed to treat intermittent claudication associated with peripheral artery disease. The aim of the Stimulating β3-Adrenergic Receptors for Peripheral Artery Disease (STAR-PAD) trial is to test whether mirabegron improves walking distance in people with intermittent claudication.

Methods and analysis

The STAR-PAD trial is a Phase II, multicentre, double-blind, randomised, placebo-controlled trial of mirabegron versus placebo on walking distance in patients with PAD. A total of 120 patients aged ≥40 years with stable PAD and intermittent claudication will be randomly assigned (1:1 ratio) to receive either mirabegron (50 mg orally once a day) or matched placebo, for 12 weeks. The primary endpoint is change in peak walking distance as assessed by a graded treadmill test. Secondary endpoints will include: (i) initial claudication distance; (ii) average daily step count and total step count and (iii) functional status and quality of life assessment. Mechanistic substudies will examine potential effects of mirabegron on vascular function, including brachial artery flow-mediate dilatation; MRI assessment of lower limb blood flow, tissue perfusion and arterial stiffness and numbers and angiogenesis potential of endothelial progenitor cells. Given that mirabegron is safe and clinically available for alternative purposes, a positive study is positioned to immediately impact patient care.

Ethics and dissemination

The STAR-PAD trial is approved by the Northern Sydney Local Health District Human Research Ethics Committee (HREC/18/HAWKE/50). The study results will be published in peer-reviewed medical or scientific journals and presented at scientific meetings, regardless of the study outcomes.

Trial registration number

ACTRN12619000423112; Results.
Development of a core outcome set for evaluative research into paediatric cerebral visual impairment (CVI), in the UK and Eire
Authors: Pease Anna , Goodenough Trudy , Borwick Cath , Watanabe Rose , Morris Christopher , Williams Cathy
Published: September 2021

Objectives

Cerebral visual impairment (CVI) comprises a heterogeneous group of brain-related vision problems. A core outcome set (COS) represents the most important condition-specific outcomes according to patients, carers, professionals and researchers. We aimed to produce a COS for studies evaluating interventions for children with CVI, to increase the relevance of research for families and professionals and thereby to improve outcomes for affected children.

Design

We used methods recommended by the Core Outcome Measures in Effectiveness Trials Initiative. These included a proportionate literature review of outcomes used in previous studies; qualitative interviews with children and families; a two-round Delphi survey involving parents, children and professionals and a consensus meeting to ratify the most important outcomes.

Setting

Telephone interviews and online Delphi surveys of participants who all lived in UK or Eire.

Participants

Eighteen parents and six young people were interviewed. Delphi participants (n=80 did both rounds) included professionals working with children who have CVI (teachers, orthoptists, ophthalmologists, optometrists, qualified teachers for visually impaired, family members (parents and siblings) and affected children.

Results

The literature review included 13 studies yielding 37 outcomes. Qualitative interviews provided 22 outcomes. After combining and refining similar items, the first round contained 23 outcomes and the second 46. At the consensus meeting, 5 attendees recommended 27 outcomes for inclusion in the CVI COS, of which 15 were ratified as most important, including 4 related to vision; 1 to family well-being; 1 to adults around the child being informed about CVI and the rest to the child’s abilities to engage with people and surroundings.

Conclusions

Good engagement from participants led to the development of a COS. Future research will be useful to identify the best ways to measure COS items and potentially to update this COS as more interventions for CVI are developed.

Trial registration number

ISRCTN13762177.
Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study
Authors: Cheng Qinqin , Duan Yinglong , Zheng Hongling , Xu Xianghua , Khan Khalid , Xie Jianfei , Chen Yongyi
Published: September 2021

Objectives

This study aimed to investigate the knowledge and attitudes of patients with cancer of palliative care and their preferences regarding end-of-life care in mainland China.

Design

A cross-sectional study.

Setting

This study was conducted in a tertiary cancer hospital.

Participants

Two hundred forty-seven patients with cancer were recruited and consented to fill out the questionnaires.

Outcome measures

The participants’ knowledge and attitudes of palliative care and their preferences of end-of-life care involving place of care, place of death, truth disclosure and treatments during end-of-life were measured.

Results

In total, 239 questionnaires were valid. The vast majority of patients with cancer (81.2%) had never heard about palliative care or related policies, and only a few of them (5.8%) had somewhat or totally understanding of palliative care. Most participants (75.3%) had supportive attitudes towards palliative care. In terms of preferences for end-of-life care, most patients with cancer preferred to be cared for at home at the end of their life and to die at home. The majority of patients with cancer (65.7%) wanted to know their diagnosis or prognosis of the disease, regardless of the type of disease. More than half of the participants (54%) wished to improve their quality of life rather than prolong their life expectancy. More than a third of the patients with cancer preferred to entrust a family member or agent to sign medical decision agreements for them.

Conclusions

It is essential for healthcare providers to improve the understanding of patients with cancer of palliative care and be aware of the end-of-life care preferences of patients with cancer, in order to provide support that enables patients with cancer to receive end-of-life care that is accordant with their wishes.
Cross-sectional survey to describe medicine use among Syrian asylum seekers and refugees in a German federal state: looking beyond infectious diseases
Authors: Aljadeeah Saleh , Wirtz Veronika J , Nagel Eckhard
Published: September 2021

Objectives

The aim of our study was to describe medicine use and document self-reported diseases or conditions for which medicines were used among Syrian asylum seekers and refugees (AS&Rs) in the German state of North Rhine-Westphalia (NRW). We examined in this study differences in the use of medicines among different age and sex groups of the study participants.

Setting

Fifteen different refugee shared accommodation centres in the greater Cologne area, a community centre with a language school and consultation office, and other places frequented by the Syrian community.

Participants

Syrian AS&Rs registered in NRW and residing in the city of Cologne or surrounding areas.

Primary outcome measures

The prevalence of using at least one medicine in the 7 days preceding data collection, and the use of prescribed medicines and self-medication.

Results

Of the 1641 Syrian AS&Rs who took part in our study, the overall 7-day prevalence of medicine use was 34.9%. Among adults, headache and hypertension were the most common indications that led to medicine use. By dose, hypertension (954 doses) and diabetes (595 doses) were the first and second most frequent indication. Among children, fever and cough were the most common indication; ibuprofen and hederae helicis folium preparations were the most used medicines. Low prevalence was found of medicine use for the treatment of either infectious diseases or mental disorders.

Conclusion

Among the Syrian AS&Rs in NRW who participated in the study, non-communicable diseases (NCDs) were common presumed causes of use of medication among adults. We encourage future studies to pay more attention to NCDs medicine use among AS&Rs. Researchers should also consider reaching AS&Rs who live in private housing and not limit studies only to newly arrived AS&Rs who live in shared accommodation centres.
Trends, variations and prediction of staff sickness absence rates among NHS ambulance services in England: a time series study
Authors: Asghar Zahid B , Wankhade Paresh , Bell Fiona , Sanderson Kristy , Hird Kelly , Phung Viet-Hai , Siriwardena Aloysius Niroshan
Published: September 2021

Objectives

Our aim was to measure ambulance sickness absence rates over time, comparing ambulance services and investigate the predictability of rates for future forecasting.

Setting

All English ambulance services, UK.

Design

We used a time series design analysing published monthly National Health Service staff sickness rates by gender, age, job role and region, comparing the 10 regional ambulance services in England between 2009 and 2018. Autoregressive Integrated Moving Average (ARIMA) and Seasonal ARIMA (SARIMA) models were developed using Stata V.14.2 and trends displayed graphically.

Participants

Individual participant data were not available. The total number of full-time equivalent (FTE) days lost due to sickness absence (including non-working days) and total number of days available for work for each staff group and level were available. In line with The Data Protection Act, if the organisation had less than 330 FTE days available during the study period it was censored for analysis.

Results

A total of 1117 months of sickness absence rate data for all English ambulance services were included in the analysis. We found considerable variation in annual sickness absence rates between ambulance services and over the 10-year duration of the study in England. Across all the ambulance services the median days available were 1 336 888 with IQR of 548 796 and 73 346 median days lost due to sickness absence, with IQR of 30 551 days. Among clinical staff sickness absence varied seasonally with peaks in winter and falls over summer. The winter increases in sickness absence were largely predictable using seasonally adjusted (SARIMA) time series models.

Conclusion

Sickness rates for clinical staff were found to vary considerably over time and by ambulance trust. Statistical models had sufficient predictive capability to help forecast sickness absence, enabling services to plan human resources more effectively at times of increased demand.
Elucidating the association between regional variation in diagnostic frequency with risk-adjusted mortality through analysis of claims data of medicare inpatients: a cross-sectional study
Authors: Li Linyan , Chamoun George F , Chamoun Nassib G , Sessler Daniel , Gopinath Valérie , Saini Vikas
Published: September 2021

Objective

The validity of risk-adjustment methods based on administrative data has been questioned because hospital referral regions with higher diagnosis frequencies report lower case-fatality rates, implying that diagnoses do not track the underlying health risk. The objective of this study is to test the hypothesis that regional variation of diagnostic frequency in inpatient records is not associated with different coding practices but a reflection of the underlying health risks.

Design

We applied two stratification methods to Medicare Analysis and Provider Review data from 2009 through 2014: (1) the number of chronic conditions; and, (2) quartiles of Risk Stratification Index (RSI)-defined risk. After sorting hospital referral regions into quintiles of diagnostic frequency, we examined all-cause mortality.

Setting

Medicare Analysis and Provider Review administrative database.

Participants

18 126 301 hospitalised Medicare fee-for-service beneficiaries aged 65 or older who had at least one hospital-based procedure between 2009 and 2014.

Exposure

Coding frequency and baseline regional population risk factors by hospital referral region.

Primary and secondary outcome(s) and measure(s)

One year all-cause mortality in patients having the same number of chronic conditions or within the same RSI score quartile across US health referral regions, grouped by diagnostic frequency.

Results

No consistent relationship between diagnostic frequency and mortality in the risk stratum defined by number of chronic conditions was detected. In the strata defined by RSI quartile, there was no decrease in mortality as a function of diagnostic frequency. Instead, adjusted mortality was positively correlated with socioeconomic risk factors.

Conclusions

Using present-on-admission codes only, diagnostic frequency among inpatients with at least one hospital-based procedure appears to be consequent to differences in baseline population health status, rather than diagnostic coding practices. In this population, claims-based risk-adjustment using RSI appears to be useful for assessing hospital outcomes and performance.
Effects of a physiotherapist-led approach based on a biopsychosocial model for spinal disorders: protocol for a systematic review
Authors: Miki Takahiro , Kondo Yu , Kurakata Hiroshi , Takebayashi Tsuneo , Samukawa Mina
Published: September 2021

Introduction

Low back pain and neck pain are among the most common musculoskeletal disorders, and their related medical costs are rising every year. Many interventions are based on the biopsychosocial (BPS) model since the cause of pain is more multifaceted. Physiotherapists have increased opportunities to perform multidisciplinary interventions alone in clinical practice due to a lack of understanding of the model and its cost. Therefore, physiotherapist-led interventions using the BPS model are important and require an updated report summarising their effectiveness. Thus, the purpose of this study will be to summarise and synthesise the effects of physiotherapist-led interventions using the BPS model for spinal disorders.

Methods and analysis

We will search the Web of Science, CENTRAL, MEDLINE, PsycINFO, CINAHL and PEDro electronic databases, using a date range from inception to September 2021. We will include only randomised controlled trials for patients diagnosed with spinal disorders who received physiotherapist-led interventions based on the BPS model. The search will be limited to English-language publications. Pain intensity and disability are the primary outcomes. Secondary outcomes are any psychological factors. We will examine the short-term, medium-term and long-term effects, and a subgroup analysis will be conducted, if possible, to investigate the role of additional physiotherapist training.

Ethics and dissemination

This study is exempt from ethical approval because it involves publicly available documents. The findings will be submitted for publication in a relevant peer-reviewed journal.

PROSPERO registration number

CRD42021258071.
What role for PCI in stable ischaemic heart disease?
Authors: Kimpton James , Khong Teck K
Published: September 2021

Commentary on:Maron DJ, Hochman JS, Reynolds HR,et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease.N Engl J Med. 2020;382:1395–1407.

Series co-ordinator:Dr Teck Khong, DTB Associate Editor Clinical Pharmacology, St George's, University of London, UK
Afforesting Icelandic land: A promising approach for climate-smart forestry?
Authors: Brnkalakova Stanislava , Světlík Jan , Brynleifsdóttir Sigríður Júlía , Snorrason Arnór , Baštáková Viera , Kluvankova Tatiana
Published: September 2021

Climate-smart forestry (CSF) is considered a promising approach for climate change adaptation and mitigation strategies, as highlighted in several European policy documents. This paper describes a prospective approach to introducing an incentive-based scheme to facilitate the implementation of CSF through a case study in Iceland. It is argued that the payments for ecosystem services (PES) scheme allows for effective CSF management and long-term sustainability if introduced in compliance with local, cultural, and social values. In a case study of an Icelandic afforestation programme, we conducted an institutional analysis of the PES scheme and assessed its effect on the sustainable provision of forest ecosystem services for the long term. We provide preliminary findings on the application of CSF in the 30-year-old Icelandic afforestation programme scheme. The perspectives of forest and policy experts, as well as local farmers participating in the scheme, were crucial for assessing the effectiveness of PES scheme performance in Iceland.
Enhancing Privacy in PUF-Cash through Multiple Trusted Third Parties and Reinforcement Learning
Authors: Fragkos Georgios , Minwalla Cyrus , Tsiropoulou Eirini Eleni , Plusquellic Jim
Published: September 2021

Electronic cash
(
e-Cash
) is a digital alternative to physical currency such as coins and bank notes. Suitably constructed, e-Cash has the ability to offer an anonymous offline experience much akin to cash, and in direct contrast to traditional forms of payment such as credit and debit cards. Implementing security and privacy within e-Cash, i.e., preserving user anonymity while preventing counterfeiting, fraud, and double spending, is a non-trivial challenge. In this article, we propose major improvements to an e-Cash protocol, termed PUF-Cash, based on
physical unclonable functions
(
PUFs
). PUF-Cash was created as an offline-first, secure e-Cash scheme that preserved user anonymity in payments. In addition, PUF-Cash supports remote payments; an improvement over traditional currency. In this work, a novel multi-trusted-third-party exchange scheme is introduced, which is responsible for “blinding” Alice’s e-Cash tokens; a feature at the heart of preserving her anonymity. The exchange operations are governed by machine learning techniques which are uniquely applied to optimize user privacy, while remaining resistant to identity-revealing attacks by adversaries and trusted authorities. Federation of the single trusted third party into multiple entities distributes the workload, thereby improving performance and resiliency within the e-Cash system architecture. Experimental results indicate that improvements to PUF-Cash enhance user privacy and scalability.
Depichering the Effects of Astragaloside IV on AD‐Like Phenotypes: A Systematic and Experimental Investigation
Authors: Wang Xuncui , Gao Feng , Xu Wen , Cao Yin , Wang Jinghui , Zhu Guoqi
Published: September 2021

Astragaloside IV (AS‐IV) is an active component in Astragalus membranaceus with the potential to treat neurodegenerative diseases, especially Alzheimer’s diseases (ADs). However, its mechanisms are still not known. Herein, we aimed to explore the systematic pharmacological mechanism of AS‐IV for treating AD. Drug prediction, network pharmacology, and functional bioinformatics analyses were conducted. Molecular docking was applied to validate reliability of the interactions and binding affinities between AS‐IV and related targets. Finally, experimental verification was carried out in AβO infusion produced AD‐like phenotypes to investigate the molecular mechanisms. We found that AS‐IV works through a multitarget synergistic mechanism, including inflammation, nervous system, cell proliferation, apoptosis, pyroptosis, calcium ion, and steroid. AS‐IV highly interacted with PPARγ, caspase‐1, GSK3Β, PSEN1, and TRPV1 after docking simulations. Meanwhile, PPARγ interacts with caspase‐1, GSK3Β, PSEN1, and TRPV1. In vivo experiments showed that AβO infusion produced AD‐like phenotypes in mice, including impairment of fear memory, neuronal loss, tau hyperphosphorylation, neuroinflammation, and synaptic deficits in the hippocampus. Especially, the expression of PPARγ, as well as BDNF, was also reduced in the hippocampus of AD‐like mice. Conversely, AS‐IV improved AβO infusion‐induced memory impairment, inhibited neuronal loss and the phosphorylation of tau, and prevented the synaptic deficits. AS‐IV prevented AβO infusion‐induced reduction of PPARγ and BDNF. Moreover, the inhibition of PPARγ attenuated the effects of AS‐IV on BDNF, neuroflammation, and pyroptosis in AD‐like mice. Taken together, AS‐IV could prevent AD‐like phenotypes and reduce tau hyperphosphorylation, synaptic deficits, neuroinflammation, and pyroptosis, possibly via regulating PPARγ.
An Assessment of the Economic Feasibility of Selected Surgeries in the Obstetrics and Gynaecology Department under Community-Based Health Insurance (CBHI) in a Tertiary Care Hospital in South India
Authors: Haldar Jatoveda , Kamath Rajesh , Stallone D’lima Kramer , Nazareth Jossil
Published: September 2021

Community-Based Health Insurance (CBHI) is a form of micro health insurance targeted at low-income groups that permits for grouping of assets to tackle the expenses of future, uncertain, health-related circumstances. According to the International Labour Organisation, more than 80% of India’s employed nonagricultural population is in the informal sector, implying that they are possibly excluded from receiving health insurance benefits. This is where CBHI comes into play, wherein groups of people belonging to a community define the demand and benefits and pool their resources to provide financial protection to all their members. This study aims to scrutinize the package prices sanctioned by these schemes and compare them with the cost incurred by the hospital. The expense pattern of three surgeries in the Department of Obstetrics and Gynaecology was analysed under three insurance schemes: Arogya Bhagya Yojana, Arogya Karnataka, and Employees’ State Insurance Scheme. Methodology. A retrospective study was conducted in a 2,032-bedded tertiary care hospital in South India. Patients of abdominal hysterectomy, vaginal hysterectomy, and caesarean section surgeries covered by any of the insurance schemes mentioned above were a part of the inclusion criteria. The patient records were examined from the hospital’s Medical Records Department (MRD). The patients’ bills were assembled from the inpatient billing department to scrutinize all the expenses associated with each surgery. The variable costs include consumables, medicine, electricity and AC, diagnostics, blood bank materials, doctor’s fee, package differences, and others. In contrast, fixed costs include bed cost, equipment cost (purchase + annual maintenance cost), manpower cost-OT, manpower cost-nursing, and allocated indirect costs associated with the medical treatment. These were computed and compared with the package price of respective insurance schemes to determine if the schemes are profit-yielding schemes or loss-yielding schemes, using the data from the finance department. Results and Conclusion. It has been observed that the operating loss of the hospital for abdominal hysterectomy, vaginal hysterectomy, and caesarean section under CBHI schemes ranges between 7% and 36%. The highest loss was observed in Arogya Karnataka Scheme for caesarean section surgery (BPL patients). The amount received through these schemes is insufficient to cover the costs acquired by the hospital, let alone make a profit. However, under Arogya Bhagya and ESI Schemes, the hospital has made a profit in covering the variable costs for these surgeries. The study concludes that the hospital is running under loss due to the three Community-Based Health Insurance (CBHI) schemes.
Wavelength Characteristic Analysis of a FBG Array Embedded in Quaternary Unconsolidated Strata during a Deep Borehole Installation
Authors: Zhang Dingding , Ma Chenyang , Duan Yanyan , Du Wengang , Liu Jinxuan , Chai Jing
Published: September 2021

Real‐time monitoring of settlement and deformation within a coal mine’s deep quaternary unconsolidated strata presents challenges with installation and signal analysis. This paper presents results from successfully installing a field‐scale fiber Bragg grating (FBG) sensing system in a deep borehole for the purpose of achieving real‐time monitoring of the settlement and deformation in a deep unconsolidated stratum. A 152 m deep by 133 mm diameter borehole was used to embed an array of 24 FBG sensors in 12 layers of gravel and clay from between 92.4 m and 148.7 m of unconsolidated quaternary strata. A wavelength bandwidth of ±4.5 nm was used with a wavelength division multiplexing and spatial division multiplexing technique to compose a 4‐by‐6 sensor array. During the four stages of installation, the real‐time transmission characteristics and the changes in the FBG wavelength for this sensing system were evaluated. While the FBG sensing system was stable after installation, it was clearly shown that the engineering techniques associated with both positioning and grouting influenced the mechanical properties and transmission characteristics of the system. After installation, the sensor survival rate was found to be 78.26% with a maximum FBG wavelength shift of 1.447 nm. This field‐scale installation has provided information and experience that will improve future installations of buried fiber optic sensing technology throughout the underground coal mine industry.
A High-Efficiency Fatigued Speech Feature Selection Method for Air Traffic Controllers Based on Improved Compressed Sensing
Authors: Yan Yonggang , Mao Yi , Shen Zhiyuan , Wei Yitao , Pan Guozhuang , Zhu Jinfu
Published: September 2021

Air traffic controller fatigue has recently received considerable attention from researchers because it is one of the main causes of air traffic incidents. Numerous research studies have been conducted to extract speech features related to fatigue, and their practical utilization has achieved some positive detection results. However, there are still challenges associated with the applied speech features usually being of high dimension, which leads to computational complexity and inefficient fatigue detection. This situation makes it meaningful to reduce the dimensionality and select only a few efficient features. This paper addresses these problems by proposing a high-efficiency fatigued speech selection method based on improved compressed sensing. For adapting a method to the specific field of fatigued speech, we propose an improved compressed sensing construction algorithm to decrease the reconstruction error and achieve superior sparse coding. The proposed feature selection method is then applied to optimize the high-dimension fatigued speech features based on the fractal dimension. Finally, a support vector machine classifier is applied to a series of comparative experiments using the Civil Aviation Administration of China radiotelephony corpus to demonstrate that the proposed method provides a significant improvement in the precision of fatigue detection compared with current state-of-the-art approaches.
Drivers of Stock Prices in Ghana: An Empirical Mode Decomposition Approach
Authors: Gyamfi Emmanuel. N. , Sarpong Frederick A. A. , Adam Anokye M.
Published: September 2021

This study utilized the empirical mode decomposition (EMD) technique and examined which group of investors based on their trading frequencies influence stock prices in Ghana. We applied this technique to a dataset of daily closing prices of GSE Financial Stock Index for the period 04/01/2011 to 28/08/2015. The daily closing prices were decomposed into six intrinsic mode functions (IMFs) and a residue. We used the hierarchical clustering method to reconstruct the IMFs into high frequency, low frequency, and trend components. Using statistical measures such as Pearson product moment correlation coefficient and the Kendall rank correlation, we found that the low frequency and trend components of stock prices are the main drivers of the GSE stock index. These low-frequency traders are the institutional investors. Therefore, stock prices on the GSE are affected by real economic growth but not short-lived market fluctuations.
Prevalence of Sarcopenia and Its Effect on Postoperative Complications in Patients with Crohn’s Disease
Authors: Zhang Chen , Yu Dingye , Hong Liwen , Zhang Tianyu , Liu Hua , Fan Rong , Wang Lei , Zhong Jie , Wang Zhengting
Published: September 2021

Background and Aims. Sarcopenia is a prognostic factor of outcomes for various diseases, but reports on sarcopenia in patients with Crohn’s disease (CD) are few. We aim to determine the prevalence of sarcopenia and assess the role of sarcopenia in postoperative complications in patients with CD at a tertiary referral center. Methods. Patients who underwent intestinal surgery for CD from January 2013 to October 2019 were retrospectively enrolled. The L3 skeletal muscle mass index (SMI) was used to identify sarcopenia. Demographic data, preoperative laboratory data, surgical details, and hospital outcomes were recorded. The factors associated with postoperative complications were evaluated through univariate and multivariate analyses. Results. One hundred and twenty-four patients were enrolled. Thirty-four of them (27.4%), including 11 males, were diagnosed with sarcopenia. Compared with patients without sarcopenia, sarcopenic patients had a significantly lower BMI (

P
<
0.001

); lower preoperative serum albumin (

P
=
0.006

), prealbumin (

P
=
0.030

), and hemoglobin levels (

P
<
0.001

); longer hospital stay (

34.4
±
26.8

days vs.

22.8
±
15.6

days,

P
=
0.003

); and more occurrences of complications (41.2% vs. 23.3%,

P
=
0.049

). The overall incidence of postoperative complications was 28.2%. Infection (51.4%) and intestinal fistula (22.9%) were the most common among such complications. Through the multivariate analysis, sarcopenia was identified as an independent risk factor for major postoperative complications (

odds
 
ratio
=
3.974

,

95
%
CI
=
1.171

–13.489,

P
=
0.027

). Conclusion. Sarcopenia is common in patients with CD requiring bowel resection, and it significantly increases the risk of major postoperative complications.
Mathematical Modeling of THD Mitigation Using HAPF for UPS System with Experimental Analysis via Hybrid Interface of Optical USB and Power Quality Meter
Authors: Kumar Mahender , Uqaili M. A. , Memon Z. A. , Das Bhagwan
Published: September 2021

This paper discusses a novel analysis scheme based on the hybrid interface of Optical USB and Power Quality Meter for measuring Total Harmonic Distortion (THD) that exists in the Uninterruptable Power Supply (UPS) system and connected load. The designed hybrid interface experimentally analyzes the power quality and harmonics of the Uninterrupted Power Supply (UPS) system, and mitigation is proposed with the proposed Single-Phase Hybrid Active Power Filter (HAPF) based on instantaneous Power Theory (PQ) with hysteresis control technique and synchronous frame reference (DQ) with hysteresis control techniques at nonlinear load. This study authenticates and gives appropriate measurements in analyzing the harmonics and voltage distortion during conversion of power. The designed work offers the compensation and elimination of harmonic currents using PQ and DQ theory at different nonlinear loads. The proposed HAPF for the UPS system has demonstrated the significant reduction in THD using proposed Power Theory (PQ) with hysteresis control technique from 46.58% to 1.51% and by using DQ theory with hysteresis control technique has reduced THD from 46.58% to 1.38%. Finally, the results are compared between PQ and DQ. It is validated via results that DQ theory eliminated harmonics and also having less THD as compared to PQ-theory. Furthermore, one of the key aspects of the work is the analysis of power quality using Optical USB Interface (OC4USB) and FLUKE series power quality analyzer.