bluuebunny/crossref_metadata_2025 huggingface dataset:
Deutsche Umwelthilfe eV: Implementing the Aarhus convention in EU law
Authors: Augustyniak Łukasz
Published: November 2024

The 1998 Aarhus Convention has had a transformative influence on the legal orders of the European Union (EU) and its Member States. In Case C‐873/19, the Court of Justice of the EU expanded its reasoning on the interpretation of article 9(3) of the Aarhus Convention. First, it ruled that article 5(2) of Regulation 715/2007 on EC‐type approval is to be regarded as law relating to the environment. Second, the Court confirmed that article 9(3) of the Aarhus Convention in conjunction with article 47 of the Charter of Fundamental Rights of the EU creates an obligation incumbent on EU Member States to enable an environmental organisation to have standing to challenge a decision approving certain diesel engines devices that restrict emissions. This case note enquires into the consequences of the Court's broad understanding of term ‘law relating to the environment’. Furthermore, it argues that although EU law obligations based on article 9(3) of the Aarhus Convention lack direct effect when read in conjunction with article 47 of the Charter of Fundamental Rights, they produce a similar effect in legal orders of the EU Member States and impose an obligation to provide broad procedural rights for environmental nongovernmental organisations in any matters related to environmental law.
Entangled exclusions: Borders, frontiers and urban geopolitics from northeast India
Authors: Das Prerona , Mittal Gaurav , Sarma Jasnea
Published: November 2024

An epicentre of ethnicity‐based identity politics and exclusions, India's northeastern region has long been politically imagined as both a ‘frontier’ and ‘borderland’ for state control, territorialization, extractive economies and (re)developments by colonial and subsequent post‐colonial regimes. In post‐independence India, the region experienced many territorial assertions made on ethnic grounds. With the rise of religio‐national and neoliberal politics, new urban ‘developments’ and connectivity projects in the region have deepened exclusions based on class, caste, ethnic and religious borders. These have, in turn, led to further displacement, enclavization, and ghettoization of minority communities who are deemed ‘non‐native’ along ethnocentric lines. Taking two cases from Shillong and Guwahati, we introduce the concept of entangled exclusions to analyse the layered, intertwined, multi‐scalar nature of divides within these frontier cities. We argue these cities are critical sites for understanding urban geopolitics where concentrated entanglements of exclusions and (re)borderings become manifest as these cities experience new infrastructural investments.
Study on Repairing Defects in S32101 Duplex Stainless Steel Clad Plates for Spent Fuel Storage Pools in Nuclear Power Plants Using Underwater Local Dry Laser Fillet Welding With Filler Wire
Authors: Zhao Chenglu , Zhu Jialei , Guo Fangtao , Li Guixin , Li Congwei , Huang Yushan
Published: November 2024

To address the deficiencies in the fillet welding position of the clad plates in the simulated spent fuel pool, an underwater test platform was designed for local dry laser fillet welding under both normal and high-pressure environments. This study focused on multilayer and multipass (MLMP) welding repairs, specifically examining the local underwater laser dry fillet welding process using filler wire made of duplex stainless steel S32101 for third-generation nuclear power stations in air environment (AE), underwater environment (UE), and high-pressure underwater environment (HPUE). The analysis included the microstructure, ferrite content, phase composition, chemical composition, microhardness, and localized corrosion resistance of the fillet welds across the three environments. The main conclusions are as follows: under HPUE, the grain size is the smallest, the cooling rate is the fastest, and the weld consists of intragranular austenite (IGA), grain boundary austenite (GBA), and Widmanstätten austenite (WA); the ferrite content in the heat-affected zone (HAZ) is greater than that in the weld zone, with the highest ferrite content observed in the HPUE; the full width at half maximum (FWHM) of δ (110) and γ (111) varies across different environments; the manganese (Mn) content in HPUE is low; the hardness of the weld zone is the highest, followed by the HAZ, while the base metal (BM) exhibits the lowest hardness; and the pitting corrosion resistance in HPUE is the strongest, attributed to the rapid cooling rate and the pressure of nitrogen (N2) gas velocity.
Numerical Investigation of Duct Augmented Vertical Axis Wind Turbine With Cambered Airfoils
Authors: Das Karmakar Satyajit , Chattopadhyay Himadri
Published: November 2024

In urban settings, vertical axis wind turbines (VAWTs) have gained recognition for their ease of usage and omnidirectional wind acceptance. Their low efficiency in comparison to horizontal axis wind turbines (HAWTs) has prevented them from being extensively utilized, though. A viable solution to this constraint is duct augmentation, which aims to increase airflow and, consequently, the capacity to harvest energy. This study investigates the integration of a duct in the wind turbine system to enhance the performance of VAWT. This work reports a two-dimensional (2D) numerical simulation of a ducted VAWT using a standard blade profile NACA0017 of National Advisory Committee for Aeronautics (NACA) to evaluate its performance in comparison to that of a bare VAWT. Furthermore, a thorough examination of torque ripple factor, coefficient of power (CP), instantaneous net torque coefficients, wake velocity deficit, turbulent intensity and vorticity distribution surrounding the duct is conducted. While the tip speed ratio (TSR) value for bare VAWT with NACA0017 airfoils corresponding to highest CP is 3, this value shifts to 3.5 when VAWT is augmented with duct. For ducted VAWT, the range of maximum CP is within 0.5 to 0.7 at TSR 3.5. CP is enhanced by approximately 5 times compared to the bare VAWT for inlet velocities V∈[3, 4 m/s]. With increasing wind speed beyond 5 m/s, the CP goes on reducing. The torque ripple factor is found to be lowest at a TSR of 3.5, where the maximum augmentation is achieved.
Fuel Thermal Management and Injector Part Design for LPBF Manufacturing
Authors: Becker Ralf , Kasperovich Galina , Tiessen Peter , Haubrich Jan , Behrendt Thomas , Janus Bertram
Published: November 2024

Additive manufacturing (AM) methods such as laser powder bed fusion (LPBF) are particularly attractive methods for manufacturing aero-engine burners as they allow for a complex design with well-tailored features at reasonable production costs. Unfavorable is still the lower precision in terms of geometrical accuracy and surface roughness compared to classical machining, especially if surfaces are oriented in unfavorable orientations. With regard to coke formation and the possibility of fuel line blockage due to too small cross-sectional areas, these drawbacks raise the question how fuel lines may be manufactured by AM and how AM affects the propensity of coke formation. In this study, the geometrical accuracy of LPBF manufactured parts built in small inclination angles to the working bed with “standard parameters” and well-adapted parameters is examined. For further improvement, two shape adjustment strategies are proposed and validated. Regarding the risk of coke formation, deposition rates on LPBF manufactured parts as-built and postprocessed with chemical etching are evaluated. It is shown that an optimized set of machining parameters increases the geometrical precision substantially, and the adjustment of the shape helps to meet the desired cross-sectional areas. Due to the increased roughness of LPBF manufactured parts, the evaluated coke deposition rates exceed the rates measured on classical machined parts by an order of magnitude. As presented, chemical etching the parts is an effective measure against coke deposition since the deposition rates descend to less than the half.
Research on Unsteady Flow Mixing Characteristics of Centripetal Wave Rotor Combustor
Authors: Nie Zhaolong , Gong Erlei , Li Jianzhong , Yao Qian , Zheng Renchuan , Feng Zhan
Published: November 2024

The centripetal wave rotor combustor can better match the centrifugal compressor and the axial turbine of the reference machine, reduce the size of the engine and simplify the transition section structure. In this paper, we use numerical simulations to investigate the effects of blade shape and blade deflection angle on the unsteady flow mixing characteristics of the centripetal wave rotor combustor and complete the optimization of its structure. It is shown that in all designed channels, flow separation is present. The circumferential shear forces and pressure gradient forces contribute to the uneven distribution of the mixture within the channel, and their effects are irremovable. When the blade curve is tangent to the line connecting the endpoint of the inner diameter and the rotor center, it facilitates a particular configuration. This blade shape can enhance the uniformity of the fuel-air mixture distribution within the channel. The blade deflection angle has little effect on the fuel-air mixture distribution, the pressure distribution, and the prepressurization effect in the channel. Changing the width-to-diameter ratio of the channel, or the size of the ports and the phase difference can improve the distribution of the fuel-air mixture in the channel, and both of them are also the key factors affecting the prepressurization effect.
Analysis of Jogai During Judo Matches for Athletes With Visual Impairments: Impact on Referee Decisions and Outcomes
Authors: Kons Rafael Lima , de Almeida Kleydson Ferreira , Carpinelli Yan Furtado , Detanico Daniele
Published: November 2024

This study investigated how jogai frequency influences referee decisions and match outcomes in judo athletes with visual impairment during official competitions. Video analysis of 268 matches revealed 1,395 instances of jogai, with 211 matches experiencing jogai and 57 without. Associations were carried out between jogai occurrences and match duration, sport classes, sexes, weight categories, and referee decisions post-jogai using chi-square tests (p < .05). Significant associations were found between jogai and match duration (χ2 = 39.08, p < .001) and competition phase (χ2 = 29.43, p = .043), particularly with frequent match stoppages (mate) within the first minute across all phases. These findings suggest a need for further research and potential adjustments in judo rules, informed by the new evidence-based classification, to enhance the equity and safety of matches for athletes with visual impairments.
Platelet-Rich Plasma Demonstrates Only Short-Term Benefits in the Treatment of Patellar Tendinopathy: A Critically Appraised Paper
Authors: Stull Kendall M. , Santo Ashley L.
Published: November 2024

Focused Clinical Question: Are platelet-rich plasma injections more effective than dry needling in improving reported symptoms and functioning in adults suffering from patellar tendonitis? Clinical Bottom Line: Platelet-rich plasma may be valuable for some patients who would benefit from a short-term relief of pain associated with patellar tendinopathy, but it likely has no long-term clinical benefits. The level of evidence is 1C and the grade of evidence is A.
‘Dark proteome’ survey reveals thousands of new human genes
Authors: Pennisi Elizabeth
Published: November 2024

Database confirms that overlooked segments of the genome code for a multitude of tiny proteins
Filtering dysesthetic bleb with circumferential intrapalpebral extension
Authors: Kumar Ravi , Kumari Rashmi , Saha Bhawesh Chandra , Sharma Supriya
Published: November 2024

Bleb dysesthesia, a rare condition encountered post-trabeculectomy, can be a severe issue interfering with the patient’s quality of life. Preserving bleb function while alleviating the subjective symptoms remains a challenge in managing such patients. Intensive lubrication is generally accepted as the best initial management, whereas surgical options are reserved for non-responding cases as they carry an inherent risk of bleb failure. Here, we report a case of bleb dysesthesia within 2 months of trabeculectomy. The bleb was extensive and did not respond to conservative management. It was managed successfully by combined surgical approaches, temporal compression sutures and nasal bleb-limiting conjunctivoplasty.
Necrolytic migratory erythema: a fortuitous diagnosis
Authors: Kanagarajan Amuthavalli , Babu Daya , Chandrasekaran Shanmugasekar
Published: November 2024

A woman in her late 60s presented with widespread, itchy, dark lesions over her trunk and legs for 1 month. Initially, she was managed as nutritional dermatitis and experienced partial improvement. However, her condition worsened over 2 months, characterised by aggravated skin lesions, new-onset diabetes and a 12 kg weight loss. On suspicion of necrolytic migratory erythema (NME) secondary to glucagonoma, the contrast-enhanced CT (CECT) abdomen revealed a primary pancreatic lesion with multiple liver metastases. The diagnosis of neuroendocrine tumour was confirmed by liver biopsy with immunohistochemistry, and stage 4 status was revealed by fluorodeoxyglucose-positron emission tomography CT. Following 6-monthly octreotide injections and nutritional and supportive care, her skin lesions completely resolved. This case emphasises the significance of recognising NME, a rare and often misdiagnosed dermatological condition, as it may signify an underlying occult neuroendocrine pancreatic malignancy. Early recognition is crucial for the timely initiation of appropriate management.
Early onset fulminant neonatal sepsis and multiple serous effusions caused byPantoea agglomeransin an extremely preterm neonate
Authors: Kaur Arshdeep , Deshpande Sujata , Dhayagude Snehal Vilas , Suryawanshi Pradeep
Published: November 2024

Pantoea agglomeransis a Gram-negative bacterium commonly isolated from environmental sources such as plants and soil. Infections in humans are usually reported following penetrating wounds or in hospital settings due to contaminated medical equipment. Neonatal sepsis caused by this organism is rare. Late onset sepsis in neonatal intensive care units due to contaminated parenteral nutrition solutions has been reported. This case report describes early onset sepsis due toP.agglomeransin an extremely preterm neonate, with no known maternal risk factors. The patient had a fulminant clinical course, multiorgan involvement and multiple serous cavity effusions. Timely antibiotics, supportive treatment and the use of neonatologist-performed bedside point-of-care ultrasound played an important role in management of complications and survival.
Autologous faecal microbiota transplantation via double barrel stoma to treat chronic diversion colitis
Authors: Tang Joseph Man Fung , Habib Fatmaalzahra , Rahmdil Muhammad , Apostolou Nikolaos
Published: November 2024

Diversion colitis is a common phenomenon affecting patients after defunctioning ileostomy. We present a complex case of diversion colitis where the patient was deemed unsuitable for restorative surgery due to multiple areas of stricturing in a long defunctioned colonic segment. Despite initial treatments with rectally administered topical mesalazine, butyrate enemas and topical steroid therapy, the patient remained symptomatic with rectal bleeding and mucus discharge. Furthermore, the appearance of colitis could be appreciated on endoscopy and radiological investigations with changes in histology consistent with moderate–severe diversion colitis. This article describes our experience in the use of autologous faecal transplant administered via the efferent loop of a double-barrel ileostomy to successfully treat diversion colitis refractory to standard topical therapy.
Attitudes towards FCTC Article 5.3 among tobacco control stakeholders in Thailand and their relationship with awareness of tobacco industry tactics
Authors: Patanavanich Roengrudee , Punkrajang Paweena , Ingkasereepitak Jaruayporn , Phaenthong Warodom , Yimnual Chantapol , Katithamanit Sarin , Wichakpan Praepilai
Published: November 2024

Background

Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC) was developed to protect public health policies from tobacco industry interference. The guiding principles of Article 5.3 emphasise a fundamental conflict between the tobacco industry’s interests and public health interests (principle 1) and recommend that the government be accountable and transparent (principle 2), demand accountability and transparency from the industry (principle 3), and refrain from providing incentives to the industry (principle 4). This study quantitatively explored attitudes towards Article 5.3’s guiding principles and recommendations among Thai tobacco control stakeholders and whether they were associated with awareness of tobacco industry tactics.

Methods

We conducted an online survey of 703 individuals involved in tobacco control in Thailand . We employed multivariable ordinal logistic regression analysis to explore factors associated with attitudes towards Article 5.3’s guiding principles and recommendations.

Results

441 participants responded to the survey (response rate 62.7%). Among the Article 5.3 guiding principles, principle 1 received the lowest agreement (83%), whereas the other three principles had an average of 93% agreement. In multivariable ordinal logistic regression, we found awareness of tobacco industry tactics was associated with Article 5.3’s guiding principles: principle 1 (adjusted OR (AOR) 1.11; 95% CI 1.07 to 1.15; p<0.001), principle 2 (AOR 1.07; 95% CI 1.02 to 1.12; p=0.002), principle 3 (AOR 1.11; 95% CI 1.06 to 1.15; p<0.001) and principle 4 (AOR 1.14; 95% CI 1.09 to 1.19; p<0.001). In addition to awareness of tobacco industry tactics, age, years of experience in tobacco control, role in tobacco control and smoking by family members and friends were associated with perspectives towards Article 5.3’s guidelines.

Conclusions

This study provides quantitative evidence of the association between attitudes towards WHO FCTC Article 5.3 and awareness of tobacco industry tactics in Thailand. Denormalisation of the tobacco industry is thus a vital component of successfully implementing and enforcing Article 5.3.
Trends and socioeconomic inequalities in receiving vitamin A supplementation among children aged 6–59 months in Bangladesh: analysis of nationwide cross-sectional data from 2004 to 2017
Authors: Chowdhury Syed Sharaf Ahmed , Kundu Satyajit , Jahan Ishrat , Dey Rakhi , Sharif Azaz Bin , Hossain Ahmed
Published: November 2024

Introduction

The coverage of vitamin A supplementation (VAS) is still short of the target set by the government to reach 90% coverage of VAS in Bangladesh. The present study aims to examine the socioeconomic and geographical inequalities in receiving VAS among children aged 6–59 months in Bangladesh from 2004 to 2017.

Methods

The Bangladesh Demographic and Health Surveys for the years 2004–2017 were accessed through the WHO’s Health Equity Assessment Toolkit. Inequalities were explored from socioeconomic and geographical perspectives. Specifically, it considered wealth quintile and education as socioeconomic dimensions and place of residence as geographical dimensions. We calculated difference, population attributable fraction (PAF), population attributable risk (PAR) and ratio as summary measures and their associated 95% CIs to quantify and assess the extent of health disparities.

Results

The study revealed a fluctuating trend over the years in the prevalence of receiving VAS among children in Bangladesh. The prevalence shifted from 78.68% in 2004 to a low of 62.09% in 2011, subsequently increasing to 79.29% in 2017. The PAF in 2017 for the variable wealth was 4.61 (95% CI 2.38 to 6.85), highlighting the extent of the disparity that favoured wealthier individuals. The study also detected inequalities based on educational levels; in 2017, the difference measure of inequality was 9.24 (95% CI 3.69 to 14.79), indicating a notable advantage for children from the higher educated group. Children from urban areas were also observed to have a higher likelihood of receiving VAS compared with their rural counterparts.

Conclusion

This study identified a persistent regional inequality in receiving VAS in Bangladesh over time. These inequalities remained a concern, especially for children from poor wealth groups, low-educated families and rural regions. This understanding will inform the development of a comprehensive programme aimed at increasing the prevalence of VAS among all children in Bangladesh.
What does it cost to deliver antenatal care in Papua New Guinea? Results from a health system costing and budget impact analysis using cross-sectional data
Authors: Saweri Olga Phoebe Martinella , Batura Neha , Pomat William , Vallely Andrew John , Wiseman Virginia
Published: November 2024

Objective

In Papua New Guinea (PNG), antenatal clinic attendance averaged 50% for one or more visits, and 30% for four visits in the last decade. In 2016, the WHO revised its focused antenatal care (ANC) model recommending eight rather than four visits. If implemented, this new model would require additional resources. This study estimated provider costs of ANC in PNG, including the expected cost of scaling up to universal ANC coverage as well as recommending eight visits.

Design and setting

Cross-sectional estimation of ANC costs collected from nine health facilities, which were part of a cluster randomised trial. Costs were estimated using both top-down and bottom-up approaches. The cost of the first and follow-up visits were estimated per woman, at the health facility level. Health system and scale-up costs of four visits were calculated by multiplying the aggregate cost of four visits by ANC utilisation rates. A budget impact analysis estimated the expected costs of delivering eight visits over 5 years. Univariate sensitivity analysis was conducted. Discounted costs are reported in local currency and 2019 international dollars using purchasing power parity data.

Results

The average cost of the first and follow-up visits were $17.66–$30.58 (K42.94–K74.34) in Madang and $11.26–$35.61 (K27.37–K86.56) in East New Britain. Four visits per woman cost $70.65–$122.33 (K171.76–K297.36) in Madang and $45.02–$142.45 (K109.50–K346.4) in East New Britain; and salaries represented the largest share of costs. The annual health system cost was $6.9 million (K16.9 million), the expected cost of scaling up to the universal coverage of four visits was $22.7 million (K55.2 million), and $45.4 million (K110.3 million) over 5 years for eight visits.

Conclusion

Costs varied with the number of clinicians, infrastructure and ANC coverage, suggesting scaling up requires increasing the financial investment in ANC services. These results provide a template to strengthen health systems by improving the quality of care.
Association of overweight and obesity with gestational diabetes mellitus among pregnant women attending antenatal care clinics in Addis Ababa, Ethiopia: a case-control study
Authors: Seifu Yeabsra Mesfin , Deyessa Negussie , Seid Yimer Yimer
Published: November 2024

Objective

Maternal obesity and gestational diabetes mellitus (GDM) are becoming major public health concerns in developing countries. Understanding their relationship can help in developing contextually appropriate and targeted prevention strategies and interventions to improve maternal and infant health outcomes. This study aimed to determine the association of maternal overweight and obesity with GDM among pregnant women in Ethiopia.

Design

Case-control study.

Setting

The study was conducted in selected public hospitals in Addis Ababa, Ethiopia, from 10 March to 30 July 2020.

Participants

159 pregnant women with GDM (cases) and 477 pregnant women without GDM (controls).

Outcome measures and data analysis

Screening and diagnosis of GDM in pregnant women was done by a physician using the 2013 WHO criteria of 1-hour plasma glucose level of 10.0 mmol/L (180 mg/dL) or 2-hour plasma glucose level of 8.5–11.0 mmol/L (153–199 mg/dL) following a 75 g oral glucose load. Overweight and obesity were measured using mid-upper arm circumference (MUAC). Binary logistic regression with bivariate and multivariable models was done to measure the association of overweight and obesity with GDM. Adjusted ORs (AORs) with a 95% CI were computed, and statistical significance was determined at a value of p=0.05.

Results

GDM was associated with obesity (MUAC≥31) (AOR 2.80; 95% CI 1.58 to 4.90), previous history of caesarean section (AOR 1.91; 95% CI 1.14 to 3.21) and inadequate Minimum Dietary Diversification Score <5 (AOR 3.55; 95% CI 2.15 to 5.86). The AOR for overweight (MUAC≥28 and MUAC<31) was 1.51 (95% CI 0.71 to 3.21). The odds of developing GDM were 72% lower in pregnant women who were engaging in high-level physical activity (AOR 0.28; 95% CI 0.12 to 0.67).

Conclusion

Obesity, but not overweight, was significantly associated with the development of GDM. Screening for GDM is recommended for pregnant women with obesity (MUAC≥31) for targeted intervention. Antenatal care providers should provide information for women of childbearing age on maintaining a healthy body weight before and in-between pregnancies and the need for healthy, diversified food and high-level physical activity.
Enhancing the reporting quality of rehabilitation interventions through an extension of the Template for Intervention Description and Replication (TIDieR): the TIDieR-Rehab checklist and supplementary manual
Authors: Signal Nada , Gomes Emeline , Olsen Sharon , Alder Gemma
Published: November 2024

Background

Rehabilitation is a complex biopsychosocial process in which multidisciplinary professionals work in collaboration with a person and their family, with the shared objective of enhancing the person’s participation in valued life roles. Hence, rehabilitation is integral to the management of numerous health conditions. However, poor descriptions of rehabilitation interventions, including their essential elements and dosage parameters, pose a significant barrier to their replication in clinical practice. This further limits the synthesis of rehabilitation research and the consequent advancement of the field. The original Template for Intervention Description and Replication (TIDieR) checklist and guide provides a valuable foundation for reporting but is not specific to rehabilitation. The TIDieR-Rehab checklist, an extension of the original TIDieR, was developed to enhance the reporting of rehabilitation interventions.

Objective

This paper presents the TIDieR-Rehab checklist and supplementary manual.

Methods

In accordance with the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network and other relevant guidelines, the TIDieR-Rehab checklist and supplementary manual were developed through a modified Delphi process with individuals with rehabilitation expertise and was guided by an interdisciplinary Steering Committee.

Results

The TIDieR-Rehab checklist and supplementary manual present seven original, three adapted and 12 new items to enhance the reporting of rehabilitation interventions. New items promote full descriptions of critical aspects of rehabilitation interventions, including the intended study population(Who)and timing of the intervention(When), the planned intervention dosage(How much, How challenging and Regression/Progression), person-centred care(Personalisation)and negative undesired effects(Harms). Explanations and examples of good reporting, provided within the TIDieR-Rehab supplementary manual, provide comprehensive guidance to support users of the checklist.

Conclusions

The TIDieR-Rehab checklist and supplementary manual present a systematic approach to the comprehensive reporting of rehabilitation interventions. The checklist is intended to support replication, evaluation and optimisation of rehabilitation interventions through improved reporting quality.
Prevalence and influencing factors of sarcopenia among patients with knee osteoarthritis: a systematic review and meta-analysis protocol
Authors: Guo Yabin , Zhou Yang , Zeng Biyun
Published: November 2024

Introduction

Epidemiological literature indicates that sarcopenia (SA) is increasingly prevalent among patients with knee osteoarthritis (KOA). This study aims to provide the pooled prevalence of SA and identify determinant factors associated with SA among patients with KOA.

Methods and analysis

This systematic review follows Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) auxiliary writing checklist. A thorough literature review and systematic search will be performed using the electronic databases of PubMed, Web of Science, Embase, CNKI and WanFang, covering the period from the earliest records until 11 September 2024. Reference lists of the eligible studies will also be carried out. The search strategy will be based on two main concepts, namely ‘knee osteoarthritis’ and ‘sarcopenia’, taking the form of a combination of MeSH terms and entry terms to find literature. Two reviewers will independently evaluate each title and abstract. All observational studies documenting the prevalence of SA and/or associated factors in KOA will be included. The prevalence of SA will be subjected to a single-group meta-analysis using Stata 18.0 software. Pooled prevalence with a 95% CI will be calculated using random effects and quality-effects models. The pooled relative hazards will be calculated using a random-effects Meta-analysis. The main analysis results will include differences in the prevalence of SA in KOA patients by diagnostic criteria, course of KOA, disease status (eg, knee pain, disease duration), physical activity, diagnostic criteria and different geographical contexts. Secondary results may analyse subgroups such as gender and age, and further, a meta-regression analysis will be used to synthesise the factors influencing SA. Sensitivity analyses and heterogeneity between studies and evidence of publication bias will also be assessed.

Ethics and dissemination

This review will summarise the prevalence and influencing factors of SA in patients with KOA based on existing evidence. It is expected that the results will identify gaps in knowledge and areas for further research. The review will be submitted for publication in topic specific journals and disseminated to professional networks. Individual patient data are not included, so ethical approval is not required.

PROSPERO registration number

CRD42023490539.
Do generational diversity and perceived similarity improve team functioning in rural Chinese hospitals? A cross-sectional survey study
Authors: Wang Hujie , Buljac-Samardžić Martina , van Wijngaarden Jeroen , van de Klundert Joris
Published: November 2024

Objectives

Generational diversity, increasingly prominent in the composition of the healthcare workforce in rapidly developing countries, has received much attention in practice and research recently. While research has revealed various positive and negative impacts of generational diversity on team functioning, the understanding of the mechanism explaining how generational diversity influences team functioning is still limited. This study in rural Chinese hospitals examines the relationship between (surface-level) generational diversity and (deep-level) perceived similarity and investigates how they influence three teamwork behaviours that importantly determine quality of care, namely speaking up, silence and knowledge sharing.

Design

We adopted a quantitative research design and conducted an online survey to investigate the relationship among generational diversity, perceived similarity, speaking up, silence and knowledge sharing. Multilevel mediation modelling was used to test the hypotheses.

Setting

The study was conducted in four rural Chinese hospitals.

Participants

841 healthcare professionals, including doctors, nurses and other healthcare professionals, were included in the study.

Primary and secondary outcome measures

Generational diversity was measured by calculating the average of individuals’ Blau’s indices regarding all the generations for each team. Perceived similarity, speaking up, silence and knowledge sharing were measured by validated questionnaires from literature.

Results

Perceived similarity is positively related to the three teamwork behaviours, that is, speaking up (β=0.56, p<0.01), silence (β=0.39, p<0.01) and knowledge sharing (β=0.54, p<0.01), while generational diversity is not (speaking up: β=0.08, p>0.05; silence: β=0.44, p>0.05; knowledge sharing: β=0.09, p>0.05). As the relationship between generational diversity and perceived similarity is non-significant (β=0.07, p>0.05), perceived similarity does not mediate the relationship between generational diversity and teamwork behaviour.

Conclusion

The findings suggest that increases in generational diversity that result from healthcare workforce strengthening may not impact team behaviours and performance. However, if healthcare workforce strengthening would reduce the perceived similarity in teams, explicit management efforts to mitigate the negative impact on team behaviour and care provision are called for.
Are plain language summaries published in health journals written according to instructions and health literacy principles? A systematic environmental scan
Authors: Gainey Karen , Smith Jenna , McCaffery Kirsten , Clifford Sharon , Muscat Danielle
Published: November 2024

Background

Plain language summaries (PLSs) are easy-to-understand summaries of research articles that should follow principles of plain language and health literacy. PLS author instructions from health journals help guide authors on word count/PLS length, structure and the use of jargon. However, it is unclear whether published PLSs currently adhere to author instructions.

Objectives

This study aims to determine (1) the degree of compliance of published PLSs against the PLS author instructions in health journals and (2) the extent to which PLSs meet health literacy principles.

Study design

We conducted a three-part systematic environmental scan.

Methods

We examined 26 health journals identified from a previous review. In part 1, we assessed the inclusion frequency of PLSs in the 26 journals; in part 2, we assessed the level of compliance of PLSs with PLS author instructions; and in part 3, we conducted a health literacy assessment of the PLSs.

Results

Part 1: we found PLSs for 20/26 (76.9%) included journals. Part 2: no journal achieved 100% compliance with PLS author instructions. The highest level was 88% and the lowest was 0%. Part 3: no PLS was written at a readability level suitable for a general audience. The mean reading level was grade 15.8 (range 10.2–21.2and mean percentage of complex words, 31% (range 8.5%–49.8%).

Discussion

PLSs are an important means through which consumers can access research findings. We found a lack of compliance between PLS author instructions and PLSs published in health journals that may impede access and use by consumers. This study highlights the need for better ways to support authors adhere to PLS instructions and improved monitoring by journals.
Early discharge in health facilities following vaginal delivery and its associated factors among mothers in four African countries: a cross-sectional study
Authors: Tekeba Berhan , Dessie Melkamu Tilahun , Tamir Tadesse Tarik , Zegeye Alebachew Ferede
Published: November 2024

Objective

This study aimed to assess the prevalence of early discharge among women who gave vaginal delivery in health facilities.

Design

Cross-sectional study.

Setting

Four African countries.

Participants

A total weighted sample of 14 942 women who delivered vaginally in health facilities.

Methods

In this study, data were obtained from the recent Demographic and Health Survey data from four African countries. A total weighted sample of 14 942 women who delivered vaginally in a health facility was included. A multilevel mixed effect binary logistic regression model was fitted to identify significant factors associated with early discharge following health facility vaginal delivery. Statistical significance was determined using adjusted OR (odd ratio) with a 95% CI.

Results

The overall prevalence of early discharge following health facility vaginal delivery in four African countries was 30.91% (95% CI: 30.18% to 31.66%). Overall, first-born babies (AOR=0.7; 95% CI: 0.57 to 0.85), women with a high maternal body mass index (AOR=0.8; 95% CI: 0.71 to 0.89), women with multiple pregnancies (AOR=0.48; 95% CI: 0.31 to 0.74), women who reside in Burkina Faso (AOR=0.15; 95% CI: 0.12 to 0.18) and women who reside in Ghana (AOR=0.28; 95% CI: 0.24 to 0.33) had lower odds of early discharge following health facility vaginal delivery. On the other hand, women having no difficulty accessing health facilities (AOR=1.18; 95% CI: 1.05 to 1.33) and women delivering in private health facilities (AOR=1.46; 95% CI: 1.08 to 1.99) had higher odds of early discharge following health facility vaginal delivery.

Conclusion

Overall, in four African countries, a higher proportion of women who gave birth vaginally in health facilities were discharged home early without optimum immediate postpartum care. As a result, legislators, programmers and other stakeholders should make every effort to lessen the burden of early discharge, with a special focus on women who deliver in private health institutions.
Prevalence of treatment-resistant depression and associated factors among major depressive disorder follow-up patients at Saint Amanuel Mental Specialised Hospital in Ethiopia: a cross-sectional study
Authors: Siyoum Merga , Kibrom Esayas , Fanta Tolesa , Matheyose Eyerusalem , Adem Kemeriya , Bekele Deribe , Asfaw Henock , Darcho Samuel Demissie , Dereje Jerman
Published: November 2024

Objectives

This study aimed to assess the prevalence of treatment-resistant depression (TRD) and associated factors among patients with major depressive disorder (MDD) on follow-up at Amanuel Mental Specialised Hospital, Addis Ababa, Ethiopia, 2021.

Design and setting

An institution-based cross-sectional study design was employed using systematic random sampling techniques from 17 February to 26 March 2021.

Participants

The study enrolled 412 participants with a response rate of 97.6%. The study population consisted of Saint Amanuel Mental Specialised Hospital follow-up patients with MDDs and all adult patients aged above 18.

Main outcome measures

The main outcome of this study was TRD, which was measured using the Hospital Anxiety and Depression Scale-Depression (HADS-D). The collected data were entered into Epi-data software version 3.1 and exported to the statistical package for social science version 20 for analysis. Bivariate and multivariate logistic regression analyses were used to identify associated factors with TRD. The OR with a 95% CI was used to assess the strength of the association.

Results

The prevalence of TRD was 41.5% (95% CI: 37.2 to 46.1). Female sex [AOR=2.43, 95% CI: 1.57 to 3.75], comorbid psychosis [AOR=1.89, 95% CI: 1.19 to 2.99], comorbid medical illness [AOR=1.67, 95% CI: 1.09 to 2.55] and family history of mental illness [AOR=2.27, 95% CI: 1.38 to 3.74] were factors significantly associated with TRD.

Conclusion and recommendation

In this study, the prevalence of TRD among patients with MDDs on follow-up was high. Therefore, to improve outcomes, screening for TRD and creating specific diagnostic techniques are necessary. Additionally, preventive interventions against TRD must be established.
Impact of social determinants of health on rehabilitation service use and outcomes in adults in the USA: a scoping review protocol
Authors: Wickstrom Jordan , Leone Emma J , Sasson Noa , Morris Hailey C , Livinski Alicia A , Camarillo Nathan D , Lely Justine , Venkatarajan Rajpriya , Goldberg Julie , Asante-Otoo Afua , Rasch Elizabeth K
Published: November 2024

Introduction

Many Americans fail to receive equitable access to or positive outcomes from rehabilitation services. These disparities result from broader societal inequities that disproportionately affect certain groups of people due to non-medical factors such as race, gender, education and living status. This scoping review aims to describe research papers that examine social determinants of health (SDOH) that underlie disparities in access to, use of, or outcomes related to rehabilitation (in occupational therapy, physical therapy, recreational therapy, rehabilitation medicine/physiatry and speech-language pathology) among adults in the USA. Identifying SDOH-related factors that drive inequities in rehabilitation will inform the development of potential solutions to improve access, professional education and patient outcomes.

Methods and analysis

The Joanna Briggs Institute methodological framework will be used to conduct this scoping review. To meet the inclusion criteria, articles will need to be published in English since 2013, be classified as full-length original research, include at least 100 sampled adults, be conducted in the USA or its territories, and investigate SDOH-related disparities in rehabilitation. Search terms will include SDOH, rehabilitation and disparities. Five databases (Embase, PubMed, Scopus, Sociological Abstracts and Web of Science: Core Collection) will be searched for articles published in English between 2013 and 2023. Records from these databases as well as reference lists of included papers and review papers will be screened for eligibility. Two people will independently review each record during title and abstract screening and full-text screening, and three people will independently extract data. Screening and data extraction processes will be piloted. The results will be presented in tables, graphs and narrative summaries.

Ethics and dissemination

Findings will be disseminated through scientific conferences, professional networks, stakeholder meetings, invited workshops and webinars, email listservs of professional associations, academic social media and in a peer-reviewed journal. Ethics approval is not required as the review will only include previously published data.
Barriers and facilitators for strengthening primary health systems for person-centred multimorbid care in low-income and middle-income countries: a scoping review
Authors: Zezai David , van Rensburg André Janse , Babatunde Gbotemi Bukola , Kathree Tasneem , Cornick Ruth , Levitt Naomi , Fairall Lara R , Petersen Inge
Published: November 2024

Objective

To understand barriers and facilitators for strengthening health systems for person-centred care of people with multiple long-term conditions-multimorbidity (MLTC-M) at the primary healthcare (PHC) level in low-income and middle-income countries (LMICs).

Design

A scoping review.

Methods

We adopted a systematic scoping review approach to chart literature guided by Arksey and O'Malley’s methodological framework. The review focused on studies conducted in LMICs’ PHC settings from January 2010 to December 2023. Papers were extracted from the following databases: PubMed, EBSCOhost and Google Scholar. Framework analysis was undertaken to identify barriers and facilitators for strengthening MLTC-M primary care according to the five health system pillars in the Lancet Global Health Commission on High-Quality Health Systems Framework.

Results

The literature search yielded 4322 citations, evaluated 202 studies and identified 36 for inclusion. Key barriers within the people pillar included poverty, low health education and low health literacy; within the platform pillar, fragmented services and lack of multimorbid care guidelines were mentioned; within the workforce pillar, lack of required skills and insufficient health workers; and in the tools pillar: a shortage of essential medicines and adverse polypharmacy effects were prominent. A lack of political will and the absence of relevant national health policies were identified under the governance pillar. Facilitators within the people pillar included enhancing self-management support; within the platforms, pillar included integration of services; within the tools pillar, included embracing emerging technologies and information and communication technology services; and governance issues included upscaling interventions to respond to multimorbid care needs through enhanced political commitment and financial support.

Conclusions

Potential solutions to strengthening the healthcare system to be more responsive to people with MLTC-M include empowering service users to self-manage, developing multimorbid care guidelines, incorporating community health workers into multimorbid care efforts and advocating for integrated person-centred care services across sectors. The need for policies and procedures in LMICs to meet the person-centred care needs of people with MLTC-M was highlighted.
Testing the efficacy of WORK-ON: vocational rehabilitation for people with chronic inflammatory arthritis in Denmark—protocol for a randomised controlled trial
Authors: Madsen Christina Merete Tvede , Primdahl Jette , Christensen Jeanette Reffstrup
Published: November 2024

Introduction

Among people with chronic inflammatory arthritis (IA), up to 40% lose their job in the first few years after diagnosis of this condition and are hence at high risk of being permanently excluded from the labour market. Therefore, we developed a new context-specific vocational rehabilitation (VR) for people with IA. This 6 month VR (WORK-ON) includes the following: (1) an initial assessment and goal setting by a coordinating occupational therapist, who supports cooperation and coordination between relevant partners and navigation across primary and secondary care, (2) four group sessions with peers and (3) individual sessions with a social worker, nurse or physiotherapist. The objective of this trial is to test the overall efficacy of WORK-ON as an add-on to usual care and compare it with usual care provided to a control group.

Methods and analysis

A randomised controlled trial has been planned. Patients with IA, aged at least 18 years and experiencing job insecurity will be randomised to one of two groups: (1) the intervention group receiving WORK-ON VR as an add-on to usual care and (2) the control group receiving usual care. The primary outcome is the difference in work ability 12 months after baseline, which will be measured using the Work Ability Index single item. The key secondary outcome measures are absenteeism, presenteeism, overall work impairment, activity impairment and job loss measured at baseline and at 6, 12, 18 and 30 month follow-up. Secondary outcome measures are quality of life, mental well-being, fatigue, sleep, physical activity, occupational balance and pain, which will be measured at baseline and at 6 and 12 month follow-up.

Ethics and dissemination

The Regional Committees on Health Research Ethics in Southern Denmark waived the requirement for a formal approval (Journal number S-20232000-3). The participants will provide informed consent prior to participating in the trial.

Trial registration number

NCT06299917.