bluuebunny/crossref_metadata_2025 huggingface dataset:
Linkage of Normal Heights Obtained from GNSS and Refined XGM2019 GGM to Brazilian Vertical Data Using Different Approaches
Authors: Delgado Rodrigo Evangelista , Rodrigues Tiago Lima
Published: May 2023

This work aimed to analyze the use of different approaches to link normal heights obtained via Global Navigation Satellite System (GNSS)/Global Geopotential Model (GGM) refined by the RTM technique to the Brazilian Vertical Data (Imbituba Brazilian Vertical Datum – IBVD and Santana Brazilian Vertical Datum – SBVD). Specifically, it analyzed approaches based on the weighted mean of discrepancies between height anomalies, the zero- level geopotential value, the Geodetic Boundary Value Problem (GBVP) solution, and the use of parametric modeling of a plane with a scale factor. For the numerical tests, two different study regions have been used, the first with heights referenced to IBVD and the second to SBVD. Using the first three approaches, the local modeling idea has been investigated in both regions. In this context, spatial cluster analysis of the outliers of differences between local and global height anomalies defined the sub-regions. In the fourth approach, the treatment of local modeling was initially considered. In the accuracy analysis of linkages, it has been verified that approaches based on the mean of the discrepancies between height anomalies and using zero- level geopotential value propose practically the same results. On the other hand, there were improvements at the centimeter level with the use of the GBPV solution-based approach compared to the first two, except for two worsening cases. With the approach based on parametric modeling, the accuracy results were mainly worse considering the approaches with local modeling. The most significant differences reached the decimeter level.
On the origins of the m/z = 19 signals in residual gas analysis
Authors: Davies Sean , Walker Dane E. , Rees John A. , Seymour David L.
Published: May 2023

Previous investigations of mass spectra obtained in very high vacuum systems have disagreed as to the origin and identity of the mass peak frequently observed at m/z = 19 amu. Recent work with quadrupole mass spectrometry instruments that can also be used for threshold ionization mass spectrometry has shown how the apparent conflict between different sets of published data may be resolved.
Effect of praseodymium coating on electron emission from a nanoscale gold field emitter array
Authors: De Rose L. B. , Catanzaro D. H. , Choi C. , Scherer A.
Published: May 2023

Although field emission devices are inherently robust to high temperature and radiation environments as well as have high switching speeds, their development has been hindered by high voltages that are typically required for their operation. In this work, we investigate the effect of thin-film praseodymium (Pr) coating on the emission characteristics of a lateral gold (Au) field emitter array. Because Pr has a significantly lower work function than Au, it is expected to increase the field emission measured current. Pr is deposited onto the device via thermal angled evaporation in a custom-built vacuum chamber with in situ electrical characterization capability. Our experiments demonstrate that a 10 nm-thick Pr layer reduces the turn-on voltage by almost half compared to the noncoated Au structure. These results are promising for the development of power-efficient, low voltage field emission electronics.
Buffering of genetic dominance by allele-specific protein complex assembly
Authors: Badonyi Mihaly , Marsh Joseph A
Published: May 2023

Protein complex assembly often occurs while subunits are being translated, resulting in complexes whose subunits were translated from the same mRNA in an allele-specific manner. It has thus been hypothesized that such cotranslational assembly may counter the assembly-mediated dominant-negative effect, whereby co-assembly of mutant and wild-type subunits “poisons” complex activity. Here, we show that cotranslationally assembling subunits are much less likely to be associated with autosomal dominant relative to recessive disorders, and that subunits with dominant-negative disease mutations are significantly depleted in cotranslational assembly compared to those associated with loss-of-function mutations. We also find that complexes with known dominant-negative effects tend to expose their interfaces late during translation, lessening the likelihood of cotranslational assembly. Finally, by combining complex properties with other features, we trained a computational model for predicting proteins likely to be associated with non–loss-of-function disease mechanisms, which we believe will be of considerable utility for protein variant interpretation.
The largest fully protected marine area in North America does not harm industrial fishing
Authors: Favoretto Fabio , López-Sagástegui Catalina , Sala Enric , Aburto-Oropeza Octavio
Published: May 2023

Marine protected areas (MPAs) that ban fishing restore marine life within their boundaries and can also replenish nearby fisheries. However, some argue that after large MPAs are established, fishing effort is displaced to unprotected areas and economic loss is incurred by the fishing industry. We tested these assumptions by assessing the behavior and productivity of the Mexican industrial fishing fleet before and after the implementation of the largest fully protected MPA in North America (the 147,000–square kilometer Revillagigedo National Park). We found no decrease in catches and no causal link between the variation of the spatial footprint of the industrial fleet and the implementation of the MPA. Our findings add to growing evidence that well-designed MPAs benefit marine ecosystems and, in the long term, can also benefit the fisheries they support.
Cryo-EM visualization of DNA-PKcs structural intermediates in NHEJ
Authors: Chen Siyu , Vogt Alex , Lee Linda , Naila Tasmin , McKeown Ryan , Tomkinson Alan E , Lees-Miller Susan P , He Yuan
Published: May 2023

DNA double-strand breaks (DSBs), one of the most cytotoxic forms of DNA damage, can be repaired by the tightly regulated nonhomologous end joining (NHEJ) machinery (Stinson and Loparo and Zhao
et al.
). Core NHEJ factors form an initial long-range (LR) synaptic complex that transitions into a DNA-PKcs (DNA-dependent protein kinase, catalytic subunit)–free, short-range state to align the DSB ends (Chen
et al.
). Using single-particle cryo–electron microscopy, we have visualized three additional key NHEJ complexes representing different transition states, with DNA-PKcs adopting distinct dimeric conformations within each of them. Upon DNA-PKcs autophosphorylation, the LR complex undergoes a substantial conformational change, with both Ku and DNA-PKcs rotating outward to promote DNA break exposure and DNA-PKcs dissociation. We also captured a dimeric state of catalytically inactive DNA-PKcs, which resembles structures of other PIKK (Phosphatidylinositol 3-kinase-related kinase) family kinases, revealing a model of the full regulatory cycle of DNA-PKcs during NHEJ.
Distinct armchair and zigzag charge transport through single polycyclic aromatics
Authors: Zhang Miao , Wu Zewen , Jia Hongxing , Li Peihui , Yang Lei , Hao Jie , Wang Jinying , Zhang Enyu , Meng Linan , Yan Zhuang , Liu Yi , Du Pingwu , Kong Xianghua , Xiao Shengxiong , Jia Chuancheng , Guo Xuefeng
Published: May 2023

In aromatic systems with large π-conjugated structures, armchair and zigzag configurations can affect each material’s electronic properties, determining their performance and generating certain quantum effects. Here, we explore the intrinsic effect of armchair and zigzag pathways on charge transport through single hexabenzocoronene molecules. Theoretical calculations and systematic experimental results from static carbon-based single-molecule junctions and dynamic scanning tunneling microscope break junctions show that charge carriers are preferentially transported along the hexabenzocoronene armchair pathway, and thus, the corresponding current through this pathway is approximately one order of magnitude higher than that through the zigzag pathway. In addition, the molecule with the zigzag pathway has a smaller energy gap. In combination with its lower off-state conductance, it shows a better field-effect performance because of its higher on-off ratio in electrical measurements. This study on charge transport pathways offers a useful perspective for understanding the electronic properties of π-conjugated systems and realizing high-performance molecular nanocircuits toward practical applications.
Fluorescent-based biodegradable microneedle sensor array for tether-free continuous glucose monitoring with smartphone application
Authors: Sang Mingyu , Cho Myeongki , Lim Selin , Min In Sik , Han Yuna , Lee Chanwoo , Shin Jongwoon , Yoon Kukro , Yeo Woon-Hong , Lee Taeyoon , Won Sang Min , Jung Youngmee , Heo Yun Jung , Yu Ki Jun
Published: May 2023

Continuous glucose monitoring (CGM) allows patients with diabetes to manage critical disease effectively and autonomously and prevent exacerbation. A painless, wireless, compact, and minimally invasive device that can provide CGM is essential for monitoring the health conditions of freely moving patients with diabetes. Here, we propose a glucose-responsive fluorescence-based highly sensitive biodegradable microneedle CGM system. These ultrathin and ultralight microneedle sensor arrays continuously and precisely monitored glucose concentration in the interstitial fluid with minimally invasive, pain-free, wound-free, and skin inflammation–free outcomes at various locations and thicknesses of the skin. Bioresorbability in the body without a need for device removal after use was a key characteristic of the microneedle glucose sensor. We demonstrated the potential long-term use of the bioresorbable device by applying the tether-free CGM system, thus confirming the successful detection of glucose levels based on changes in fluorescence intensity. In addition, this microneedle glucose sensor with a user-friendly designed home diagnosis system using mobile applications and portable accessories offers an advance in CGM and its applicability to other bioresorbable, wearable, and implantable monitoring device technology.
Discovery of Antimicrobial Phosphonopeptide Natural Products from Bacillus velezensis by Genome Mining
Authors: Wilson Jake , Cui Jerry , Nakao Toshiki , Kwok Happy , Zhang Yeying , Kayrouz Chase M. , Pham Tiffany M. , Roodhouse Hannah , Ju Kou-San
Published: May 2023

Phosphonate natural products produced by bacteria have been a rich source of clinical antibiotics and commercial pesticides. Here, we describe the discovery of two new phosphonopeptides produced by
B. velezensis
with antibacterial activity against human and plant pathogens, including those responsible for widespread soft rot in crops and American foulbrood.
TargeTron Inactivation of Chlamydia trachomatis
gseA
Results in a Lipopolysaccharide 3-Deoxy-
d
-Manno-Oct-2-Ulosonic Acid-Deficient Strain That Is Cytotoxic for Cells
Authors: DeBoer Addison G. , Lei Lei , Yang Chunfu , Martens Craig A. , Anzick Sarah L. , Antonioli-Schmit Sophia , Suchland Robert J. , McClarty Grant , Caldwell Harlan D. , Rockey Daniel D.
Published: May 2023

All members of the family
Chlamydiaceae
have lipopolysaccharides (LPS) that possess a shared carbohydrate trisaccharide antigen, 3-deoxy-
d
-manno-oct-2-ulosonic acid (Kdo) that is functionally uncharacterized. A single gene, genus-specific epitope (
gseA
), is responsible for attaching the tri-Kdo to lipid IVA. To investigate the function of Kdo in chlamydial host cell interactions, we made a
gseA
-null strain (L2Δ
gseA
) by using TargeTron mutagenesis.
CancerHERVdb: Human Endogenous Retrovirus (HERV) Expression Database for Human Cancer Accelerates Studies of the Retrovirome and Predictions for HERV-Based Therapies
Authors: Stricker Erik , Peckham-Gregory Erin C. , Scheurer Michael E.
Published: May 2023

Human endogenous retroviruses (HERVs), which in the past have inserted themselves in various regions of the human genome, are to various degrees activated in virtually every cancer type. While a centralized naming system and resources summarizing HERV levels in cancers are lacking, the CancerHERVdb database provides a consolidated resource for cross-study comparisons, data exploration, and targeted searches of HERV activation.
Complete Genome Sequence of an Avian Orthoavulavirus 13 Strain Detected in Ukraine
Authors: Goraichuk Iryna V. , Muzyka Denys , Gaidash Oleksandr , Gerilovych Anton , Stegniy Borys , Pantin-Jackwood Mary J. , Miller Patti J. , Afonso Claudio L. , Suarez David L.
Published: May 2023

We report the complete genome sequence of an avian orthoavulavirus 13 strain, isolated from a white-fronted goose in the Odesa region of Ukraine in 2013. The detection of avian orthoavulavirus 13 in Ukraine confirms that the geographic distribution of this virus extends beyond Asia.
Quantification of metabolic niche occupancy dynamics in a Baltic Sea bacterial community
Authors: Massing Jana C , Fahimipour Ashkaan K. , Bunse Carina , Pinhassi Jarone , Gross Thilo
Published: May 2023

Progress in molecular methods has enabled the monitoring of bacterial populations in time. Nevertheless, understanding community dynamics and its links with ecosystem functioning remains challenging due to the tremendous diversity of microorganisms. Conceptual frameworks that make sense of time series of taxonomically rich bacterial communities, regarding their potential ecological function, are needed. A key concept for organizing ecological functions is the niche, the set of strategies that enable a population to persist and define its impacts on the surroundings. Here we present a framework based on manifold learning to organize genomic information into potentially occupied bacterial metabolic niches over time. Manifold learning tries to uncover low-dimensional data structures in high-dimensional data sets that can be used to describe the data in reduced dimensions. We apply the method to re-construct the dynamics of putatively occupied metabolic niches using a long-term bacterial time series from the Baltic Sea, the Linnaeus Microbial Observatory (LMO). The results reveal a relatively low-dimensional space of occupied metabolic niches comprising groups of taxa with similar functional capabilities. Time patterns of occupied niches were strongly driven by seasonality. Some metabolic niches were dominated by one bacterial taxon, whereas others were occupied by multiple taxa, depending on the season. These results illustrate the power of manifold learning approaches to advance our understanding of the links between community composition and functioning in microbial systems.

IMPORTANCE

The increase in data availability of bacterial communities highlights the need for conceptual frameworks to advance our understanding of these complex and diverse communities alongside the production of such data. To understand the dynamics of these tremendously diverse communities, we need tools to identify overarching strategies and describe their role and function in the ecosystem in a comprehensive way. Here, we show that a manifold learning approach can coarse grain bacterial communities in terms of their metabolic strategies and that we can thereby quantitatively organize genomic information in terms of potentially occupied niches over time. This approach, therefore, advances our understanding of how fluctuations in bacterial abundances and species composition can relate to ecosystem functions and it can facilitate the analysis, monitoring, and future predictions of the development of microbial communities.
Characterization of Pseudomonas aeruginosa
l,d
-Transpeptidases and Evaluation of Their Role in Peptidoglycan Adaptation to Biofilm Growth
Authors: Hugonneau-Beaufet Inès , Barnier Jean-Philippe , Thiriet-Rupert Stanislas , Létoffé Sylvie , Mainardi Jean-Luc , Ghigo Jean-Marc , Beloin Christophe , Arthur Michel
Published: May 2023

Active-site cysteine LDTs form a functionally heterologous family of enzymes that contribute to the biogenesis of the bacterial cell envelope through formation of peptidoglycan cross-links and through the dynamic anchoring of lipoproteins to peptidoglycan. Here, we report the role of three
P. aeruginosa
LDTs that had not been previously characterized.
Copy Number Variation on
ABCC2-DNMBP
Loci Affects the Diversity and Composition of the Fecal Microbiota in Pigs
Authors: Ramayo-Caldas Yuliaxis , Crespo-Piazuelo Daniel , Morata Jordi , González-Rodríguez Olga , Sebastià Cristina , Castello Anna , Dalmau Antoni , Ramos-Onsins Sebastian , Alexiou Konstantinos G. , Folch Josep M. , Quintanilla Raquel , Ballester Maria
Published: May 2023

A better understanding of the environmental and host factors modulating gut microbiomes is a topic of greatest interest. Recent evidence suggests that genetic variation in the pig genome partially controls the composition of porcine gut microbiota.
Inﬂiximab for intensification of primary therapy for patients with Kawasaki disease and coronary artery aneurysms at diagnosis
Authors: Miyata Koichi , Bainto Emelia V , Sun Xiaoying , Jain Sonia , Dummer Kirsten B , Burns Jane C , Tremoulet Adriana H
Published: May 2023

Objective

Children with Kawasaki disease (KD) and an initial echocardiogram that demonstrates coronary artery aneurysms (CAAs, Z score ≥2.5) are at high risk for severe cardiovascular complications. We sought to determine if primary adjunctive infliximab treatment at a dose of either 5 or 10 mg/kg, compared with intravenous immunoglobulin (IVIG) alone, is associated with a greater likelihood of CAA regression in patients with KD with CAA at the time of diagnosis.

Design and setting

Single-centre observational study.

Patients

Children with acute KD and Z score ≥2.5 at baseline.

Interventions

Primary adjunctive infliximab (5 or 10 mg/kg) within 48 hours of initiating IVIG 2 g/kg.

Main outcome measures

Incidence of CAA regression to Zmax <2 within 2 months of disease onset.

Results

Of the 168 patients with KD, 111 received IVIG alone and 57 received primary adjunctive infliximab therapy: 39 received 5 mg/kg and 18 received 10 mg/kg. Incidence of CAA regression to Zmax <2 within 2 months was statistically significant at 52%, 62% and 83% in the IVIG alone, IVIG+infliximab 5 mg/kg and IVIG+infliximab 10 mg/kg, respectively. The multivariable logistic regression model adjusting for age, sex, baseline Zmax and bilateral CAA at baseline showed that IVIG plus 10 mg/kg infliximab was significantly associated with a greater likelihood of CAA regression (adjusted OR: 4.45, 95% CI 1.17 to 16.89, p=0.028) compared with IVIG alone. The difference between IVIG+infliximab 5 mg/kg and IVIG alone was not significant.

Conclusions

Primary adjunctive high-dose 10 mg/kg infliximab treatment was associated with a greater likelihood of CAA regression in patients with CAA at the time of diagnosis.
Blastic plasmacytoid dendritic cell neoplasm in an adolescent female: a rare entity with challenging diagnosis and management
Authors: Agarwal Ankit , Amit Michelle , Chaffin Joanna , Strobel Amanda
Published: May 2023

Blastic plasmacytoid dendritic cell neoplasm is a rare and aggressive haematopoietic neoplasm with poor prognosis. It usually presents with cutaneous lesions and symptoms secondary to bone marrow involvement. Due to rarity and lack of standard treatment protocols, these cases are difficult to diagnose and treat. We report a case of a female in early adolescence who presented with skin nodules on the leg. The diagnosis was established by immunophenotypic studies. We discuss the investigations and treatment options available to diagnose and treat this malignancy.
Opioid and benzodiazepine prescription among patients with cirrhosis compared to other forms of chronic disease
Authors: Konerman Monica A , Rogers Mary , Kenney Brooke , Singal Amit G , Tapper Elliot , Sharma Pratima , Saini Sameer , Nallamothu Brahmajee , Waljee Akbar
Published: May 2023

Objective

Data on patterns and correlates of opioid and benzodiazepines prescriptions among patients with chronic conditions are limited. Given a diminished capacity for hepatic clearance, patients with cirrhosis represent a high risk group for use. The aim of this study was to characterise the patterns and correlates of prescription opioid, benzodiazepine and dual drug prescriptions among individuals with common chronic diseases.

Design

Analysis of Truven Marketscan database to evaluate individuals with drug coverage with cirrhosis (n=169,181), chronic hepatitis C without cirrhosis (n=210 191), congestive heart failure (n=766 840) or chronic obstructive pulmonary disease (n=1 438 798). Pharmacy files were examined for outpatient prescriptions.

Results

Patients with cirrhosis had a significantly higher prevalence of opioid prescriptions (37.1 per 100 person-years vs 24.3–26.0, p≤0.001) and benzodiazepine prescriptions (21.3 per 100 person-years vs 12.1–12.9, p<0.001). High dose opioid prescription (>90 daily oral morphine equivalents) (29.1% vs 14.4%, p<0.001) and dual opioid and benzodiazepine prescription (17.5% vs 9.6%–10.5 %, p<0.001) were also significantly more prevalent in cirrhosis. High dose opioid prescription was greater in men, individuals ages 40–59, in the Western USA, and among those with a mental health or substance abuse condition. Dual opioid and benzodiazepine prescription were highest among those with alcoholic cirrhosis and middle aged-adults.

Conclusion

Persons with cirrhosis have significantly higher rates of prescription opioid and benzodiazepine prescription compared to others with chronic diseases despite their high risk for adverse drug reactions. Demographics and mental health or substance abuse history can help identify high risk groups to target interventions.
Prevalence and correlates of stunting and thinness among adolescent students in Lideta subcity, Addis Ababa, Ethiopia: a cross-sectional study
Authors: Getahun Genanew Kassie , Assfaw Alebachew , Muhammad Esmael Ali , Shitemaw Tewoderos
Published: May 2023

Objectives

To determine the prevalence of stunting and thinness and associated factors among adolescents attending public schools in Lideta subcity, Addis Ababa, Ethiopia, in 2021.

Design

Cross-sectional.

Setting

Public schools in Lideta subcity, Addis Ababa, Ethiopia.

Eligibility

Adolescents from grades 5–12 in public schools and students whose parents gave consent for participation.

Data analysis

Bivariate and multivariable logistic regression analyses were used to examine the association between the independent variables and stunting and thinness. Using a 95% CI and adjusted OR (AOR), factors with a p value of less than 0.05 were determined to have a significant association.

Outcome measures

The prevalence of stunting and thinness, as well as the factors associated with stunting and thinness, were secondary outcomes.

Results

The overall prevalence of stunting and thinness was 7.2% (95% CI: 5.3% to 9.3%) and 9% (95% CI: 6.8% to 11.4%), respectively. Stunting was associated with a larger family size (AOR=3.76; 95% CI: 1.58 to 8.94), low dietary diversity (AOR=2.87; 95% CI: 1.44 to 5.74), food insecurity (AOR=2.81; 95% CI: 1.38 to 5.71) and a lower wealth index (AOR=3.34; 95% CI: 1.51 to 7.41). On the other hand, thinness was associated with maternal education in those who were unable to read and write (AOR=2.5; 95% CI: 1.97 to 8.11), inadequate dietary diversity (AOR=4.81; 95% CI: 2.55 to 9.07) and larger family size (AOR=2.46; 95% CI: 1.14 to 5.29).

Conclusion

Adolescent stunting and thinness were common in Addis Ababa’s public schools. Family size, dietary diversity and food security were the main factors associated with both thinness and stunting. Therefore, to solve the problem of adolescent stunting and thinness, the administration of Addis Ababa city should prioritise minimising food insecurity while boosting productivity to enhance adolescent nutritional diversity. Moreover, nutritional education should be strengthened by healthcare providers working at public schools as well as health extension workers.
Social bias in artificial intelligence algorithms designed to improve cardiovascular risk assessment relative to the Framingham Risk Score: a protocol for a systematic review
Authors: Garcha Ivneet , Phillips Susan Paula
Published: May 2023

Introduction

Cardiovascular disease (CVD) prevention relies on timely identification of and intervention for individuals at risk. Risk assessment models such as the Framingham Risk Score (FRS) have been shown to over-estimate or under-estimate risk in certain groups, such as socioeconomically disadvantaged populations. Artificial intelligence (AI) and machine learning (ML) could be used to address such equity gaps to improve risk assessment; however, critical appraisal is warranted before ML-informed clinical decision-making is implemented.

Methods and analysis

This study will employ an equity-lens to identify sources of bias (ie, race/ethnicity, gender and social stratum) in ML algorithms designed to improve CVD risk assessment relative to the FRS. A comprehensive literature search will be completed using MEDLINE, Embase and IEEE to answer the research question: do AI algorithms that are designed for the estimation of CVD risk and that compare performance with the FRS address the sources of bias inherent in the FRS? No study date filters will be imposed on the search, but English language filters will be applied. Studies describing a specific algorithm or ML approach that provided a risk assessment output for coronary artery disease, heart failure, cardiac arrhythmias (ie, atrial fibrillation), stroke or a global CVD risk score, and that compared performance with the FRS are eligible for inclusion. Papers describing algorithms for the diagnosis rather than the prevention of CVD will be excluded. A structured narrative review analysis of included studies will be completed.

Ethics and dissemination

Ethics approval was not required. Ethics exemption was formally received from the General Research Ethics Board at Queen’s University. The completed systematic review will be submitted to a peer-reviewed journal and parts of the work will be presented at relevant conferences.
Motivation to stop smoking in the German population between 2016 - 2021 and associated factors: results from a repeated cross-sectional representative population survey (German Study on Tobacco Use, DEBRA study)
Authors: Borchardt Benjamin , Kastaun Sabrina , Pashutina Yekaterina , Viechtbauer Wolfgang , Kotz Daniel
Published: May 2023

Objectives

We aimed to describe population trends in motivation to stop smoking between 2016 and 2021 in Germany. Furthermore, the aim was to estimate to what extent higher ratings on the validated German version of the Motivation To Stop Scale (MTSS) are associated with sociodemographics, nicotine dependence, past quit attempts, and use of e-cigarettes and tobacco product alternatives.

Methods

We used data from the German Study on Tobacco Use: an ongoing repeated cross-sectional face-to-face household survey collecting representative data of the German population every other month since 2016. We analysed data from 18 969 adult current smokers with multivariable ordinal regression and described MTSS scores between 2016 and 2021 (scores 1–7=lowest to highest level of motivation).

Results

The mean MTSS score was 2.04 (SD=1.37) and showed a slight downward trend over time. Younger age, higher level of education, fewer cigarettes per day, more time spent with urges to smoke, a recent quit attempt, no previous waterpipe use and current or past e-cigarette use were associated with higher MTSS scores. The largest effect estimates were observed for at least one quit attempt 0–6 months ago versus no attempt in the past year (OR=7.54; 95% CI 6.78 to 8.40), at least one quit attempt 7–12 months ago versus no attempt in the past year (OR=4.00; 95% CI 3.59 to 4.45) and for current versus never use of e-cigarettes (OR=1.71; 95% CI 1.48 to 1.99).

Conclusions

Recent quit attempts and current use of e-cigarettes were associated with higher motivation to stop smoking in the German population. Actions to boost the general motivation to stop smoking are required.
Remdesivir-associated bradycardia in COVID-19: a rapid review protocol
Authors: Tian Elli , Cosme Celica , Bauzon Justin , Batra Kavita , Azar Fadi , Schreiber Ariyon
Published: May 2023

Introduction

Remdesivir is an antiviral medication that is used in the treatment of severe COVID-19. Research has highlighted the potential cardiac side effects of remdesivir, including the occurrence of remdesivir-associated bradycardia (RAB), but these findings have not been consistent. In addition, very little is known about the clinical implications and outcomes of RAB. The aim of this rapid systematic review is to determine the event rate of developing bradycardia while receiving remdesivir treatment compared with not receiving remdesivir in patients diagnosed with COVID-19.

Methods and analysis

This study follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines and will include original papers related to COVID-19, remdesivir and bradycardia. Only English language papers published from 1 December 2019 to 31 December 2022 will be included. The following databases will be searched using keywords and controlled vocabulary: Ovid MEDLINE, Ovid EMBASE, Scopus, Cochrane, PubMed and Web of Science. Two reviewers will independently perform screening and data abstraction. Data will be synthesised qualitatively as well as quantitatively. A random-effects model will be used to calculate the pooled estimates.

Ethics and dissemination

This review will systematically analyse the clinical studies available to help better characterise RAB. The results will support a retrospective study investigating RAB that is currently being conducted at the University Medical Center of Southern Nevada in Las Vegas, Nevada.

PROSPERO registration number

This protocol has been submitted to and approved by PROSPERO (Protocol ID: CRD42022331614).
Preoperative steroid for enhancing patients’ recovery after head and neck cancer surgery with free tissue transfer reconstruction: protocol for a phase III, placebo-controlled, randomised, double-blind study (J-SUPPORT 2022, PreSte-HN Study)
Authors: Shinozaki Takeshi , Imai Takayuki , Kobayashi Kenya , Yoshimoto Seiichi , Zenda Sadamoto , Yamaguchi Takuhiro , Eguchi Kohtaro , Okano Tomoka , Mashiko Tomoe , Kurosaki Miyuki , Miyaji Tempei , Matsuura Kazuto
Published: May 2023

Introduction

There is no established methodology for the perioperative management of head and neck cancer surgery and free tissue transfer reconstruction (HNS-FTR). A single dose of corticosteroid administered immediately before surgery has been shown to reduce postoperative pain and nausea/vomiting after some types of surgery. However, the efficacy of this strategy has not been demonstrated in HNS-FTR, and the increased risk of infectious complications associated with its use cannot be ruled out. This phase III, placebo-controlled, randomised, double-blind, comparative, multicentre study seeks to determine if preoperative administration of corticosteroid hormone has an adjunctive effect in terms of reducing pain and nausea/vomiting after surgery and improving the quality of postoperative recovery.

Methods and analysis

Using the minimisation method, patients undergoing HNS-FTR are currently being recruited and randomly assigned to a study arm at a 1:1 allocation rate. The study treatment arm consists of 8.0 mg of dexamethasone phosphate dissolved in 100 mL of saline administered as a single dose by intravenous infusion. These treatments will be administered in a double-blind fashion. All patients will receive perioperative care according to the common multicentre enhanced recovery after surgery programme. The primary endpoint is the quality of postoperative recovery, as determined by the area under the curve (AUC) for total score on the Japanese version of the Quality of Recovery Score (QOR-40J) on postoperative days 2 and 4. The point estimate and CI for the difference in the AUC between the groups on postoperative days 2 and 4 will be calculated.

Ethics and dissemination

The study will be performed in accordance with the Declaration of Helsinki and Japan’s Clinical Trials Act. The study protocol was approved by the Certified Review Board of National Cancer Center Hospital East (Reference K2021004).

Trial registration number

The study was registered in the Japan Registry of Clinical Trials (jRCTs031210593; V.3.0, November 2021, available athttps://jrct.niph.go.jp/en-latest-detail/jRCTs031210593).
Prevalence and associated factors of low back pain among taxi drivers in Gondar City, Northwest Ethiopia: a community-based cross-sectional study
Authors: Abere Giziew , Yenealem Dawit Getachew , Worede Eshetu Abera
Published: May 2023

Objective

This study aimed to assess the prevalence of low back pain and associated factors among professional taxi drivers.

Design

Community-based cross-sectional study.

Setting and participants

A Modified Nordic Musculoskeletal Questionnaire was used to collect data. Through a simple random sampling technique, 371 taxi drivers were selected in Gondar City, Ethiopia.

Data analysis

SPSS V.22 was used for data analysis. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with low back pain. A p value less than 0.05 and an adjusted odds ratio (AOR) with 95% CI were used to declare statistical significance.

Result

A total of 371 respondents, with a response rate of 95.4%, have participated. The past 1 year and week’s prevalence of low back pain among taxi drivers was 85.7% (95% CI 82.5 to 89.2) and 53.4% (95% Cl 48.0 to 58.5), respectively. Overweight/obese (AOR=0.33, 95% CI (0.14 to 0.80)), alcohol drinking (AOR=4.77, 95% CI (1.16 to 19.5)), job dissatisfaction (AOR=4.58, 95% CI (1.39 to 15.2)), prolonged working hours per day (AOR=2.64; 95% CI (1.02 to 6.08)), not using the adjustable seat with back support (AOR=6.38, 95% CI (2.39 to 17.01)) were associated with low back pain among taxi drivers.

Conclusion

The prevalence of low back pain among taxi drivers was high. Being overweight/obese, alcohol drinking, job dissatisfaction, prolonged working hours per day, and not using adjustable seats with back support, were factors associated with low back pain among taxi drivers. Therefore, ergonomic and behavioural-related awareness training is recommended to minimise the burden of low back pain among taxi drivers.
Ciprofol versus propofol for sedation in gastrointestinal endoscopy: protocol for a systematic review and meta-analysis
Authors: Qin Xiaoyu , Lu Xiaoting , Tang Lu , Wang Chunai , Xue Jianjun
Published: May 2023

Introduction

Painless gastrointestinal endoscopy is being increasingly practised in the clinical field. The management and choice of sedation are important during the endoscopy procedure to reduce patient discomfort and facilitate high disease detection rates. Ciprofol is principally an agonist of the γ-aminobutyric acid type A receptor; it comprises the active ingredient HSK3486, which is similar to the currently used intravenous anaesthetic propofol in clinical practice. A systematic review and meta-analysis comparing ciprofol and propofol will be conducted to assess their efficacy and safety during endoscopy. Before starting the study, we describe the specific protocol of this systematic review.

Methods and analysis

This protocol was prepared in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols 2015. The following databases will be searched: Embase, Cochrane Library, PubMed, Web of Science, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and a clinical trial registry. The database search strategy will adopt a combination of subject words and free words. Randomised controlled trials related to ciprofol use for sedation during gastrointestinal endoscopy will also be included. Based on the inclusion and exclusion criteria, two researchers will independently screen the articles and extracted data. Following the qualitative evaluation of each study, analysis will be conducted using Review Manager software.

Ethics and dissemination

The protocol for this systematic review and meta-analysis involves no individual patient data; thus, ethical approval is not required. This will be the first meta-analysis to assess the sedation efficacy of ciprofol and provide evidence to clinicians for decision-making. The results will be disseminated through conference presentations and publications in peer-review journals related to this field.

PROSPERO registration number

CRD42022370047.
Risk reduction intervention for raised blood pressure (REVERSE): protocol for a mixed-methods feasibility study
Authors: Hives Lucy , Georgiou Rachel F , Spencer Joseph , Benedetto Valerio , Clegg Andrew , Rutter Paul , Watkins Caroline , Williams Nefyn , Bray Emma P
Published: May 2023

Introduction

Around 40% of adults have pre-hypertension (blood pressure between 120–139/80–89), meaning they are at increased risk of developing hypertension and other cardiovascular disease-related conditions. There are limited studies on the management of pre-hypertension; however, guidance recommends that it should be focused on lifestyle modification rather than on medication. Self-monitoring of blood pressure could allow people to monitor and manage their risk status and may allow individuals to modify lifestyle factors. The purpose of this study is to determine the feasibility and acceptability, to both healthcare professionals and people with pre-hypertension, of blood pressure self-monitoring.

Methods and analysis

A prospective, non-randomised feasibility study, with a mixed-methods approach will be employed. Eligible participants (n=114) will be recruited from general practices, pharmacies and community providers across Lancashire and South Cumbria. Participants will self-monitor their blood pressure at home for 6 months and will complete questionnaires at three timepoints (baseline, 6 and 12 months). Healthcare professionals and participants involved in the study will be invited to take part in follow-up interviews and a focus group. The primary outcomes include the willingness to engage with the concept of pre-hypertension, the acceptability of self-monitoring, and the study processes. Secondary outcomes will inform the design of a potential future trial. A cost-analysis and cost-benefit analysis will be conducted.

Ethics and dissemination

Ethics approval has been obtained from London–Fulham NHS Research Ethics Committee, the University of Central Lancashire Health Ethics Review Panel and the HRA. The results of the study will be disseminated via peer-reviewed publications, feedback to service users and healthcare professionals, and to professional bodies in primary care and pharmacy.

Trial registration number

ISRCTN13649483.
Mandibular advancement device versus CPAP in lowering 24-hour blood pressure in patients with obstructive sleep apnoea and hypertension: the CRESCENT trial protocol
Authors: Ou Yi-Hui , Colpani Juliana Tereza , Chan Siew-Pang , Loke Weiqiang , Cheong Crystal S , Kong William , Chin Calvin W , Kojodjojo Pipin , Wong Philip , Cistulli Peter , Lee Chi-Hang
Published: May 2023

Introduction

Although treatment of obstructive sleep apnoea (OSA) using continuous positive airway pressure (CPAP) reduces blood pressure (BP), adherence to CPAP is often suboptimal. A mandibular advancement device (MAD) is a guideline-endorsed alternative therapy for OSA. Still, there is limited evidence on the relative efficacy between MAD and CPAP on BP reduction. We evaluate whether treatment of moderate-to-severe OSA using MAD can improve BP and other health-related outcomes compared with CPAP.

Methods and analysis

This is a randomised, controlled, non-inferiority trial conducted. We will recruit 220 Asians with a history of hypertension and high cardiovascular risk for an overnight polysomnography screening. Those with moderate-to-severe OSA (apnoea–hypopnoea index ≥15 events/hour) will be randomised to treatment with either MAD or CPAP in a 1:1 ratio. Stratified by age (60 vs <60 years old), body mass index (25 vs <25 kg/m2) and apnoea–hypopnoea index (30 vs <30 events/hour), an adaptive randomisation scheme with permuted blocks constructed in real-time is implemented to restrict imbalance. The overall study duration is 12 months. The primary endpoint is the 24-hour mean arterial BP difference between baseline and 6-month follow-up. The secondary endpoints include other measures of ambulatory BP monitoring, arrhythmia based on a 4-day electrocardiographic monitoring, biomarker and proteomic analysis, cardiovascular magnetic resonance-derived myocardial fibrosis and remodelling and quality-of-life questionnaires. Recruitment began in October 2019 and ended in December 2022. Comparison between MAD and CPAP will be performed using covariance (ANCOVA) analysis of the changes in 24-hour mean arterial BP while adjusting for the baseline 24-hour mean arterial BP. We will compare the 95% CIs around the treatment difference point estimate with the prespecified non-inferiority margin (1.5 mm Hg). If the upper limit of the 95% CI is <1.5 mm Hg and crosses 0, non-inferiority of the MAD relative to CPAP will be established.

Ethics and dissemination

The Domain Specific Review Board-C, National Healthcare Group under approved the study protocol (NHG DSRB Ref: 2019/00359, approved on 28 August 2019). Study findings will be disseminated to various local, national, and international audiences through abstract presentations and publication in peer-reviewed journals.

Trial registration number

NCT04119999.
Factors that influence the administration of tranexamic acid (TXA) to trauma patients in prehospital settings: a systematic review
Authors: Nicholson Helen , Scotney Natalie , Briscoe Simon , Kirby Kim , Bedson Adam , Goodwin Laura , Robinson Maria , Taylor Hazel , Thompson Coon Jo , Voss Sarah , Benger Jonathan Richard
Published: May 2023

Objective

In the UK there are around 5400 deaths annually from injury. Tranexamic acid (TXA) prevents bleeding and has been shown to reduce trauma mortality. However, only 5% of UK major trauma patients who are at risk of haemorrhage receive prehospital TXA. This review aims to examine the evidence regarding factors influencing the prehospital administration of TXA to trauma patients.

Design

Systematic literature review.

Data sources

AMED, CENTRAL, CINAHL, Cochrane Database of Systematic Reviews, Conference Proceedings Citation Index—Science, Embase and MEDLINE were searched from January 2010 to 2020; searches were updated in June 2022. Clinicaltrials.gov and OpenGrey were also searched and forward and backwards citation chasing performed.

Eligibility criteria

All primary research reporting factors influencing TXA administration to trauma patients in the prehospital setting was included.

Data extraction and synthesis

Two independent reviewers performed the selection process, quality assessment and data extraction. Data were tabulated, grouped by setting and influencing factor and synthesised narratively.

Results

Twenty papers (278 249 participants in total) were included in the final synthesis; 13 papers from civilian and 7 from military settings. Thirteen studies were rated as ‘moderate’ using the Effective Public Health Practice Project Quality Assessment Tool. Several common factors were identified: knowledge and skills; consequences and social influences; injury type (severity, injury site and mechanism); protocols; resources; priorities; patient age; patient sex.

Conclusions

This review highlights an absence of high-quality research. Preliminary evidence suggests a host of system and individual-level factors that may be important in determining whether TXA is administered to trauma patients in the prehospital setting.

Funding and registration

This review was supported by Research Capability Funding from the South Western Ambulance Service NHS Foundation Trust and the National Institute for Health Research Applied Research Collaboration South West Peninsula.

PROSPERO registration number

CRD42020162943.
Reducing catheter-associated urinary tract infections in the cardiac intensive care unit with a coordinated strategy and nursing staff empowerment
Authors: Gupta Poonam , Thomas Mincy , Mathews Leena , Zacharia Nidhu , Fayiz Ibrahim Ashraf , Garcia Ma Leni , Simbulan Cherlyn , Attia Mohamed Fatma , El Hassan Mawahib
Published: May 2023

Background

Catheter-associated urinary tract infection (CAUTI) is one of the most common hospital-acquired infections. The use of urinary catheters is associated with several complications and increased mortality and morbidity. At the coronary intensive care unit (CICU) of a tertiary cardiac care facility, the CAUTI rate was 7.6/1000 catheter days in January 2017. In collaboration with the Institute for Healthcare Improvement, we implemented evidence-based practices in the form of bundles based on the value improvement methodology to eliminate CAUTIs in the CICU.

Methods

This initiative aimed to reduce the CAUTI rate using a multifaceted approach. The key interventions were empowering front-line nurses for automatic stop orders and ensuring compliance to the catheter insertion and maintenance bundles. We used a model for improvement and tested the changes using small plan–do–study–act cycles. Surveillance methods and CAUTI definitions proposed by the National Healthcare Safety Network were used to monitor the outcomes. Monthly rates of CAUTIs 24 months before the intervention were compared with those 44 months after the intervention using an independent t-test. Statistical significance was set at p<0.05.

Results

The rate of CAUTIs dropped from 7.6 per 1000 catheter days in January 2017 to 0 from October 2021 to August 2022. The unit had achieved 280 calendar days free of CAUTI untill August 2022.

Conclusions

Behavioural changes, including empowerment of nurses and adherence to all elements of the care bundle, led to significant and sustained improvement in reducing the CAUTI rate in the adult CICU.
Dapagliflozin in people with chronic kidney disease
Authors: Sylvester Rochelle D , Khong Teck K
Published: May 2023

Commentary on:Heerspink HJL, Stefánsson BV, Correa-Rotter R,et al. Dapagliflozin in patients with chronic kidney disease.N Engl J Med2020;383:1436–46.

Series Editor:Dr Teck Khong, DTB Associate Editor, Clinical Pharmacology, St George’s, University of London, UK