bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Susceptibility of Skyrmion Crystal
Authors: Timofeev V. E. , Aristov D. N.
Published: May 2023

Using stereographic projection approach, we develop a theory for calculation of dynamic susceptibility tensor of Skyrmion crystals (SkX), formed in thin ferromagnetic films with Dzyaloshinskii–Moriya interaction and in the external magnetic field. Staying whenever possible within analytical framework, we employ the model ansatz for static SkX configuration and discuss small fluctuations around it. The obtained formulas are numerically analyzed in the important case of uniform susceptibility, accessible in magnetic resonance experiments. We show that, in addition to three characteristic magnetic resonance frequencies discussed earlier both theoretically and experimentally, one should also expect several resonances of smaller amplitude at somewhat higher frequencies.
First Find of a Frozen Mummy of the Fossil Don Hare Lepus tanaiticus (Leporidae, Lagomorpha) from the Pleistocene of Yakutia
Authors: Boeskorov G. G. , Chernova O. F. , Shchelchkova M. V.
Published: May 2023

Until recently, only bone remains of Don hares, which went extinct in the Holocene, were known. For the first time, the mummy of an adult hare, identified as a Don hare, has made it possible to expand our understanding of this species and its morphological adaptations to living conditions in the Arctic steppes of the Pleistocene of Yakutia: large body length, short ears and feet, powerful locomotor apparatus of the hind limbs, hard hair brushes on the feet, and excellent heat-shielding properties of the fur, including the specific microstructure of the hairs.
Alkali Waters of the Ultrabasic Massif of Mount Soldatskaya, Kamchatka: Chemical and Isotopic Compositions, Mineralogy, and 14C Age of Travertines
Authors: Taran Yu. A. , Savelyev D. P. , Palyanova G. A. , Pokrovskii B. G.
Published: May 2023

A detailed description of alkali water springs (pH > 10) found within the ultrabasic massif of Mount Soldatskaya in the Kamchatsky Mys Peninsula in Kamchatka is presented for the first time. The chemical composition of the springs and the dependence of the ratios and concentrations of some components on pH are indicative of the fact that these waters were involved in the present-day serpentinization of ultrabasic rocks. The springs with the highest alkali levels (pH 12.3) contain dissolved hydrogen at a concentration of about 0.6 mmol/l. The isotopic composition behavior of carbonate travertines deposited from these springs (δ13C and δ18O) differs from the known trend of “meteogenic” travertines related to serpentinization of ultrabasic rocks in Oman and California. The age of travertines determined by the radiocarbon method is close to modern.
Efficacious retrial of electroconvulsive therapy for major depressive disorder after a prolonged seizure in an older adult
Authors: Kramkowski Joseph , Rath Swapnil
Published: May 2023

This is a case of a woman in her 70s with treatment-resistant major depression who was admitted psychiatrically for the fifth time in 1.5 years. She had a history of intensive psychotherapy and psychotropic medication trials with poor efficacy. She also had a history of adverse complications to electroconvulsive therapy (ECT) with prolonged seizures and postictal confusion during her third hospitalisation. At her fifth hospitalisation, due to poor response to routine psychiatric treatment, ECT was pursued. We discuss challenges in pursuing ECT and the outcome of the retrial of an acute ECT series, in the context of a paucity of similar literature regarding geriatric depression.
Sphenochoanal polyps
Authors: Bayazid Leith , Josephson Gary D
Published: May 2023

Nasal polyps are a common aetiology for persistent nasal obstruction. While antrochoanal polyps predominate the literature, the lesser known sphenochoanal polyp is equally as bothersome. To our knowledge, no prior dedicated review exists that characterises the patient population affected by this disease. We present a case and associated literature review over the past 30 years on the patient demographics and treatment of sphenochoanal polyps. A total of 88 cases were identified. Of the published cases, 77 were included in our search as patient characteristics were available. The age ranged from 2 to 80 years old. There were 35 female and 42 male patients. Only 58 studies established laterality, with the polyps originating from the left in 32 cases, right in 25 and bilateral in 1 case. Sphenochoanal polyps occur in all ages, nearly even distribution across sex. Endoscopic removal is safe with favourable outcomes.
Clinicoradiological course of abemaciclib-induced pneumonitis with histology findings
Authors: Okayasu Kaori , Kawasaki Tsutomu , Kumagai Jiro , Miyazaki Yasunari
Published: May 2023

A woman in her late 40s presented with multiple abnormal shadows on high-resolution CT (HRCT), was treated with abemaciclib for recurrent right breast cancer post-surgery and chemoradiation therapy. During the 10-month chemotherapy, HRCT revealed a recurrent pattern of a partly appearing and disappearing organising pneumonia pattern without clinical symptoms. Bronchoalveolar lavage analysis revealed lymphocytosis, while transbronchial lung biopsy revealed alveolitis with epithelial cell injury. Based on the diagnosis of drug-induced pneumonitis due to abemaciclib, the discontinuation of abemaciclib and administration of prednisolone were effective. Abnormal shadow on HRCT disappeared gradually, while elevated Krebs von den Lungen (KL)-6 and surfactant protein (SP)-D levels were restored to normal range. This is the first case report of abemaciclib-induced pneumonitis with histology findings. Since the severity of abemaciclib-induced pneumonitis ranges from mild to fatal, regular monitoring of pneumonitis with radiography, HRCT, and measurement of KL-6 and SP-D levels should be considered.
Variations in all-cause mortality, premature mortality and cause-specific mortality among persons with diabetes in Ontario, Canada
Authors: Rosella Laura C , Kornas Kathy , Negatu Ednah , Zhou Limei
Published: May 2023

Introduction

Patients with diabetes have a higher risk of mortality compared with the general population. Large population-based studies that quantify variations in mortality risk for patients with diabetes among subgroups in the population are lacking. This study aimed to examine the sociodemographic differences in the risk of all-cause mortality, premature mortality, and cause-specific mortality in persons diagnosed with diabetes.

Research design and methods

We conducted a population-based cohort study of 1 741 098 adults diagnosed with diabetes between 1994 and 2017 in Ontario, Canada using linked population files, Canadian census, health administrative and death registry databases. We analyzed the association between sociodemographics and other covariates on all-cause mortality and premature mortality using Cox proportional hazards models. A competing risk analysis using Fine-Gray subdistribution hazards models was used to analyze cardiovascular and circular mortality, cancer mortality, respiratory mortality, and mortality from external causes of injury and poisoning.

Results

After full adjustment, individuals with diabetes who lived in the lowest income neighborhoods had a 26% (HR 1.26, 95% CI 1.25 to 1.27) increased hazard of all-cause mortality and 44% (HR 1.44, 95% CI 1.42 to 1.46) increased risk of premature mortality, compared with individuals with diabetes living in the highest income neighborhoods. In fully adjusted models, immigrants with diabetes had reduced risk of all-cause mortality (HR 0.46, 95% CI 0.46 to 0.47) and premature mortality (HR 0.40, 95% CI 0.40 to 0.41), compared with long-term residents with diabetes. Similar HRs associated with income and immigrant status were observed for cause-specific mortality, except for cancer mortality, where we observed attenuation in the income gradient among persons with diabetes.

Conclusions

The observed mortality variations suggest a need to address inequality gaps in diabetes care for persons with diabetes living in the lowest income areas.
Understanding birthing preferences of women in Benin City, Nigeria: a qualitative study
Authors: Eluobaju Debra , Okonofua F , Weine Stevan , Goba Gelila
Published: May 2023

Objective

The aim of this study was to explore women’s birthing preferences and the motivational and contextual factors that influence their preferences in Benin City, Nigeria, so as to better understand the low rates of healthcare facility usage during childbirth.

Setting

Two primary care centres, a community health centre and a church within Benin City, Nigeria.

Participants

We conducted one-on-one in-depth interviews with 23 women, and six focus groups (FGDs) with 37 husbands of women who delivered, skilled birth attendants (SBAs), and traditional birth attendants (TBAs) in a semi-rural region of Benin City, Nigeria.

Results

Three themes emerged in the data: (1) women reported frequently experiencing maltreatment from SBAs in clinic settings and hearing stories of maltreatment dissuaded women from giving birth in clinics, (2) women reported that the decision of where to deliver is impacted by how they sort through a range of social, economic, cultural and environmental factors; (3) women and SBAs offered systemic and individual level solutions for increasing usage of healthcare facilities delivery, which included decreasing costs, increasing the ratio of SBAs to patients and SBAs adopting some practices of TBAs, such as providing psychosocial support to women during the perinatal period.

Conclusion

Women in Benin City, Nigeria indicated that they want a birthing experience that is emotionally supportive, results in a healthy baby and is within their cultural scope. Adopting a woman-centred care approach may encourage more women to transition from prenatal care to childbirth with SBAs. Efforts should be placed on training SBAs as well as investigating how non-harmful cultural practices can be integrated into local healthcare systems.
Effectiveness of warm-up interventions on work-related musculoskeletal disorders, physical and psychosocial functions among workers: a systematic review
Authors: Larinier Nicolas , Vuillerme Nicolas , Balaguier Romain
Published: May 2023

Objectives

The aim of this systematic review was to identify from published literature the available evidence regarding the effects of warm-up intervention implemented in the workplace on work -related musculoskeletal disorders (WMSDs) and physical and psychosocial functions.

Design

Systematic review.

Data sources

The following four electronic databases were searched (from inception onwards to October 2022): Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (Medline), Web of Science and Physiotherapy Evidence Database (PEDro).

Eligibility criteria

Randomised and non-randomised controlled studies were included in this review. Interventions should include a warm-up physical intervention in real-workplaces.

Data extraction and synthesis

The primary outcomes were pain, discomfort, fatigue and physical functions. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Grading of Recommendations, Assessment, Development and Evaluation evidence synthesis. To assess the risk of bias, the Cochrane ROB2 was used for randomised controlled trial (RCT) and the Risk Of Bias In Non-randomised Studies-of Interventions was used for the non-RCT studies.

Results

Three studies met the inclusion criterion, one cluster RCT and two non-RCTs. There was an important heterogeneity in the included studies principally concerning population and warm-up intervention exercises. There were important risks of bias in the four selected studies, due to blinding and confounding factors. Overall certainty of evidence was very low.

Conclusion

Due to the poor methodological quality of studies and conflicting results, there was no evidence supporting the use of warm-up to prevent WMSDs in the workplace. The present findings highlighted the need of good quality studies targeting the effects of warm-up intervention to prevent WMSDs.

PROSPERO registration number

CRD42019137211.
Effect of the machine learning-derived Hypotension Prediction Index (HPI) combined with diagnostic guidance versus standard care on depth and duration of intraoperative and postoperative hypotension in elective cardiac surgery patients: HYPE-2 – study protocol of a randomised clinical trial
Authors: Rellum Santino R , Schuurmans Jaap , Schenk Jimmy , van der Ster Björn J P , van der Ven Ward H , Geerts Bart F , Hollmann Markus W , Cherpanath Thomas G V , Lagrand Wim K , Wynandts Paul , Paulus Frederique , Driessen Antoine H G , Terwindt Lotte E , Eberl Susanne , Hermanns Henning , Veelo Denise P , Vlaar Alexander P J
Published: May 2023

Introduction

Hypotension is common during cardiac surgery and often persists postoperatively in the intensive care unit (ICU). Still, treatment is mainly reactive, causing a delay in its management. The Hypotension Prediction Index (HPI) can predict hypotension with high accuracy. Using the HPI combined with a guidance protocol resulted in a significant reduction in the severity of hypotension in four non-cardiac surgery trials. This randomised trial aims to evaluate the effectiveness of the HPI in combination with a diagnostic guidance protocol on reducing the occurrence and severity of hypotension during coronary artery bypass grafting (CABG) surgery and subsequent ICU admission.

Methods and analysis

This is a single-centre, randomised clinical trial in adult patients undergoing elective on-pump CABG surgery with a target mean arterial pressure of 65 mm Hg. One hundred and thirty patients will be randomly allocated in a 1:1 ratio to either the intervention or control group. In both groups, a HemoSphere patient monitor with embedded HPI software will be connected to the arterial line. In the intervention group, HPI values of 75 or above will initiate the diagnostic guidance protocol, both intraoperatively and postoperatively in the ICU during mechanical ventilation. In the control group, the HemoSphere patient monitor will be covered and silenced. The primary outcome is the time-weighted average of hypotension during the combined study phases.

Ethics and dissemination

The medical research ethics committee and the institutional review board of the Amsterdam UMC, location AMC, the Netherlands, approved the trial protocol (NL76236.018.21). No publication restrictions apply, and the study results will be disseminated through a peer-reviewed journal.

Trial registration number

The Netherlands Trial Register (NL9449), ClinicalTrials.gov (NCT05821647).
Mom’s Good Mood: screening and management of perinatal depression within primary healthcare system in China–protocol for an effectiveness–implementation design study
Authors: Lu Mengjuan , Jiang Minmin , Gu Yue , Li Haiyan , Hou Yanyan , Yu Xiayan , Cao Yunxia , Zhu Beibei , Tao Fangbiao
Published: May 2023

Introduction

The management of perinatal depression (PND) is challenging in China. The Thinking Healthy Programme (THP), developed under the core theory of cognitive–behavioural therapy, is an evidence-based approach that is recommended as a psychosocial intervention for managing PND in low/middle-income countries. Sparse evidence has been generated, however, to assess the effectiveness of THP and guide its implementation in China.

Methods and analysis

A hybrid type II effectiveness–implementation study is ongoing in four cities in Anhui Province, China. A comprehensive online platform, Mom’s Good Mood (MGM), has been developed. Perinatal women are screened using the WeChat screening tool (ie, Edinburgh Postnatal Depression Scale embedded as metrics) in clinics. Different intensities of the intervention are delivered through the mobile application for different degrees of depression, according to the stratified care model. The THP WHO treatment manual has been tailored to be the core component of intervention. Guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, process evaluations will be conducted to identify the facilitators and barriers to implementation and to modify the implementation strategy; summative evaluations will be carried out to examine the effectiveness of MGM in the management of PND within the primary healthcare system in China.

Ethics and dissemination

Ethics approval and consent for this programme were obtained from Institutional Review Boards in China: Anhui Medical University, Hefei, People’s Republic of China (20170358). Results will be submitted to relevant conferences and peer-reviewed journals.

Trial registration number

ChiCTR1800016844.
Understanding medication safety involving patient transfer from intensive care to hospital ward: a qualitative sociotechnical factor study
Authors: Bourne Richard S , Jeffries Mark , Phipps Denham L , Jennings Jennifer K , Boxall Emma , Wilson Franki , March Helen , Ashcroft Darren M
Published: May 2023

Objective

To understand the sociotechnical factors affecting medication safety when intensive care patients are transferred to a hospital ward. Consideration of these medication safety factors would provide a theoretical basis, on which future interventions can be developed and evaluated to improve patient care.

Design

Qualitative study using semistructured interviews of intensive care and hospital ward-based healthcare professionals. Transcripts were anonymised prior to thematic analysis using the London Protocol and Systems Engineering in Patient Safety V.3.0 model frameworks.

Setting

Four north of England National Health Service hospitals. All hospitals used electronic prescribing in intensive care and hospital ward settings.

Participants

Intensive care and hospital ward healthcare professionals (intensive care medical staff, advanced practitioners, pharmacists and outreach team members; ward-based medical staff and clinical pharmacists).

Results

Twenty-two healthcare professionals were interviewed. We identified 13 factors within five broad themes, describing the interactions that most strongly influenced the performance of the intensive care to hospital ward system interface. The themes were: Complexity of process performance and interactions; Time pressures and considerations; Communication processes and challenges; Technology and systems and Beliefs about consequences for the patient and organisation.

Conclusions

The complexity of the interactions on the system performance and time dependency was clear. We make several recommendations for policy change and further research based on improving: availability of hospital-wide integrated and functional electronic prescribing systems, patient flow systems, sufficient multiprofessional critical care staffing, knowledge and skills of staff, team performance, communication and collaboration and patient and family engagement.
Cohort profile: Using primary care data to understand Opioid Prescribing, Policy Impacts and Clinical Outcomes (OPPICO) in Victoria, Australia.
Authors: Nielsen Suzanne , Buchbinder Rachelle , Pearce Christopher , Lubman Dan , Lalic Samanta , Haas Romi , Picco Louisa , Jung Monica , Cangadis-Douglass Helena , Ilomaki Jenni , Bell J Simon , Xia Ting
Published: May 2023

Purpose

The OPPICO cohort is a population-based cohort based on non-identifiable electronic health records routinely collected from 464 general practices in Victoria, Australia, created with the aim of understanding opioid prescribing, policy impacts and clinical outcomes. The aim of this paper is to provide a profile of the study cohort by summarising available demographic, clinical and prescribing characteristics.

Participants

The cohort described in this paper comprises people who were aged at least 14 years at cohort entry, and who were prescribed an opioid analgesic at least once at participating practices for a total of 1 137 728 person-years from 1 January 2015 to 31 December 2020. The cohort was formed using the data collected from electronic health records through the Population Level Analysis and Reporting (POLAR) system. The POLAR data primarily consist of patient demographics, clinical measurements, Australian Medicare Benefits Scheme item numbers, diagnoses, pathology testing and prescribed medications.

Finding to date

In total, the cohort consists of 676 970 participants with 4 389 185 opioid prescription records from 1 January 2015 to 31 December 2020. Approximately half (48.7%) received a single opioid prescription, and 0.9% received more than 100 opioid prescriptions. The mean number of opioid prescriptions per patient was 6.5 (SD=20.9); prescriptions for strong opioids accounted for 55.6% of all opioid prescriptions.

Future plans

The OPPICO cohort data will be used for various types of pharmacoepidemiological research, including examining the impact of policy changes on coprescription of opioids with benzodiazepines and gabapentin, and monitoring trends and patterns of other medication utilisation. Through data-linkage between our OPPICO cohort and hospital outcome data, we will examine whether policy changes for opioid prescribing lead to changes in prescription opioid-related harms, and other drug and mental health-related outcomes.

Trial registration number

EU PAS Register (EUPAS43218, prospectively registered).
Efficacy of non-pharmacological interventions on depressive symptoms in patients with Parkinson’s disease: a study protocol for a systematic review and network meta-analysis
Authors: Jiang Xiaoyu , Zhang Linlin , Liu Huifen , Su Hang , Jiang Jiahui , Qiang Chen , Wang Qing , Qu Xinjie , Sun Wenyu , Bi Hongyan
Published: May 2023

Introduction

Depression is the most dominant non-motor symptom of Parkinson’s disease (PD), with a prevalence of up to 50%, and can lead to a range of psychiatric and psychological problems that can affect quality of life and overall functioning. While several randomised controlled trials (RCTs) have tested the effect of certain non-pharmacological interventions on the outcome of PD depression symptoms, the comparative benefits and harms of these remain unclear. We will conduct a systematic review and network meta-analysis to compare the efficacy and safety of different non-pharmacological interventions for patients with PD depression.

Methods and analysis

We will search PubMed, Web of Science, Cochrane, Embase, Google Scholar, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, WanFang Data and the Chongqing VIP Database from their inception date to June 2022. The studies will be limited to results published in English or Chinese. The primary outcomes will be the changes in the depressive symptoms, while secondary outcomes will include adverse effects and the quality of life. Two researchers will screen those documents that meet the inclusion criteria, extracting data according to the preset table and evaluating the methodological quality of the included studies using the Cochrane Risk of Bias 2.0 Tool. The STATA and ADDIS statistical software will be used to conduct a systematic review and network meta-analysis. A traditional pairwise meta-analysis and a network meta-analysis will be performed to compare the efficacy and safety of different non-pharmacological interventions, ensuring the robustness of the findings. The Grading of Recommendations Assessment, Development and Evaluation system will be used to assess the overall quality of the body of evidence associated with the main results. The publication bias assessment will be conducted using comparison-adjusted funnel plots.

Ethics and dissemination

All the data for this study will be extracted from published RCTs. As a literature-based systematic review, this study does not require ethical approval. The results will be disseminated through peer-reviewed journals and national/international conference presentations.

PROSPERO registration number

CRD42022347772.
Development and validation of a prediction nomogram for academic burnout among Chinese adolescents: a cross-sectional study
Authors: Ye Sheng , Wang Rui , Pan Huiqing , Zhao Feiyang , Li Weijia , Xing Jingjing , Wu Jinting
Published: May 2023

Objectives

This study aimed to screen the potential risk factors for academic burnout among adolescents during the COVID-19 pandemic, develop and validate a predictive tool based on the risk factors for predicting academic burnout.

Design

This article presents a cross-sectional study.

Setting

This study surveyed two high schools in Anhui Province, China.

Participants

A total of 1472 adolescents were enrolled in this study.

Outcome measures

The questionnaires included demographic characteristic variables, living and learning states and adolescents’ academic burnout scale. Least absolute shrinkage and selection operator and multivariate logistic regression analyses were employed to screen the risk factors for academic burnout and develop a predictive model. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the accuracy and discrimination of the nomogram.

Results

In this study, 21.70% of adolescents reported academic burnout. Multivariable logistic regression analysis showed that single-child family (OR=1.742, 95% CI: 1.243 to 2.441, p=0.001), domestic violence (OR=1.694, 95% CI: 1.159 to 2.476, p=0.007), online entertainment (>8 hours/day, OR=3.058, 95% CI: 1.634 to 5.720, p<0.001), physical activity (<3 hours/week, OR=1.686, 95% CI: 1.032 to 2.754, p=0.037), sleep duration (<6 hours/night, OR=2.342, 95% CI: 1.315 to 4.170, p=0.004) and academic performance (<400 score, OR=2.180, 95% CI: 1.201 to 3.958, p=0.010) were independent significant risk factors associated with academic burnout. The area under the curve of ROC with the nomogram was 0.686 in the training set and 0.706 in the validation set. Furthermore, DCA demonstrated that the nomogram had good clinical utility for both sets.

Conclusions

The developed nomogram was a useful predictive model for academic burnout among adolescents during the COVID-19 pandemic. It is essential to emphasise the importance of mental health and promote a healthy lifestyle among adolescents during the future pandemic.
Calibrating the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) for detecting alcohol-related problems among Canadian, UK and US soldiers: cross-sectional pre-deployment and post-deployment survey results
Authors: Duffy Farifteh Firoozmand , Sudom Kerry , Jones Margaret , Fear Nicola T , Greenberg Neil , Adler Amy B , Hoge Charles W , Wilk Joshua E , Riviere Lyndon A
Published: May 2023

Objectives

Excessive alcohol use can bring about adverse health and work-related consequences in civilian and military populations. Screening for excessive drinking can help identify individuals at risk for alcohol-related problems who may require clinical interventions. The brief validated measures of alcohol use such as the Alcohol Use Disorders Identification Test (AUDIT), or abbreviated AUDIT-Consumption (AUDIT-C), are often included in military deployment screening and epidemiologic surveys, but appropriate cut-points must be used to effectively identify individuals at risk. Although the conventional AUDIT-C cut-points ≥4 for men and ≥3 for women are commonly used, recent validation studies of veterans and civilians recommend higher cut-points to minimise misclassification and overestimation of alcohol-related problems. This study aims to ascertain optimal AUDIT-C cut-points for detecting alcohol-related problems among serving Canadian, UK and US soldiers.

Design

Cross-sectional pre/post-deployment survey data were used.

Settings

Comprised Army locations in Canada and UK, and selected US Army units.

Participants

Included soldiers in each of the above-mentioned settings.

Outcome measures

Soldiers’ AUDIT scores for hazardous and harmful alcohol use or high levels of alcohol problems served as a benchmark against which optimal sex-specific AUDIT-C cut-points were assessed.

Results

Across the three-nation samples, AUDIT-C cut-points of ≥6/7 for men and ≥5/6 for women performed well in detecting hazardous and harmful alcohol use and provided comparable prevalence estimates to AUDIT scores ≥8 for men and ≥7 for women. The AUDIT-C cut-point ≥8/9 for both men and women performed fair-to-good when benchmarked against AUDIT ≥16, although inflated AUDIT-C-derived prevalence estimates and low positive predictive values were observed.

Conclusion

This multi-national study provides valuable information regarding appropriate AUDIT-C cut-points for detecting hazardous and harmful alcohol use, and high levels of alcohol problems among soldiers. Such information can be useful for population surveillance, pre-deployment/post-deployment screening of military personnel, and clinical practice.
Fertility and contraceptive dynamics amidst COVID-19: who is at greatest risk for unintended pregnancy among a cohort of adolescents and young adults in Nairobi, Kenya?
Authors: Wood Shannon N , Byrne Meagan E , Thiongo Mary , Devoto Bianca , Wamue-Ngare Grace , Decker Michele R , Gichangi Peter
Published: May 2023

Objectives

Among youth in Nairobi, we (1) characterised fertility and contraceptive use dynamics by gender; (2) estimated pregnancy prevalence over the pandemic; and (3) assessed factors associated with unintended pandemic pregnancy for young women.

Design

Longitudinal analyses use cohort data collected at three timepoints prior to and during the COVID-19 pandemic: June to August 2019 (pre-pandemic), August to October 2020 (12-month follow-up) and April to May 2021 (18-month follow-up).

Setting

Nairobi, Kenya.

Participants

At initial cohort recruitment, eligible youth were aged 15–24 years, unmarried and residing in Nairobi for at least 1 year. Within-timepoint analyses were restricted to participants with survey data per round; trend and prospective analyses were restricted to those with complete data at all three timepoints (n=586 young men, n=589 young women).

Primary and secondary outcome measures

Primary outcomes comprised fertility and contraceptive use for both genders, and pregnancy for young women. Unintended pandemic pregnancy (assessed at 18-month follow-up) was defined as a current or past 6-month pregnancy with intent to delay pregnancy for more than 1 year at 2020 survey.

Results

While fertility intentions remained stable, contraceptive dynamics varied by gender—young men both adopted and discontinued coital-dependent methods, whereas young women adopted coital-dependent or short-acting methods at 12-month follow-up (2020). Current pregnancy was highest at 2020 (4.8%), and approximately 2% at 2019 and 2021. Unintended pandemic pregnancy prevalence was 6.1%, with increased odds for young women recently married (adjusted OR (aOR)=3.79; 95% confidence interval (CI) 1.83–7.86); recent contraceptive use was protective against unintended pandemic pregnancy (aOR=0.23; 95% CI 0.11–0.47).

Conclusions

Current pregnancy in Nairobi was highest at the height of the COVID-19 pandemic (2020), and subsided to pre-pandemic levels by 2021 data collection; however, requires further monitoring. New marriages posed considerable risk for unintended pandemic pregnancy. Contraceptive use remains a crucial preventive strategy to averting unintended pregnancy, particularly for married young women.
COVID-19 vaccine effectiveness among healthcare workers: a hospital-based cohort study
Authors: Gaio Vânia , Santos Ana João , Amaral Palmira , Faro Viana João , Antunes Isabel , Pacheco Vânia , Paiva Artur , Pinto Leite Pedro , Antunes Gonçalves Lígia , Araújo Lucília , Silva Adriana , Dias Carlos , Kislaya Irina , Nunes Baltazar , Machado Ausenda
Published: May 2023

Objectives

Healthcare workers (HCWs) were the first to be prioritised for COVID-19 vaccination. This study aims to estimate the COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 symptomatic infection among HCWs in Portuguese hospitals.

Design

Prospective cohort study.

Setting and participants

We analysed data from HCWs (all professional categories) from three central hospitals: one in the Lisbon and Tagus Valley region and two in the central region of mainland Portugal, between December 2020 and March 2022. VE against symptomatic SARS-CoV-2 infection was estimated as one minus the confounder adjusted HRs by Cox models considering age group, sex, self-reported chronic disease and occupational exposure to patients diagnosed with COVID-19 as adjustment variables.

Results

During the 15 months of follow-up, the 3034 HCWs contributed a total of 3054 person-years at risk, and 581 SARS-CoV-2 events occurred. Most participants were already vaccinated with a booster dose (n=2653, 87%), some are vaccinated with only the primary scheme (n=369, 12.6%) and a few remained unvaccinated (n=12, 0.4%) at the end of the study period. VE against symptomatic infection was 63.6% (95% CI 22.6% to 82.9%) for HCWs vaccinated with two doses and 55.9% (95% CI −1.3% to 80.8%) for HCWs vaccinated with one booster dose. Point estimate VE was higher for individuals with two doses taken between 14 days and 98 days (VE=71.9%; 95% CI 32.3% to 88.3%).

Conclusion

This cohort study found a high COVID-19 VE against symptomatic SARS-CoV-2 infection in Portuguese HCWs after vaccination with one booster dose, even after Omicron variant occurrence. The small sample size, the high vaccine coverage, the very low number of unvaccinated individuals and the few events observed during the study period contributed to the low precision of the estimates.
Effects of qCON and qNOX-guided general anaesthesia management on patient opioid use and prognosis: a study protocol
Authors: Kang Jiamin , Fang Chongliang , Li Yuanjie , Yuan Yuan , Niu Kaijun , Zheng Yuxin , Yu Yonghao , Wang Guolin , Li Yize
Published: May 2023

Introduction

The adverse effects of general anaesthetic drugs (especially opioids) cannot be ignored. However, current nociceptive-monitoring techniques still lack consistency in guiding the use of opioids. This trial will study the demand for opioid use and patient prognosis in qCON and qNOX-guided general anaesthesia management.

Methods and analysis

This prospective, randomised, controlled trial will randomly recruit 124 patients undergoing general anaesthesia for non-cardiac surgery in equal numbers to either the qCON or BIS group. The qCON group will adjust intraoperative propofol and remifentanil dosage according to qCON and qNOX values, while the BIS group will adjust according to BIS values and haemodynamic fluctuations. The differences between the two groups will be observed in remifentanil dosing and prognosis. The primary outcome will be intraoperative remifentanil use. Secondary outcomes will include propofol consumption; the predictive ability of BIS, qCON and qNOX on conscious responses, noxious stimulus and body movements; and changes in cognitive function at 90 days postoperatively.

Ethics and dissemination

This study involves human participants and was approved by the Ethics Committee of the Tianjin Medical University General Hospital (IRB2022-YX-075-01). Participants gave informed consent to participate in the study before taking part. The study results will be published in peer-reviewed journals and presented at relevant academic conferences.

Trial registration number

ChiCTR2200059877
Association between triglyceride glucose-related markers and the risk of metabolic-associated fatty liver disease: a cross-sectional study in healthy Chinese participants
Authors: Chang Mingxing , Shao Zhihao , Shen Guifang
Published: May 2023

Objectives

This study aimed to evaluate the performance of the triglyceride glucose (TyG) index and its related markers in predicting metabolic-associated fatty liver disease (MAFLD) in healthy Chinese participants.

Design

This was a cross-sectional study.

Setting

The study was conducted at Health Management Department of the Affiliated Hospital of Xuzhou Medical University.

Participants

A total of 20 922 asymptomatic Chinese participants (56% men) were enrolled.

Outcome measures

Hepatic ultrasonography was performed to diagnose MAFLD based on the latest diagnostic criteria. The TyG, TyG-body mass (TyG-BMI) and TyG-waist circumference indices were calculated and analysed.

Results

Compared with the lowest quartile of the TyG-BMI, the adjusted ORs and 95% CIs for MAFLD were 20.76 (14.54 to 29.65), 92.33 (64.61 to 131.95) and 380.87 (263.25 to 551.05) in the second, third and fourth quartiles, respectively. According to the subgroup analysis, the TyG-BMI in the female and the lean groups (BMI<23 kg/m2) showed the strongest predictive value, with optimal cut-off values for MAFLD of 162.05 and 156.31, respectively. The areas under the receiver operating characteristic curves in female and lean groups were 0.933 (95% CI 0.927 to 0.938) and 0.928 (95% CI 0.914 to 0.943), respectively, with 90.7% sensitivity and 81.2% specificity in female participants with MAFLD and 87.2% sensitivity and 87.1% specificity in lean participants with MAFLD. The TyG-BMI index demonstrated superior predictive ability for MAFLD compared with other markers.

Conclusions

The TyG-BMI is an effective, simple and promising tool for predicting MAFLD, especially in lean and female participants.
Clinical practice guidelines for cardiovascular disease: how is depression addressed? Protocol for a systematic review
Authors: Blatch Armon Dana , Buhayer Aliki , Dobretz Kevin , Meinlschmidt Gunther , Battegay Edouard
Published: May 2023

Introduction

Depression frequently affects patients with cardiovascular disease (CVD). When these conditions co-occur, outcomes such as quality of life and life expectancy worsen. In everyday practice, this specific and prevalent disease-disease interaction complicates patient management. Clinical practice guidelines (CPGs) aim to provide the best available advice for clinical decision-making to improve patient care. This study will aim to evaluate how CPGs specifically address depression in patients with CVD, and whether they provide any operational guidance for screening and management of depression in the primary care and outpatient setting.

Methods and analysis

We will conduct a systematic review of CPGs on CVD management published from 2012 to 2023. A broad literature search for guidelines will be performed through electronic medical databases, grey literature search tools, and websites of national and professional medical organisations.

Based on the inclusion criteria, two independent reviewers will evaluate eligible guidelines for screening and management recommendations on depression in patients with CVD. Additional points to be evaluated will be any mention of drug–drug or drug–disease interactions, other aspects of specific relevance to treating physicians, as well as general information on mental health. We will assess the quality of CPGs with a recommendation regarding depression in CVD patients using the Appraisal of Guidelines for Research and Evaluation II.

Ethics and dissemination

As this systematic review is based on available published data, ethics approval and consent are not applicable. Our intent is that our results will be published in a peer-reviewed journal, presented at international scientific meetings, and distributed to healthcare providers.

PROSPERO registration number

CRD42022384152.
A culturally tailored personaliseD nutrition intErvention in South ASIan women at risk of Gestational Diabetes Mellitus (DESI-GDM): a randomised controlled trial protocol
Authors: Stennett Rosain N , Adamo Kristi B , Anand Sonia S , Bajaj Harpreet S , Bangdiwala Shrikant I , Desai Dipika , Gerstein Hertzel C , Kandasamy Sujane , Khan Farah , Lear Scott A , McDonald Sarah D , Pocsai Tayler , Ritvo Paul , Rogge Andrea , Schulze Karleen M , Sherifali Diana , Stearns Jennifer C , Wahi Gita , Williams Natalie C , Zulyniak Michael A , de Souza Russell J
Published: May 2023

Introduction

South Asians are more likely to develop gestational diabetes mellitus (GDM) than white Europeans. Diet and lifestyle modifications may prevent GDM and reduce undesirable outcomes in both the mother and offspring. Our study seeks to evaluate the effectiveness and participant acceptability of a culturally tailored, personalised nutrition intervention on the glucose area under the curve (AUC) after a 2-hour 75 g oral glucose tolerance test (OGTT) in pregnant women of South Asian ancestry with GDM risk factors.

Methods and analysis

A total of 190 South Asian pregnant women with at least 2 of the following GDM risk factors—prepregnancy body mass index>23, age>29, poor-quality diet, family history of type 2 diabetes in a first-degree relative or GDM in a previous pregnancy will be enrolled during gestational weeks 12–18, and randomly assigned in a 1:1 ratio to: (1) usual care, plus weekly text messages to encourage walking and paper handouts or (2) a personalised nutrition plan developed and delivered by a culturally congruent dietitian and health coach; and FitBit to track steps. The intervention lasts 6–16 weeks, depending on week of recruitment. The primary outcome is the glucose AUC from a three-sample 75 g OGTT 24–28 weeks’ gestation. The secondary outcome is GDM diagnosis, based on Born-in-Bradford criteria (fasting glucose>5.2 mmol/L or 2 hours post load>7.2 mmol/L).

Ethics and dissemination

The study has been approved by the Hamilton Integrated Research Ethics Board (HiREB #10942). Findings will be disseminated among academics and policy-makers through scientific publications along with community-orientated strategies.

Trial registration number

NCT03607799.
Skeletal muscle mass recovery after oesophagectomy and neoadjuvant chemotherapy in oesophageal cancer: retrospective cohort study
Authors: Harada Tsuyoshi , Tsuji Tetsuya , Yanagisawa Takumi , Ueno Junya , Hijikata Nanako , Ishikawa Aiko , Hiroshige Keiichi , Kotani Daisuke , Kojima Takashi , Fujita Takeo
Published: May 2023

Objective

Skeletal muscle mass (SMM) is an important biomarker for prognosis and health in older patients with cancer. Limited information is available on the recovery course of SMM after oesophagectomy following neoadjuvant chemotherapy (NAC) in older patients. This study was performed to investigate the recovery course of SMM after oesophagectomy following NAC and the preoperative predictors of delayed recovery in older patients with locally advanced oesophageal cancer (LAEC).

Methods

This single-centre retrospective cohort study involved older (≥65 years) and non-older (<65 years) patients with LAEC who underwent oesophagectomy following NAC. The SMM index (SMI) was calculated using CT images. One-way analysis of variance and multivariate logistic regression analysis were performed.

Results

In total, 110 older patients and 57 non-older patients were analysed. Loss of the SMI after NAC to 12 months postoperatively was significantly greater in older patients than in non-older patients (p<0.01). The significant preoperative predictor of delayed recovery of the SMI 12 months after surgery was loss of the SMI during NAC in older patients (per 1%: adjusted OR 1.249; 95% CI 1.131 to 1.403; p<0.001), but not in non-older patients (per 1%: OR 1.074; 95% CI 0.988 to 1.179; p=0.108).

Conclusions

There is an especially large unmet need for preventing the long-term sequelae of SMM loss in older patients with LAEC after oesophagectomy following NAC. In older patients, loss of SMM during NAC is an especially useful biomarker for prescribing postoperative rehabilitation to prevent postoperative loss of SMM.
Land use in the Prairie Pothole Region influences the soil bacterial community composition and relative abundance of nitrogen cycling genes
Authors: Town Jennifer R. , Yu Min , Lemke Reynald , Helgason Bobbi L.
Published: May 2023

The undulating topography of Prairie Pothole Region of North America creates spatial and temporal variability in soil moisture and nutrient levels, affecting microbial community processes and greenhouse gas emissions. By identifying differences in soil bacterial and archaeal community composition and the abundance of nitrogen cycling genes in permanent cover versus annual crop land over two growing seasons (2017 and 2018), we were able to assess the effects of topography and land use on the functional capacity of the soil microbiome. Permanent grassland cover was associated with higher bacterial diversity in upland positions and lower diversity in low-lying depressions. Bacterial community composition was also significantly different between cultivated and permanent cover at all points along the topographic slope, with the largest effects seen in the footslope and backslope positions. Compared to permanent cover, soil from annual cropland had consistently more abundant nitrifiers, including Nitrospira in the toeslope and backslope, and Nitrososphaeraceae in the shoulder and knoll samples while soils from permanent cover had a greater abundance of several Alphaproteobacteria from Rhodospirillales and Hyphomicrobiaceae across multiple upland positions. Upland soils from annual cropland also had consistently higher abundance of both bacterial and archaeal ammonia oxidizing ( amoA) genes and a higher ratio of nirK: nirS genes compared to those from permanent cover. These differences in microbial community composition were associated with higher N2O and CO2 emissions in upland soils in annual cropland; however, there were no differences in GHG emissions between the two systems in low-lying positions.
On Practical Nearest Sub-Trajectory Queries under the Fréchet Distance
Authors: Gudmundsson Joachim , Pfeifer John , Seybold Martin P.
Published: May 2023

We study the problem of sub-trajectory nearest-neighbor queries on polygonal curves under the continuous Fréchet distance. Given an
n
vertex trajectory
P
and an
m
vertex query trajectory
Q
, we seek to
report
a vertex-aligned sub-trajectory
P
′ of
P
that is closest to
Q
, i.e.,
P′
must start and end on contiguous vertices of
P
. Since in real data
P
typically contains a
very large
number of vertices, we focus on answering queries, without restrictions on
P
or
Q
, using only precomputed structures of
𝒪(n)
size.

We use three baseline algorithms from straightforward extensions of known work; however, they have impractical performance on realistic inputs. Therefore, we propose a new Hierarchical Simplification Tree (HST) data structure and an adaptive clustering-based query algorithm that efficiently explores relevant parts of
P
. The core of our query methods is a novel greedy-backtracking algorithm that solves the Fréchet decision problem using
𝒪(n+m)
space and
𝒪O(nm)
time in the worst case.

Experiments on real and synthetic data show that our heuristic effectively prunes the search space and greatly reduces computations compared to baseline approaches.
Quantum Computing with Differentiable Quantum Transforms
Authors: Matteo Olivia Di , Izaac Josh , Bromley Thomas R. , Hayes Anthony , Lee Christina , Schuld Maria , Száva Antal , Roberts Chase , Killoran Nathan
Published: May 2023

We present a framework for differentiable quantum transforms. Such transforms are metaprograms capable of manipulating quantum programs in a way that preserves their differentiability. We highlight their potential with a set of relevant examples across quantum computing (gradient computation, circuit compilation, and error mitigation), and implement them using the transform framework of PennyLane, a software library for differentiable quantum programming. In this framework, the transforms themselves are differentiable and can be parametrized and optimized, which opens up the possibility of improved quantum resource requirements across a spectrum of tasks.