bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical Simulation of Diverting Fracturing for Staged Fracturing Horizontal Well in Shale Gas Reservoir
Authors: Zhao Jinzhou , Wang Zhenhua , Lin Ran , Ren Lan , Wu Jianfa , Wu Jianjun
Published: October 2022

Hydraulic fractures are difficult to initiate simultaneously during multi-cluster fracturing owing to the strong heterogeneity of shale reservoir and the stress interference effect between adjacent hydraulic fractures. Some hydraulic fractures can initiate early and propagate rapidly, whereas others exhibit late initiation (or even fail to initiate) and propagate slowly, resulting in non-uniform propagation behavior of multiple fractures. This non-uniform propagation behavior can significantly limit hydraulic fracturing performance in shale gas reservoirs. Therefore, the minimization of non-uniform propagation of multi-cluster fractures is important in improving the shale gas development. Currently, diverting fracturing technology is implemented to restrain overextended fractures while promoting restricted fractures to facilitate uniform propagation. Pumping diversion balls to block the perforations of overlong fractures has become an important method to improve non-uniform fracture propagation. This method is, however, limited by lagging behind of theoretical simulation, and significant blindness in the current implementation of diverting fracturing. A dynamic propagation model for multiple-cluster hydraulic fractures was established in the current study by considering the stress interference effect between adjacent fractures and the effect of flowrate dynamic adjustment by diversion balls. This model is effective for the dynamic simulation of fractures propagation after pumping diversion balls. A fractured well in the Changning block was used as an example for the simulation of the dynamic fracture’s extension and the distribution of SRV before and after diversion. The findings showed that the temporary plugging ball significantly promoted the uniform extension. The number of temporary plugging balls, the number of diversions, and the timing of diversion were then optimized. The simulation method developed in this study has important theoretical significance and field application value in guiding regulation of uniform expansion of fractures and improving optimization of diverting fracturing design.
A Novel Non-Intrusive Imaging Technique to Quantify Shrinkage of Elephant Foot Yam During Convective Drying
Authors: Singh Punit , Chakraborty Saurav , Talukdar Prabal
Published: October 2022

The current work discusses the design and development of a novel convective drying system which predicts both the drying and the shrinkage characteristics of any food material simultaneously at different drying air velocities and temperatures. In the present work, the shrinkage characteristics of a cylindrical-shaped Elephant Foot Yam (EFY) food sample are determined by a non-intrusive imaging method. The top- and side-view images of the EFY sample at drying air velocities of 2, 4, and 6 m/s and at air temperatures of 313, 323, and 333 K are captured and processed using an in-house image processing code. The shrinkage characteristics reveal the nature of the transient variation of the bulk volume and the bulk density of the EFY with its moisture content. Suitable correlations developed for the bulk volume of the EFY suggest that it varies quadratically with moisture content, whereas the bulk density varies exponentially with moisture content for all drying conditions. It was also found that the developed methodology can predict the transient volume and density of the drying EFY sample for different cases of air velocities and temperature with significant accuracies.
Development of a Modular, Adaptable and Scalable Gravity Anchor System for Various Floating Foundations
Authors: Flores Ganuza Imanol , Wahrendorf Johannes , Hlawatsch Eva , Adam Frank , Großmann Jochen
Published: October 2022

A significant requirement for the further development of floating wind turbines is the reduction of cost and fabrication time. This can be achieved through a universally applicable anchor design, that can be utilized in almost all use cases and that enables decentralized and industrialized mass production.

For this reason, a universal modular and scalable gravity anchor system was developed and is presented within this paper. The gravity anchor system consists of reinforced concrete modules which can be combined with each other by a connector system in order to scale the mass and bearing surface. Each module weighs approximately 1000 tons. A “module kit” of several modules for the various functions of a gravity anchor structure was developed. This enables a wide range of adaption of the structure to fit the specific requirements of the case. The modules can be produced decentralized and transported to a dry dock, where a time and cost-efficient assembly takes place.

The installation process of the anchor is fast and cost efficient and almost independent of the water depth. The modules of the anchor are hollow inside and therefore buoyant. During installation process the modules are filled with water. Transport and installation of the anchor can be done by simple tug boats.

The anchor is suitable for almost all seabed types, environmental impact during installation is kept to a minimum. Due to modularity the anchor system can be optimally adapted to all types of floating structures, mooring configurations and seabed conditions and can be used both as a single-point and as a multi-point anchor in a wind farm.
Influence on Structural Loading of a Wave Energy Converter by Controlling Variable-Geometry Components and the Power Take-Off
Authors: Husain Salman , Davis Jacob , Tom Nathan , Thiagarajan Krish , Burge Cole , Nguyen Nhu
Published: October 2022

Oceans are harsh environments and can impose significant loads on deployed structures. The deployment of wave energy converters (WECs) faces a design challenge with apparently contradictory goals. A WEC should be designed to maximize the energy absorbed while ensuring the operating wave condition does not exceed the failure limits of the device itself. Therefore, the loads endured by the support structure are a design constraint for the system. Adaptability to different sea states is, therefore, highly desirable. This work uses a WEC-Sim model of a variable-geometry oscillating wave energy converter (VGOSWEC) mounted on a support structure simulated under different wave scenarios. A VGOSWEC resembles a paddle pitching about a fixed hinge perpendicular to the incoming wave fronts. Therefore, the hinge experiences loads perpendicular to its axis as it maintains its position. The geometry of the VGOSWEC is varied by opening a series of controllable flaps on the pitching paddle when the structure experiences threshold loads. Because opening the flaps lets the waves transmit through the paddle, it is hypothesized that opening the flaps should result in load shedding at the base of the support structure. The load shedding is achieved by reducing the moments about the hinge axis. This work compares the hydrodynamic coefficients, natural periods, and response amplitude operators from completely closed to completely open configurations of the controllable flaps. The comparisons quantify the effects of letting the waves transmit through the VGOSWEC. This work shows that the completely open configuration can reduce the pitch and surge loads on the base of the support structure by as much as 80%. It was observed that at the paddle’s resonance frequency, the loads on the structure increased substantially. This increase in loads can be mitigated by a rotational power take-off damping about the hinge axis. Changing the rotational power take-off damping was identified as an additional design parameter that can be used to control the loads experienced by the WEC’s support structure.
External Focus Reduces Accuracy and Increases Antagonist Muscle Activation in Novice Adolescent Soccer Players
Authors: Uslu Serkan , Çetin Özdoğan Emel
Published: October 2022

Instep kick is one of the most effective kicking techniques in soccer. Lower extremity muscles and joints play a crucial role during instep kick. However, external (EF) and internal focus and their effect on the muscles are still ambiguous. In this study, 13 male adolescent soccer players were included and aimed to hit the targets in internal and EF conditions. Lower extremity muscle activations were measured with surface electromyography, and kinematics were measured with a high-speed video camera. Muscle activations and movement latencies were analyzed in four different phases (backswing, leg cocking, acceleration, and follow-through) of kicking. While 10 out of 13 participants kicked accurately in internal focus, only five out of 13 in EF kicked accurately. Gastrocnemius muscle activations increased significantly in EF in all phases except acceleration. Movement latencies were found 0.07 ± 0.002 s for accurate and 0.05 ± 0.004 s for inaccurate kicks in EF. A correlation has been found between accuracy and movement latency in EF (R = .67). Our results suggest that novices cannot yet coordinate their muscles in EF, cocontraction ratio increases. Therefore, training strategies that aim to reduce the cocontraction ratio can help the athlete increase performance through better motor coordination. Moreover, better motor coordination may be beneficial in preventing injuries (joint stiffness, etc.) caused by increased cocontraction ratio.
Interconnectedness and (in)coherence as a signature of conspiracy worldviews
Authors: Miani Alessandro , Hills Thomas , Bangerter Adrian
Published: October 2022

Conspiracy theories may arise out of an overarching conspiracy worldview that identifies common elements of subterfuge across unrelated or even contradictory explanations, leading to networks of self-reinforcing beliefs. We test this conjecture by analyzing a large natural language database of conspiracy and nonconspiracy texts for the same events, thus linking theory-driven psychological research with data-driven computational approaches. We find that, relative to nonconspiracy texts, conspiracy texts are more interconnected, more topically heterogeneous, and more similar to one another, revealing lower cohesion within texts but higher cohesion between texts and providing strong empirical support for an overarching conspiracy worldview. Our results provide inroads for classification algorithms and further exploration into individual differences in belief structures.
Magnetic torque–driven living microrobots for increased tumor infiltration
Authors: Gwisai T. , Mirkhani N. , Christiansen M. G. , Nguyen T. T. , Ling V. , Schuerle S.
Published: October 2022

Biohybrid bacteria–based microrobots are increasingly recognized as promising externally controllable vehicles for targeted cancer therapy. Magnetic fields in particular have been used as a safe means to transfer energy and direct their motion. Thus far, the magnetic control strategies used in this context rely on poorly scalable magnetic field gradients, require active position feedback, or are ill-suited to diffuse distributions within the body. Here, we present a magnetic torque–driven control scheme for enhanced transport through biological barriers that complements the innate taxis toward tumor cores exhibited by a range of bacteria, shown for
Magnetospirillum magneticum
as a magnetically responsive model organism. This hybrid control strategy is readily scalable, independent of position feedback, and applicable to bacterial microrobots dispersed by the circulatory system. We observed a fourfold increase in translocation of magnetically responsive bacteria across a model of the vascular endothelium and found that the primary mechanism driving increased transport is torque-driven surface exploration at the cell interface. Using spheroids as a three-dimensional tumor model, fluorescently labeled bacteria colonized their core regions with up to 21-fold higher signal in samples exposed to rotating magnetic fields. In addition to enhanced transport, we demonstrated that our control scheme offers further advantages, including the possibility for closed-loop optimization based on inductive detection, as well as spatially selective actuation to reduce off-target effects. Last, after systemic intravenous injection in mice, we showed significantly increased bacterial tumor accumulation, supporting the feasibility of deploying this control scheme clinically for magnetically responsive biohybrid microrobots.
High-performance electrified hydrogel actuators based on wrinkled nanomembrane electrodes for untethered insect-scale soft aquabots
Authors: Ko Jongkuk , Kim Changhwan , Kim Dongjin , Song Yongkwon , Lee Seokmin , Yeom Bongjun , Huh June , Han Seungyong , Kang Daeshik , Koh Je-Sung , Cho Jinhan
Published: October 2022

Hydrogels have diverse chemical properties and can exhibit reversibly large mechanical deformations in response to external stimuli; these characteristics suggest that hydrogels are promising materials for soft robots. However, reported actuators based on hydrogels generally suffer from slow response speed and/or poor controllability due to intrinsic material limitations and electrode fabrication technologies. Here, we report a hydrogel actuator that operates at low voltages (<3 volts) with high performance (strain > 50%, energy density > 7 × 10
5
joules per cubic meter, and power density > 3 × 10
4
watts per cubic meter), surpassing existing hydrogel actuators and other types of electroactive soft actuators. The enhanced performance of our actuator is due to the formation of wrinkled nanomembrane electrodes that exhibit high conductivity and excellent mechanical deformation through capillary-assisted assembly of metal nanoparticles and deswelling-induced wrinkled structures. By applying an electric potential through the wrinkled nanomembrane electrodes that sandwich the hydrogel, we were able to trigger a reversible and substantial electroosmotic water flow inside a hydrogel film, which drove the controlled swelling of the hydrogel. The high energy efficiency and power density of our wrinkled nanomembrane electrode–induced actuator enabled the fabrication of an untethered insect-scale aquabot integrated with an on-board control unit demonstrating maneuverability with fast locomotion speed (1.02 body length per second), which occupies only 2% of the total mass of the robot.
Therapeutic gene editing of T cells to correct CTLA-4 insufficiency
Authors: Fox Thomas Andrew , Houghton Benjamin Christopher , Petersone Lina , Waters Erin , Edner Natalie Mona , McKenna Alex , Preham Olivier , Hinze Claudia , Williams Cayman , de Albuquerque Adriana Silva , Kennedy Alan , Pesenacker Anne Maria , Genovese Pietro , Walker Lucy Sarah Kate , Burns Siobhan Oisin , Sansom David Michael , Booth Claire , Morris Emma Catherine
Published: October 2022

Heterozygous mutations in
CTLA-4
result in an inborn error of immunity with an autoimmune and frequently severe clinical phenotype. Autologous T cell gene therapy may offer a cure without the immunological complications of allogeneic hematopoietic stem cell transplantation. Here, we designed a homology-directed repair (HDR) gene editing strategy that inserts the
CTLA-4
cDNA into the first intron of the
CTLA-4
genomic locus in primary human T cells. This resulted in regulated expression of CTLA-4 in CD4
+
T cells, and functional studies demonstrated CD80 and CD86 transendocytosis. Gene editing of T cells isolated from three patients with CTLA-4 insufficiency also restored CTLA-4 protein expression and rescued transendocytosis of CD80 and CD86 in vitro. Last, gene-corrected T cells from
CTLA-4
−/−
mice engrafted and prevented lymphoproliferation in an in vivo murine model of CTLA-4 insufficiency. These results demonstrate the feasibility of a therapeutic approach using T cell gene therapy for CTLA-4 insufficiency.
Antileishmanial Activities of (
Z
)-2-(Nitroimidazolylmethylene)-3(
2H
)-Benzofuranones: Synthesis,
In Vitro
Assessment, and Bioactivation by NTR 1 and 2
Authors: Navidpour Latifeh , Lima Marta Lopes , Milne Rachel , Wyllie Susan , Hadj-esfandiari Narges , Choudhary Muhammad Iqbal , Khan Samreen , Yousuf Sammer
Published: October 2022

The antileishmanial activity of a series of (
Z
)-2-(heteroarylmethylene)-3(2
H
)-benzofuranone derivatives, possessing 5-nitroimidazole or 4-nitroimidazole moieties, was investigated against
Leishmania major
promastigotes and some analogues exhibited prominent activities. Compounds with IC
50
values lower than 20 μM were further examined against
L. donovani
axenic amastigotes.
MixviR: an R Package for Exploring Variation Associated with Genomic Sequence Data from Environmental SARS-CoV-2 and Other Mixed Microbial Samples
Authors: Sovic Michael G. , Savona Francesca , Bohrerova Zuzana , Faith Seth A.
Published: October 2022

High-throughput sequencing technologies hold great potential for contributing to genomic-based surveillance of microbial diversity from environmental samples. However, the size of the data sets, along with the potential for environmental samples to contain multiple evolutionary lineages of interest, present challenges around analyzing and effectively communicating inferences from these data sets.
Oral Commensal Streptococci: Gatekeepers of the Oral Cavity
Authors: Baty Joshua J. , Stoner Sara N. , Scoffield Jessica A.
Published: October 2022

Oral commensal streptococci are primary colonizers of the oral cavity. These streptococci produce many adhesins, metabolites, and antimicrobials that modulate microbial succession and diversity within the oral cavity.
Cellular Heterogeneity and Molecular Reprogramming of the Host Response during Influenza Acute Lung Injury
Authors: Guo Kai , Yombo Dan Justin Kalenda , Schmit Taylor , Wang Zhihan , Navaeiseddighi Zahrasadat , Sathish Venkatachelem , Mathur Ramkumar , Wu Min , Kumar Bony De , Hur Junguk , Khan Nadeem
Published: October 2022

A dysregulated host response develops acute lung injury during IAV infection. However, the pathological immune mechanism(s) associated with acute lung injury during IAV infection is yet to be elucidated.
Genome-Wide Association Studies across Environmental and Genetic Contexts Reveal Complex Genetic Architecture of Symbiotic Extended Phenotypes
Authors: Batstone Rebecca T. , Lindgren Hanna , Allsup Cassandra M. , Goralka Laura A. , Riley Alex B. , Grillo Michael A. , Marshall-Colon Amy , Heath Katy D.
Published: October 2022

Given the rapid rise of research on how microbiomes can be harnessed to improve host health, understanding the contribution of microbial genetic variation to host phenotypic variation is pressing, and will better enable us to predict the evolution of (and select more precisely for) symbiotic extended phenotypes that impact host health. We uncover extensive context-dependency in both the identity and functions of symbiont loci that control host growth, which makes predicting the genes and pathways important for determining symbiotic outcomes under different conditions more challenging.
Complete Genome Sequence of an African Raw Honey Bacterial Isolate, Bacillus safensis Strain AHB11
Authors: Shin Carson J. , O’Connor Tamara J.
Published: October 2022

We present the complete genome sequence of
Bacillus safensis
strain AHB11, which was isolated from African raw honey from Kajo Keji, South Sudan, that had been purchased from a third-party vendor. The genome is composed of a 3,697,357-bp chromosome and a 7,105-bp plasmid, collectively encompassing 3,699 predicted protein-coding sequences and 110 RNA genes.
Complete Genome Sequence of Mesorhizobium ciceri Strain R30, a Rhizobium Used as a Commercial Inoculant for Chickpea in Argentina
Authors: Foresto Emiliano , Revale Santiago , Primo Emiliano , Nievas Fiorela , Carezzano Evangelina , Puente Mariana , Alzari Pedro , Martínez Mariano , Ben-Assaya Mathilde , Mornico Damien , Santoro Maricel , Martínez-Abarca Francisco , Giordano Walter , Bogino Pablo
Published: October 2022

We report the complete genome sequence of
Mesorhizobium ciceri
strain R30, a rhizobium strain recommended and used as a commercial inoculant for chickpea in Argentina. The genome consists of almost 7 Mb, distributed into two circular replicons: a chromosome of 6.49 Mb and a plasmid of 0.46 Mb.
Draft Genome of
Frankia
sp. Strain R82, an Isolate from Root Nodules of Myrica gale
Authors: Normand Philippe , Pujic Petar , Abrouk Danis , Vemulapally Spandana , Guerra Trina , Carlos-Shanley Camila , Hahn Dittmar
Published: October 2022

The
Frankia
sp. strain R82 genome is described as representative of a novel candidate species within
Frankia
cluster 1, as indicated by average nucleotide identity (ANI) analyses, with its closest relatives being
Frankia nodulisporulans
AgTrs and strains Ag45/Mut15 and AgPM24 (86% identity).
The Diversity of Lipopeptides in the Pseudomonas syringae Complex Parallels Phylogeny and Sheds Light on Structural Diversification during Evolutionary History
Authors: Bricout Alexandre , Morris Cindy E. , Chandeysson Charlotte , Duban Matthieu , Boistel Corinne , Chataigné Gabrielle , Lecouturier Didier , Jacques Philippe , Leclère Valérie , Rochex Alice
Published: October 2022

This study provides an insight into the
P. syringae
metabolome that emphasizes the high diversity of lipopeptides produced within the
P. syringae
complex. The production profiles of strains are closely related to their phylogenetic classification, indicating that structural diversification of lipopeptides parallels the phylogeny of this bacterial complex, thereby further illustrating the inherent importance of lipopeptides in the ecology of this group of bacteria throughout its evolutionary history.
Detection of Extended-Spectrum β-Lactamases (ESBLs) and AmpC in Class A and Class B Carbapenemase-Producing
Enterobacterales
Authors: Imkamp Frank , Kolesnik-Goldmann Natalia , Bodendoerfer Elias , Zbinden Reinhard , Mancini Stefano
Published: October 2022

Antimicrobial resistance is a growing public health threat of broad concern worldwide. Timely detection of antibiotic resistance mechanisms can help to monitor and to curb the spread of resistant bacteria within the hospital setting as well as in the environment.
Morning SARS-CoV-2 Testing Yields Better Detection of Infection Due to Higher Viral Loads in Saliva and Nasal Swabs upon Waking
Authors: Viloria Winnett Alexander , Porter Michael K. , Romano Anna E. , Savela Emily S. , Akana Reid , Shelby Natasha , Reyes Jessica A. , Schlenker Noah W. , Cooper Matthew M. , Carter Alyssa M. , Ji Jenny , Barlow Jacob T. , Tognazzini Colten , Feaster Matthew , Goh Ying-Ying , Ismagilov Rustem F.
Published: October 2022

Our findings suggest that collecting saliva and nasal swab specimens in the morning immediately after waking yields higher SARS-CoV-2 viral loads than collection later in the day. The higher viral loads from morning specimen collection are predicted to significantly improve detection of SARS-CoV-2 in symptomatic individuals, particularly when using moderate- to low-analytical-sensitivity COVID-19 diagnostic tests, such as rapid antigen tests.
Supplemental Material: Rapid southeastern Laurentide Ice Sheet thinning during the last deglaciation revealed by elevation profiles of in situ cosmogenic 10Be
Authors: Halsted Christopher T. , al. et
Published: October 2022

Tables S1–S4; Figures S1 and S2.
Assessing maternal alcohol consumption in pregnancy: does phosphatidylethanol measured from day 5 newborn blood spot cards have any value? An observational, population-based study
Authors: Henderson Elizabeth M A , Tappin David , Young David , Favretto Donata , Mactier Helen
Published: October 2022

Objective

Prenatal alcohol exposure (PAE) places children at risk of fetal alcohol spectrum disorder (FASD) but ascertainment of PAE is problematic. Early intervention for children at risk of FASD may help mitigate long-term difficulties. Phosphatidylethanol (PEth), a metabolite of alcohol, is incorporated into red cell membranes and can be measured in dried blood spot (DBS) cards. In the UK, DBS samples are collected on day 5 for routine newborn screening. We sought to examine if PEth measured from DBS correlates with postnatal maternal self-report of alcohol consumption in pregnancy.

Design

Observational population-based study. Comparison of infant PEth concentration and self-report of maternal alcohol use during pregnancy.

Setting

Large maternity unit in Glasgow, Scotland.

Participants

All singleton mother–infant dyads delivered during each fourth consecutive 24-hour period.

Interventions

Mother: direct, confidential, immediate postnatal interview by a single researcher examining alcohol use during pregnancy. Infant: one extra DBS collected coincident with routine newborn screening if bleeding continued.

Results

92.5% of eligible mothers agreed to participate. 510 DBS were obtained of which 502 were successfully analysed. 216 (43%) samples contained PEth at a concentration of ≥8 ng/mL and 148 (29.5%) at ≥20 ng/mL. The sensitivity of PEth ≥8 ng/mL and ≥20 ng/mL in identifying women who self-reported modest alcohol use after 36 weeks’ gestation was 50% and 36.4%, respectively.

Conclusion

PEth measured from DBS obtained on day 5 of life does not reliably identify modest PAE after 36 weeks’ gestation from maternal self-report.
Neurodevelopment assessment of small for gestational age children in a community-based cohort from Pakistan
Authors: Naz Sabahat , Hoodbhoy Zahra , Jaffar Ali , Kaleem Sidra , Hasan Babar S , Chowdhury Devyani , Gladstone Melissa
Published: October 2022

Background

Children born small for gestational age (SGA) may experience more long-term neurodevelopmental issues than those born appropriate for gestational age (AGA). This study aimed to assess differences in the neurodevelopment of children born SGA or AGA within a periurban community in Pakistan.

Methods

This was a prospective cohort study in which study participants were followed from the pilot Doppler cohort study conducted in 2018. This pilot study aimed to develop a pregnancy risk stratification model using machine learning on fetal Dopplers. This project identified 119 newborns who were born SGA (2.4±0.4 kg) based on International Fetal and Newborn Growth Consortium standards. We assessed 180 children (90 SGA and 90 AGA) between 2 and 4 years of age (76% of follow-up rate) using the Malawi Developmental Assessment Tool (MDAT).

Findings

Multivariable linear regression analysis comparing the absolute scores of MDAT showed significantly lower fine motor scores (β: −0.98; 95% CI −1.90 to –0.06) among SGAs, whereas comparing the z-scores using multivariable logistic regression, SGA children had three times higher odds of overall z-scores ≤−2 (OR: 3.78; 95% CI 1.20 to 11.89) as compared with AGA children.

Interpretation

SGA exposure is associated with poor performance on overall MDAT, mainly due to changes in the fine motor domain in young children. The scores on the other domains (gross motor, language and social) were also lower among SGAs; however, none of these reached statistical significance. There is a need to design follow-up studies to assess the impact of SGA on child’s neurodevelopmental trajectory and school performance.
Effect of the COVID-19 pandemic on maternal healthcare indices in Southern Iran: an interrupted time series analysis
Authors: Yadollahi Parvin , Zangeneh Negar , Heiran Alireza , Sharafi Mehdi , Heiran Khadije Neda , Hesami Elham , Saffari Masoumeh , Azima Sara , Mirahmadizadeh Alireza
Published: October 2022

Objectives

Epidemics are anticipated to influence the coverage of health services. We assessed the impact of the COVID-19 pandemic on maternal healthcare indices and care providers’ performance.

Setting

1801 maternal healthcare centres under the auspices of Shiraz University of Medical Sciences, Shiraz, Southern Iran.

Participants

Approximately 63 000 pregnant women.

Primary and secondary outcome measures

In this prospective ecological study, interrupted time series analysis was used to model and compare the trend of maternal healthcare indices before and after the COVID-19 pandemic announcement.

Results

The results showed a significant drop in count of preconception healthcare visits, first routine laboratory tests, first trimester prenatal care, first trimester sonography, prenatal screening for birth defects at weeks 11–13, prenatal care visits at weeks 16–20, second routine laboratory tests, second trimester sonography, prenatal care visits at weeks 24–30, prenatal care visits at weeks 31–34, postpartum care visits at days 10–15 and postpartum care visits at days 30–42 with the start of the COVID-19 pandemic (−50% (95% CI −48.68% to –51.36%), −19.67% (95% CI −22.12% to –17.15%), −25.88% (95% CI −28.46% to –23.21%), −23.84% (95% CI −26.26% to –21.34%), −20.16% (95% CI −23.01% to –17.20%), −18.53% (95% CI −21.25% to –15.71%), −28.63% (95% CI −31.03% to –26.14%), −27.48% (95% CI −30.07% to –24.79%), −31.08% (95% CI −33.43% to –28.61%), −31.84% (95% CI −34.35% to –29.23%), 32.55% (95% CI −35.12% to –29.89%) and −39.28% (95% CI −41.59% to –36.88%), respectively). Nevertheless, the trend in coverage of these services showed recovery in the subsequent months (8.36%, 10.55%, 5.74%, 8.01%, 4.40%, 5.06%, 11.20%, 7.58%, 7.38%, 7.80%, 9.59% and 9.61% per month, respectively).

Conclusions

Using ecological data during the COVID-19 pandemic era, we observed a ‘level change and slope change’ as the major pattern of interruption of maternal healthcare coverage, indicating a possible indirect effect rather than a causative relationship. Such relative predictability might assist with future pandemic planning.
Effects of dry needling intervention on lower limb dysfunction after stroke: study protocol for a randomised controlled trial
Authors: Tang Li , Liu Shanshan , Gan Lin , Ding Hao , Huang Qiang-Min , Gao Fang , Li Yan
Published: October 2022

Introduction

Lower limb dysfunction is among the common sequelae of patients who had a poststroke and often results in the reduction of the quality of life. This study aims to assess the short and interim-term efficacy of dry needling (DN) intervention on lower extremity function, balance and gait in lower limb dysfunction after stroke.

Methods and analysis

This protocol entails an assessor and statistician-blinded, single-centre study with a randomised controlled trial. Forty-four patients who had a poststroke will be randomly allocated (1:1) to either the conventional treatment group (n=22) or the DN group (n=22). The conventional treatment group will receive conventional rehabilitation treatment once a day for 40 min each time. The treatment will be performed five times a week for 2 weeks. In the DN group, participants will be treated with DN on the basis of the conventional treatment. The intervention will be performed thrice a week for 2 weeks. The primary outcome that determines the efficacy of lower limb dysfunction will be the change in the Fugl-Meyer Assessment of Lower Extremity scale. The secondary indicators include the range of motion of knee and ankle joints, limits of stability, modified Clinical Test of Sensory Interaction on Balance, Timed Up and Go test, Modified Ashworth Scale and Barthel Index. Results will be evaluated at baseline, at 24 hours after intervention, at 2 weeks after intervention and at 3-month follow-up. Data will be released after the completion of the study. Adverse events will be reported.

Ethics and dissemination

The experiment was approved by the Ethical Committee of Shanghai Tong Ren Hospital in October 2021 (approval number: 202105702). The results of this study will be published in peer-reviewed journals.

Trial registration number

ChiCTR2000040754.
Prospective multicentre Italian pregnancy cohort study (SIMPLE) on the associations of maternal first trimester SIMPLE nutritional score with early placental function markers and pregnancy outcomes
Authors: Parisi Francesca , Coco Chiara , Cetin Irene
Published: October 2022

Introduction

Currently, the adherence to nutritional guidelines is low, with alarming rates of obesity worldwide and micronutrient deficiencies documented even in industrialised countries. As a consequence, nutritional screening and counselling represent a critical subject in early pregnancy, aiming to improve pregnancy outcomes and population health.

Methods and analysis

In this setting, the development of a simple and reproducible nutritional checklist is of utmost importance. The Simple Study is a longitudinal prospective multicentre study aiming to identify the associations between maternal nutritional habits in the first trimester, early markers of placental function and pregnancy outcomes on a large population of singleton pregnancies in Italy.

Ongoing healthy singleton pregnancies will be enrolled at the ultrasound scan of the first trimester combined screening test (11+0–13+6gestational weeks). A nutritional score measuring the adherence to a healthy diet and nutritional deficiencies will be collected at recruitment. Fetal (crown-rump length, nuchal translucency (NT), biparietal diameter, femur length) and utero placental (placental volume, uterine arteries Doppler velocimetry) ultrasound data and biochemical placental markers (pregnancy-associated plasma protein A, free ß-human chorionic gonadotropin) will be collected. Second and third trimester ultrasound records and birth outcomes will be recorded from medical registers. This study will set the stage for introducing a reproducible, time-saving and low-cost nutritional screening in pregnancy. The nutritional score will allow the implementation of specific corrective measures with potential large impact on placentation and pregnancy outcomes.

Ethical and dissemination

Ethical approval for this study was obtained from the Milano Area 1 Ethics Committee (No 46091, 7 November 2018) prior to the commencement of the research.

The dissemination plan includes the presentation of abstracts and findings at national and international scientific meetings.
Acceptability and feasibility of an online information linker service for caregivers who have a child with genetic epilepsy: a mixed-method pilot study protocol
Authors: Robertson Eden G , Kelada Lauren , Best Stephanie , Goranitis I , Grainger Natalie , Le Marne Fleur , Pierce Kristine , Nevin Suzanne M , Macintosh Rebecca , Beavis Erin , Sachdev Rani , Bye Annie , Palmer Elizabeth E
Published: October 2022

Introduction

Developmental and epileptic encephalopathies (DEEs) are rare epilepsy conditions that collectively impact 1 in 2000 children. They are highly genetically heterogeneous, resulting in significant barriers to accurate and adequate information for caregivers. This can lead to increased distress and dissatisfaction with the healthcare system. To address this gap, we developed ‘GenE Compass’ to provide caregivers with the highest-quality possible, understandable and relevant information in response to specific questions about their child’s DEE. Using a mixed-method design, we will now pilot GenE Compass to evaluate the acceptability to caregivers and clinicians, feasibility and impact to caregivers.

Methods and analysis

We will recruit 88 caregivers (estimated final sample of 50 at follow-up) who have a child under 18 years of age with a suspected or confirmed DEE diagnosis. Following consent and a baseline questionnaire (questionnaire 1 (Q1)), participants will be able to submit questions to GenE Compass over a 3-month period. After 3 months, participants will complete a follow-up questionnaire (Q2) and an optional telephone interview to answer the research questions. Primary outcomes are acceptability of GenE Compass and feasibility of delivering the intervention (eg, cost of the intervention, number of questions submitted and time taken to respond to questions). Secondary outcomes include the impact of GenE Compass on caregivers’ quality of life, information searching behaviours, perceptions of their child’s illness and activation.

Ethics and discussion

The study protocol (V.2, dated 16 September 2021) has been approved by the Sydney Children’s Hospitals Network Human Research Ethics Committee (ETH11277). The results will be disseminated in peer-reviewed journals and at scientific conferences. A lay summary will be disseminated to all participants.

Trial registration number

ACTRN12621001544864.
Vulnerability of populations to malaria after indoor residual spraying is withdrawn from areas where its use has previously been sustained: a protocol for a systematic review
Authors: Orishaba Philip , Kayongo Edward , Lusiba Pastan , Nakalema Caroline , Kasadha Peter , Kirya Perez , Kawooya Ismael , Mijumbi-Deve Rhona
Published: October 2022

Introduction

With its proven effectiveness, indoor residual spraying (IRS) as a malaria vector control strategy forms one of the reliable vector control strategies, especially when at least 80% of the population is covered. However, to date, there is uncertainty regarding the consequences of IRS withdrawal on malaria control when there is no clear exit strategy in place. Therefore, there is a need to comprehensively update literature regarding malaria burden indicators when IRS is withdrawn following sustained use.

Methods and analysis

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search of studies published between 2000 and 2022 will be performed in CINAHL, Embase, MEDLINE, ProQuest, PsychInfo, Scopus and OpenGrey. Preset eligibility criteria will be used to identify studies for inclusion by two independent reviewers. Title/abstracts will first be screened and potentially eligible ones screened using their full-text publications. Any conflicts/discrepancies at the two stages will be resolved through regular discussion sessions. Included studies will be extracted to capture study and patient characteristics and relevant outcomes (malaria incidence and malaria vector abundance). Relevant tools will be used to assess the risk of bias in the studies measuring the impact of withdrawal. A meta-analysis will be performed if sufficient homogeneity exists; otherwise, data arising will be presented using tables and by employing narrative synthesis techniques. Heterogeneity will be assessed using a combination of visual inspection of the forest plot along with consideration of the χ2test and I2statistic results.

Ethics and dissemination

Ethics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publications and conference presentations. Furthermore, this systematic review will inform the design of exit strategies for IRS-based programmes in malaria-endemic areas.

PROSPERO registration number

CRD42022310655.
Cohort profile: the Swedish Maternal Microbiome project (SweMaMi) – assessing the dynamic associations between the microbiome and maternal and neonatal adverse events
Authors: Fransson Emma , Gudnadottir Unnur , Hugerth Luisa W , Itzel Eva Wiberg , Hamsten Marica , Boulund Fredrik , Pennhag Alexandra , Du Juan , Schuppe-Koistinen Ina , Brusselaers Nele , Engstrand Lars
Published: October 2022

Purpose

The Swedish Maternal Microbiome (SweMaMi) project was initiated to better understand the dynamics of the microbiome in pregnancy, with longitudinal microbiome sampling, shotgun metagenomics, extensive questionnaires and health registry linkage.

Participants

Pregnant women were recruited before the 20th gestational week during 2017–2021 in Sweden. In total, 5439 pregnancies (5193 unique women) were included. For 3973 pregnancies (73%), samples were provided at baseline, and for 3141 (58%) at all three timepoints (second and third trimester and postpartum). In total, 31 740 maternal microbiome samples (vaginal, faecal and saliva) and 3109 infant faecal samples were collected. Questionnaires were used to collect information on general, reproductive and mental health, diet and lifestyle, complemented by linkage to the nationwide health registries, also used to follow up the health of the offspring (up to age 10).

Findings to date

The cohort is fairly representative for the total Swedish pregnant population (data from 2019), with 41% first-time mothers. Women with university level education, born in Sweden, with normal body mass index, not using tobacco-products and aged 30–34 years were slightly over-represented.

Future plans

The sample and data collection were finalised in November 2021. The next steps are the characterisation of the microbial DNA and linkage to the health and demographic information from the questionnaires and registries. The role of the microbiome on maternal and neonatal outcomes and early-childhood diseases will be explored (including preterm birth, miscarriage) and the role and interaction of other risk factors and confounders (including endometriosis, polycystic ovarian syndrome, diet, drug use). This is currently among the largest pregnancy cohorts in the world with longitudinal design and detailed and standardised microbiome sampling enabling follow-up of both mothers and children. The findings are expected to contribute greatly to the field of reproductive health focusing on pregnancy and neonatal outcomes.
Adapting population health interventions for new contexts: qualitative interviews understanding the experiences, practices and challenges of researchers, funders and journal editors
Authors: Copeland Lauren , Littlecott Hannah J , Couturiaux Danielle , Hoddinott Pat , Segrott Jeremy , Murphy Simon , Moore Graham , Evans Rhiannon E
Published: October 2022

Objectives

Research on the adaptation of population health interventions for implementation in new contexts is rapidly expanding. This has been accompanied by a recent increase in the number of frameworks and guidance to support adaptation processes. Nevertheless, there remains limited exploration of the real-world experiences of undertaking intervention adaptation, notably the challenges encountered by different groups of stakeholders, and how these are managed. Understanding experiences is imperative in ensuring that guidance to support adaptation has practical utility. This qualitative study examines researcher and stakeholder experiences of funding, conducting and reporting adaptation research.

Setting

Adaptation studies.

Participants

Participants/cases were purposefully sampled to represent a range of adapted interventions, types of evaluations, expertise and countries. Semistructured interviews were conducted with a sample of researchers (n=23), representatives from research funding panels (n=6), journal editors (n=5) and practitioners (n=3).

Measures

A case study research design was used. Data were analysed using the framework approach. Overarching themes were discussed within the study team, with further iterative refinement of subthemes.

Results

The results generated four central themes. The first three relate to the experience of intervention adaptation (1) involving stakeholders throughout the adaptation process and how to integrate the evidence base with experience; (2) selecting the intervention and negotiating the mismatch between the original and the new context; and (3) the complexity and uncertainty when deciding the re-evaluation process. The final theme (4) reflects on participants’ experiences of using adaptation frameworks in practice, considering recommendations for future guidance development and refinement.

Conclusion

This study highlights the range of complexities and challenges experienced in funding, conducting and reporting research on intervention adaptation. Moving forward, guidance can be helpful in systematising processes, provided that it remains responsive to local contexts and encourage innovative practice.
Postvaccination anti-S IgG levels predict anti-SARS-CoV-2 neutralising activity over 24 weeks in patients with RA
Authors: Schmiedeberg Kristin , Abela Irene A , Pikor Natalia Barbara , Vuilleumier Nicolas , Schwarzmueller Magdalena , Epp Selina , Pagano Sabrina , Grabherr Sarah , Patterson Angelica Brooke , Nussberger Madalina , Trkola Alexandra , Ludewig Burkhard , von Kempis Johannes , Rubbert-Roth Andrea
Published: October 2022

Objectives

To correlate immune responses following a two-dose regimen of mRNA anti-SARS-CoV-2 vaccines in patients with rheumatoid arthritis (RA) to the development of a potent neutralising antiviral activity.

Methods

The RECOVER study was a prospective, monocentric study including patients with RA and healthy controls (HCs). Assessments were performed before, and 3, 6, 12 and 24 weeks, after the first vaccine dose, respectively, and included IgG, IgA and IgM responses (against receptor binding domain, S1, S2, N), IFN-γ ELISpots as well as neutralisation assays.

Results

In patients with RA, IgG responses developed slower with lower peak titres compared with HC. Potent neutralising activity assessed by a SARS-CoV-2 pseudovirus neutralisation assay after 12 weeks was observed in all 21 HCs, and in 60.3% of 73 patients with RA. A significant correlation between peak anti-S IgG levels 2 weeks after the second vaccine dose and potent neutralising activity against SARS-CoV-2 was observed at weeks 12 and 24. The analysis of IgG, IgA and IgM isotype responses to different viral proteins demonstrated a delay in IgG but not in IgA and IgM responses. T cell responses were comparable in HC and patients with RA but declined earlier in patients with RA.

Conclusion

In patients with RA, vaccine-induced IgG antibody levels were diminished, while IgA and IgM responses persisted, indicating a delayed isotype switch. Anti-S IgG levels 2 weeks after the second vaccine dose correlate with the development of a potent neutralising activity after 12 and 24 weeks and may allow to identify patients who might benefit from additional vaccine doses or prophylactic regimen.
End of life in general practice: trends 2009–2019
Authors: Bergman Tessa D , Pasman H Roeline W , Hendriksen Janneke MT , Onwuteaka-Philipsen Bregje D
Published: October 2022

Objectives

To assess possible trends between 2009 and 2019 in the Netherlands of palliative care indicators: the provision of palliative care or treatment, hospitalisations in the last month before death, use of specialised palliative care services and place of death.

Methods

The study design was a repeated retrospective cross-sectional design with questionnaires filled in by general practitioners within a clustered sample of 67 Sentinel practices. Patients whose death was non-sudden, and thus could have received palliative care, between 1 January 2009 and 31 December 2019 were included in the study, resulting in 3121 patients.

Results

Between 2009 and 2019, there is a significant increase in the number of people who receive palliative care or treatment alongside life-prolonging or curative treatment and the number of people who die at home, while the number of hospitalisations in the last month before death and the number of people dying in hospital shows a significant decrease. However, there is no trend in the involvement of specialised palliative care services or people receiving solely palliative care or treatment.

Conclusion

This study suggests improvements in end-of-life care provided in primary care in the Netherlands. Trends coincided with increased attention to palliative care both in practice and policy. Yet, there is still considerable room for improvement as there is no significant increase in people solely receiving palliative care or treatment and the involvement of specialised palliative care services.