bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-production of an educational package for the universal human papillomavirus (HPV) vaccination programme tailored for schools with low uptake: a participatory study protocol
Authors: Fisher Harriet , Audrey Suzanne , Chantler Tracey , Finn Adam , Letley Louise , Mounier-Jack Sandra , Thomas Clare , Yates Julie , Hickman Matthew
Published: November 2020

Aim

To co-produce with young people an educational package about the human papillomavirus (HPV) vaccine that is tailored to increase vaccine uptake in schools and populations with lower uptake.

Introduction

Persistent infection with HPV can result in cancers affecting men and especially women. From September 2019, the English-schools-based HPV vaccination programme was expanded to include young men (in addition to young women) aged 12–13 years. Some young people attending schools with lower uptake of the vaccine have unmet information needs. We hypothesise that mechanisms to address information needs and increase young people’s autonomy in consent procedures will result in higher uptake.

Methods and analysis

The Medical Research Council’s framework for development and evaluation of complex interventions will inform intervention development. Recruitment of young people aged 12–15 years and key stakeholders (National Health Service commissioners, school staff, immunisation nurses and youth workers/practitioners) will be facilitated through existing links with healthcare organisations, schools and youth organisations in areas with lower uptake of the HPV vaccination programme. The proposed research will comprise three phases: (1) a rapid review of adolescent immunisation materials and preliminary qualitative interviews with young people and key stakeholders, (2) theory development and co-production of HPV vaccine communication materials through an iterative process with young people and (iii) testing delivery mechanisms and acceptability of the educational package in four schools with lower uptake.

Ethics and dissemination

The University of Bristol’s Faculty of Health Sciences and London School of Hygiene and Tropical Medicine's Research Ethics Committees provided approvals for the study. A dissemination event for young people and key stakeholders and webinar with the National Immunisation Network will be organised. The study findings will be published in peer-reviewed journals and presented at conferences. Recommendations for a future larger scale study will be made.
Retrospective cohort study of health service use for cardiovascular disease among adults with and without a record of injury hospital admission
Authors: Randall Sean M , Wood Fiona M , Fear Mark W , Boyd James , Rea Suzanne , Duke Janine M
Published: November 2020

Objective

To quantify postinjury cardiovascular-related health service use experienced by mid to older aged adults hospitalised for injury, compared with uninjured adults. Additionally, to explore the effect of beta-blocker medications on postinjury cardiovascular hospitalisations among injury patients, given the potential cardioprotective effects of beta blockers.

Design

A retrospective cohort study using linked administrative and survey data.

Participants

Records of 35 026 injured and 60 823 uninjured matched adults aged over 45 from New South Wales, Australia, who completed the 45 and up survey.

Primary and secondary outcome measures

Admission rates and cumulative lengths of stay for cardiovascular hospitalisations, and prescription rates for cardiovascular medications. Negative binomial and Cox proportional hazards regression modelling were used to generate incident rate ratios (IRRs) and HR.

Results

Compared with the uninjured, those with injury had a 19% higher adjusted rate of postinjury cardiovascular admissions (IRR 1.19, 95% CI 1.14 to 1.25), spent 40% longer in hospital for ardiovascular disease (IRR 1.40, 95% CI 1.26 to 1.57) and had slightly higher cardiovascular prescription rates (IRR 1.04, 95% CI 1.02 to 1.06), during study follow-up. Those in the injury cohort that used beta blockers both prior to and after injury (continuous) appeared to have reduced need for post-injury cardiovascular hospitalisation (IRR 1.09, 95% CI 1.17 to 1.42) compared with those commencing on beta blockers after injury (after 30 days: IRR 1.69, 95% CI 1.37 to 2.08).

Conclusions

Apparent increased postinjury hospitalisation rates and prolonged length of stay related to cardiovascular disease suggest that injury patients may require clinical support for an extended period after injury. Additionally, injury patients who were on continuous beta blocker treatment appeared to have lower need for post-injury cardiovascular hospitalisations. However, the data do not allow us to draw clear conclusions and further clinical research is required.
Modelling geographical accessibility to support disaster response and rehabilitation of a healthcare system: an impact analysis of Cyclones Idai and Kenneth in Mozambique
Authors: Hierink Fleur , Rodrigues Nelson , Muñiz Maria , Panciera Rocco , Ray Nicolas
Published: November 2020

Objectives

Modelling and assessing the loss of geographical accessibility is key to support disaster response and rehabilitation of the healthcare system. The aim of this study was therefore to estimate postdisaster travel times to functional health facilities and analyse losses in accessibility coverage after Cyclones Idai and Kenneth in Mozambique in 2019.

Setting

We modelled travel time of vulnerable population to the nearest functional health facility in two cyclone-affected regions in Mozambique. Modelling was done using AccessMod V.5.6.30, where roads, rivers, lakes, flood extent, topography and land cover datasets were overlaid with health facility coordinates and high-resolution population data to obtain accessibility coverage estimates under different travel scenarios.

Outcome measures

Travel time to functional health facilities and accessibility coverage estimates were used to identify spatial differences between predisaster and postdisaster geographical accessibility.

Results

We found that accessibility coverage decreased in the cyclone-affected districts, as a result of reduced travel speeds, barriers to movement, road constraints and non-functional health facilities. In Idai-affected districts, accessibility coverage decreased from 78.8% to 52.5%, implying that 136 941 children under 5 years of age were no longer able to reach the nearest facility within 2 hours travel time. In Kenneth-affected districts, accessibility coverage decreased from 82.2% to 71.5%, corresponding to 14 330 children under 5 years of age having to travel >2 hours to reach the nearest facility. Damage to transport networks and reduced travel speeds resulted in the most substantial accessibility coverage losses in both Idai-affected and Kenneth-affected districts.

Conclusions

Postdisaster accessibility modelling can increase our understanding of spatial differences in geographical access to care in the direct aftermath of a disaster and can inform targeting and prioritisation of limited resources. Our results reflect opportunities for integrating accessibility modelling in early disaster response, and to inform discussions on health system recovery, mitigation and preparedness.
Clinical communication in inflammatory bowel disease: a systematic literature review protocol
Authors: Karimi Neda , Moore Alison Rotha , Lukin Annabelle , Kanazaki Ria , Williams Astrid-Jane , Connor Susan
Published: November 2020

Introduction

Evidence regarding effective communication between clinicians and patients with inflammatory bowel disease (IBD) is limited. Studies that investigate clinical communication in IBD are much fewer in number than studies that investigate the perceptions of patients and clinicians about communication in clinical encounters. The current review aims to identify, organise and summarise systematically what is currently known about (1) the characteristics of interactions between clinicians who manage IBD and patients with IBD, and (2) how clinical discussion affects health outcomes in IBD.

Methods and analysis

Scopus, PubMed, Embase, Communication Abstracts, Health & Society, Linguistics and Language Behavior Abstracts and PsycINFO will be systematically searched for studies that investigate the characteristics of IBD clinical interactions during recorded consultations, from earliest available dates within each database to May 2020. A specifically developed quality assessment tool, grounded in linguistic theory, will be used to critically assess the evidence. In addition, a data extraction template will be developed and utilised to provide a description of the characteristics of IBD clinical communication as well as an estimation of its effect on health outcomes in a narrative synthesis.

Ethics and dissemination

Ethical review and approval is not required for this systematic review as no primary data will be collected. The results will be published in peer-reviewed journals and presented at academic conferences.

PROSPERO registration number

International Prospective Register of Systematic Reviews (PROSPERO) on 28 April 2020 (registration number: CRD42020169657).
Defining timeliness in care for patients with lung cancer: protocol for a scoping review
Authors: Ansar Adnan , Lewis Virginia , McDonald Christine Faye , Liu Chaojie , Rahman Aziz
Published: November 2020

Introduction

Cancer is the second leading cause of death worldwide, and lung cancer is the single leading cause of cancer mortality worldwide. Early diagnosis of lung cancer is the key to better prognosis and longer survival. While there are substantial literature reporting delays in cancer diagnosis, there is a lack of consensus in the definitions and terms used to describe ‘delay’ in the treatment pathway. The aim of this scoping review is to identify and critically synthesise the operational definitions and terminologies used to describe the timely initiation of care and consequent treatments over the care pathway for patients with lung cancer. This scoping review will also compare how timeliness was operationalised in Western and Asian countries.

Methods and analysis

The scoping review will use the methodology described by Arksey and O’Malley and endorsed by the Joanna Briggs Institute. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases will be searched. Grey literature sources and the reference lists of key studies will be used to identify additional relevant studies. The scoping review will include all studies, irrespective of study methodology and quality. Two reviewers will independently screen all titles and abstracts to identify eligible studies for inclusion. The full texts of identified studies will be further examined and charted using a data extraction form. A narrative synthesis will be performed to assess and categorise available definitions of timeliness.

Ethics and dissemination

Ethical approval is not needed as this scoping review will be reviewing already published articles. The results produced from this review will be submitted to a scientific peer-reviewed journal for publication and will be presented at scientific meetings.
Impact of SARS-CoV-2 (COVID-19) on pregnancy: a systematic review and meta-analysis protocol
Authors: Medeiros Kleyton Santos , Sarmento Ayane Cristine Alves , Martins Erico Silva , Costa Ana Paula Ferreira , Eleutério Jr José , Gonçalves Ana Katherine
Published: November 2020

Introduction

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been growing at an accelerating rate, and has become a public health emergency. Pregnant women and their fetuses are susceptible to viral infection, and outcomes in this population need to be investigated.

Methods and analysis

PubMed, Web of Science, Embase, CINAHAL, Latin American and Caribbean Health Sciences Literature, clinicaltrials.gov, SCOPUS, Google Scholar and Cochrane Central Controlled Trials Registry will be searched for observational studies (cohort and control cases) published from December 2019 to present. This systematic review and meta-analysis will include studies of pregnant women at any gestational stage diagnosed with COVID-19. The primary outcomes will be maternal and foetal morbidity and mortality. Three independent reviewers will select the studies and extract data from the original publications. The risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies. To evaluate the strength of evidence from the included data, we will use Grading of Recommendation Assessment, Development, and Evaluation method. Data synthesis will be performed using Review Manager software V.5.2.3. To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous.

Ethics and dissemination

This study will be a review of the published data, and thus it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.

PROSPERO registration number

PROSPERO 2020: CRD42020181519.
Impact of surgical margin status on the survival outcome after surgical resection of gastric cancer: a protocol for systematic review and meta-analysis
Authors: Jiang Zhiyuan , Cai Zhaolun , Yin Yuan , Shen Chaoyong , Huang Jinming , Yin Yiqiong , Zhang Bo
Published: November 2020

Introduction

Generally, complete resection with cancer cell negative (R0) margin has been accepted as the most effective treatment of gastric cancer and positive resection (R1/R2) margin has been associated with decreased survival to varied degrees. However, the independent impact of microscopical positive (R1) margin on long-term survival may be confounded. No meta-analysis has worked at the association between R1 margin and outcomes of gastric cancer and the available evidence are scant. Therefore, we plan to conduct a systematic review and meta-analysis to quantitatively explore the role of R1 margin on gastric (including oesophagogastric junction) cancer survival after curative intent resection.

Methods and analysis

The protocol was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. A systematic search of PubMed, Embase and the Cochrane Central Register of Controlled Trials databases will be performed from their inceptions to 30 April 2020 to identify randomised controlled trials (RCTs), cohort studies and case–control studies focusing on the impact of R1 margin on survival of gastric cancer after curative intent resection. The primary outcome will be the overall survival (OS) and disease-free survival (DFS) and the secondary outcomes will be 5-year OS rate and 5-year DFS rate. The Cochrane tool for bias assessment in randomised trials and Risk Of Bias In Non-randomised Studies-I for the assessment of bias in non-randomised studies (NRS) will be used. Statistical heterogeneity will be assessed by visual inspection of forest plots and measured using the I2 statistics. A fixed-effect model will be used when heterogeneity is low, otherwise, a random-effect model will be chosen. Publication bias will be assessed by funnel plots, subgroup analysis and sensitivity analysis will be performed in the right context. For each outcome, we will perform data synthesis separately for RCTs and NRS using Rev Man V.5.3 software and compile ‘summary of findings’ tables separately for RCTs and NRS using GRADEpro software. Grading of Recommendations, Assessment, Development and Evaluations considerations will also be used to make an overall assessment of the quality of evidence.

Ethics and dissemination

There is no requirement for ethics approval because no patient data will be collected at an individual level in this systematic review and meta-analysis.

The results of this systematic review will be published in a peer-reviewed journal and presented at relevant conferences, any deviations from the protocol will be clearly documented and explained in its final report.

PROSPERO registration number

CRD42020165110.
Tranexamic ACid during PancereaticoDuodenectomy (TAC-PD): study protocol for a multicentre randomised, blind, placebo-controlled trial
Authors: Ishii Kenta , Yokoyama Yukihiro , Yonekawa Yoshihiko , Ebata Tomoki
Published: November 2020

Introduction

Pancreaticoduodenectomy (PD) is a major gastroenterological surgery that results in a substantial amount of blood loss. Several studies have demonstrated that major blood loss during PD is associated with both short-term and long-term poor outcomes. Administration of perioperative tranexamic acid (TXA) has been reported to reduce intraoperative blood loss in various surgeries, including cardiovascular surgery and orthopaedic surgery. Nevertheless, the effect of perioperative TXA use in patients undergoing PD has not been investigated. This study aims to investigate the effect of TXA on blood loss during PD.

Methods and analysis

A multicentre (six hospitals), randomised, blind (patient-blinded, surgeon-blinded, anaesthesiologist-blinded, monitor-blinded), placebo-controlled trial of TXA during PD was started in September 2019. Patients undergoing PD for biliary, duodenal or pancreatic diseases are randomly assigned to the TXA or placebo group. The stratification factors are the institutions and preoperative clinical diagnosis. Before skin incision, the participants in TXA group are administrated 1 g TXA as a loading infusion followed by a maintenance infusion of 125 mg/hour TXA until the end of surgery or 8 hours from the incision. Participants in the placebo group are administrated the same volume of saline that is indistinguishable from the TXA. The primary outcome is blood loss during PD. The secondary outcomes are intraoperative and postoperative (up to day 2) blood transfusions, operation time, anaesthesia time, postoperative laboratory variables, length of hospital stay, in-hospital and 90-day mortality and postoperative complications occurring within 28 days of surgery or requiring readmission. To date, 115 patients of a planned 220 have been enrolled in the study.

Ethics and dissemination

This protocol was approved by the Nagoya University Clinical Research Review Board and is registered with Japan Registry of Clinical Trials on 15 August 2019. The results of this trial will be disseminated through peer-reviewed journals.

Trial registration number

jRCTs041190062.
Accuracy of signs, symptoms and blood tests for diagnosing acute bacterial rhinosinusitis and CT-confirmed acute rhinosinusitis in adults: protocol of an individual patient data meta-analysis
Authors: Venekamp Roderick , Hansen Jens Georg , Reitsma Johannes B , Ebell Mark H , Lindbaek Morten
Published: November 2020

Introduction

This protocol outlines a diagnostic individual patient data (IPD) meta-analysis aimed at developing simple prediction models based on readily available signs, symptoms and blood tests to accurately predict acute bacterial rhinosinusitis and CT-confirmed (fluid level or total opacification in any sinus) acute rhinosinusitis (ARS) in adults presenting to primary care with clinically diagnosed ARS, target conditions associated with antibiotic benefit.

Methods and analysis

The systematic searches of PubMed and Embase of a review on the accuracy of signs and symptoms for diagnosing ARS in ambulatory care will be updated to April 2020 to identify relevant studies. Authors of eligible studies will be contacted and invited to provide IPD. Methodological quality of the studies will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Candidate predictor selection will be based on knowledge from existing literature, clinical reasoning and availability. Multivariable logistic regression analyses will be used to develop prediction models aimed at calculating absolute risk estimates. Large unexplained between-study heterogeneity in predictive accuracy of the models will be explored and may lead to either model adjustment or derivation of separate context-specific models. Calibration and discrimination will be evaluated to assess the models’ performance. Bootstrap resampling techniques will be used to assess internal validation and to inform on possible adjustment for overfitting. In addition, we aim to perform internal–external cross-validation procedures.

Ethics and dissemination

In this IPD meta-analysis, no identifiable patient data will be used. As such, the Medical Research Involving Humans Subject Act does not apply, and official ethical approval is not required. Findings will be published in international peer-reviewed journals and presented at scientific conferences.

PROSPERO registration number

PROSPERO CRD42020175659.
Acute hypoxaemic respiratory failure in a low-income country: a prospective observational study of hospital prevalence and mortality
Authors: Kwizera Arthur , Nakibuuka Jane , Nakiyingi Lydia , Sendagire Cornelius , Tumukunde Janat , Katabira Catherine , Ssenyonga Ronald , Kiwanuka Noah , Kateete David Patrick , Joloba Moses , Kabatoro Daphne , Atwine Diana , Summers Charlotte
Published: November 2020

Introduction

Limited data exist on the epidemiology of acute hypoxaemic respiratory failure (AHRF) in low-income countries (LICs). We sought to determine the prevalence of AHRF in critically ill adult patients admitted to a Ugandan tertiary referral hospital; determine clinical and treatment characteristics as well as assess factors associated with mortality.

Materials and methods

We conducted a prospective observational study at the Mulago National Referral and Teaching Hospital in Uganda. Critically ill adults who were hospitalised at the emergency department and met the criteria for AHRF (acute shortness of breath for less than a week) were enrolled and followed up for 90 days. Multivariable analyses were conducted to determine the risk factors for death.

Results

A total of 7300 patients was screened. Of these, 327 (4.5%) presented with AHRF. The majority (60 %) was male and the median age was 38 years (IQR 27–52). The mean plethysmographic oxygen saturation (SpO2) was 77.6% (SD 12.7); mean SpO2/FiO2ratio 194 (SD 32) and the mean Lung Injury Prediction Score (LIPS) 6.7 (SD 0.8). Pneumonia (80%) was the most common diagnosis. Only 6% of the patients received mechanical ventilatory support. In-hospital mortality was 77% with an average length of hospital stay of 9.2 days (SD 7). At 90 days after enrolment, the mortality increased to 85%. Factors associated with mortality were severity of hypoxaemia (risk ratio (RR) 1.29 (95% CI 1.15 to 1.54), p=0.01); a high LIPS (RR 1.79 (95% CI 1.79 1.14 to 2.83), p=0.01); thrombocytopenia (RR 1.23 (95% CI 1.11 to 1.38), p=0.01); anaemia (RR 1.15 (95% CI 1.01 to 1.31), p=0.03) ; HIV co-infection (RR 0.84 (95% CI 0.72 to 0.97), p=0.019) and male gender (RR 1.15 (95% CI 1.01 to 1.31) p=0.04).

Conclusions

The prevalence of AHRF among emergency department patients in a tertiary hospital in an LIC was low but was associated with very high mortality. Pneumonia was the most common cause of AHRF. Mortality was associated with higher severity of hypoxaemia, high LIPS, anaemia, HIV co-infection, thrombocytopenia and being male.
State-of-the-art review: preventing child and youth pedestrian motor vehicle collisions: critical issues and future directions
Authors: Cloutier Marie-Soleil , Beaulieu Emilie , Fridman Liraz , Macpherson Alison K , Hagel Brent E , Howard Andrew William , Churchill Tony , Fuselli Pamela , Macarthur Colin , Rothman Linda
Published: November 2020

Aim

To undertake a comprehensive review of the best available evidence related to risk factors for child pedestrian motor vehicle collision (PMVC), as well as identification of established and emerging prevention strategies.

Methods

Articles on risk factors were identified through a search of English language publications listed in Medline, Embase, Transport, SafetyLit, Web of Science, CINHAL, Scopus and PsycINFO within the last 30 years (~1989 onwards).

Results

This state-of-the-art review uses the road safety Safe System approach as a new lens to examine three risk factor domains affecting child pedestrian safety (built environment, drivers and vehicles) and four cross-cutting critical issues (reliable collision and exposure data, evaluation of interventions, evidence-based policy and intersectoral collaboration).

Conclusions

Research conducted over the past 30 years has reported extensively on child PMVC risk factors. The challenge facing us now is how to move these findings into action and intervene to reduce the child PMVC injury and fatality rates worldwide.
Gender-based violence and its association with mental health among Somali women in a Kenyan refugee camp: a latent class analysis
Authors: Hossain Mazeda , Pearson Rachel Jane , McAlpine Alys , Bacchus Loraine J , Spangaro Jo , Muthuri Stella , Muuo Sheru , Franchi Giorgia , Hess Tim , Bangha Martin , Izugbara Chimaraoke
Published: November 2020

Background

In conflict-affected settings, women and girls are vulnerable to gender-based violence (GBV). GBV is associated with poor long-term mental health such as anxiety, depression and post-traumatic stress disorder (PTSD). Understanding the interaction between current violence and past conflict-related violence with ongoing mental health is essential for improving mental health service provision in refugee camps.

Methods

Using data collected from 209 women attending GBV case management centres in the Dadaab refugee camps, Kenya, we grouped women by recent experience of GBV using latent class analysis and modelled the relationship between the groups and symptomatic scores for anxiety, depression and PTSD using linear regression.

Results

Women with past-year experience of intimate partner violence alone may have a higher risk of depression than women with past-year experience of non-partner violence alone (Coef. 1.68, 95% CI 0.25 to 3.11). Conflict-related violence was an important risk factor for poor mental health among women who accessed GBV services, despite time since occurrence (average time in camp was 11.5 years) and even for those with a past-year experience of GBV (Anxiety: 3.48, 1.85–5.10; Depression: 2.26, 0.51–4.02; PTSD: 6.83, 4.21–9.44).

Conclusion

Refugee women who experienced past-year intimate partner violence or conflict-related violence may be at increased risk of depression, anxiety or PTSD. Service providers should be aware that compared to the general refugee population, women who have experienced violence may require additional psychological support and recognise the enduring impact of violence that occurred before, during and after periods of conflict and tailor outreach and treatment services accordingly.
Incidentally Detected Acromegaly: Single-Center Study of Surgically Treated Patients over 22 Years
Authors: Giraldi Erica Alexandra , Veledar Emir , Oyesiku Nelson M , Ioachimescu Adriana G
Published: November 2020

Acromegaly is a rare disease associated with comorbidities that are common in the general population. Most patients undergo screening for classic phenotypical (CP) or mass effect manifestations. By retrospective review of pituitary tumor surgeries performed between 1994 and 2016 (1836), we identified patients with acromegaly (112). Main presentations were: CP (43%), mass effect (26%), incidentally detected (ID) tumors (17%), and other (14%). We compared the ID and CP groups regarding prevalence, clinical, biochemical, radiological and histopathological characteristics, and postoperative outcomes. The prevalence of ID among all surgeries increased after 2011 from 0.6% to 1.9% (p=0.01), while prevalence of CP remained stable (2.8% and 2.33%, p=0.65). Almost half of ID (47.4%) presented with otolaryngological manifestations. The ID and CP groups were similar regarding age, gender, comorbidities (hypertension, diabetes, hypopituitarism), tumor diameter and cavernous sinus invasion. Median insulin-like growth factor (IGF-1) and growth hormone (GH) levels were lower in the ID than CP (p<0.05 and p=0.07). Patients younger than 40 had smaller tumors in the ID than CP, while the opposite was true for older patients. The 3-month biochemical remission rates were similar (68% ID and 58% CP). A similar number of patients had normal IGF-1 at last follow-up (89.5% ID and 81.25% CP) after surgery alone and multimodality treatment. In conclusion, an increased number of patients with GH-secreting adenomas were ID in recent years. Education of physicians other than endocrinologists regarding presentation and comorbidity clustering may lead to an earlier diagnosis of acromegaly and improved outcomes.
Prescribing meaning: hedonistic perspectives on the therapeutic use of psychedelic-assisted meaning enhancement
Authors: Miceli McMillan Riccardo
Published: November 2020

The recent renaissance in research on psychedelic-assisted psychotherapy is showing great promise for the treatment of many psychiatric conditions. Interestingly, therapeutic outcomes for patients undergoing these treatments are predicted by the occurrence of a mystical experience—an experience characterised in part by a sense of profound meaning. This has led to hypotheses that psychedelic-assisted psychotherapy is therapeutic because it enhances perception of meaning, and consequently leads to a meaning response (a therapeutic mechanism that has been well described in the philosophical literature on the placebo effect). The putative mechanism of action of psychedelics as meaning enhancers raises normative ethical questions as to whether it can be justified to pharmacologically increase the perception of meaning in order to heal patients. Using the perspectives of hedonistic moral theories, this paper argues that if psychedelics operate as meaning enhancers, psychedelic-assisted psychotherapy can be ethically justified. An anti-hedonistic objection is presented by applying Robert Nozick’s Experience Machine thought experiment to the case of psychedelic-assisted psychotherapy. However, it is argued that this objection falls short for two reasons. First, even if pleasure and pain are not the only consequences which have moral value they are not morally irrelevant, therefore, therapeutic meaning enhancement can still be justified in cases of extreme suffering. Second, it is possible that psychedelic states of consciousness do not represent a false reality, hence their therapeutic meaning enhancement is not problematic according to Nozick’s standards.
Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2score
Authors: Shah Shreyansh , Liang Li , Bhandary Durgesh , Johansson Saga , Smith Eric E , Bhatt Deepak L , Fonarow Gregg C , Khan Naeem D , Peterson Eric , Bettger Janet Prvu
Published: November 2020

Background

Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack (TIA) and role of ABCD2score in identifying high-risk individuals are not studied.

Methods

We identified 40 825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines (GWTG)-Stroke hospital and classified them using ABCD2score. Proportional hazards models were used to assess 1-year event rates of mortality and rehospitalisation (all-cause, ischaemic stroke, haemorrhagic stroke, myocardial infarction, and gastrointestinal and intracranial haemorrhage) for high-risk versus low-risk groups adjusted for patient and hospital characteristics.

Results

Of the 40 825 patients, 35 118 (86%) were high risk (ABCD2≥4) and 5707 (14%) were low risk (ABCD2=0–3). Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%, 44.3% were rehospitalised for any reason and 3.6% were readmitted due to stroke. Patients with ABCD2score ≥4 had higher mortality at 1 year than not (adjusted HR 1.18, 95% CI 1.07 to 1.30). Adjusted risks for ischaemic stroke, all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD2score ≥4 vs 0–3. In contrast, haemorrhagic stroke, myocardial infarction, gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD2score.

Conclusions

This study validates the use of ABCD2score for long-term risk assessment after TIA in patients aged 65 years and older. Attentive efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.
Universal p-form black holes in generalized theories of gravity
Authors: Hervik Sigbjørn , Ortaggio Marcello
Published: November 2020

We explore how far one can go in constructing d-dimensional static black holes coupled to p-form and scalar fields before actually specifying the gravity and electrodynamics theory one wants to solve. At the same time, we study to what extent one can enlarge the space of black hole solutions by allowing for horizon geometries more general than spaces of constant curvature. We prove that a generalized Schwarzschild-like ansatz with an arbitrary isotropy-irreducible homogeneous base space (IHS) provides an answer to both questions, up to naturally adapting the gauge fields to the spacetime geometry. In particular, an IHS–Kähler base space enables one to construct magnetic and dyonic 2-form solutions in a large class of theories, including non-minimally couplings. We exemplify our results by constructing simple solutions to particular theories such as $$R^2$$

R
2

, Gauss–Bonnet and (a sector of) Einstein–Horndeski gravity coupled to certain p-form and conformally invariant electrodynamics.
Discussions about the landscape of possibilities for treatments of cosmic inflation involving continuous spontaneous localization models
Authors: Bengochea Gabriel R. , León Gabriel , Pearle Philip , Sudarsky Daniel
Published: November 2020

In this work we consider a wide variety of alternatives opened when applying the continuous spontaneous localization (CSL) dynamical collapse theory to the inflationary era. The definitive resolution of many of the issues discussed here will have to await, not only for a general relativistic CSL theory, but for a fully workable theory of quantum gravity. Our concern here is to explore these issues, and to warn against premature conclusions. This exploration includes: two different approaches to deal with quantum field theory and gravitation, the identification of the collapse-generating operator and the general nature and values of the parameters of the CSL theory. All the choices connected with these issues have the potential to dramatically alter the conclusions one can draw. We also argue that the incompatibilities found in a recent paper, between the CSL parameter values and the cosmic microwave background observational data, are associated with specific choices made for the extrapolation to the cosmological context of the CSL theory (as it is known to work in non-relativistic laboratory situations) which do not represent the most natural ones.
Massive scalar perturbations on Myers-Perry–de Sitter black holes with a single rotation
Authors: Ponglertsakul Supakchai , Gwak Bogeun
Published: November 2020

This study investigates the stability of higher-dimensional singly rotating Myers-Perry–de Sitter (MP–dS) black holes against scalar field perturbations. The phase spaces of MP-dS black holes with one spin parameter are discussed. Additionally, the quasinormal modes (QNMs) of MP-dS black holes are calculated via the asymptotic iteration method and sixth-order Wentzel–Kramers–Brillouin approximation. For near-extremal MP-dS black holes, the event horizon may be considerably close to the cosmological horizon. In such cases, the Pöschl–Teller technique yields an accurate analytic formula for the QNMs. It is found that when the spin parameter of a black hole increases, the scalar perturbation modes oscillate at higher frequencies and decay faster. Furthermore, the MP-dS black hole with a single rotation is found to be stable under perturbation.
THE IMPACT OF INSTITUTIONAL QUALITY ON MONETARY POLICY RESPONSE FUNCTION: EVIDENCE FROM DEVELOPED AND DEVELOPING ECONOMIES
Authors: KAKAR AIMAL KHAN , YOUNAS MUHAMMAD ZEESHAN , MALIK WASIM SHAHID
Published: November 2020

There is a plethora of empirical evidence available which postulates that the central banks across the world respond asymmetrically to inflation. The response of monetary authorities toward inflation changes, when it reaches a threshold level. After estimating the nonlinear Taylor rule for 51 countries over the period of 1983–2015, including 28 advanced economies and 23 emerging and developing economies, we come to the conclusion that the quality of political institutions has a significant impact on the threshold level of the inflation rate. In contrast to the countries with weak institutional quality, countries with high institutional quality have a very low level of inflation rate where monetary authorities change their behavior. Our finding further reveals that the countries with low corruption, stable governments, efficient bureaucracy and good socio-economic conditions have a very low level of inflation rate. Central banks respond aggressively in these countries when inflation exceeds a threshold level inflation rate. The socio-economic condition index has a greater impact on the inflation threshold level as compared to other sub-indexes of institutional quality. The findings imply that the improvement in institutional quality enables the central banks to keep inflation at a low level.
INFLUENCE OF THE SUBSTRATE TEMPERATURE ON TiO2 THIN LAYERS DEPOSITED BY THE DIRECT CURRENT MAGNETRON SPUTTERING TECHNOLOGY
Authors: GRAINE RADOUANE , BEDOUD KHOULOUD , SEHAB NADJETTE , ZELMATI DJAMEL
Published: November 2020

In this study, Anatase thin films of titanium dioxide (TiO[Formula: see text] are deposited by the Direct Current (DC) magnetron sputtering technique on glass substrate for future application in gas sensors. In our work, we focused and discussed the effect of various substrate temperatures [Formula: see text]C, [Formula: see text]C and [Formula: see text]C, and film thicknesses 142, 220 and 410[Formula: see text]nm, respectively, in order to study the structural and optical properties of the TiO2 thin films. The crystalline structure and optical properties of TiO2 nanoparticles were investigated using X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Energy-Dispersive X-ray Spectroscopy (EDS), Atomic Force Microscopy (AFM), Raman spectroscopy and UV–visible spectroscopy. The formation of the Anatase TiO2 with Tetragonal crystal structure has been confirmed with XRD. UV–visible spectrophotometry characterization of the developed thin films showed that all the films had an optical transmission greater than 92% in the visible region. In addition, the obtained direct and indirect optical band gaps using the Tauc plot are 3.66, 3.34[Formula: see text]eV at [Formula: see text]C 3.74, 3.37[Formula: see text]eV at [Formula: see text]C and 3.71, 3.37[Formula: see text]eV at [Formula: see text]C, respectively. Forouhi–Bloomer (FB) physical model has been used to obtain the refractive index and extinction coefficient by fitting theoretical transmittance curves to experimental ones. The optical refractive index is found to vary from 2.350 for [Formula: see text]C, 2.1499 for [Formula: see text]C and 2.1420 for [Formula: see text]C. Moreover, we have obtained an extinction coefficient [Formula: see text] ([Formula: see text] of around [Formula: see text] for both substrate temperatures [Formula: see text]C and [Formula: see text]C, and around [Formula: see text] for the [Formula: see text]C.
A survey on agent learning architecture that adopts internet of things and wireless sensor networks
Authors: Joshva Devadas T.
Published: November 2020

Trustworthy and reliable applications built using intelligent software agents aim to provide improved performance using its characteristics. Agents introduced in various architectures represent its functionality as functional elements of the architecture and shows the interaction between other components present in the architecture. The Internet of things (IoT) reveals as a frequent technology that allows accessing the physical objects present in the world. IoT systems utilize wireless sensor network to transmit and receive data by establishing communication. Wireless Sensor Networks transmits digital signals to the cyber-world for analyzing and processing the information into useful data by either formulating or communicating with the intelligent and innovative system. While talking about IoT and WSN, agents introduced in such environments assist in making decisions quickly by perceiving the input from the environment. The number of agents needed for an application depends upon the complexity of the problem. Multi-Agent architectures discussed in the article describe their association, roles, functionality and interaction. This paper gives a detailed survey of various agent/multi-agent learning architectures introduced over IoT and WSN. Moreover, this survey with the performance and the SWOT analysis on the Agent-based learning architecture helps the reader and paves a way to pursue research on Agent-based architectural deployment over IoT and WSN paradigms.
A Powerful Transmission Line Model for Analysis of Impedance of Insertion Battery Cells: A Case Study on the NMC-Li System
Authors: Moškon Jože , Žuntar Jan , Drvarič Talian Sara , Dominko Robert , Gaberšček Miran
Published: November 2020

Transmission line modeling (TLM) has become an important approach for analysis of measured impedance spectra of battery cells. Still, the existing models lack some important features which prevents a full and accurate analysis of measured spectra. Here we present a general physics-based TLM that contains all the processes known from treatments of transport/reaction schemes based on the Newman porous electrode model or the corresponding Poisson-Nernst-Planck framework. Compared to previous TLMs, the present model additionally takes into account the movement of non-active mobile ions in all phases. After detailed description of the individual TLM model elements and their physical background we show, step-by-step, how it can be used to interpret the measured response of NMC cathodes, lithium anodes and full NMC-Li cells. Many details are considered the origin of which is identified by performing carefully designed additional experiments, e.g. electrolytes with variable concentration of salt. Besides identifying all the meaningful impedance features of electrodes and full cells, we also show how various materials parameters such as transport number, diffusion coefficient, conductivity etc can be calculated for various phases appearing in a porous battery electrode system. Finally, we use the findings to analyze the development of impedance response during discharge of a NMC-Li cell.
CrN/Cr-Coated Steel Plates for High-Temperature Polymer Electrolyte Fuel Cells: Performance and Durability
Authors: Li Ruiyu , Cai Yun , Reimer Uwe , Wippermann Klaus , Shao Zhigang , Lehnert Werner
Published: November 2020

This paper investigates the general performance and durability performance of a high-temperature polymer electrolyte fuel cell (HT-PEFC) with CrN/Cr-coated SS316L as bipolar plates and compares this with the bare SS316L and graphite bipolar plates. Polarization curves are conducted every 200 h during the 1000 h durability tests for evaluating the overall performances of the HT-PEFCs with different types of bipolar plates. An electrochemical model based on polarization curves, combined with electrochemical impedance spectroscopy (EIS) and scanning electron microscopy (SEM), is used for understanding the degradation mechanisms at play. The CrN/Cr-coated SS316L bipolar plates show excellent corrosion resistance and performance in a real HT-PEFC. Thereby, the degradation rate decrease from ca. 16% of the highest output power with the bare metallic bipolar plates and graphite bipolar plates to almost zero with the CrN/Cr-coated steel bipolar plate.
Performance of Perovskite-Type Oxides for Oxygen Reduction Reaction in Direct Hydrazine Fuel Cell
Authors: Nagai Tsukasa , Kojima Toshikatsu , Takeichi Nobuhiko , Asahi Masafumi , Yamazaki Shin-ichi , Siroma Zyun , Fujiwara Naoko , Ioroi Tsutomu
Published: November 2020

Perovskite-type oxide-based La0.6Sr0.4Mn(1-x)Co
x
O3/carbon (x = 0, 0.1, 0.2, 0.3, 1) catalysts were prepared by calcination of a mixture of metal nitrates and PVP at 600 °C, followed by milling of the calcined powder with a carbon support. The catalytic activities for the oxygen reduction reaction (ORR) were tested in alkaline electrolyte by using a rotating ring-disk electrode (RRDE) at 25 °C. With an increase in the doping amount of Co, the onset potential of the La0.6Sr0.4Mn(1-x)Co
x
O3/carbon catalyst was found to be shifted in a positive direction and the ring current during ORR decreased. Especially, the La0.6Sr0.4Mn0.7Co0.3O3/carbon (x = 0.3) catalyst showed the highest ORR activity among the prepared catalysts. The La0.6Sr0.4Mn0.7Co0.3O3/carbon was tested as the cathode of an alkaline membrane-type direct hydrazine fuel cell (DHFC), and a maximum power density of 133 mW cm−2, which exceeded that for the MEA using Pt/C (73.4 mW cm−2), was obtained at 50 °C. In addition, the open circuit voltage (OCV) for the DHFC (0.846 V) was greater than that of a commercial Pt/C cathode (0.788 V). Thus, the perovskite-type La0.6Sr0.4Mn0.7Co0.3O3 catalyst is expected to be a good candidate for use as a catalytic material for a DHFC cathode as an alternative to Pt.
Forces, Fluxes, and Fuels: Tracking mitochondrial metabolism by integrating measurements of membrane potential, respiration, and metabolites
Authors: Jones Anthony E. , Sheng Li , Acevedo Aracely , Veliova Michaela , Shirihai Orian S. , Stiles Linsey , Divakaruni Ajit S
Published: November 2020

Assessing mitochondrial function in cell-based systems is a central component of metabolism research. However, the selection of an initial measurement technique may be complicated given the range of parameters that can be studied as well as the need to define the mitochondrial (dys)function of interest. This methods-focused review compares and contrasts the use of mitochondrial membrane potential measurements, plate-based respirometry, and metabolomics and stable isotope tracing. We demonstrate how measurements of (i) cellular substrate preference, (ii) respiratory chain activity, (iii) cell activation, and (iv) mitochondrial biogenesis are enriched by integrating information from multiple methods. This manuscript is meant to serve as a perspective to help choose which technique might be an appropriate initial method to answer a given question, as well as provide a broad 'roadmap' for designing follow-up assays to enrich datasets or resolve ambiguous results.
Water intake accelerates ATP release from myofibroblast cells in rats: ATP-mediated podoplanin-dependent control for physiological function and immunity
Authors: Hayashi Moyuru , Watanabe-Asaka Tomomi , Nagashio Sachiho , Kaidoh Maki , Yokoyama Yumiko , Maejima Daisuke , Kajihara Ryo , Amari Kei , Arai Nariaki , Kawai Yoshiko , Ohhashi Toshio
Published: November 2020

We investigated effects of shear stress stimulation on cultured myofibroblast cells and water intake on podoplanin and IL-22 expressions in rat jejunal villi. The stimulation induced ATP release from the cells. Water intake accelerated podoplanin and IL-22 expression levels. ATP increased IL-22 mRNA expression in innate lymphoid cells (ILC)-3. Hence, water intake maintains higher osmotic pressure in the jejunal villi through ATP release and podoplanin upregulation. Water intake may regulate the mucosal immunity.