bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroprevalence of anti‐Leptospira antibodies in equines and associated workers—Isolation of Leptospira interrogans serogroup Canicola from equine urine
Authors: Meny Paulina , Iglesias Tamara , Menéndez Clara , Quintero Jair , Ríos Cristina , Ashfield Natalia , Ferreira Oscar , Mosca Virginia , De Brun Laureana , Ortiz Gabriela , De Vries Isabel , Varela Gustavo , Schelotto Felipe
Published: March 2022

To investigate seroprevalence of anti‐Leptospira antibodies in equines and associated workers in Uruguay, 891 equine and 150 human sera were drawn; 212 equine urine samples were also taken for culture. Environmental conditions and equine raising or managing practices were recorded in all 72 visited establishments; epidemiological information was obtained from each worker. Microscopic agglutination technique (MAT) was performed with 10 Leptospira strains for equines and 18 for human sera, that were also studied with IgM indirect immunofluorescence (IgM‐IIF). Equine titres ≥100 were considered positive, and human sera titres ≥200 suggested probable recent or past infection. Urines were cultured in Ellinghausen–McCullough–Johnson–Harris (EMJH) media; local identification of one obtained isolate with lipL32 PCR, Multiple Locus Variable number tandem repeat Analysis and partial rrs gene sequencing, were completed at Institut Pasteur, Paris. Estimated reactivity was 61.3% for equines, which was higher than the studied bovine national levels (21%) and mainly observed with Icterohaemorrhagiae serogroup (40.3%), Sejroe, Canicola, Pomona or Ballum. Aged animals from slaughterhouses and cattle farms were the most frequently positive. Multiple regression analysis confirmed a significant association between seropositivity and equine age. Only one positive culture could be fully studied, and confirmed to be Leptospira interrogans serogroup Canicola; it was added to the MAT antigen panel and revealed fairly frequent reaction with equine and human sera. Three workers (2%) showed titres = 200 with Icterohaemorrhagiae or Canicola serogroups, without recent clinical manifestations. Their attended equines reacted with the same serogroups, suggesting common source infections or infection transmitted by equines. Three other humans yielded titres = 100, and none of the 150 showed an IgM‐IIF‐positive result. Equines seem not to be an important origin of regional human leptospirosis, except perhaps during acute animal infection. More culture work is required to study intensity and lapses of leptospiruria, as well as to further identify circulating strains.
Emulating Spatial and Temporal Outputs From Fuel Cell and Battery Models: A Comparison of Deep Learning and Gaussian Process Models
Authors: Xing W. W. , Dai S. , Shah A. A. , Luo L. , Xu Q. , Leung P. K.
Published: March 2022

Neural network models have a long history in fuel cell and battery modeling. With the recent advent of deep learning, there is potential for further improvements in these models. Conversely, deep learning is primarily designed for image detection and classification using large data sets and its performance on typical regression tasks in fuel cell and battery modeling remains largely unexplored. In this article, we present a new method for applying deep learning to general vector outputs from battery and fuel cell models and investigate the use of different deep learning architectures. We compare these methods to equivalent Gaussian process (GP) models on a range of regression tasks. We further provide the first rigorous error and asymptotic analysis of the multivariate GP model. For scalar outputs, deep networks are found to be less accurate on small data sets, but for large data sets, convolutional and recurrent networks are able to marginally exceed the accuracy of GP models.
Development of a Model Efficiency Improvement for the Designing of Feedwater Heaters Network in Thermal Power Plants
Authors: Hoseinzadeh Siamak , Stephan Heyns P.
Published: March 2022

Thermal power plants play a significant role in generating power, electricity, and energy consumption in the world, especially in developing countries. Therefore, the energy analysis of these power plants is very useful to increase the efficiency of systems and reduce energy consumption. One of the components of power plants that play a great role in energy consumption and recovery is the feedwater heater. In this study, a design method-based pinch technology for feedwater heaters of a coal power plant is presented. This method is used to reduce the irreversibility of heat transfer in feedwater heaters in this power plant. This study is performed on six feedwater heaters, which are similar in pairs. The results of this method show that this method is feasible for this system, and the results also show that the implementation of this method with a Pinch range of 10 °C indicated a deficit hot utility of about 48.54 MW. Also, the amount of power plant efficiency improvement is 12.12%, and according to the Pinch method, the energy price of the power plant can be reduced by about 125,489 $/year.
Medium-Scale Methanol Pool Fire Model Validation
Authors: Hubbard Joshua A. , Hansen Michael A. , Kirsch Jared R. , Hewson John C. , Domino Stefan P.
Published: March 2022

Medium scale (30 cm diameter) methanol pool fires were simulated using the latest fire modeling suite implemented in Sierra/Fuego, a low Mach number multiphysics reacting flow code. The sensitivity of model outputs to various model parameters was studied with the objective of providing model validation. This work also assesses model performance relative to other recently published large eddy simulations (LES) of the same validation case. Two pool surface boundary conditions were simulated. The first was a prescribed fuel mass flux and the second used an algorithm to predict mass flux based on a mass and energy balance at the fuel surface. Gray gas radiation model parameters (absorption coefficients and gas radiation sources) were varied to assess radiant heat losses to the surroundings and pool surface. The radiation model was calibrated by comparing the simulated radiant fraction of the plume to experimental data. The effects of mesh resolution were also quantified starting with a grid resolution representative of engineering type fire calculations and then uniformly refining that mesh in the plume region. Simulation data were compared to experimental data collected at the University of Waterloo and the National Institute of Standards and Technology (NIST). Validation data included plume temperature, radial and axial velocities, velocity temperature turbulent correlations, velocity velocity turbulent correlations, radiant and convective heat fluxes to the pool surface, and plume radiant fraction. Additional analyses were performed in the pool boundary layer to assess simulated flame anchoring and the effect on convective heat fluxes. This work assesses the capability of the latest Fuego physics and chemistry model suite and provides additional insight into pool fire modeling for nonluminous, nonsooting flames.
Study on Joint Protection of Air Tank and Air Valve in Long-Distance Water Supply System
Authors: Chen Xuyun , Zhang Jian , Yu Xiaodong , Chen Sheng , Shi Lin
Published: March 2022

In the long-distance water supply system, the air tank can effectively protect the pump failure water hammer, but the large air tank will increase the investment. This paper analyzes the hydraulic transient process of the water supply system with air tanks, and proposes a joint protection method with an air tank behind the pump and air valves at the end of the pipeline. The function and coupling relationship of the air tank and air valves are clarified, the theoretical analysis system and numerical optimization framework of the joint protection layout scheme are constructed, and the potential hidden trouble conditions are discussed. A setting method of combined air valves is proposed to eliminate the possible water and gas problems in the pipeline. Combined with the actual project, the water hammer protection effects of different protection schemes are compared and analyzed. The results show that this joint protection scheme can effectively protect against water hammer damage, and greatly reduce the volume of the air tank compared to a single air tank protection.
A Novel Approach for Performance Analysis of Air–Air Wickless Heat Pipe Heat Exchanger
Authors: Brahim Taoufik
Published: March 2022

Wickless heat pipe heat exchangers (HPHE) consistently showed instabilities and omits many experimental tests. The performance of a heat pipe is governed by many parameters, and the effects of which may influence each other. The objective of this paper is to develop a new approach for an air–air heat pipe heat exchanger that takes into consideration the effect of heat transfer coefficients, saturation temperature, and thermal resistances inside the heat pipes as well as maximum heat transfer limit. The approach is based on analyzing inner heat pipe parameters with HPHE external working conditions. Results are also assessed for higher heat capacities ratio and found that the thermal resistances inside a heat pipe are a limiting factor, leading the HPHE system to perform poorly in particular for Cr ≤ 1. Overall heat transfer coefficients at HPHE sides as well as HPHE effectiveness as a function of Cr are assessed. Trying to follow the Chaudourne (1992, “The Heat Pipe Heat Exchangers: Design, Technology and Applications,” Design and Operation of Heat Exchangers, Springer, Berlin, Heidelberg, pp. 386–396) profile for conventional heat exchangers, HPHE effectiveness is determined and limited to 0.5 number of transferred units. The established model is verified by the existing literature and demonstrates numerical results that agree with the experimental data within a 2.86% error.
“What if I Get Injured?”: An Acceptance and Commitment Therapy Approach for Fear of Injury With a Semielite Youth Snowboarder
Authors: Price David , Wagstaff Christopher R.D. , Thelwell Richard C.
Published: March 2022

We outline the sport psychology service delivery provided to a 13-year-old male semielite youth Snowboarder, who reported experiencing a fear of injury when performing difficult tricks in training. The trainee practitioner used an approach informed by acceptance and commitment therapy that targeted the six core processes (acceptance, defusion, self-as-context, contact with the present moment, values, and committed action) to increase psychological flexibility. First, the acceptance and commitment therapy matrix was used to conceptualize the client’s “stuckness” and provide a foundation for mindfulness and defusion techniques to be implemented. Subsequently, the case reports how focus circles and “thanking the mind” exercises were introduced to increase the client’s contact with the present moment, and to cognitively defuse from the thought “What if I get injured?” Reflections from the client and their father were obtained to monitor and evaluate the service delivery process. The trainee’s reflections on practice also served to highlight the challenges of using acceptance and commitment therapy with a youth athlete, in particular the dominating “control” agenda, which in performance contexts, can be reinforced by the socially inferred narrative that athletes must control internal states as a prerequisite for optimal performance.
Tuning the signal: ATP-sensitive K
+
channels direct blood flow to cerebral capillaries
Authors: Jackson William F.
Published: March 2022

Cerebral blood flow must be exquisitely regulated to match the metabolic demands of neurons. In this issue of
Science Signaling
, Sancho
et al.
characterize functional ATP-sensitive K
+
(K
ATP
) channels in cerebral capillary endothelial cells and pericytes that can be activated by adenosine signaling, thereby leading to increases in capillary blood flow.
Cutting down in size by not making a cut
Authors: Wong Wei
Published: March 2022

Preventing the metalloprotease MT1-MMP from cleaving an anorexigenic receptor may be an anti-obesity strategy.
Persistent, Asymptomatic Colonization with
Candida
is Associated with Elevated Frequencies of Highly Activated Cervical Th17-Like Cells and Related Cytokines in the Reproductive Tract of South African Adolescents
Authors: Happel Anna-Ursula , Gasper Melanie , Balle Christina , Konstantinus Iyaloo , Gamieldien Hoyam , Dabee Smritee , Gill Katherine , Bekker Linda-Gail , Passmore Jo-Ann S. , Jaspan Heather B.
Published: March 2022

Sub-Saharan African female adolescents are globally at the highest risk of HIV acquisition, and genital inflammation, microbial dysbiosis, and cervical HIV target cell activation are thought to contribute to this risk. Previously, the relationship between these mucosal factors and subclinical vaginal
Candida
colonization or hyphae has not been described, and the role of HIV-susceptible Th17 cells in mediating anti-
Candida
immunity in the human female genital tract has not been clearly established.
Discovery and Characterization of an Aberrant Small Form of Glycoprotein I of Herpes Simplex Virus Type I in Cell Culture
Authors: Gui Xixi , Zhang Wuchao , Gao Peng , Zhang Yongning , Zhou Lei , Ge Xinna , Guo Xin , Wills John W. , Han Jun , Yang Hanchun
Published: March 2022

The HSV-1 gI is required for viral cell-to-cell spread within the host, but its behavior during infection has remained poorly defined. Along with the classic 66 kDa product, here we report a previously unrecognized, approximately 23 kDa form of gI.
Supplemental Material: A juvenile Paleozoic ocean floor origin for eastern Stikinia, Canadian Cordillera
Authors: Ootes L. , al. et
Published: March 2022

Contains analytical techniques for zircon U-Pb, Hf, and trace elements, tables with sample locations and analytical results, and figures.
Plastic Deformation of Copper and Its Alloys under the Action of Nanosecond UV Laser Pulse
Authors: Malinskii T. V. , Rogalin V. E. , Yamshchikov V. A.
Published: March 2022

The effect of nanosecond UV laser pulses on copper and low-alloy copper samples has been studied. Traces of high-temperature deformation have been found at the energy density of 0.1–1 J/cm2 in the below-threshold regime without obvious traces of melting. They manifest themselves as the results of slipping and cracking along grain boundaries, as well as traces of crystallographic slip inside grains. The surface of the metal in the irradiated zone exhibits an uplift. The damage increases with the number of pulses. The height of the resulting uplift can reach 1 μm, and even more in some cases. The results obtained are similar to the electroplastic and magnetoplastic effects. By analogy, we propose to call the detected effect opticoplastic.
Ectopic extramammary Paget’s disease of the abdominal wall with abdominoplasty reconstruction
Authors: Wigley Catrin , Zargaran David , Nikkhah Dariush , Butler Peter
Published: March 2022

Ectopic extramammary Paget’s disease describes an exceedingly rare intraepithelial adenocarcinoma arising within non-apocrine tissues. We present a case report of E-EPMD arising on the lower abdomen without underlying secondary malignancy in a 56-year-old female patient. We performed a wide local excision of the lesion with subsequent mini abdominoplasty reconstruction.
Sinogenic polymicrobial anaerobic orbital cellulitis: the importance of source control and broad empirical antibiotics
Authors: Blunsum Andrew , Treharne Clare , Tikka Theofano , Iyer Arunachalam , Tsarfati Elan Micha
Published: March 2022

A man in his twenties with a history of recurrent sinusitis was urgently referred to the emergency department (ED) by an out-of-hours general practitioner following a 2-day history of increasing right eye pain, redness and swelling after a week of coryzal symptoms. He denied visual impairment and any history of recent dental pain or procedures. Initial assessment in ED noted fever, tachycardia and hypotension. Video consultation with ophthalmologist in the ED identified proptosis, periorbital erythema and chemosis with full eye movement solely affecting the right eye. Visual acuity of 6/6 was confirmed in both eyes. After review by the ear, nose and throat (ENT) team, a diagnosis of sinogenic right orbital cellulitis was made, empirical antibiotics started and care transferred to the ENT team for immediate surgical intervention. 48 hours postoperatively, the patient acutely deteriorated, developing ophthalmoplegia and visual acuity of 6/95 in the right eye. Repeat imaging demonstrated a deteriorating picture and urgent surgery was organised at a neighbouring hospital’s specialist ENT unit combined with a change to his antibiotics. On day 4, 1 day following transfer, an anaerobic bacterium,Eggerthia catenaformis,was isolated from blood cultures collected on admission. The patient improved clinically following the second surgery and targeted antimicrobial therapy, eventually being discharged 10 days after initial presentation. In addition toE. catenaformis, the Anaerobic Reference Unit (Cardiff) identified two further anaerobic bacteria,Parvimonas micraandDialister pneumosintes. This paper presents the first documented case of polymicrobial anaerobic orbital cellulitis secondary to acute bacterial sinusitis. Moreover, this case underpins the importance of broad empirical antibiotics coupled with surgical source control to effectively manage a rare but sight-threatening and life-threatening disease.
Health policy analysis on barriers and facilitators for better oral health in German care homes: a qualitative study
Authors: Gomez-Rossi Jesus , Schwartzkopff Jondis , Müller Anne , Hertrampf Katrin , Abraham Jens , Gassmann Georg , Schlattmann Peter , Göstemeyer Gerd , Schwendicke Falk
Published: March 2022

Objectives

To assess possible health policy interventions derived from the theoretical domains framework (TDF) by studying barriers and facilitators on the delivery of oral healthcare and oral hygiene in German care homes using a behavioural change framework.

Design

Qualitative correlational study to evaluate a national intervention programme.

Setting

Primary healthcare in two care homes in rural Germany.

Participants

Eleven stakeholders participating in the delivery of oral healthcare (hygiene, treatment) to older people, including two care home managers, four section managers, two nurses/carers and three dentists.

Interventions

Semistructured interviews conducted in person in the care homes or by phone. A questionnaire developed along the domains of the TDF and the Capabilities, Opportunities and Motivations influencing Behaviours model was used to guide the interviews. Interviews were transcribed and systematised using Mayring’s content analysis along the TDF.

Results

860 statements were collected. We identified 19 barriers, facilitators and conflicting themes related to capabilities, 34 to opportunities and 24 to motivation. The lack of access to professional dental care was confirmed by all stakeholders as a major limitation hampering better oral health.

Primary outcome

A range of interventions can be discussed with the methodology we utilised. In our interviews, lack of dentists willing to treat patients at these facilities was the most discussed barrier for improving oral health of nursing home residents.

Secondary outcomes

Dentists highlighted the need for better incentives and facilities to deliver oral healthcare in these institutions. Differences with urban settings regarding access to healthcare were frequently discussed by our study participants.

Conclusions

Within our sample, greater capacitation of care home staff, better financial incentives for dentists and increased cooperation between the two stakeholders should be considered when designing interventions to tackle oral health of care home residents in Germany.
Development and validation of clinical prediction models for breast cancer incidence and mortality: a protocol for a dual cohort study
Authors: Clift Ashley Kieran , Hippisley-Cox Julia , Dodwell David , Lord Simon , Brady Mike , Petrou Stavros , Collins Gary S.
Published: March 2022

Introduction

Breast cancer is the most common cancer and the leading cause of cancer-related death in women worldwide. Risk prediction models may be useful to guide risk-reducing interventions (such as pharmacological agents) in women at increased risk or inform screening strategies for early detection methods such as screening.

Methods and analysis

The study will use data for women aged 20–90 years between 2000 and 2020 from QResearch linked at the individual level to hospital episodes, cancer registry and death registry data. It will evaluate a set of modelling approaches to predict the risk of developing breast cancer within the next 10 years, the ‘combined’ risk of developing a breast cancer and then dying from it within 10 years, and the risk of breast cancer mortality within 10 years of diagnosis. Cox proportional hazards, competing risks, random survival forest, deep learning and XGBoost models will be explored. Models will be developed on the entire dataset, with ‘apparent’ performance reported, and internal-external cross-validation used to assess performance and geographical and temporal transportability (two 10-year time periods). Random effects meta-analysis will pool discrimination and calibration metric estimates from individual geographical units obtained from internal-external cross-validation. We will then externally validate the models in an independent dataset. Evaluation of performance heterogeneity will be conducted throughout, such as exploring performance across ethnic groups.

Ethics and dissemination

Ethics approval was granted by the QResearch scientific committee (reference number REC 18/EM/0400: OX129). The results will be written up for submission to peer-reviewed journals.
Pilot cross-sectional study of foreign domestic workers supporting the basic healthcare needs of older persons in the community
Authors: Ang Kim Wai , Koh Yi Ling Eileen , Wang Xue Fei , Yusoff Azizah Mohd , Tan Ai Meng , Poh Xin Yi Cindy , Zhang Ning , Tan Ngiap Chuan
Published: March 2022

Objective

This pilot study aimed to determine the proportions, level of knowledge, anxiety and confidence of foreign domestic workers (FDWs) who were involved in supporting the healthcare needs of older persons with long-term non-communicable diseases.

Design

The pilot study used a cross-sectional and descriptive design.

FDWs who accompanied the older adults attending a primary healthcare setting in Singapore. 100 eligible FDWs’ demographic data, knowledge and confidence level of caregiving in food preparation, medication supervision, exercise, blood pressure (BP), blood glucose (BG) monitoring and anxiety level assessed by the Generalised Anxiety Disorder-7 scale were recorded. Descriptive statistics were performed and presented. Items on confidence were regrouped into two groups of ‘very’ versus ‘no/a little/moderate’. Knowledge scores and caregiving tasks were assessed with items on confidence using Mann-Whitney U test and χ2 test, respectively.

Results

The FDWs were from Indonesia (60%), Philippines (23%) and Myanmar (14%). Their mean age was 33 years with an average of 5.8 years working experience; 62% self-reported previous caregiver training for elderly. The mean age of care-recipients was 81 years. Knowledge of FDWs on BP and BG monitoring was low (<50% answered correctly). Among the 55 FDWs who were required to perform BP monitoring, 45.5% lack confidence. Similarly, 40% of the 30 FDWs were not confident in performing BG monitoring. Those with very high confidence levels had higher knowledge on BP and BG monitoring. Of those who were involved in medication supervision (n=86), 36% lacked confidence. The majority of the FDWs (96%) were not affected by anxiety in managing these healthcare tasks for older persons.

Conclusion

More than half of the FDWs supported healthcare needs of older persons but they had inadequate knowledge and lacked confidence in performing the healthcare-related tasks.
Brief assessment of male depression in clinical care: Validation of the Male Depression Risk Scale short form in a cross-sectional study of Australian men
Authors: Herreen Danielle , Rice Simon , Zajac Ian
Published: March 2022

Objectives

To develop and validate a short form of the Male Depression Risk Scale (MDRS-22) for use in primary care, examining associations with prototypic depression symptoms, psychological distress and suicidality.

Design

Cross-sectional study with 8-month follow-up.

Setting

Community-based.

Participants

A community sample of younger (n=510; 18–64 years) and older (n=439; 65–93 years) men residing in Australia (M age=58.09 years, SD=17.77) participated in the study. A subset of respondents (n=159 younger men; n=169 older men) provided follow-up data approximately eight months later.

Primary and secondary outcome measures

Quantitative data were obtained through a survey comprising a range of validated measures, including the MDRS-22, the Patient Health Questionnaire (PHQ-9) and the Kessler Psychological Distress Scale (K10). The MDRS-22 was refined using exploratory and confirmatory factor analysis in line with best practice guidelines. Analysis of variance and generalised linear models were conducted to explore relationships between variables.

Results

The short-form MDRS consisted of seven items (MDRS-7) and captured all of the domains in the original tool. Participants with mixed symptoms (PHQ-9 ≥ 10 and MDRS-7 > 5) had significantly higher risk of mental illness (K10 ≥ 25) and current suicidality (PHQ-9 item 9 ≥ 1) than those with exclusively prototypic symptoms (PHQ-9 ≥ 10 and MDRS-7 ≤ 5). Furthermore, the MDRS-7 was shown to be effective at predicting elevated symptoms of depression at follow-up, after controlling for previous depression diagnosis.

Conclusions

Findings provide preliminary evidence of the potential utility of the MDRS-7 as a screening tool for externalised and male-type symptoms associated with major depression in men. Field trials of the MDRS-7 in primary care settings may facilitate identification of men at risk of suicide and psychological distress who do not meet cut-off scores for existing measures of major depression symptoms.
Barriers and facilitators of successful deprescribing as described by older patients living with frailty, their informal carers and clinicians: a qualitative interview study
Authors: Peat George , Fylan Beth , Marques Iuri , Raynor David K , Breen Liz , Olaniyan Janice , Alldred David Phillip
Published: March 2022

Objective

To explore the barriers/facilitators to deprescribing in primary care in England from the perspectives of clinicians, patients living with frailty who reside at home, and their informal carers, drawing on the Theoretical Domains Framework to identify behavioural components associated with barriers/facilitators of the process.

Design

Exploratory qualitative study.

Setting

General practice (primary care) in England.

Participants

9 patients aged 65+ living with frailty who attended a consultation to reduce or stop a medicine/s. 3 informal carers of patients living with frailty. 14 primary care clinicians including general practitioners, practice pharmacists and advanced nurse practitioners.

Methods

Qualitative semistructured interviews took place with patients living with frailty, their informal carers and clinicians. Patients (n=9) and informal carers (n=3) were interviewed two times: immediately after deprescribing and 5/6 weeks later. Clinicians (n=14) were interviewed once. In total, 38 interviews were undertaken. Framework analysis was applied to manage and analyse the data.

Results

6 themes associated with facilitators and barriers to deprescribing were generated, respectively, with each supported by between two and three subthemes. Identified facilitators of deprescribing with patients living with frailty included shared decision-making, gradual introduction of the topic, clear communication of the topic to the patient and multidisciplinary working. Identified barriers of deprescribing included consultation constraints, patients' fear of negative consequences and inaccessible terminology and information.

Conclusions

This paper offers timely insight into the barriers and facilitators to deprescribing for patients living with frailty within the context of primary care in England. As deprescribing continues to grow in national and international significance, it is important that future deprescribing interventions acknowledge the current barriers and facilitators and their associated behavioural components experienced by clinicians, patients living with frailty and their informal carers to improve the safety and effectiveness of the process.
Effects of evidence-based ICU care on long-term outcomes of patients with sepsis or septic shock (ILOSS): protocol for a multicentre prospective observational cohort study in Japan
Authors: Liu Keibun , Kotani Toru , Nakamura Kensuke , Chihiro Takai , Morita Yasunari , Ishii Kenzo , Fujizuka Kenji , Yasumura Daisetsu , Taniguchi Daisuke , Hamagami Tomohiro , Shimojo Nobutake , Nitta Masakazu , Hongo Takashi , Akieda Kazuki , Atsuo Maeda , Kaneko Tadashi , Sakuda Yutaka , Andoh Kohkichi , Nagatomi Akiyoshi , Tanaka Yukiko , Irie Yuhei , Kamijo Hiroshi , Hanazawa Manabu , Kasugai Daisuke , Ayaka Matsuoka , Oike Kenji , Lefor Alan Kawarai , Takahashi Kunihiko , Katsukawa Hajime , Ogura Takayuki
Published: March 2022

Introduction

Sepsis is not only the leading cause of death in the intensive care unit (ICU) but also a major risk factor for physical and cognitive impairment and mental disorders, known as postintensive care syndrome (PICS), reduced health-related quality of life (HRQoL) and even mental health disorders in patient families (PICS-family; PICS-F). The ABCDEF bundle is strongly recommended to overcome them, while the association between implementing the bundle and the long-term outcomes is also unknown.

Methods and analysis

This is a multicentre prospective observational study at 26 ICUs. All consecutive patients between 1 November 2020 and 30 April 2022, who are 18 years old or older and expected to stay in an ICU for more than 48 hours due to sepsis or septic shock, are enrolled. Follow-up to evaluate survival and PICS/ PICS-F will be performed at 3, 6 and 12 months and additionally every 6 months up to 5 years after hospital discharge. Primary outcomes include survival at 12 months, which is the primary outcome, and the incidence of PICS defined as the presence of any physical impairment, cognitive impairment or mental disorders. PICS assessment scores, HRQoL and employment status are evaluated. The association between the implementation rate for the ABCDEF bundle and for each of the individual elements and long-term outcomes will be evaluated. The PICS-F, defined as the presence of mental disorders, and HRQoL of the family is also assessed. Additional analyses with data up to 5 years follow-up are planned.

Ethics and dissemination

This study received ethics approvals from Saiseikai Utsunomiya Hospital (2020-42) and all other participating institutions and was registered in the University Hospital Medical Information Network Clinical Trials Registry. Informed consent will be obtained from all patients. The findings will be published in peer-reviewed journals and presented at scientific conferences.

Trial registration number

UMIN000041433.
Mobile intervention to promote correct hand hygiene at key times to prevent COVID-19 in the Swiss adult general population: study protocol of a multiphase optimisation strategy
Authors: Amrein Melanie Alexandra , Ruschetti Gian Giacomo , Baeder Carole , Bamert Melanie , Inauen Jennifer
Published: March 2022

Introduction

Behaviour change is key to the public health measures that have been issued in many countries worldwide to contain COVID-19. Public health measures will only take preventive effect if people adhere to them. Interventions taking health psychology approaches may promote adherence to public health measures. However, evidence from randomised controlled behaviour change trials is scarce during an ongoing pandemic. We aim to use the example of hand washing with soap to optimise and test a digital, theory-based and evidence-based behaviour change intervention to prevent the spread of COVID-19.

Methods and analysis

This protocol describes the multiphase optimisation strategy for the preparation, optimisation and evaluation of a theory-based and evidence-based intervention delivered via app. The app aims to promote correct hand hygiene at key times in the adult general population. The study will be conducted in German-speaking Switzerland. The preparation phase has identified relevant behavioural determinants of hand hygiene during a pandemic from health behaviour theories and formative research with focus groups (n=8). The optimisation phase will identify the most effective and acceptable combination and sequence of three intervention modules in a parallel randomised trial (n=387) with analysis of variance (ANOVA) and regression analysis. Additionally, thematic analysis of qualitative interview data (n=15) will be used to gain insights on the feasibility, usability and satisfaction of the intervention. The evaluation phase will test the optimised intervention against an active control group in a randomised controlled trial (n=205), analysing pre-post differences and 6-month follow-up effects with ANOVA and regression analysis.

Ethics and dissemination

The trial was approved by the Cantonal Ethics Commission Bern of the Swiss Association of Research Ethics Committees (protocol ID: 2021-00164). Final results will be presented in peer-reviewed journals and at conferences.

Trial registration number

NCT04830761.
Identifying actions to foster cross-disciplinary global health research: a mixed-methods qualitative case study of the IMPALA programme on lung health and tuberculosis in Africa
Authors: Ding Yan , Tomeny Ewan M , Bates Imelda
Published: March 2022

Objectives

To identify actions for fostering cross-disciplinary research (CDR) skills and collaborations in global health, and to produce recommendations for improving the design, implementation and management of cross-disciplinary global health research programmes.

Design

Using a North–South global health research programme as a case study—and following an adapted framework—we conducted qualitative research using document reviews, semi-structured interviews (purposive sampling) and participatory observation. We used baseline survey findings to identify potential interviewees and tailor interview guides.

Setting

Our case study was a 4.5-year (2017–2021) programme, namely, the International Multidisciplinary Programme to Address Lung Health and Tuberculosis in Africa (IMPALA). Led by a UK research institute, IMPALA spanned 22 partner organisations from 13 countries (10 in sub-Saharan Africa), and involved five research discipline groups: clinical science,social science,health systems,health economicsandpolicy/research capacity.

Participants

Thirty-one IMPALA members were interviewed (July 2018–November 2019), with interviewees evenly split by gender (16 female and 15 male) and by Global North/South institution (15 non-African and 16 African). Twenty-five (81%) were researchers, comprising 18 senior researchers (professors, readers, associate professors and senior lecturers) and seven early career researchers (assistant professors, lecturers, research fellows, postdocs, research assistants and PhD students). Twenty-four programme events were observed (September 2018–April 2020) and 49 documents were reviewed (December 2017–April 2020). All 66 IMPALA staff were sent the baseline survey, receiving 51 responses (43/56 researchers and 8/10 non-researchers).

Results

Fourteen themes emerged, which suggested that CDR—while valued by many—is not universally understood, and the time it requires is often underestimated. We found that fostering CDR and managing tensions needs planning and continuous discussions and interactions. A shared vision with explicitly agreed goals and roles and active management of cross-disciplinary activities is essential.

Conclusions

Active planning, implementation and management of cross-disciplinary activities are essential for the success of cross-disciplinary global health research and should be separate from the primary research activities.
Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: a systematic review and meta-analysis
Authors: Zhang Jiayu , Zheng Xutong , Ma Danyan , Liu Changqin , Ding Yulan
Published: March 2022

Objects

This study aims to systematically evaluate the effectiveness of nurse-led cares on cardiovascular risk factors among individuals with type 2 diabetes mellitus.

Design

Systematic review and meta-analysis.

Methods

The electronic databases PubMed, EMBASE, CINAHL and Cochrane Library databases were searched for randomised controlled trials of nurse-led care for individuals with type 2 diabetes mellitus (T2DM) published in English from inception to 23 December 2021. Random effects models were used to calculate weighted mean differences (WMD) with 95%CI.

Results

13 articles were included in the meta-analysis, with a total of3757 participants. Considering baseline measurements, pooled analysis showed that nurse-led care significantly decreased the glycosylated haemoglobin (HbA1c) (WMD=−0.68 mmol/L; 95% CI −0.85 to –0.52; p<0.001), body mass index (BMI) (WMD=−0.54 kg/m2; 95% CI: −0.97 to –0.11; p=0.01) and systolic blood pressure (SBP) (WMD=−1.17 mmHg; 95% CI: −2.11 to –0.22; p=0.02) for patients with T2DM. But there was no difference in low-density lipoprotein cholesterol (LDL-c) (WMD=−2.50 mg/dL ; 95% CI: −5.07 to 0.08; p=0.06) between the nurse-led and control groups.

Conclusion

Nurse-led care is an effective and accessible intervention that could improve HbA1c, SBP, BMI levels among individuals with T2DM.

PROSPERO registration number

CRD42021248275.
Protocol for the IMPART study: IMplementation of the preterm birth surveillance PAthway – a RealisT evaluation
Authors: Carlisle Naomi , Dalkin Sonia Michelle , Shennan Andrew H , Sandall Jane
Published: March 2022

Introduction

New guidance, from NHS England (Saving Babies Lives Care Bundle Version 2 Element 5 (SBLCBv2)) has recommended a best practice pathway for women at risk of preterm birth (the Preterm Birth Pathway). This is to help meet the Department of Health’s aim to reduce preterm birth from 8% to 6% by 2025. Considering most hospitals do not currently have a preterm prevention clinic, implementing this pathway will require significant coordination.

Methods and analysis

The study will aim to investigate key features of contexts, mechanisms and outcomes, and their interactions in the implementation of the asymptomatic prediction and prevention components of the SBLCBv2 Preterm Birth Surveillance Pathway. This will be through a theory driven realist evaluation, utilising mixed methods (interviews with staff and women, observational analysis and analysing routinely collected hospital and admin data) in three case sites in England. The study has a Project Advisory Group composed of five women who have recently given birth.

Ethics and dissemination

The study has ethical approval (King’s College London REC approval number: MRSP-20/21-20955, and, IRAS:289144). A dissemination plan will be fully created with the Project Advisory Group, and we anticipate this will include presenting at conferences, publications, webinars, alongside dissemination to the wider population through parent and baby groups, the media and charities.

Trial registration number

ISRCTN57127874.
Experience of hospital-initiated medication changes in older people with multimorbidity: a multicentre mixed-methods study embedded in the OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM) trial
Authors: Thevelin Stefanie , Pétein Catherine , Metry Beatrice , Adam Luise , van Herksen Anniek , Murphy Kevin , Knol Wilma , O'Mahony Denis , Rodondi Nicolas , Spinewine Anne , Dalleur Olivia
Published: March 2022

Background

A patient-centred approach to medicines optimisation is considered essential. The OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM) trial evaluated the effectiveness of medication review with shared decision-making (SDM) in older people with multimorbidity. Beyond evaluating the clinical effectiveness, exploring the patient experience facilitates a better understanding of contextual factors and mechanisms affecting medication review effectiveness.

Objective

To explore experiences of hospital-initiated medication changes in older people with multimorbidity.

Methods

We conducted a multicentre mixed-methods study, embedded in the OPERAM trial, combining semi-structured interviews and the Beliefs about Medicines Questionnaire (BMQ) with a purposive sample of 48 patients (70–94 years) from four European countries. Interviews were analysed using the Framework approach. Trial implementation data on SDM were collected and the 9-item SDM questionnaire was conducted with 17 clinicians.

Results

Patients generally displayed positive attitudes towards medication review, yet emphasised the importance of long-term, trusting relationships such as with their general practitioners for medication review. Many patients reported a lack of information and communication about medication changes and predominantly experienced paternalistic decision-making. Patients’ beliefs that ‘doctors know best’, ‘blind trust’, having limited opportunities for questions, use of jargon terms by clinicians, ‘feeling too ill’, dismissive clinicians, etc highlight the powerlessness some patients felt during hospitalisation, all representing barriers to SDM. Conversely, involvement of companions, health literacy, empathetic and trusting patient-doctor relationships, facilitated SDM. Paradoxical to patients’ experiential accounts, clinicians reported high levels of SDM. The BMQ showed that most patients had high necessity and low concern beliefs about medicines. Beliefs about medicines, experiencing benefits or harms from medication changes, illness perception, trust and balancing advice between different healthcare professionals all affected acceptance of medication changes.

Conclusion

To meet patients’ needs, future medicines optimisation interventions should enhance information exchange, better prepare patients and clinicians for partnership in care and foster collaborative medication reviews across care settings.
Associations between household air pollution and early child development among children aged 36–59 months in Bangladesh
Authors: Rana Juwel , Luna-Gutiérrez Patricia , Haque Syed Emdadul , Ignacio Nazif-Muñoz José , Mitra Dipak Kumar , Oulhote Youssef
Published: March 2022

Background

Household air pollution (HAP) from solid fuel use (SFU) for cooking may impact child health in low-resources countries. This study examined the associations between HAP and early childhood development (ECD) outcomes among children under 5 years of age in Bangladesh and explored potential effect modification by sex and urbanicity.

Methods

The study sample consisted of 9395 children aged 36–59 months in the households from the Bangladesh Multiple Indicator Cluster Survey 2019. SFU and levels of exposure to SFU (unexposed, moderately exposed and highly exposed) were used as proxies of HAP exposure. We estimated the covariate-adjusted prevalence ratios (aPRs) and 95% CIs for the associations between HAP and ECD outcomes using multilevel mixed-effects Poisson regression models with a robust variance estimator.

Results

81.4% of children were exposed to SFU, and the prevalence of developmental delay (in Early Childhood Development Index) was 25.3%. Children exposed to SFU were 1.47 times more likely to have developmental delays (95% CI: 1.25, 1.73; p<0.001) compared with children with no SFU exposure. SFU was significantly associated with developmental delay in socioemotional (aPR: 1.17; 95% CI: 1.01, 1.36; p=0.035) and learning-cognitive (aPR: 1.90; 95% CI: 1.39, 2.60; p<0.001) domains. Similarly, children moderately exposed and highly exposed to HAP had higher prevalence of developmental delays than unexposed children. We did not observe effect modification by sex or urbanicity.

Conclusion

Public health policies should promote the use of clean cooking fuels and cookstoves to reduce the high burden of HAP exposure in low-resource countries for helping younger children to meet their developmental milestones.
Seismic performance assessment of an existing multispan bridge in eastern Canada retrofitted with fiber reinforced elastomeric isolator
Authors: Fosoul Saber A.S. , Tait Michael J.
Published: March 2022

A seismically resilient transportation network entails preprioritized retrofit plans for conventionally designed highway bridges. This is particularly important for the province of Ontario in Canada, where more than 44% of the multispan bridges have been constructed prior to 1970. To support future seismic risk mitigation efforts, this study evaluated the seismic performance of a multispan continuous reinforced concrete bridge in Ontario, Canada, in its as-built and retrofitted conditions. Seismic retrofit is conducted utilizing novel Fiber Reinforced Elastomeric Isolators (FREIs). Analytical fragility curves are developed using Incremental Dynamic Analysis (IDA) on a three-dimensional nonlinear finite element model of the bridge using 45 synthetic ground motion records for eastern Canada. Results indicate that seismic isolation can effectively mitigate the seismic demand on columns and transfer the shear forces to the end abutments resulting in excessive backfill soil deformation. However, this deformation does not necessarily result in bridge failure and traffic disruption.
Quantum gravitational corrections to the entropy of a Reissner–Nordström black hole
Authors: Campos Delgado Ruben
Published: March 2022

Starting from an effective action for quantum gravity, we calculate the quantum gravitational corrections to the Wald entropy of a four dimensional non-extremal Reissner–Nordström (RN) black hole in the limit of small electric charge, generalising a previous calculation carried out by Calmet and Kuipers (Phys Rev D 104(6):066012, 2021) for a Schwarzschild black hole. We show that, at second order in the Ricci curvature, the RN metric receives quantum corrections which shift the classical position of the event horizon. We apply the Wald entropy formula by integrating over the perimeter of the quantum corrected event horizon. We then compute the quantum gravitational corrections to the temperature and the pressure of the black hole.
An Accelerated and Flexible SIFT Parallel-Computing Approach Based on the General Multi-Core Platform
Authors: Wang Gang , Zhou Mingliang , Fang Bin , Huang Haichao , Shu Zhenyu , Chen Xueshu
Published: March 2022

Visual retrieval has been a significant technology in the computer vision task. Visual feature descriptors are the key to the visual retrieval. The famous local feature descriptor is called the Scale Invariant Feature Transform (SIFT), which can keep invariant mapping for the scale, rotate and simulate images. To utilize effectively the SIFT feature descriptor for visual matching on different hardware platforms, this paper proposes an accelerated SIFT algorithm based on the SIFT feature computing principle of the general multi-core platform. First, our multi-core task allocation method introduces the WFM theory into task assignment for each core to improve the core computing resource utilization for high-efficient parallel computing. Then, to improve the efficiency of picture matching, we introduce global geometric constraints condition to optimal picture matching for the multi-core parallelization approach. Experimental results show that the proposed approach can save on average 87.31% on the Intel X86 platform, compared to the single-core time. Also, our approach can save on average 33.79% on the Raspberry Pi platform, compared to the single-core time.