bluuebunny/crossref_metadata_2025 huggingface dataset:
Standardising health history and injury surveillance of participants in endurance events: a modified Delphi consensus statement from the AMSSM runner health consortium
Authors: Tenforde Adam S , Kraus Emily , Kliethermes Stephanie A , Fontana Mark A , Barrack Michelle T , Dubon Mary , Heikura Ida A , Hollander Karsten , Kroshus Emily , Joachim Mikel R , Lopes Alexandre Dias , Rauh Mitchell J , Chastain Ragen , Harrast Mark , Heiderscheit Bryan , Krabak Brian J , Miller Emily M , Napier Christopher , Roberts William O , Roche Deborah , Roche Megan , Schroeder Allison N , Taylor-Douglas Dezmond , Tenforde Kate , Verhagen Evert , Warden Stuart J , Willy Richard W , Toresdahl Brett G
Published: November 2024

Endurance events are popular worldwide and have many health benefits. However, runners and Para athletes may sustain musculoskeletal injuries or experience other health consequences from endurance events. The American Medical Society for Sports Medicine (AMSSM) Runner Health Consortium aimed to generate consensus-based survey items for use in prospective research to identify risk factors for injuries in runners and Para athletes training and competing in endurance events.The study design employed a modified Delphi approach, with a panel comprising 28 experts, including healthcare professionals, coaches, and athletes. Potential survey items were generated by panel members who subsequently engaged in three rounds of voting using Research Electronic Data Capture. Items were graded by clarity, relevance, and importance. Items achieving 80% consensus on all three aspects were retained.The response rate was 100% in R round 1 and 96% in Rrounds 2 and 3. Of 124 initial survey items, consensus was reached on 53, 34 and 22 items during Rrounds 1, 2, and 3, respectively. Two accepted items were removed due to redundancy. Combined with 10 non-voting items, 117 items covered key domains, including training and injury history, dietary behaviours and associated factors (such as menstrual function), footwear, mental health, and specific considerations for Para athletes.The consensus-based survey items should be considered by researchers to better understand the health of runners and Para athletes who train and compete in endurance sports to identify risk factors for injury.
Seroprevalence of seven arboviruses of public health importance in sub-Saharan Africa: a systematic review and meta-analysis
Authors: Bangoura Salifou Talassone , Sidibé Sidikiba , Kaba Lanceï , Mbaye Aminata , Hounmenou Castro Gbêmêmali , Diallo Alhassane , Camara Saidouba Cherif , Diaby Maladho , Kadio Kadio Jean-Jacques Olivier , D’Ortenzio Eric , Camara Alioune , Vanhems Philippe , Delamou Alexandre , Delaporte Eric , Keita Alpha-Kabinet , Ottmann Michèle , Touré Abdoulaye , Khanafer Nagham
Published: November 2024

Background

The arboviruses continue to be a threat to public health and socioeconomic development in sub-Saharan Africa (SSA). Seroprevalence surveys can be used as a population surveillance strategy for arboviruses in the absence of treatment and vaccines for most arboviruses, guiding the public health interventions. The objective of this study was to analyse the seroprevalence of arboviruses in SSA through a systematic review and meta-analysis.

Methods

We searched PubMed/MEDLINE, Web of Science, Embase, Scopus and ScienceDirect databases for articles published between 2000 and 2022 reporting the seroprevalence of immunoglobulin G (IgG) antibodies to seven arboviruses in various human populations residing in SSA. The included studies were assessed using the checklist for assessing the risk of bias in prevalence studies, and the data were extracted using a standard form. A random effects model was used to estimate pooled seroprevalences. The potential sources of heterogeneity were explored through subgroup analyses and meta-regression. The protocol had been previously registered on International Prospective Register of Systematic Reviews with the identifier: CRD42022377946.

Results

A total of 165 studies from 27 countries, comprising 186 332 participants, were included. Of these, 141 were low-risk and 24 were moderate-risk. The pooled IgG seroprevalence was 23.7% (17.9–30.0%) for Chikungunya virus, 22.7% (17.5–28.4%) for dengue virus, 22.6% (14.1–32.5%) for West Nile virus, 16.4% (7.1–28.5%) for yellow fever virus, 13.1% (6.4–21.7%) for Zika virus, 9.2% (6.5–12.3%) for Rift Valley fever virus and 6.0% (3.1–9.7) for Crimean–Congo haemorrhagic fever virus. Subgroup and meta-regression analyses showed that seroprevalence differed considerably between countries, study populations, specific age categories, sample sizes and laboratory methods.

Conclusion

This SRMA provides information on the significant circulation of various arboviruses in SSA, which is essential for the adoption and planning of vaccines. These findings suggest the need to invest in surveillance and research activities on arbovirus in SSA countries to increase our understanding of their epidemiology to prevent and respond to future epidemics.
Impact of BMI on fertility in an otherwise healthy population: a systematic review and meta-analysis
Authors: Turner Florence , Powell Simon G , Al-Lamee Hannan , Gadhvi Anjali , Palmer Ellen , Drakeley Andrew , Sprung Victoria S , Hapangama Dharani , Tempest Nicola
Published: November 2024

Background

An increased body mass index (BMI) can lead to subfertility; however, current literature fails to exclude the effect of other confounding medical conditions, raising questions regarding the direct link between increased BMI and fertility outcomes.

Objectives

To conduct a systematic review and meta-analysis to elucidate the effects of increased BMI on fertility outcomes in females with no other comorbidities.

Search strategy

A comprehensive search was conducted using EMBASE, MEDLINE and the Cochrane library from January 2000 until July 2023.

Data collection and analysis

Two authors independently conducted data extraction and assessed study quality. Odds ratio (OR) (dichotomous data), standardised mean difference (SMD) (continuous data) and 95% CIs were calculated.

Main results

Nine eligible studies were identified: one natural conception and eight assisted reproductive technology (ART). Aggregated data revealed women with BMI ≥25 were less likely to attain clinical pregnancy (OR 0.76, 95% CIs 0.62 to 0.93, p=0.007), with BMI ≥30 associated with a further decreased likelihood of clinical pregnancy (OR 0.61, 95% CIs 0.39 to 0.98, p=0.04). Women with raised BMI required longer duration of stimulation (SMD=0.08, 95% CIs 0.00 to 0.16, p=0.04) and obtained reduced oocytes (SMD=−0.11, 95% CIs −0.18 to −0.04, p=0.002).

Conclusions

These data demonstrate an adverse impact of being overweight/obese on ART outcomes in women with no other diagnosed medical comorbidities and highlight the distinct lack of data concerning the effects of isolated obesity on natural conception. Infertility represents an enormous burden for couples and society; it is essential to identify and tackle modifiable risk factors to improve chances of conception.

PROSPERO registration number

CRD42022293631.
Development and psychometric testing of a scale for diet self-management among urban residents in China: a cross-sectional study
Authors: Zhou Li , Wei Lai , Chu Yalin , Tang Yuhong
Published: November 2024

Objective

Design

The diet self-management scale (DSE-MS) items were identified and evaluated by literature and guideline review, expert consultation and pilot testing. Factor structure was tested by randomly dividing the sample into two equal groups for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The scale was further tested for internal consistency, convergent validity, discriminant validity and known-group validity.

Setting

A city in China.

Participants

A total of 724 urban residents from a city in China participated in this study in 2023.

Results

The final DSE-MS included 45 items and showed good internal consistency with a Cronbach’s alpha coefficient of 0.961. EFA identified 6 dimensions explaining 67.89% of the total variance: cognition (11 items), microenvironment (12 items), macroenvironment (4 items), safety management (7 items), nutrition management (6 items) and environment management (5 items). The CFA showed a good model fit of the six-dimension scale: χ2/df=1.8878, root mean square error of approximate=0.0496, Comparing Fit Index=0.9425, Incremental Fit Index=0.9428, Tucker-Lewis Index=0.9369 and standard root mean square residual=0.0525. Convergent validity was supported by high composite reliability (CR=0.89–0.96) and average variance extracted (AVE=0.58–0.72), while discriminant validity was confirmed by higher AVE estimates than the squared interconstruct correlations. The DSE-MS scores varied by various sample characteristics, verifying the known-group validity.

Conclusion

The 6-factor 45-item DSE-MS had good psychometric properties assessing diet self-management among urban citizens. The scale can guide future intervention programmes to improve diet self-management and evaluate the intervention effect. Further validation of the DSE-MS in other populations in other areas is needed to verify its wide application.
Association between sarcopenia index, intraoperative events and post-discharge mortality in patients undergoing percutaneous coronary intervention: a retrospective cohort study in a teaching hospital in Western China
Authors: Lu Shaochun , Huang Sha , Li Jianqun , Chen Xiaoyan , Zhao Lizhi
Published: November 2024

Objectives

To examine the association between the sarcopenia index (SI) and the risk of intraprocedural events and post-discharge death during percutaneous coronary intervention (PCI).

Design

A retrospective cohort study.

Setting

The study was conducted at a teaching hospital in Western China.

Participants

The participants were patients aged 45 years and older who underwent PCI at the hospital and had an estimated glomerular filtration rate (eGFR) of ≥15 mL/min/1.73 m2. Patients who died during hospitalisation, as well as those with unknown death dates, those lost to follow-up and those with missing information for the SI calculation, were excluded.

Primary and secondary outcome measures

The SI was calculated as serum creatinine/cystatin C (Cr/CysC) × 100. The high-SI group was defined as the highest quartile, while the remaining participants were included in the low-SI group. Intraprocedural events included intraprocedural coronary slow flow (CSF)/coronary artery no-reflow (CNR) and malignant ventricular arrhythmia (MVA). In the event of death, the date of death was recorded.

Results

The study included 497 patients who underwent PCI in our hospital, of whom 369 (74.25%) were males. A total of 57 (11.47%) patients developed CSF, 100 (20.12%) developed CNR and 4 (0.8%) developed MVA. Forty-four (8.85%) patients died post-discharge. The proportion of patients in the low-SI group who developed CSF was higher than those who did not (16.94% vs 9.65%, p=0.027). In addition, the average SI was lower in patients who developed CSF than in those who did not (81.99 vs 87.11, p=0.043). After adjusting for possible confounding factors, logistic regression analysis showed that the risk of CSF in the low-SI group was higher than that in the high-SI group (OR = 2.01, 95% CI: 1.04 to 3.89). In addition, it was found that the lower the SI, the higher the risk of CSF (OR = 0.983, 95% CI: 0.967 to 0.999).

Conclusions

Patients with lower SI had a greater risk of developing CSF, and the lower the SI, the higher the risk of CSF. However, these data suggest that SI is not associated with CNR and the risk of post-discharge death in patients after PCI.
Use of dexmedetomidine during light versus deep anaesthesia on postoperative delirium among elderly patients undergoing major non-cardiac surgery: protocol for a multicentre randomised factorial trial
Authors: Shi Hai-Jing , Zhuang Min-Yuan , Hu Jing-Hui , Long Yu-Qin , Gao Yan-Ping , Zheng Zhong , Feng Xiao-Mei , Ji Fu-Hai , Peng Ke
Published: November 2024

Introduction

Elderly patients are at a high risk of postoperative delirium (POD), leading to increased postoperative morbidity and mortality. The use of dexmedetomidine and depth of anaesthesia may influence POD. This study aims to determine the effects of dexmedetomidine infusion versus normal saline placebo during light versus deep anaesthesia on POD among elderly patients undergoing major non-cardiac surgery.

Methods and analysis

This prospective, multicentre, randomised, controlled, factorial trial will be conducted at three tertiary hospitals in Jiangsu, China. We will recruit a total of 420 patients who are at least 60 years old and undergoing major non-cardiac surgery (thoracic, abdominal, urology, orthopaedic and spine surgery) under general anaesthesia. Patients will be randomised (1:1:1:1) to receive one of four anaesthesia regimens: (1) dexmedetomidine and light anaesthesia, (2) dexmedetomidine and deep anaesthesia, (3) placebo and light anaesthesia or (4) placebo and deep anaesthesia. Dexmedetomidine will be infused at 0.5 µg/kg/h throughout surgery, and intraoperative bispectral index target will be 55 for light anaesthesia and 40 for deep anaesthesia. The primary outcome is the occurrence of POD during the first 7 days postoperatively or until hospital discharge, assessed using the 3-min Confusion Assessment Method two times per day. The secondary outcomes include days with POD, type of POD, pain scores at rest and on movement at 24 and 48 hours postoperatively, patient-controlled intravenous fentanyl consumption during 0–24 and 24–48 hours postoperatively, hypotension, bradycardia, postoperative nausea and vomiting, non-delirium complications, length of postoperative hospital stay, 30-day cognitive function and 30-day mortality. Data will be analysed on a modified intention-to-treat basis.

Ethics and dissemination

This trial was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University and each participating centre. The trial results will be published in a peer-reviewed journal.

Trial registration

Chinese Clinical Trial Registry (ChiCTR2300073271)
Do summaries of evidence enable informed decision-making about COVID-19 and influenza vaccination equitably across more and less disadvantaged groups? Study protocol for a multi-centre cluster randomised controlled trial of ‘fact boxes’ in health and social care in Germany
Authors: Ellermann Christin , Savaskan Nicolai , Rebitschek Felix G
Published: November 2024

Introduction

Evidence summaries on the benefits and harms of treatment options support informed decisions under controlled conditions. However, few studies have investigated how such formats support decision-making across different social groups. There is a risk that only disadvantaged people will be able to make informed health decisions—possibly increasing the health equity gap. It is also unclear whether they support decision-making in the field at all. The aim of our study is to assess whether evidence summaries based on the fact box format can help people from different social groups make informed decisions about COVID-19 and influenza vaccinations, and thus reduce inequity in health communication.

Methods and analysis

In a multi-centre, cluster-randomised, controlled trial, health educators from usual care and outreach work in Germany will be randomised in a 1:1 ratio to provide either usual health communication plus an evidence summary (‘fact box’) or usual health communication. Health educators provide a flyer about COVID-19 or influenza vaccination which contains a link to an online study either with (intervention) or without (control) fact box on the reverse side. Flyer and online study will be available in Arabic, German, Turkish and Russian language. The primary outcome is informed vaccination intention, based on vaccination knowledge, attitudes, intentions and behaviour. Secondary outcomes include risk perception, decisional conflict and shared decision-making. We will use linear mixed models to analyse the influence of both individual (eg, education status) and cluster level factors and account for the expected cluster variability in realising usual health communication or the intervention. The statistical analysis plan includes the selection of appropriate measures of effect size and power calculation, assuming a sample size of 800 patients.

Ethics and dissemination

The trial has been approved by the Ethics Committee of the University of Potsdam, Germany (application numbers: 34/2021 and 57/2022).

Results will be disseminated through peer-reviewed journals, conferences and to relevant stakeholders.

Protocol version

Version 6 (4 October 2024); Preprint available on Research Square:https://doi.org/10.21203/rs.3.rs-3401234/v3

Trial registration number

NCT06076421.
Efficacy and long-term effects of the intervention of Zhan Zhuang Qigong on Pisa syndrome in Parkinson’s disease: the study protocol for a randomised control trial
Authors: Zhang Linlin , Chen Yuxiao , Zhang Yuqi , Xi Xiaoming , Bi Hongyan , Chen Pujian , Chen Fen , Wang Cheng , Huang Bin
Published: November 2024

Introduction

Pisa syndrome (PS) is a postural abnormality that frequently manifests in various neurological disorders. In recent years, the dangers associated with Parkinson’s disease (PD) and PS have been increasingly acknowledged, leading to heightened research efforts directed toward the treatment of PS. Nevertheless, the underlying causes of PS remain complex, and no clinically effective treatments have been established. While several studies have demonstrated the significant effects of Qigong in treating PD, there is currently no evidence to support the efficacy of Qigong in the treatment of PS.

Objective

To assess the immediate and long-term effects of Zhan Zhuang Qigong on PS in participants with PD using a rigorous randomised, parallel-control design with assignment concealment and evaluator-blinding methodologies.

Methods

60 PD participants meeting the inclusion criteria will be recruited and randomly assigned to one of two groups: conventional treatment (n=30) or Zhan Zhuang Qigong (n=30). The conventional treatment group will receive standard medications and physical therapy. The Zhan Zhuang Qigong group will receive conventional medicine plus 30 min of Zhan Zhuang Qigong practiced five times per week. The long-term effects of Qigong on PS will be evaluated after 6 months and 1 year of follow-up. Assessment tools will include the NeuroPostureApp, the B-PHY(A model of a balance testing system) balance check training system, the Unified Parkinson’s Disease Rating Scale and the Parkinson’s Disease Quality of Life Questionnaire, which will measure total camptocormia, upper hump degree, Pisa angles, plantar pressure distribution, motor function and quality of life in participants with PD.

Ethics and dissemination

The local ethics committee approved this study (approval number: 2023-K068). The committee will oversee the study throughout its duration and will be notified of any protocol modifications. The results of the study will be disseminated through publication in an international journal or presentation at a conference.

Trial registration number

ChiCTR2400079696.
Effectiveness of non-pharmacological interventions for pain management in patients with cancer:a protocol for systematic review and network meta-analysis
Authors: Ye Lu , Li Yun-Hua , Huang Yu-He , Deng Qing Chuan , Huang Yu-Xin , Peng Yun-Han , Li Da
Published: November 2024

Introduction

Pain management in patients with cancer is a critical aspect of oncological care, yet remains challenging with current pharmacological therapies. Non-pharmacological interventions, offering potential benefits without the adverse effects of drugs, have gained attention. However, the effectiveness of these diverse non-pharmacological interventions is not well understood, creating a gap in clinical practice. This study aims to conduct a systematic review and network meta-analysis (NMA) to evaluate the efficacy of various non-pharmacological interventions for pain management in patients with cancer, providing evidence-based guidance for clinicians and patients.

Methods and analysis

A systematic review and Bayesian NMA will be performed. To assess the efficacy of interventions for cancer pain, we will search six electronic databases: Cochrane Library, Web of Science, PubMed, EMBASE, PsycINFO and the Cumulative Index to Nursing and Allied Health Literature, focusing on identifying randomised controlled trials. Literature screening should be independently performed by two reviewers. A NMA will evaluate the efficacy of various non-pharmacological interventions for cancer pain. A second NMA will compare the efficacy of different non-pharmacological interventions in relieving pain interference in patients with cancer pain. Bayesian 95% credible intervals will be used to estimate the pooled mean effect size for each treatment, and the surface under the cumulative ranking area will be employed to rank the effectiveness of the treatments.

Ethics and dissemination

Ethical approval is not required for this systematic review of the published data. Findings will be disseminated via peer-reviewed publication.

PROSPERO registration number

CRD42024483025.
Safety of diagnostic hysteroscopy for the investigation of type II endometrial cancer: systematic review with meta-analysis
Authors: Yang Wenmei , Zhao Xiaoqi , Pan Jingyi , Zhi Zhifu
Published: November 2024

Aim

The goal of this study is to evaluate the safety of diagnostic hysteroscopy (HSC) in type II endometrial cancer (EC).

Methods

We searched PubMed, the Cochrane Library and the Chinese Medical Journal Full-Text Database until December 2023. Eligible trials were all cohort studies in which patients were allocated to diagnostic HSC group or dilation and curettage (D&C) group. Quality assessments of eligible studies were performed using the Newcastle–Ottawa scales. Risk ratios (RRs) with 95% CIs were calculated as a measure of effects.

Results

Three trials were included in our analysis, which were all retrospective cohort studies. 696 patients with histologically proven type II EC were allocated to HSC or D&C before surgery. 257 patients underwent preoperative HSC, and 439 patients underwent D&C. The positive peritoneal cytology rate did not statistically differ between the groups (RR, 1.9; 95% CI, 1.00 to 3.61; p=0.05). There was no significant difference in the incidence of International Federation of Gynecology and Obstetrics (FIGO) stage between the HSC and D&C groups (stage I/II: RR, 1.08; 95% CI, 0.95 to 1.24; p=0.25; stage III/IV: RR, 0.82; 95% CI, 0.62 to 1.09; p=0.18). There was no significant difference in recurrence between the HSC and D&C groups (RR, 0.92; 95% CI, 0.66 to 1.32; p=0.66); the heterogeneity of the two included studies was acceptable (p=0.54, I2=0%).

Conclusions

Preoperative HSC in patients with type II EC does not increase the risk for cancer cell dissemination within the peritoneal cavity. Preoperative HSC does not progress the FIGO staging in patients with type II EC and does not increase the risk of tumour recurrence. There is no reason to avoid HSC for the diagnosis of type II EC currently. However, type II tumours generally are less well differentiated and have poorer prognoses than type I tumours. More prospective and adequately powered trials are required to clarify whether preoperative HSC in patients with type II EC is safe.
Living systematic review and comprehensive network meta-analysis of ALS clinical trials: study protocol
Authors: Van Loon Floris T , Seitidis Georgios , Mavridis Dimitris , van Unnik Jordi W J , Weemering Daphne N , van den Berg Leonard H , Bethani Ilianna , Nikolakopoulos Stavros , van Eijk Ruben P A
Published: November 2024

Introduction

Amyotrophic lateral sclerosis (ALS) is a fatal neurogenerative disease with no effective treatment to date. Despite numerous clinical trials, the majority of studies have been futile in their effort to significantly alter the course of the disease. However, these studies may still provide valuable information for identifying patient subgroups and generating new hypotheses for future research. Additionally, synthesising evidence from these studies may help overcome the limitations of individual studies. Network meta-analysis may refine the assessment of efficacy in specific patient subgroups, evaluate intervention characteristics such as mode of administration or biological mechanisms of action, and rank order promising therapeutic areas of interest. Therefore, we aim to synthesise the available evidence from ALS clinical trials.

Methods and analysis

We will conduct a systematic review to identify all clinical trials that assessed disease-modifying pharmaceutical therapies, cell therapies, or supplements in patients with ALS. Outcomes of interest are clinical disease progression outcomes and survival. We will conduct this search in the period Q4 2024 in three databases: PubMed, Embase and ClinicalTrials.gov for studies from 1999 to 2023. Individual patient data and aggregate data will be collected and subsequentially synthesised in meta-analytical models. The final model will be presented as an open-source web application with biannual updates of the underlying data, thereby providing a ‘living’ overview of the ALS clinical trial landscape.

Ethics and dissemination

No ethics approvals are required. Findings will be presented at relevant conferences and submitted to peer-reviewed journals. Data will be stored anonymously in secure repositories.
Evaluating the impact of needs assessment models on autistic children’s participation in the habilitation process: protocol for a prospective observational study
Authors: Lundqvist Lars-Olov , Sjödin Linda , Karvonen Evelina , Arnell Susann
Published: November 2024

Introduction

The rising prevalence of autism spectrum disorder (ASD) among children poses significant challenges for healthcare services. Research has underscored the crucial role of children’s involvement in their healthcare. However, due to the intricate nature of ASD, marked by communication and social interaction differences, healthcare providers face challenges in tailoring their services to accommodate these children. This project aims to explore the impact of two distinct needs assessment models on children’s participation in the needs assessment process.

Methods and analysis

We will conduct a prospective observational study comparing responses from children subjected to two different needs assessment procedures: survey-based and meeting-based. Supplementary data will be collected from the children’s parents/guardians and healthcare professionals. Data collection methods will include questionnaires, interviews and document analysis of individual habilitation plans. We aim to recruit 120 children aged 7–17 diagnosed with ASD but without intellectual disability, with 60 undergoing the survey-based needs assessment and 60 undergoing the meeting-based assessment. The primary outcome measure will be the perception of participation in the needs assessment procedure. Secondary outcomes will include the children’s quality of life and mental health; the parents’ knowledge of their child’s strengths, abilities and special needs; and the parents’ perception of the quality of collaboration with the healthcare team.

Ethics and dissemination

The study received ethics approval from the Swedish Ethical Review Authority on 4 March 2024 (reference number 2024-00227-01). All children and their caregivers will receive both verbal and written information about the study before being asked to provide written informed consent to participate. The findings will be disseminated through publication in peer-reviewed journals and presentation at conferences. Additionally, a popular science report summarising the data and its interpretation will be published.

Trial registration number

NCT06381856.
Correlation between illness perceptions and self-reported degree-of-worry in somatic ill patients in emergency care: a Danish cross-sectional study
Authors: Jensen Andrea Nedergaard , Kallemose Thomas , Frostholm Lisbeth , Gamst-Jensen Hejdi
Published: November 2024

Objectives

The study aimed to investigate the correlation between illness perceptions and self-reported degree-of-worry (DOW) in patients presenting to the emergency department with acute somatic illness.

Design

A cross-sectional survey study collected data from a survey on DOW, the Brief-illness Perception Questionnaire (B-IPQ) and demographics.

Setting

An emergency department at a university hospital in the Capital Region of Denmark.

Participants

944 patients (≥18 years) presenting to the emergency department with acute somatic illness. Data collection was conducted during day and evening shifts on weekdays from 13 January to 19 December 2020.

Methods

Correlations between B-IPQ scores and DOW, including (1) the total B-IPQ score, (2) emotional representations (emotion and illness concern combined) and (3) the single items, respectively.
Secondary analysis
: linear relationships between the single B-IPQ items and DOW. Analyses included the variables sex, age, reason for contact, self-reported comorbidity, employment, highest educational attainment, cohabitation status and region of origin.

Results

The study found moderate correlations between the total illness perceptions score and DOW of 0.47 (95% CI 0.42 to 0.52) and emotional representations and DOW of 0.57 (95% CI 0.52 to 0.61). Linear regression showed the largest and most significant changes in DOW with an increasing score of the B-IPQ items for consequence, illness concern and emotion.

Conclusion

Illness perceptions overall and perceptions of consequences of symptoms, illness concern and emotional representations are correlated with patients’ DOW, with increasing DOW related to more negative illness perceptions. This finding contributes to insight into how illness perceptions are related to illness worry when presenting to the emergency department. Incorporating the novel DOW scale may aid triage and clinical encounters in the emergency department.

Study registration

ClinicalTrails.gov reference:
NCT04226040
.
Augmentation of cognitive-behavioural therapy for obsessive-compulsive and anxiety disorders: a protocol for a systematic review and meta-analysis
Authors: Torbecke Jonathan , Langhammer Till , Mewes Lisa , Lueken Ulrike , Fendel Johannes Caspar
Published: November 2024

Introduction

While cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) has been proven to be effective and is commonly recommended, a considerable proportion of patients remain symptomatic, do not respond to treatment or discontinue it. Thus, augmentation strategies aimed at enhancing CBT outcomes are essential to reduce the burden of OCD and ADs on patients and society. Various augmentation strategies for CBT in OCD and ADs have been investigated, yet it remains unclear if they show robust beneficial effects beyond first-line CBT. With this systematic review and meta-analysis, we will provide an overview and critically assess the efficacy of non-pharmacological augmentation strategies in addition to first-line CBT treatment for symptom reduction, response rates and dropout rates in individuals with OCD or ADs.

Methods and analysis

We will screen PubMed, Embase, PsycArticles, PsycInfo, CINAHL, PSYNDEX and Cochrane Register of Controlled Trials without restrictions on publication dates or languages. Additionally, forward, and backward searches of included studies and systematic reviews will be conducted. Two reviewers will independently screen the studies, extract data and assess the methodological quality of the studies. We will exclusively include randomised controlled trials. The primary outcomes will be symptom severity and response rates. Dropout rates will serve as a secondary outcome. Moreover, we will provide a narrative review of the results. We will use subgroup and meta-regression analyses to identify potential moderators and sources of between-study heterogeneity. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the overall quality of evidence.

Ethics and dissemination

Ethical approval is not required. Results will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42024561027.
Impact of the COVID-19 pandemic on maternal, neonatal and child health service utilisation, delivery and health outcomes in Gauteng province, South Africa: an interrupted time series (ITS) analysis
Authors: Fonka Cyril Bernsah , Khamisa Natasha , Worku Eshetu , Blaauw Duane
Published: November 2024

Background

Gauteng was one of the provinces in South Africa most hit by COVID-19. However, there has been no assessment of the pandemic’s impact on essential maternal, neonatal and child health (MNCH) services in Gauteng, for planning against future emergencies. This study sought to assess the impact of the COVID-19 pandemic on essential MNCH service utilisation, delivery and health outcomes in Gauteng province.

Methods

We employed a quasi-experimental interrupted time series (ITS) study design, using the District Health Information System (DHIS) data set to evaluate the impact of COVID-19 on eight key MNCH indicators between March 2019 to February 2021. Using Stata V.17.0 and 5% alpha, a segmented linear regression (ITS) model quantified the trends of the indicators before COVID-19 (March 2019 to February 2020) (β1), the immediate change in level due to the March 2020 lockdown (β2), the post-lockdown (March 2020 to February 2021) trend (β4) and the change in gradient from before to after the lockdown (β3).

Results

COVID-19 lockdown exerted a significant decline in primary healthcare headcount<5 years (n) (β2= −60 106.9 (95% CI, −116 710.4; −3503.3), p=0.039); and postnatal care visits within 6 days (rate) (β2=−8.2 (95% CI, −12.4; −4.1), p=0.001). Antenatal care first visits before 20 weeks (rate) declined during COVID-19 (β3=−0.4 (95% CI, −0.7; −0.1), p=0.013) compared with the pre-COVID-19 period. COVID-19 adverse effects on service delivery (measles second dose coverage and fully immunised<1 year) and health outcomes (facility deaths 0–6 days, maternal mortality ratio and pneumonia case fatality<1 year) were insignificant. While some indicators post-lockdown attempted to recover, others deteriorated.

Conclusion

In Gauteng province, the COVID-19 pandemic significantly disrupted essential MNCH service utilisation, particularly during the March 2020 lockdown. The mechanism of MNCH service disruption by COVID-19 was induced by both supply and demand services. It is imperative to strike a balance between maintaining routine healthcare services and managing an outbreak.
Decision analytical modelling of strategies for investigating suspected acute aortic syndrome
Authors: Thokala Praveen , Goodacre Steve , Cooper Graham , Hinchliffe Robert , Reed Matthew J , Thomas Steven , Wilson Sarah , Fowler Catherine , Lechene Valérie
Published: November 2024

Background

Acute aortic syndrome (AAS) requires urgent diagnosis with computed tomographic angiography (CTA). Diagnostic strategies need to weigh the benefits of detecting AAS against the costs of using CTA with a low yield of AAS when the prevalence of AAS is low. We aimed to estimate the cost-effectiveness of diagnostic strategies using clinical probability scoring and D-dimer to select patients with potential symptoms of AAS for CTA.

Methods

We developed a decision analytical model to simulate the management of patients attending hospital with possible AAS. We modelled diagnostic strategies that used the Aortic Dissection Detection Risk Score (ADD-RS) and D-dimer to select patients for CTA. We used estimates from our meta-analysis, existing literature and clinical experts to model the consequences of diagnostic strategies on survival, health utility, and health and social care costs. We estimated the incremental cost per quality-adjusted life-years gained by each strategy compared with the next most effective alternative on the efficiency frontier.

Results

A strategy based on the Canadian guideline (CTA if ADD-RS>1 or ADD-RS=1 with D-dimer >500 ng/mL) is cost-effective but would result in high rates of CTA if applied to an unselected population (AAS prevalence 0.26%). The strategy is also cost-effective and would result in lower rates of CTA if applied to a more selected population, such as those with a non-zero clinical suspicion of AAS (prevalence 0.61%). For patients currently receiving CTA, using ADD-RS>1 or D-dimer >500 ng/mL to select patients for CTA is cost-effective.

Conclusions

A strategy using ADD-RS>1 or ADD-RS=1 with D-dimer >500 ng/mL to select patients for CTA appears cost-effective but primary research is required to evaluate this strategy in practice and determine how suspicion of AAS is identified.
Prehospital endotracheal intubation for traumatic out-of-hospital cardiac arrest and improved neurological outcomes
Authors: Yamamoto Ryo , Suzuki Masaru , Takemura Ryo , Sasaki Junichi
Published: November 2024

Background

Patients with traumatic out-of-hospital cardiac arrest (t-OHCA) require on-scene airway management to maintain tissue oxygenation. However, the benefits of prehospital endotracheal intubation remain unclear, particularly regarding neurological outcomes. Therefore, this study aimed to evaluate the association between prehospital intubation and favourable neurological outcomes in patients with t-OHCA.

Methods

This retrospective cohort study used a Japanese nationwide trauma registry from 2019 to 2021. It included adult patients diagnosed with traumatic cardiac arrest on emergency medical service arrival. Glasgow Outcome Scale (GOS) scores, survival at discharge and presence of signs of life on hospital arrival were compared between patients with prehospital intubation and those with supraglottic airway or manual airway management. Inverse probability weighting with propensity scores was used to adjust for patient, injury, treatment and institutional characteristics, and the effects of intubation on outcomes averaged over baseline covariates were shown as marginal ORs.

Results

A total of 1524 patients were included in this study, with 370 undergoing intubation before hospital arrival. Prehospital intubation was associated with favourable neurological outcomes at discharge (GOS≥4 in 5/362 (1.4%) vs 10/1129 (0.9%); marginal OR 1.99; 95% CI 1.12 to 3.53; p=0.021) and higher survival to discharge (25/370 (6.8%) vs 63/1154 (5.5%); marginal OR 1.43; 95% CI 1.08 to 1.90; p=0.012). However, no association with signs of life on hospital arrival was observed (65/341 (19.1%) vs 147/1026 (14.3%); marginal OR 1.09; 95% CI 0.89 to 1.34). Favourable outcomes were observed only in patients who underwent intubation with a severe chest injury (Abbreviated Injury Score ≥3) and with transportation time to hospital >15 min (OR 14.44 and 2.00; 95% CI 1.89 to 110.02 and 1.09 to 3.65, respectively).

Conclusions

Prehospital intubation was associated with favourable neurological outcomes among adult patients with t-OHCA who had severe chest injury or transportation time >15 min.
Association of innate versus specific immunity with heart failure incidence: a prospective study
Authors: Wang Junxue , Zhang Ziteng , Sun Ying , Yu Bowei , Wang Yuying , Lu Yingli , Yu Jiao , Wang Ningjian , Xia Fangzhen
Published: November 2024

Background

Immune disorders are key heart failure (HF) triggers, but little is known about whether the status of immunity affects the incidence of HF. To explore this, we used blood cell counts and derived ratios to investigate the association between immunity status markers and HF incidence.

Methods

The number and proportion of peripheral blood leucocytes in a physiological state are related to the body’s immune status. Neutrophils, monocytes, SII (systemic immune-inflammatory index), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio) serve as innate immunity status markers, while lymphocytes and LMR (lymphocyte-to-monocyte ratio) serve as specific immunity status markers. 330 362 UK Biobank (UKB) participants were finally examined. Cox proportional hazard models were used to explore the relationship between immunity status markers and HF incidence. Flexible parametric survival models were used to capture time-varying relationships between blood cell ratios and HRs for HF. Subgroup analyses were conducted by age, sex, and body mass index. Finally, sensitivity analyses were performed to validate the results.

Results

During a median follow-up of 14.1 years, 9611 (2.9%) participants developed HF. Neutrophils, monocytes, SII, and NLR were positively associated with HF incidence, with fully adjusted per SD increment HR (95% CI) of 1.20 (1.17 to 1.22), 1.09 (1.07 to 1.12), 1.12 (1.10 to 1.14), and 1.16 (1.14 to 1.18), respectively. Platelets, lymphocytes, and LMR were inversely correlated with HF incidence, with fully adjusted per SD increment HR (95% CI) of 0.97 (0.95 to 1.00), 0.97 (0.95 to 0.99), and 0.90 (0.88 to 0.92), respectively.

Conclusions

The innate immunity status markers were positively associated with HF incidence, while specific immunity status markers exhibited an inverse association, offering novel insights for HF prediction and intervention.
Unlocking the therapeutic potential of the NKG2A-HLA-E immune checkpoint pathway in T cells and NK cells for cancer immunotherapy
Authors: Li Yan , Li Zhu , Tang Yisen , Zhuang Xiaomei , Feng Wanhua , Boor Patrick P C , Buschow Sonja , Sprengers Dave , Zhou Guoying
Published: November 2024

Immune checkpoint blockade, which enhances the reactivity of T cells to eliminate cancer cells, has emerged as a potent strategy in cancer therapy. Besides T cells, natural killer (NK) cells also play an indispensable role in tumor surveillance and destruction. NK Group 2 family of receptor A (NKG2A), an emerging co-inhibitory immune checkpoint expressed on both NK cells and T cells, mediates inhibitory signal via interaction with its ligand human leukocyte antigen-E (HLA-E), thereby attenuating the effector and cytotoxic functions of NK cells and T cells. Developing antibodies to block NKG2A, holds promise in restoring the antitumor cytotoxicity of NK cells and T cells. In this review, we delve into the expression and functional significance of NKG2A and HLA-E, elucidating how the NKG2A-HLA-E axis contributes to tumor immune escape via signal transduction mechanisms. Furthermore, we provide an overview of clinical trials investigating NKG2A blockade, either as monotherapy or in combination with other therapeutic antibodies, highlighting the responses of the immune system and the clinical benefits for patients. We pay special attention to additional immune co-signaling molecules that serve as potential targets on both NK cells and T cells, aiming to evoke more robust immune responses against cancer. This review offers an in-depth exploration of the NKG2A-HLA-E pathway as a pivotal checkpoint in the anti-tumor responses, paving the way for new immunotherapeutic strategies to improve cancer patient outcomes.
Study on performance deterioration of asphalt and asphalt mixtures containing Mafilon under internal salt freeze–thaw cycles
Authors: Zhang Haihu , Qian Jinsong , Guo Runhua , Wen Long
Published: October 2024

The purpose of this work is to determine the implications of internal salt freeze–thaw cycles (F–TCs) on performance deterioration to asphalt and asphalt mixtures containing Mafilon (MFL). The deterioration to different numbers of F–TCs and different MFL contents on asphalt properties and mechanism were investigated by physical properties tests and microcosmic tests. Then the damages of road performance indexes of asphalt mixtures containing different MFL contents were studied by road performance tests. The experimental results show that asphalt containing MFL after F–TCs has a remarkable decline in ductility and penetration, while growth in softening point. Internal salt F–TCs are most damaging to the cryogenic properties of asphalt. Chemical reactions and salt aging effects occur in salt F–TCs, raising the glass transition temperature of asphalt. Road performance tests indicate the deterioration of internal salt F–TCs to high temperature stability and water stability is the most pronounced, with 29.18% and 21.78% reduction, respectively.
Socio-cultural indicators for bioenergy: a survey-based review
Authors: Berthold Etienne , Pawliw Kim , Boivin Maryse , Thiffault Évelyne
Published: November 2024

The development of bioenergy projects, which play a major role in the ongoing energy transition, must rely on research by indicators. This type of research allows the establishment of criteria that can guide development choices on scientific bases. To promote the continuation and development of bioenergy projects as much as possible, it is very important to take an interest in the dimensions and socio-cultural issues of bioenergy. Based on a corpus of 257 articles sorted into two distinct phases, this paper analyzed 25 academic articles that specifically discussed and proposed socio-cultural indicators for the assessment and evaluation of bioenergy projects. We looked at how the indicators were used across the papers and identified differences and commonalities. This has led us to identify a total of 71 indicators and to propose 18 key indicators based on their widespread use and their ability to cover the socio-cultural dimensions of bioenergy production.
The Lomonosov Ridge, central Arctic Ocean – the world's longest submarine ridge of continental origin: outline of the history of exploration, morphology, sediment deposition and exhumation of the North American and Central ridge segments
Authors: Kristoffersen Y. , Hall J.K. , Nilsen E. Harris
Published: November 2024

We accessed the North American Segment of the Lomonosov Ridge in the central Arctic Ocean during a 12-month hovercraft expedition on drifting sea ice and revisited legacy seismic data to explore the geological history of the ridge. Seismic reflection images on the North American Segment resemble the acoustic reflection sequence calibrated by scientific drilling at the Arctic Coring Expedition (ACEX) site on the Central Segment of the ridge, although the thickness of the Cenozoic sediment section is reduced to 70%. A base-Cenozoic unconformity is present north of
c.
88° 30′ N and older sediments dip towards the Makarov Basin along the entire ridge segment. During the Eocene, sediment drifts were deposited along the flanks on top of the North American Segment north of 87° N as well as next to the ACEX drill site on the Central Segment of the ridge. Two local sediment lenses deposited at the Canadian end of the Lomonosov Ridge document local ridge uplift events at
c.
56 and 48 Ma during the Eurekan Orogeny. Compressional velocity gradients derived from published seismic reflection/refraction measurements are consistent with 1–3 km of Cretaceous–early Cenozoic exhumation of an up to 500 km wide swath of continental crust along the polar continental margin, including the Lomonosov Ridge, Svalbard and Franz Josef Land.