bluuebunny/crossref_metadata_2025 huggingface dataset:
Cohort profile: the Spanish Early-onset Colorectal Cancer (SECOC) cohort: a multicentre cohort study on the molecular basis of colorectal cancer among young individuals in Spain
Authors: Perea Jose , Marti Marc , Espin Eloy , Hernandez-Villafranca Sergio , Orihuela Pilar , Vidal Tocino Rosario , Alcazar Jose Antonio , Vivas Alfredo , Narvaez Cristina , Prieto Isabel , Asensio Luis , López Rojo Irene , Encinas Garcia Sara , Hurtado Elena , Jiménez Luis M , Jiménez Fernando , Cavero Adriana , Alvaro Edurne , Fuenmayor Maria Luisa , Jiménez Toscano Marta , Iglesias Comas Mar , Balaguer Francesc , Daca Maria , Ballestero Araceli , Die Trill Javier , Sanz Gonzalo , Sanz López Rodrigo , Melone Sirio , Rueda Jose A , Brandariz Lorena , Valverde Ignacio , Arredondo Jorge , Pastor Carlos , Garcia-Olmo Damian , Malats Nuria , Urioste Miguel , Gonzalez-Sarmiento Rogelio , Spinelli Antonino , Holowatyj Andreana N
Published: December 2021

Purpose

The Spanish Early-onset Colorectal Cancer (SECOC) study is a multicentre prospective cohort established in Spain to investigate the molecular basis of early-onset colorectal cancer (EOCRC), including metabolic alterations.

Participants

220 patients with EOCRC have been enrolled since January 2019 through 18 centres across Spain. Individual-level data were collected by questionnaire, including lifestyle and other colorectal cancer-related factors. Medical record review was performed to capture clinical, histopathological and familial cancer history data. Biospecimen collection (blood, stool, tissue) at diagnosis and at various time points across treatment, as applicable, is also completed.

Findings to date

Participants had a median age of 44 years (range 14–49), and the majority are men (60%), with individuals age 40–49 years at EOCRC diagnosis being over-represented. Forty-three per cent of participants were diagnosed with a tumour in the rectosigmoid junction/rectum. Nearly two-thirds of EOCRC cases (64%) were diagnosed with advanced stage (III–IV) disease, and 28% of cases had no reported familial history of cancer.

Future plans

We are actively recruiting and observing participants; we plan to administer follow-up questionnaires and perform additional biospecimen collection. This prospective cohort offers a unique, rich resource for research on EOCRC aetiologies and will contribute to larger international efforts to disentangle the rising disease burden.
Durham University students’ experiences of asymptomatic COVID-19 testing: a qualitative study
Authors: Jones Leah Ffion , Batteux Eleonore , Bonfield Stefanie , Bhogal Jaskiran Kaur , Taylor Jo , Caiado Camila , Ramagge Jacqui , Weston Dale
Published: December 2021

Objectives

To evaluate the asymptomatic coronavirus testing programme at Durham University by exploring students’ barriers and facilitators to taking part and provide recommendations to improve the programme.

Design

Qualitative interviews.

Setting

Online.

Participants

30 students enrolled at Durham University were interviewed in March 2021.

Main outcome measures

Attitudes towards testing, experiences of testing and barriers and facilitators to engaging in testing at Durham University.

Results

Key motivations for testing included protecting oneself and others and accessing facilities and events. The process of booking, accessing and doing a test was mostly easy and convenient, although some may prefer home testing. There were concerns about the accuracy of tests and the implications of a positive result. Some highlighted they might be less likely to engage in testing if vaccinated. A negative test result provided confidence to engage in their daily activities, while encouraging some to socialise more.

Conclusions

The findings show that the testing programme at Durham University is convenient and well organised, with testing as a potential requirement to access social events, and self-isolation support being key contributor to uptake. These findings provide insights into young adults’ attitudes towards testing and can inform testing programmes in other universities and settings with asymptomatic testing programmes.
Disparities in HIV/STI burden and care coverage among men and transgender persons who have sex with men in Nairobi, Kenya: a cross-sectional study
Authors: Smith Adrian D , Fearon Elizabeth , Kabuti Rhoda , Irungu Erastus , Kungu Mary , Babu Hellen , Nyabuto Chrispo , Muthoga Peter , Weatherburn Peter , Bourne Adam , Kimani Joshua
Published: December 2021

Objectives

The study aimed to estimate the prevalence of, and associations, with HIV and metrics of HIV care engagement in a representative population of gay, bisexual and other men who have sex with men (GBMSM) and transgender persons (TP) who have sex with men (GBMSM/TP)

Setting

Urban districts of Nairobi, Kenya.

Design

Cross-sectional.

Participants

608 eligible participants were identified through respondent-driven sampling over 19 waves of recruitment arising from ten seeds between May and December 2017. Inclusion criteria were: age >18 years; Nairobi residence; male sex assignment at birth or current identification as male, and recent consensual sex with male partners. Exclusion criteria were: missing or invalid recruitment coupon; repeat registration; intoxication at study visit.

Primary and secondary outcome measures

HIV status measured using Determine Alere HIV 1/2 and First Response HIV 1–2.0 and GeneXpert HIV-1 Qual. Self-reported metrics of HIV status awareness, antiretroviral use and objective quantification of viral suppression using GeneXpert HIV-1 VL.

Results

26.4% (286/618) were HIV positive of whom 76.6% were status aware, 65.3% were on antiretroviral therapy (ART), and 47.4% were virally suppressed (<50 copies/mL). Participants 18–22 years were less likely to be status aware, be receiving ART or to have achieved viral suppression. Mean log viral load was 3.14 log higher in 18–22 years compared with older participants. Bacterial sexually transmitted infections were common at both urethral and rectal sites and most infections were asymptomatic by self-report (rectal 82.2%, urethral 82.3%).

Conclusions

Engagement in the HIV diagnosis and care cascade among GBMSM/TP in Nairobi is markedly better than in most sub-Saharan African countries, yet falls short of achievements for the general population in Kenya and for GBMSM in high income settings. Young GBMSM/TP are least well served by the current configuration of adult key population services, and programmes should identify and address the sexual, social and developmental needs of adolescent and young key populations.
Facilitators and barriers to implement nurse-led physical activities for people with dementia in nursing homes: a protocol for a mixed-methods systematic review
Authors: Hirt Julian , Vetsch Janine , Heinrich Steffen
Published: December 2021

Introduction

Dementia is a major neurocognitive disorder and accounts for a great proportion of nursing home residents. Bodily symptoms such as gait, balance difficulties and muscle weakness are common in people with dementia. Physical activities are important to maintain and promote physical functioning and activities of daily living.

Nurses are a prone stakeholder to deliver physical activity interventions in nursing homes. However, several barriers have been reported for implementing nurse-led physical activity programmes. Also synthesised strategies for sustainable implementation in nursing homes are lacking. We, therefore, aim to synthesise the evidence on physical activity interventions which can be led by nurses and to identify facilitators and barriers of sustainable implementation of physical activity for people with dementia.

Methods and analysis

We will conduct a mixed-methods systematic review to (1) describe the characteristics of nurse-led physical activities for people with dementia living in nursing homes and to (2) determine facilitators and barriers for sustainable implementation of nurse-led physical activities for people with dementia in nursing homes. We will search four different electronic databases, do forward and backward citation tracking and will web-search additionally. We will also search through guideline databases. Two reviewers will independently screen the identified studies for their eligibility. Data extraction and critical appraisal of included studies will be performed by one reviewer and double-checked by another reviewer. We will analyse the data using an integrative mixed-method synthesis and we will summarise the findings narratively.

Ethics and dissemination

No ethics approval is needed to perform this systematic review. We will publish our review results as scientific and non-scientific journal articles and we will hold an oral or a poster conference presentation. The review results will inform the development of structured and easy to understand guidance for nurses to initiate tailored physical activities for people with dementia in nursing homes.
Heterogeneity in outcome assessment for inflammatory bowel disease in routine clinical practice: a mixed-methods study in a sample of English hospitals
Authors: Razanskaite Violeta , Kallis Constantinos , Young Bridget , Williamson Paula R , Bodger Keith
Published: December 2021

Objectives

Knowledge of the extent of variation in outcome assessment for inflammatory bowel disease (IBD) in routine practice is limited. We aimed to describe and quantify variation in outcome coverage and to explore patient, clinician and practitioner factors associated with it.

Design

Prospective exploratory mixed-methods study.

Setting

IBD clinics at six hospitals in North West England with differing electronic health record (EHR) systems.

Methods

Mixed-methods study comprising: (a) structured observations of outcomes elicited during consultations (102 patients consulting 24 clinicians); (b) retrospective analysis of outcomes recorded in the EHR (909 consultations; 127 clinicians) and (c) semistructured interviews with the 24 observed clinicians. We determined whether specific outcome ‘sets’ were elicited or recorded, including: (1) a minimum set of symptom pairs (‘PRO-2’); (2) symptom sets from disease activity indices and (3) a reference list of 37 symptoms, signs and impacts. Factors associated with variation were explored in univariate and multivariate binary logistic regression analyses and from clinician interviews.

Results

PRO-2 coverage was not invariable (elicited during 81% of observed consultations; recorded in 56% of EHR) and infrequent for complete activity indices (all domains from Harvey-Bradshaw Index: elicited, 18%; recorded, 5%). The median number of outcomes from the reference list elicited per consultation was 12 (13-fold variation) and recorded in EHR was 7 (>20-fold variation). Symptom quantification (PRO-2) seldom adhered closely to standardised descriptors and an explicit timeframe was defined rarely. PRO-2 recording in EHR was associated with a diagnosis of ulcerative colitis (OR: 2.09 (95% CI 1.15 to 3.80)) and nurse-led consultations (OR: 6.98 (95% CI 3.28 to 14.83)) and a three-way model suggested 26% of total variability lay between clinicians, 17% between patients but the remainder was unexplained. Most clinicians expressed preference for individualised health status evaluations versus standardised outcome assessments.

Conclusions

There was little evidence for standardised assessment and recording of IBD outcomes and substantial intra-clinician and inter-clinician variation from one consultation to another. Nurses demonstrated a greater tendency to standardised practice.
Healthcare workers’ perception of gender and work roles during the COVID-19 pandemic: a mixed-methods study
Authors: Mele Bria Scriven , Holroyd-Leduc Jayna M , Harasym Patricia , Dumanski Sandra M , Fiest Kirsten , Graham Ian D , Nerenberg Kara , Norris Colleen , Parsons Leigh Jeanna , Pilote Louise , Pruden Harlan , Raparelli Valeria , Rabi Doreen , Ruzycki Shannon M , Somayaji Ranjani , Stelfox Henry Thomas , Ahmed Sofia B
Published: December 2021

Objectives

A high functioning healthcare workforce is a key priority during the COVID-19 pandemic. We sought to determine how work and mental health for healthcare workers changed during the COVID-19 pandemic in a universal healthcare system, stratified by gender factors.

Design

A mixed-methods study was employed. Phase 1 was an anonymous, internet-based survey (7 May–15 July 2020). Phase 2 was semistructured interviews offered to all respondents upon survey completion to describe how experiences may have differed by gender identity, roles and relations.

Setting

National universal healthcare system (Canada).

Participants

2058 Canadian healthcare worker survey respondents (87% women, 11% men, 1% transgender or Two-Spirit), including 783 health professionals, 673 allied health professionals, 557 health support staff. Of the 63 unique healthcare worker types reported, registered nurses (11.5%), physicians (9.9%) and pharmacists (4.5%) were most common. Forty-six healthcare workers were interviewed.

Main outcome measures

Reported pandemic-induced changes to occupational leadership roles and responsibilities, household and caregiving responsibilities, and anxiety levels by gender identity.

Results

Men (19.8%) were more likely to hold pandemic leadership roles compared with women (13.4%). Women (57.5%) were more likely to report increased domestic responsibilities than men (45%). Women and those with dependents under the age of 10 years reported the greatest levels of anxiety during the pandemic. Interviews with healthcare workers further revealed a perceived imbalance in leadership opportunities based on gender identity, a lack of workplace supports disproportionately affecting women and an increase in domestic responsibilities influenced by gender roles.

Conclusions

The COVID-19 pandemic response has important gendered effects on the healthcare workforce. Healthcare workers are central to effective pandemic control, highlighting an urgent need for a gender-transformative pandemic response strategy.
Implementation of a novel stratified PAthway of CarE for common musculoskeletal (MSK) conditions in primary care: protocol for a multicentre pragmatic randomised controlled trial (the PACE MSK trial)
Authors: Rebbeck Trudy , Evans Kerrie , Ferreira Paulo , Beales Darren , Sterling Michele , Bennell Kim L , Cameron Ian , Nicholas Michael , Ritchie Carrie , Jull Gwen , Treleaven Julia , Trevena Lyndal , Refshauge Kathryn , Connelly Luke , Foster Nadine , Black Deborah , Hodges Paul , Ferreira Manuela , Shaw Tim J , Simic Milena
Published: December 2021

Introduction

Musculoskeletal (MSK) conditions constitute the highest burden of disease globally, with healthcare services often utilised inappropriately and overburdened. The aim of this trial is to evaluate the effectiveness of a novel clinical PAthway of CarE programme (PACE programme), where care is provided based on people’s risk of poor outcome.

Methods and analysis

Multicentre randomised controlled trial. 716 people with MSK conditions (low back pain, neck pain or knee osteoarthritis) will be recruited in primary care. They will be stratified for risk of a poor outcome (low risk/high risk) using the Short Form Örebro Musculoskeletal Pain Screening Questionnaire (SF-ÖMSPQ) then randomised to usual care (n=358) or the PACE programme (n=358). Participants at low risk in the PACE programme will receive up to 3 sessions of guideline based care from their primary healthcare professional (HCP) supported by a custom designed website (mypainhub.com). Those at high risk will be referred to an allied health MSK specialist who will conduct a comprehensive patient-centred assessment then liaise with the primary HCP to determine further care. Primary outcome (SF 12-item PCS) and secondary outcomes (eg, pain self-efficacy, psychological health) will be collected at baseline, 3, 6 and 12 months. Cost-effectiveness will be measured as cost per quality-adjusted life-year gained. Health economic analysis will include direct and indirect costs. Analyses will be conducted on an intention-to-treat basis. Primary and secondary outcomes will be analysed independently, using generalised linear models. Qualitative and mixed-methods studies embedded within the trial will evaluate patient experience, health professional practice and interprofessional collaboration.

Ethics and dissemination

Ethics approval has been received from the following Human Research Ethics Committees: The University of Sydney (2018/926), The University of Queensland (2019000700/2018/926), University of Melbourne (1954239), Curtin University (HRE2019-0263) and Northern Sydney Local Health District (2019/ETH03632). Dissemination of findings will occur via peer-reviewed publications, conference presentations and social media.

Trial registration number

ACTRN12619000871145.
Time to inclusion in clinical guidance documents for non-oncological orphan drugs and biologics with expedited FDA designations: a retrospective survival analysis
Authors: Rodriguez Ryan , Brunner Rachel , Spencer Samantha , Qato Dima M
Published: December 2021

Objectives

Drug and biological products that treat rare, serious or life-threatening conditions can receive US Food and Drug Administration (FDA) orphan designation and expedited programme designations (accelerated approval, breakthrough therapy, fast track or priority review) meant to incentivise development. Timely recommendations from guidance documents may encourage more rapid and appropriate use and access to these medicines for serious conditions. We sought to determine time between FDA approval and inclusion in guidance documents for non-oncological orphan products overall and by number and type of expedited programme designations.

Design and setting

Retrospective survival analysis of non-oncological orphan products with ≥1 expedited designation approved since 1992. In June 2020, PubMed, Turning Research into Practice and Guideline Central databases were searched to identify guidance documents influencing US practice that included each product.

Main outcomes and measures

The primary outcome was time to guidance inclusion, defined as any recommendation on use provided within the recommendation framework used by the guidance document.

Results

Among 135 included non-oncological orphan products, 97.0% (n=131) were designated with priority review, 49.6% (n=67) fast track, 16.3% (n=22) breakthrough therapy and 14.1% (n=19) accelerated approval. Sixty per cent of products (n=81) received ≥2 designations. Overall, 74.1% (n=100) were included in a guidance document. The median time to inclusion was 2.87 years (IQR 2.21–4.18) for the entire cohort. In survival analyses, guidance inclusion was more likely to occur earlier for products with ≥2 designations (HR, 1.84; 95% CI 1.21 to 2.79) and for those with fast-track designation compared with priority review (HR 1.40; 95% CI 1.02 to 2.0). Of 35 products not included in a guidance document, 54.3% (n=19) were approved in 2018 or later.

Conclusions

Among non-oncological orphan products with priority designations, nearly 3 years had passed between FDA approval and inclusion in any guidance document. These findings suggest that despite efforts to expedite availability, appropriate access to these treatments may be delayed because of the lack of timely guidance on their use in clinical practice.
Prospective comparison of AMB, GAP AND START scores and triage nurse clinical judgement for predicting admission from an ED: a single-centre prospective study
Authors: Salvato Mauro , Solbiati Monica , Bosco Paola , Casazza Giovanni , Binda Filippo , Iotti Marco , Calegari Jessica , Laquintana Dario , Costantino Giorgio
Published: December 2021

Background

It is postulated that early determination of the need for admission can improve flow through EDs. There are several scoring systems which have been developed for predicting patient admission at triage, although they have not been directly compared. In addition, it is not known if these scoring systems perform better than clinical judgement. Therefore, the aim of this study was to validate existing tools in predicting hospital admission during triage and then compare them with the clinical judgement of triage nurses.

Methods

To conduct this prospective, single-centre observational study, we enrolled consecutive adult patients who presented between 30 September 2019 and 25 October 2019 at the ED of a large teaching hospital in Milan, Italy. For each patient, triage nurses recorded all of the variables needed to perform Ambulatory (AMB), Glasgow Admission Prediction (GAP) and Sydney Triage to Admission Risk Tool (START) scoring. The probability of admission was estimated by the triage nurses using clinical judgement and expressed as a percentage from 0 to 100 with intervals of 5. Nurse estimates were dichotomised for analysis, with ≥50% likelihood being a prediction of admission. Receiver operating characteristic curves were generated for accuracy of the predictions. Area under the curve (AUC) with 95% CI for each of the scores and for the nursing judgements was also calculated.

Results

A total of 1710 patients (844 men; median age, 54 years (IQR: 34–75)) and 35 nurses (15 men; median age, 37 years (IQR: 33–48)) were included in this study. Among these patients, 310 (18%) were admitted to hospital from the ED. AUC values for AMB, GAP and START scores were 0.77 (95% CI: 0.74 to 0.79), 0.72 (95% CI: 0.69 to 0.75) and 0.61 (95% CI: 0.58 to 0.64), respectively. The AUC for nurse clinical judgement was 0.86 (95% CI: 0.84 to 0.89).

Conclusion

AMB, GAP and START scores provided moderate accuracy in predicting patient admission. However, all of the scores were significantly worse than the clinical judgement of the triage nurses.
Occupational injury among paramedics: a systematic review
Authors: Kearney Jason , Muir Carlyn , Smith Karen
Published: December 2021

Introduction

Paramedics are frequently exposed to acute and/or chronic environmental, operational and patient-related factors that increase their risk of physical and psychological injury. However, there has been wide variation in reported paramedic injury rates. This systematic review aims to synthesise the evidence to examine the incidence and nature of occupational injury among paramedics.

Methods

This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO 2020: CRD42020164556). A systematic search of four electronic databases was conducted for the years 2004–2019. Peer-reviewed studies examining the incidence and proportions of paramedic occupational injury within civilian emergency medical services (EMS) were included. Injury types, mechanisms, contributing factors and incidence of injury were synthesised narratively.

Results

Twelve studies met the inclusion criteria. The incidence of injury ranged from 29.7 to 345.6 injuries per 1000 workers per year. Sprains and strains were the most reported injury types, and the trunk and upper limbs were the main sites. Body motion was the most frequently reported mechanism of injury, accounting for 35%–55% of all injuries. Female paramedics had a proportionally higher rate of injury compared with male paramedics. Paramedics aged 25–34 years accounted for the majority of fatal (mean 34.0%) and non-fatal (mean 51.7%) injuries.

Conclusion

This review highlights the increased risk of occupational injury among paramedics and provides further insight into their overall injury profile.
Development of a working core outcome set for cutaneous lupus erythematosus: a practical approach to an urgent unmet need
Authors: Guo Lisa N , Perez-Chada Lourdes M , Borucki Robert , Nambudiri Vinod E , Werth Victoria P , Merola Joseph F
Published: December 2021

Objective

The lack of standardised outcomes and outcome measures for cutaneous lupus erythematosus (CLE) represents a substantial barrier to clinical trial design, comparative analysis and approval of novel investigative treatments. We aimed to develop a working core outcome set (COS) for CLE randomised controlled trials and longitudinal observational studies.

Methods

We conducted a multistage literature review of CLE and SLE studies to generate candidate domains and outcome measures. Domains were narrowed to a working core domain set. Outcome measures for core domains were identified and examined.

Results

Proposed core domains include skin-specific disease activity and damage, investigator global assessment (IGA) of disease activity, symptoms (encompassing itch, pain and photosensitivity), health-related quality of life (HRQoL) and patient global assessment (PtGA) of disease activity. Recommended physician-reported outcome measures include the Cutaneous Lupus Erythematous Disease Area and Severity Index (CLASI) and Cutaneous Lupus Activity IGA (CLA-IGA). For the domains of symptoms, HRQoL and PtGA of disease activity, we were unable to recommend one clearly superior instrument.

Conclusion

This work represents a starting point for further refinement pending formal consensus activities and more rigorous evaluations of outcome measure quality. In the interim, the proposed working COS can serve as a much-needed guide for upcoming CLE clinical trials.
Effect of occupational exposure to antineoplastic drugs on DNA damage in nurses: a cross-sectional study
Authors: Huang Xiaohong , Gao Chaoxian , Cai Wenzhi , Tao Yanling , Zhong Xiao , Liu Haiying , Hong Xiaodan , Ding Xiaorong , Lu Hong , Lai Wenjuan , Yi Xiaoqing , Gu Yeqing
Published: December 2021

Background

Although the therapeutic effect of antineoplastic drugs is incontestable, these agents can also potentially act as carcinogens, mutagens and/or teratogens in people. The aim of this study was to assess the effect of occupational exposure to antineoplastic drugs on DNA damage, assessed by the comet assay and cytokinesis-block micronucleus (CBMN) assay, in nurses.

Methods

The cross-sectional study enrolled 305 nursing staff members from 7 public hospitals in Shenzhen who handled antineoplastic drugs, and 150 healthy nursing staff members who were not exposed to antineoplastic drugs as the control group. DNA damage was assessed by the comet and CBMN assay. Multiple linear regressions and logistic regressions models were used to analyse the effect of occupational exposure to antineoplastic drugs on DNA damage.

Results

After adjustment for confounding factors, compared with non-exposure to antineoplastic drugs, exposure to antineoplastic drugs was positively related to tail moment, olive moment, tail length and tail DNA per cent, and adjusted β or OR (95% CI) was 0.17 (0.08 to 0.26), 0.18 (0.10 to 0.27), 1.03 (0.47 to 1.60) and 1.16 (1.04 to 1.29) (all p<0.05). Moreover, similar significant relationships were observed for the biomarkers of the CBMN assay. Additionally, other than age, there was no interaction between antineoplastic drug exposure and other variables for the levels of biomarkers of the CBMN assay and the comet assay.

Conclusions

The present results showed that exposure to antineoplastic drugs was positively related to the risk of DNA damage in nurses. The results imply that occupational exposure to antineoplastic agents is an important global public health problem that requires urgent attention.
Sodium and water perturbations in patients who had an acute stroke: clinical relevance and management strategies for the neurologist
Authors: Yuen Kevin C J , Sharf Valerie , Smith Elizabeth , Kim Minhwan , Yuen Alissya S M , MacDonald Paul R
Published: December 2021

Sodium and water perturbations, manifesting as hyponatraemia and hypernatraemia, are common in patients who had an acute stroke, and are associated with worse outcomes and increased mortality. Other non-stroke-related causes of sodium and water perturbations in these patients include underlying comorbidities and concomitant medications. Additionally, hospitalised patients who had an acute stroke may receive excessive intravenous hypotonic solutions, have poor fluid intake due to impaired neurocognition and consciousness, may develop sepsis or are administered drugs (eg, mannitol); factors that can further alter serum sodium levels. Sodium and water perturbations can also be exacerbated by the development of endocrine consequences after an acute stroke, including secondary adrenal insufficiency, syndrome of inappropriate antidiuretic hormone secretion and diabetes insipidus. Recently, COVID-19 infection has been reported to increase the risk of development of sodium and water perturbations that may further worsen the outcomes of patients who had an acute stroke. Because there are currently no accepted consensus guidelines on the management of sodium and water perturbations in patients who had an acute stroke, we conducted a systematic review of the literature published in English and in peer-reviewed journals between January 2000 and December 2020, according to PRISMA guidelines, to assess on the current knowledge and clinical practices of this condition. In this review, we discuss the signs and symptoms of hyponatraemia and hypernatraemia, the pathogenesis of hyponatraemia and hypernatraemia, their clinical relevance, and we provide our recommendations for effective treatment strategies for the neurologist in the management of sodium and water perturbations in commonly encountered aetiologies of patients who had an acute stroke.
Nonassociative black ellipsoids distorted by R-fluxes and four dimensional thin locally anisotropic accretion disks
Authors: Bubuianu Laurenţiu , Vacaru Sergiu I. , Veliev Elşen Veli
Published: December 2021

We construct nonassociative quasi-stationary solutions describing deformations of Schwarzschild black holes, BHs, to ellipsoid configurations, which can be black ellipsoids, BEs, and/or BHs with ellipsoidal accretion disks. Such solutions are defined by generic off-diagonal symmetric metrics and nonsymmetric components of metrics (which are zero on base four dimensional, 4-d, Lorentz manifold spacetimes but nontrivial in respective 8-d total (co) tangent bundles). Distorted nonassociative BH and BE solutions are found for effective real sources with terms proportional to $$\hbar \kappa $$

ħ
κ

(for respective Planck and string constants). These sources and related effective nontrivial cosmological constants are determined by nonlinear symmetries and deformations of the Ricci tensor by nonholonomic star products encoding R-flux contributions from string theory. To generate various classes of (non) associative /commutative distorted solutions we generalize and apply the anholonomic frame and connection deformation method for constructing exact and parametric solutions in modified gravity and/or general relativity theories. We study properties of locally anisotropic relativistic, optically thick, could and thin accretion disks around nonassociative distorted BHs, or BEs, when the effects due to the rotation are negligible. Such configurations describe angular anisotropic deformations of axially symmetric astrophysical models when the nonassociative distortions are related to the outer parts of the accretion disks.
The dynamics of CO2 emissions and economic growth: A comparative analysis using symbolic time series
Authors: Brida Juan Gabriel , Matesanz Gómez David , Segarra Verónica
Published: December 2021

The aim of this paper is to analyze the dynamic relationship between economic growth and CO2 emissions for a set of 98 countries over the lengthy period from 1951 to 2014. We describe the topology and hierarchy of countries and introduce a different concept of economic performance based on the idea of dynamic regimes. These regimes are defined by the average levels of per-capita CO2 emissions and the growth rates of per-capita GDP. By presenting a nonparametric clustering technique, the paper identifies two main groups. One cluster can be identified as the group of developed countries, which presents a homogeneous structure and tends toward more similar dynamics over time. The other cluster, associated with developing countries, is homogeneous but the dynamics of the countries do not show convergence. The study also finds some, though little, mobility between the groups.
Intelligent gravitational search random forest algorithm for fake news detection
Authors: Natarajan Rathika , Mehbodniya Abolfazl , Rane Kantilal Pitambar , Jindal Sonika , Hasan Mohammed Faez , Vives Luis , Bhatt Abhishek
Published: December 2021

Online social media has made the process of disseminating news so quick that people have shifted their way of accessing news from traditional journalism and press to online social media sources. The rapid rotation of news on social media makes it challenging to evaluate its reliability. Fake news not only erodes public trust but also subverts their opinions. An intelligent automated system is required to detect fake news as there is a tenuous difference between fake and real news. This paper proposes an intelligent gravitational search random forest (IGSRF) algorithm to be employed to detect fake news. The IGSRF algorithm amalgamates the Intelligent Gravitational Search Algorithm (IGSA) and the Random Forest (RF) algorithm. The IGSA is an improved intelligent variant of the classical gravitational search algorithm (GSA) that adds information about the best and worst gravitational mass agents in order to retain the exploitation ability of agents at later iterations and thus avoid the trapping of the classical GSA in local optimum. In the proposed IGSRF algorithm, all the intelligent mass agents determine the solution by generating decision trees (DT) with a random subset of attributes following the hypothesis of random forest. The mass agents generate the collection of solutions from solution space using random proportional rules. The comprehensive prediction to decide the class of news (fake or real) is determined by all the agents following the attributes of random forest. The performance of the proposed algorithm is determined for the FakeNewsNet dataset, which has sub-categories of BuzzFeed and PolitiFact news categories. To analyze the effectiveness of the proposed algorithm, the results are also evaluated with decision tree and random forest algorithms. The proposed IGSRF algorithm has attained superlative results compared to the DT, RF and state-of-the-art techniques.
Analysis of entropy generation and Joule heating on curvilinear flow of thermally radiative viscous fluid due to an oscillation of curved Riga surface
Authors: Naveed M. , Imran M. , Abbas Z. , Nadeem A.
Published: December 2021

This paper investigates the phenomena of heat transfer and entropy generation on time-dependent electro-magnetohydrodynamic boundary layer flow of viscous fluid past a curved oscillatory stretchable Riga surface. Also, the impacts of thermal radiation and Joule heating are accounted for in the energy equation. To develop the flow model in mathematical form, curvilinear coordinates system is followed. The series solution of the governing nonlinear partial differential equations is attained with the help of the homotopy analysis method (HAM). The impacts of various involved parameters like dimensionless radius of curvature, modified magnetic parameter, the proportion of frequency of oscillation of the sheet to its stretchable rate parameter, magnetic parameter, Prandtl number, Eckert number, radiation parameter and Brinkman number on entropy generation, Bejan number, temperature and flow equations are comprehensively examined and results are displayed through graphs. Numerical variation in the magnitude of surface drag force and local Nusselt number under the influence of aforesaid parameters are presented through the tables. Entropy generation is enhanced with an enhancement in a radius of curvature and Brinkman number, while the Bejan number shows opposite behavior for both parameters. The amplitude of velocity distribution shows growing behavior with modified magnetic parameter.
ASSOCIATION BETWEEN CELL PHONE USAGE AND MUSCULOSKELETAL DISORDERS IN SCHOOL GOING CHILDREN
Authors: Mandhwani Sujata , Zia Sadaf , Shaikh Emad Salman , Duarte Dante , Tanveer Erum
Published: December 2021

The adverse effects of excessive mobile phone (MP) use on children include deprivation from sleep, increased risk of lack of concentration, depression, anxiety and obesity. No such study has been conducted in children from Pakistan. Objectives: To assess the association of MP usage and musculoskeletal disorders in school going children. Methods: This was a cross sectional survey. Data were collected from different private schools of Karachi, Pakistan. Convenient non probability sampling technique was used. A sample size of 385 students was taken keeping a confidence interval of 95% with 5% margin of error. Results: A total of 385 subjects participated. It was also noticed that 75.6% (291) students have smart phone and 5.2% (20) have conventional phone and remaining 19.2% (74) have camera phone. It was noticed that the participants 306 (79.5%) said they slept for 1–2[Formula: see text]h daily and 30 (7.8%) had sleep for 3–4[Formula: see text]h daily. One hundred and four 104 (27%) had noticed pain in neck. Conclusion: The use of MP for any activity was associated with sleep deprivation and pain in wrist/hands followed by neck and upper back pain. The usage of MP should be limited to avoid the stress on musculoskeletal parts of the body.
Cable Force Determination Using Phase-Based Video Motion Magnification and Digital Image Correlation
Authors: Chen Wenbing , Yan Banfu , Liao Jingbo , Luo Lei , Dong You
Published: December 2021

The mode shape-aided method provides a simple and effective way for cable force determination, which, however, requires accurate parameter identification of the cable structure. This paper proposes a phase-based video motion magnification to process the image sequences of a cable. Digital image correlations were engaged to measure the dynamic displacement–time history, through tracking the surface characteristic features of the cable. Thereafter, a frequency–domain decomposition technique was applied to extract the natural frequency and mode shape of the cable from the displacement–time history measurements. The identified cable mode shapes, along with a tensioned pinned-pinned cable model, were used to estimate the cable force. The accuracy of the proposed methodology was subsequently verified through laboratory testing on an inclined cable model and field testing on a typical hanger cable of a real-world arch bridge. Overall, the study results indicated that the proposed methodology could expediently and cost-effectively estimate the tension forces of a cable with reasonably acceptable identification accuracy.
A Simplified Method for Estimating the Critical Wind Speed of Moving Vehicles on Bridges Under Crosswinds
Authors: Sun Mengjin , Wang Dalei , Shen Xiang , Chen Airong
Published: December 2021

To evaluate the crosswind stability (overturning and sideslip) of vehicles driving on the bridge, obtaining critical wind speed is essential. The traditional method is based on the aerodynamic forces of moving vehicles on the bridge and the analysis of force equilibrations. However, various shapes of the bridge make the flow field around the vehicle on the bridge very complicated to obtain. In this paper, a simplified method is introduced to calculate the critical wind speeds of moving vehicles on bridges based on the influence of coefficients of the wind environment on the bridge and the aerodynamic forces of moving vehicles on open fields. The aerodynamic forces of moving vehicles are simulated with dynamic mesh techniques. Besides, the characteristics of the wind environment on the bridge deck are studied to evaluate the driving safety and determine the influence coefficient. To further demonstrate the reliability, critical wind speed in different road conditions of the proposed simplified method shows very good agreement with the traditional method.
MECHANISM OF SENSORINEURAL HEARING LOSS CAUSED BY TYPICAL SCLEROSIS OF COCHLEA
Authors: ZHAO ZHENGSHAN , YAO WENJUAN , WANG JIAKUN , ZHOU LEI , HUANG XINSHENG
Published: December 2021

It is difficult to measure the cochlea directly because of the ethical problems and the complexity of cochlear structure. Therefore, finite element model (FEM) can be used as an effective alternative research method. An accurate FEM of the human ear can not only help people understand the mechanisms of sound transmission, but also effectively assess the effects of otologic diseases and guide research on the treatment of hearing loss. In this paper, a three-dimensional (3D) FEM of the human normal cochlea is proposed to study the changes in the biomechanical behavior of the cochlear sensory structure caused by the anterior fissure sclerosis and bottom-turn and apex-turn ossification of the cochlear window. The degree and harm of hearing loss caused by diseases are quantitatively predicted, which can deepen the understanding of the biomechanical mechanism of cochlea, and provide theoretical basis for clinical medicine.
Weighted random sampling and reconstruction in general multivariate trigonometric polynomial spaces
Authors: Li Wei , Xian Jun
Published: December 2021

The set of sampling and reconstruction in trigonometric polynomial spaces will play an important role in signal processing. However, in many applications, the frequencies in trigonometric polynomial spaces are not all integers. In this paper, we consider the problem of weighted random sampling and reconstruction of functions in general multivariate trigonometric polynomial spaces. The sampling set is randomly selected on a bounded cube with a probability distribution. We obtain that with overwhelming probability, the sampling inequality holds and the explicit reconstruction formula succeeds for all functions in the general multivariate trigonometric polynomial spaces when the sampling size is sufficiently large.
Biocompatibility Evaluation of Hollow Pollen Grains/Fe3 O4 Nanoparticles Composites as Potential Medical Devices
Authors: Zakhireh Solmaz , Omidi Yadollah , Beygi-Khosrowshahi Younes , Aghanejad Ayoub , Barar Jaleh , Adibkia Khosro
Published: December 2021

Recently, pollen grains (PGs) have been introduced as drug carriers and scaffolding building blocks. This study aimed to assess the in-vitro biocompatibility of Pistacia vera L. hollow PGs/Fe3O4 nanoparticles (HPGs/Fe3O4NPs) composites using human adipose-derived mesenchymal stem cells (hAD-MSCs). In this regard, iron oxide nanoparticles (Fe3O4NPs) were assembled on the surface of HPGs at different concentrations. The biocompatibility of the prepared composites was assessed through MTT assay, apoptosis-related gene expression and field emission scanning electron microscopy (FE-SEM) analysis. Compared to the bare HPGs, the HPGs/Fe3O4NPs exhibited a biphasic impact on hAD-MSCs. The composite containing 1% Fe3O4NPs demonstrated no cytotoxicity up to 21 days while higher Fe3O4NPs contents and long-term exposure revealed adverse effects on the hAD-MSCs’ growth. The obtained result was verified by the qRT-PCR and morphological analysis carried out through FE-SEM which suggests that a narrow region below 1% Fe3O4NPs may be the optimum choice for medicinal applications of HPGs/Fe3O4NPs microdevices.
The Higgs mechanism and geometrical flows for two-manifolds
Authors: Cartas-Fuentevilla R. , Herrera-Aguilar A. , Berra-Montiel J.
Published: December 2021

Using Perelman’s approach for geometrical flows in terms of an entropy functional, the Higgs mechanism is studied dynamically along flows defined in the space of parameters and in fields space. The model corresponds to two-dimensional gravity that incorporates torsion as the gradient of a Higgs field, and with the reflection symmetry to be spontaneously broken. The results show a discrete mass spectrum and the existence of a mass gap between the Unbroken Exact Symmetry and the Spontaneously Broken Symmetry scenarios. In the latter scenario, the geometries at the degenerate vacua correspond to conformally flat manifolds without torsion; twisted two-dimensional geometries are obtained by building perturbation theory around a ground state; the tunneling quantum probability between vacua is determined along the flows.
Immediate effect of stabilization exercises versus conventional exercises of the trunk on dynamic balance among trained soccer players
Authors: D’souza Cyanna Joseph , Santhakumar Haripriya , Bhandary Bhaskara , Rokaya Abhishek
Published: December 2021

Background: Trunk stability is key in controlling body balance and movements. Trunk Stabilization Exercises (TSE) and Conventional Trunk Exercises (CTE) are performed to improve dynamic balance. The authors have previously reported that dynamic balance was improved by a 12-week and 6-week TSE program. However, there is a dearth of research on its immediate effect on dynamic balance in trained soccer players.

Objective: To compare the immediate effect of TSE with that of CTE on dynamic balance in trained soccer players.

Methods: Forty-eight male soccer players (24.60 ± 1.38 years) participated in this crossover study, wherein each participant took part in three exercise sessions: TSE, CTE, and No Exercise control (NE), each consisting of three steps: pre-test, intervention and post-test, with an interval of one week between each exercise condition. To assess dynamic balance, the Y Balance Test-Lower Quarter (YBT-LQ) score in the anterior, posteromedial, and posterolateral directions was measured before and 5 minutes after each intervention.

Results: The YBT-LQ composite score was significantly improved after TSE (0.51) as compared to CTE (0.22) and NE (0.04) (p<0.05). Furthermore, in TSE and CTE conditions, YBT-LQ scores of the posterolateral and posteromedial directions significantly improved at the post-test (p<0.05).

Conclusion: Both TSE and CTE are effective in immediately improving dynamic balance; however, TSE showed greater improvement as compared to the latter. Immediate improvements in the posteromedial and posterolateral directions of the YBT-LQ were demonstrated after performing the TSE and CTE.
Impact of On-chip Interconnect on In-memory Acceleration of Deep Neural Networks
Authors: Krishnan Gokul , Mandal Sumit K. , Chakrabarti Chaitali , Seo Jae-Sun , Ogras Umit Y. , Cao Yu
Published: December 2021

With the widespread use of Deep Neural Networks (DNNs), machine learning algorithms have evolved in two diverse directions—one with ever-increasing connection density for better accuracy and the other with more compact sizing for energy efficiency. The increase in connection density increases on-chip data movement, which makes efficient on-chip communication a critical function of the DNN accelerator. The contribution of this work is threefold. First, we illustrate that the point-to-point (P2P)-based interconnect is incapable of handling a high volume of on-chip data movement for DNNs. Second, we evaluate P2P and network-on-chip (NoC) interconnect (with a regular topology such as a mesh) for SRAM- and ReRAM-based in-memory computing (IMC) architectures for a range of DNNs. This analysis shows the necessity for the optimal interconnect choice for an IMC DNN accelerator. Finally, we perform an experimental evaluation for different DNNs to empirically obtain the performance of the IMC architecture with both NoC-tree and NoC-mesh. We conclude that, at the tile level, NoC-tree is appropriate for compact DNNs employed at the edge, and NoC-mesh is necessary to accelerate DNNs with high connection density. Furthermore, we propose a technique to determine the optimal choice of interconnect for any given DNN. In this technique, we use analytical models of NoC to evaluate end-to-end communication latency of any given DNN. We demonstrate that the interconnect optimization in the IMC architecture results in up to 6 × improvement in energy-delay-area product for VGG-19 inference compared to the state-of-the-art ReRAM-based IMC architectures.