bluuebunny/crossref_metadata_2025 huggingface dataset:
RNAscope in situ hybridization and RT‐PCR for detection of SARS‐CoV‐2 in chilblain‐like lesions: A clinical, laboratory and histopathological study
Authors: Robustelli Test Elisa , Sena Paolo , Locatelli Andrea Gustavo , Carugno Andrea , di Mercurio Marco , Moggio Erica , Gambini Daniele Mario , Arosio Marco Enrico Giovanni , Callegaro Annapaola , Morotti Denise , Gianatti Andrea , Vezzoli Pamela
Published: January 2022

Background

Since the beginning of the coronavirus disease 2019 (COVID‐19) pandemic, an increasing number of chilblain‐like lesions (ChLL) have been increasingly reported worldwide. To date, the causal link between ChLL and SARS‐CoV‐2 infection has not been unequivocally established.

Methods

In this case series, we present demographic, clinical, laboratory, and histopathological information regarding 27 young patients with a clinical diagnosis of ChLL who referred to the Dermatology Unit of Papa Giovanni XXIII Hospital, Bergamo, Italy, from 1 April 2020 to 1 June 2020.

Results

The mean age was 14.2 years, and 21 patients (78%) experienced mild systemic symptoms a median of 28 days before the onset of cutaneous lesions. ChLL mostly involved the feet (20 patients – 74%). Among acral lesions, we identified three different clinical patterns: (i) chilblains in 20 patients (74%); (ii) fixed erythematous macules in 4 children (15%); (iii) erythrocyanosis in 3 female patients (11%). Blood examinations and viral serologies, including parvovirus B19, cytomegalovirus (CMV), Epstein‐Barr virus (EBV), and coxsackievirus were normal in all. Three patients (11%) underwent nasopharyngeal swab for RT‐PCR for SARS‐CoV‐2 showing only 1 positive. Histopathological examinations of 7 skin biopsies confirmed the clinical diagnosis of chilblains; vessel thrombi were observed only in 1 case. Our findings failed to demonstrate the direct presence of SARS‐CoV‐2 RNA in skin biopsies, both with real‐time polymerase chain reaction (RT‐PCR) and RNAscope in situ hybridization (ISH).

Limitations

Limited number of cases, unavailability of laboratory confirmation of COVID‐19 in all patients, potential methodological weakness, and latency of skin biopsies in comparison to cutaneous lesions onset.

Conclusions

These observations may support the hypothesis of an inflammatory pathogenesis rather than the presence of peripheral viral particles. Although, we could not exclude an early phase of viral endothelial damage followed by an IFN‐I or complement‐mediated inflammatory phase. Further observations on a large number of patients are needed to confirm this hypothesis.
Public health and hospital‐based nursing intersection: Case study of drug‐resistant tuberculosis patients
Authors: Pietersen Elize , Anderson Kim , van der Heijden Yuri F.
Published: January 2022

Objective

Public health nurses (PHN) are key partners in continuity of care for drug‐resistant tuberculosis (DR‐TB) patients. We examined complexities in DR‐TB care transition between community‐ and hospital‐based care.

Design

We conducted a case study using medical record data. Four patients were purposively selected to illustrate intersectional complexities in DR‐TB care transition involving PHN.

Results

Case A (HIV negative male) received PHN care at a community‐based facility 124 km from Cape Town. Cases B, C, and D (males living with HIV) received PHN community‐based care, averaging 25 km from the hospital. Treatment failed in cases A, B, and C; they subsequently died. Case D was cured. All cases were granted leave of absence at least once while hospitalized. None returned when expected mainly due to lack of transport funds. PHN played critical roles regarding patients’ return by conducting home visits, interacting with relatives, and assisting emergency officers to transport patients back to the hospital. PHN supported relatives to endure protracted patient hospitalizations.

Conclusion

The role of PHN in continuity of DR‐TB care in low‐middle income countries is unambiguous. PHN are key partners in the DR‐TB care cascade, namely facilitating retention in care between hospital and community‐based care. Effective DR‐TB control relies on effective partnerships among healthcare personnel, patients, and their families.
Ultrasonographic detection of apex nodules in the urinary bladder of Scottish Terriers
Authors: Heng Hock Gan , Ramos‐Vara José A. , Fulkerson Christopher M. , Fourez Lindsey M. , Knapp Deborah W.
Published: January 2022

An apex nodule was recently identified in the urinary bladder of Scottish Terriers being screened for bladder cancer at our institution. This prospective, single‐center, case series study was performed to better characterize the apex nodule and assess the clinical importance of the nodule. Scottish Terriers ≥6 years of age with no evidence of urinary tract disease underwent urinary tract ultrasonography and urinalysis at 6‐month intervals. In dogs with evidence of the apex nodule, ultrasound features such as location, margins, number, echogenicity, size, and shape of the lesion were recorded by a veterinary oncologist and veterinary radiologist. The apex nodule was identified in eight (6%) of 134 dogs in the absence of other detectable bladder disease. Features of the nodules included the following: one nodule per dog, triangular to an oval shape, smooth mucosal covering, well‐defined margins, isoechoic to the bladder wall, 2–4 mm at the base, and 4–6 mm protruding into the bladder lumen. In five dogs undergoing multiple ultrasonographic examinations, the nodule did not appear to change over time (up to 3.5 years). Cystoscopy performed in three dogs revealed a column of tissue covered by normal mucosa protruding into the bladder lumen. Histological features consistent with a neoplastic growth were absent. Five dogs remained free of any bladder disease. Three dogs developed urothelial carcinoma at sites distant to the nodule at 8–53 months after the nodule was first observed. Findings indicated that incidental apex nodules could mimic neoplasia and other bladder diseases in Scottish Terriers.
Taxonomic entities of two Korean plant taxa: Vicia bifolia (Fabaceae) and Cyperus compressus (Cyperaceae)
Authors: CHOI Seung Se , KIM Jonghwan , Kim Myoung Jun , KIM Chul Hwan
Published: January 2022

Vicia bifolia Nakai (Fabaceae) and Cyperus compressus L. (Cyperaceae) have been ambiguous in terms of their distribution and taxonomic entities in Korea. The existence of these two taxa was confirmed when V. bifolia and C. compressus was found on Jellabuk-do, Gyeongsangnam-do, and Jeju-do. Vicia bifolia is similar to V. unijuga by having a pair of leaflets but is distinguished by the length of the petiole, the size and degree of longevity of the bracts, and the shape of the stipules. Cyperus compressus was found on Jeju-do, is similar to C. tenuispica, C. haspan, and C. flaccidus, but is distinguished by the branching pattern of the inflorescences and the size of scales and achenes. A description, differences from related species, a key to the taxa and photographs of Korean Vicia bifolia and Cyperus compressus are provided in this study.
New record of an alien plant, Petrorhagia nanteuilii (Caryophyllaceae) in Korea
Authors: HONG Jeong-Ki , SHIM Sang Deog , KIM Hyun Sik , SIM Sunhee , HYUN Chang Woo , KIM Jung-Hyun
Published: January 2022

Petrorhagia nanteuilii (Burnat) P. W. Ball & Heywood (Caryophyllaceae), native to western Europe and western North Africa and an introduced or alien plant in South America, Australia, and Japan, was newly found in Gyeongsangnam-do, Korea. Petrorhagia is clearly distinguished from other genera by a bract at the base of calyx, which differs from Gypsophila L., and commissures at the sepals, which is different from Dianthus L. Petrorhagia nanteuilii grows on slopes and roadsides, suggesting that it is likely to have been introduced through the installation of green sites and road construction. A precise description, illustration, photographs, and a key to related genera and species is provided.
Altered muscle mitochondrial, inflammatory and trophic markers, and reduced exercise training adaptations in type 1 diabetes
Authors: Minnock Dean , Annibalini Giosuè , Valli Giacomo , Saltarelli Roberta , Krause Mauricio , Barbieri Elena , De Vito Giuseppe
Published: January 2022

Growing evidence of impaired skeletal muscle health in people with type 1 diabetes points toward the presence of a mild myopathy in this population. However, this myopathic condition is not yet well characterised and often overlooked, even though it might affect the whole‐body glucose homeostasis and the development of comorbidities. This study aimed to compare skeletal muscle adaptations and changes in glycaemic control after 12 weeks of combined resistance and aerobic (COMB) training between people with type 1 diabetes and healthy controls, and to determine whether the impaired muscle health in type 1 diabetes can affect the exercise‐induced adaptations. The COMB training intervention increased aerobic capacity and muscle strength in both healthy and type 1 diabetes sedentary participants, although these improvements were higher in the control group. Better glucose control, reduced glycaemic fluctuations and fewer hypoglycaemic events were recorded at post‐ compared to pre‐intervention in type 1 diabetes. Analysis of muscle biopsies showed an alteration of muscle markers of mitochondrial functions, inflammation, ageing and growth/atrophy compared to the control group. These muscular molecular differences were only partially modified by the COMB training and might explain the reduced exercise adaptation observed in type 1 diabetes. In brief, type 1 diabetes impairs many aspects of skeletal muscle health and might affect the exercise‐induced adaptations. Defining the magnitude of diabetic myopathy and the effect of exercise, including longer duration of the intervention, will drive the development of strategies to maximise muscle health in the type 1 diabetes population.

Key points

Type 1 diabetes negatively affects skeletal muscle health; however, the effect of structured exercise training on markers of mitochondrial function, inflammation and regeneration is not known.

Even though participants with type 1 diabetes and healthy control were comparable for cardiorespiratory fitness () and muscle strength at baseline, molecular markers related to muscle health were decreased in type 1 diabetes.

After training, both groups increased and muscle strength; however, a larger improvement was achieved by the control group.

The training intervention decreased glucose fluctuations and occurrence of hypoglycaemic events in type 1 diabetes, while signs of mild myopathy found in the muscle of participants with type 1 diabetes only partially improved after training

Improving muscle health by specific exercise protocols is of considerable clinical interest in therapeutic strategies for improving type 1 diabetes management and preventing or delaying long‐term complications.
User Requirements Analysis on Augmented Reality-Based Maintenance in Manufacturing
Authors: Runji Joel Murithi , Lee Yun-Ju , Chu Chih-Hsing
Published: January 2022

Maintenance of technical equipment in manufacturing is inevitable for sustained productivity with minimal downtimes. Elimination of unscheduled interruptions as well as real-time monitoring of equipment health can potentially benefit from adopting augmented reality (AR) technology. How best to employ this technology in maintenance demands a fundamental comprehension of user requirements for production planners. Despite AR applications being developed to assist various manufacturing operations, no previous study has examined how these user requirements in maintenance have been fulfilled and the potential opportunities that exist for further development. Reviews on maintenance have been general on all industrial fields rather than focusing on a specific industry. In this regard, a systematic literature review was performed on previous studies on AR applications in the maintenance of manufacturing entities from 2017 to 2021. Specifically, the review examines how user requirements have been addressed by these studies and identifies gaps for future research. The user requirements are drawn from the challenges encountered during AR-based maintenance in manufacturing following a similar approach to usability engineering methodologies. The needs are identified as ergonomics, communication, situational awareness, intelligence sources, feedback, safety, motivation, and performance assessment. Contributing factors to those needs are cross-tabulated with the requirements and their results presented as trends, prior to drawing insights and providing possible future suggestions for the made observations.
Design of a Noncircular Gear Mechanism With Twice Unequal Amplitude Transmission Ratio
Authors: Liu Jiangang , Tong Zhipeng , Yu Gaohong , Zhao Xiong , Zhou Haili
Published: January 2022

This article proposes a new noncircular gear transmission mechanism with an involute–cycloid composite tooth profile to obtain the twice unequal amplitude transmission of noncircular gears. That is, the instantaneous transmission ratio has twice obvious fluctuations with unequal amplitude in a complete rotation cycle of gear transmission. The twice unequal amplitude transmission ratio curve was designed based on Fourier and polynomial functions, the change law of the Fourier coefficient on the instantaneous transmission ratio was analyzed, and the pressure angle and contact ratio of the involute–cycloid composite tooth profile was calculated. The involute–cycloid composite tooth profile noncircular gear was machined by wire cut electrical discharge machining technology, while its meshing experiment was performed using high-speed camera technology. The results demonstrate that the instantaneous transmission ratio curve value obtained via the high-speed camera experiment was consistent with the simulation value of virtual software. Furthermore, the involute–cycloid composite tooth profile was applied in the seedling pickup mechanism of noncircular gear planetary gear train. The possibility of the application of the involute–cycloid composite tooth profile in the seedling pickup mechanism was verified by comparing the consistency of the theoretical and simulated seedling picking trajectory.
Multi-target 2D tracking method for singing humpback whales using vector sensors
Authors: Tenorio-Hallé Ludovic , Thode Aaron M. , Lammers Marc O. , Conrad Alexander S. , Kim Katherine H.
Published: January 2022

Acoustic vector sensors allow estimating the direction of travel of an acoustic wave at a single point by measuring both acoustic pressure and particle motion on orthogonal axes. In a two-dimensional plane, the location of an acoustic source can thus be determined by triangulation using the estimated azimuths from at least two vector sensors. However, when tracking multiple acoustic sources simultaneously, it becomes challenging to identify and link sequences of azimuthal measurements between sensors to their respective sources. This work illustrates how two-dimensional vector sensors, deployed off the coast of western Maui, can be used to generate azimuthal tracks from individual humpback whales singing simultaneously. Incorporating acoustic transport velocity estimates into the processing generates high-quality azimuthal tracks that can be linked between sensors by cross-correlating features of their respective azigrams, a particular time-frequency representation of sound directionality. Once the correct azimuthal track associations have been made between instruments, subsequent localization and tracking in latitude and longitude of simultaneous whales can be achieved using a minimum of two vector sensors. Two-dimensional tracks and positional uncertainties of six singing whales are presented, along with swimming speed estimates derived from a high-quality track.
A High-Intensity Warm-Up Increases Thermal Strain But Does Not Affect Repeated Sprint Performance in Athletes With a Cervical Spinal Cord Injury
Authors: O’Brien Thomas J. , Briley Simon J. , Mason Barry S. , Leicht Christof A. , Tolfrey Keith , Goosey-Tolfrey Victoria L.
Published: January 2022

Purpose: To compare the effects of typical competition versus high-intensity intermittent warm-up (WU) on thermoregulatory responses and repeated sprint performance during wheelchair rugby game play. Methods: An intermittent sprint protocol (ISP) simulating the demands of wheelchair rugby was performed by male wheelchair rugby players (7 with cervical spinal cord injury [SCI] and 8 without SCI) following 2 WU protocols. These included a typical competition WU (control) and a WU consisting of high-intensity efforts (INT). Core temperature (Tcore), thermal sensation, and thermal comfort were recorded. Wheelchair performance variables associated to power, speed, and fatigue were also calculated. Results: During the WU, Tcore was similar between conditions for both groups. During the ISP, a higher Tcore was found for SCI compared to NON-SCI (38.1 [0.3] vs 37.7 [0.3] °C: P = .036, d = 0.75), and the SCI group experienced a higher peak Tcore for INT compared with control (39.0 [0.4] vs 38.6 [0.6] °C; P = .004). Peak Tcore occurred later in the ISP for players with SCI (96 [5.8] vs 48 [2.7] min; P < .001). All players reported a higher thermal sensation and thermal comfort following INT (P < .001), with no differences between conditions throughout the ISP. No significant differences were found in wheelchair performance variables during the ISP between conditions (P ≥ .143). Conclusions: The high-INT WU increased thermal strain in the SCI group during the ISP, potentially due to increased metabolic heat production and impaired thermoregulation, while not impacting on repeated sprint performance. It may be advisable to limit high-INT bouts during a WU in players with SCI to mitigate issues related to hyperthermia in subsequent performance.
Quantifying Infant Exploratory Learning
Authors: Kim Jeong Ah , Park Sungwoo , Fetters Linda , Eckel Sandrah P. , Kubo Masayoshi , Sargent Barbara
Published: January 2022

Exploration is considered essential to infant learning, but few studies have quantified infants’ task exploration. The purpose of this study was to quantify how infants explored task space with their feet while learning to activate a kick-activated mobile. Data were analyzed from fifteen 4-month-old infants who participated in a 10-min mobile task on 2–3 consecutive days. Infants learned that their vertical leg movements above a systematically increased threshold height activated the mobile. Five kinematic variables were analyzed: (a) exploration space volume, (b) exploration path length, (c) duration of time in the region of interest around the threshold that activated the mobile, (d) task-specific vertical variance of kicks, and (e) non-task-specific horizontal variance of kicks. The infants increased their general spatial exploration, volume, and path, and the infants adapted their exploration by maintaining their feet within the region of interest, although the task-specific region increased in height as the threshold increased. The infants used task-specific strategies quantified by the increased variance of kicks in the vertical direction and no change in the horizontal variance of kicks. Quantifying infants’ task exploration may provide critical insights into how learning emerges in infancy and enable researchers to more systematically describe, interpret, and support learning.
A Systematic Review of Correlates of the Moderate-to-Vigorous Physical Activity of Students in Elementary School Physical Education
Authors: Wang Lijuan , Zhou Yulan
Published: January 2022

This study systematically summarize existing literature focusing on the correlates of students’ moderate-to-vigorous physical activity (MVPA) during elementary school physical education (PE). A systematic search was initiated to identify studies investigating the physical activity correlates in students during elementary PE. Two researchers independently screened the studies, assessed their methodological quality, and extracted relevant data. The correlates were synthesized and further assessed using the semiquantitative method. A total of 42 studies were included in the review. Out of 44 variables identified from these studies, 10 were consistently associated with MVPA. Gender (boys), PE activities (team games), PE context (fitness activities, game play, and skill practice), class location (outdoors)and perceived competence were consistently and positively associated with the MVPA of students in PE. Other variables, namely body mass index, larger class size, and PE activities (movement activities), were consistently and negatively related to MVPA. In conclusion, this study improves our understanding of the correlates of students’ physical activity from the demographic,biological, instructional, physical environment, social support, and psychological perspectives. These variables should be focused on when designing new or improving current interventions.
Antibody-mediated broad sarbecovirus neutralization through ACE2 molecular mimicry
Authors: Park Young-Jun , De Marco Anna , Starr Tyler N. , Liu Zhuoming , Pinto Dora , Walls Alexandra C. , Zatta Fabrizia , Zepeda Samantha K. , Bowen John E. , Sprouse Kaitlin R. , Joshi Anshu , Giurdanella Martina , Guarino Barbara , Noack Julia , Abdelnabi Rana , Foo Shi-Yan Caroline , Rosen Laura E. , Lempp Florian A. , Benigni Fabio , Snell Gyorgy , Neyts Johan , Whelan Sean P. J. , Virgin Herbert W. , Bloom Jesse D. , Corti Davide , Pizzuto Matteo Samuele , Veesler David
Published: January 2022

Understanding broadly neutralizing sarbecovirus antibody responses is key to developing countermeasures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and future zoonotic sarbecoviruses. We describe the isolation and characterization of a human monoclonal antibody, designated S2K146, that broadly neutralizes viruses belonging to SARS-CoV– and SARS-CoV-2–related sarbecovirus clades, which use angiotensin-converting enzyme 2 (ACE2) as an entry receptor. Structural and functional studies show that most of the virus residues that directly bind S2K146 are also involved in binding to ACE2. This allows the antibody to potently inhibit receptor attachment. S2K146 protects against SARS-CoV-2 Beta variant challenge in hamsters, and viral passaging experiments reveal a high barrier for emergence of escape mutants, making it a good candidate for clinical development. The conserved ACE2-binding residues present a site of vulnerability that might be leveraged for developing vaccines eliciting broad sarbecovirus immunity.
Whole-Genome Sequence of a Porcine Circovirus Type 2 Strain Detected in Assam, India
Authors: Bharali Arpita , Buragohain Lukumoni , Barman Nagendra Nath , Gogoi Sophia M.
Published: January 2022

Porcine circovirus-associated disease caused by porcine circovirus type 2 (PCV2) is a vital threat to the global pig industry. In this study, we have characterized the complete genome sequence of a PCV2 isolate, namely, Assam-01, belonging to the genotype PCV2d.
Complete Genome Sequence of Pseudomonas sp. Strain MM213, an Isolate from a Brookside in Bielefeld, Germany
Authors: Verwaaijen Bart , Cevahir Özgülen , Hitz Fabian , Römmich Jacqueline , Wulf Donat
Published: January 2022

Here, we report the complete genome sequence of
Pseudomonas
sp. strain MM213 of the
Pseudomonas mandelii
group, which was isolated from a brookside in Bielefeld, Germany. The genome size is 6,746,355 bp, with a GC content of 59.4% and 6,145 predicted protein-coding sequences.
Metagenomes of Lichens Solorina crocea and Peltigera canina
Authors: Vecherskii Maxim V. , Khayrullin David R. , Shadrin Andrey M. , Lisov Alexander V. , Zavarzina Anna G. , Zavarzin Alexey A. , Leontievsky Alexey A.
Published: January 2022

Lichen genomes are usually considered genomes of separately cultured mycobiont and photobiont. Analysis of lichen metagenomes can give important information on specific lichen-associated microorganisms that can affect lichen metabolism. Here, we report a metagenome of peltigeralean lichens, containing cyanobacterial (
Peltigera canina
) and cyanobacterial/green algal (
Solorina crocea
) partners.
BK Polyomavirus Subtypes II and IV in Hematopoietic Cell Transplant Recipients
Authors: Odegard Elizabeth A. , Meeds Heidi L. , Kleiboeker Steven B. , Ziady Assem , Sabulski Anthony , Jodele Sonata , Seif Alix E. , Davies Stella M. , Laskin Benjamin L. , Blackard Jason T.
Published: January 2022

Symptomatic BK polyomavirus (BKPyV) infections are common and relevant in immunocompromised patients. Here, we present full-length BKPyV genomes from samples from patients who received hematopoietic cell transplants in the United States. These individuals had non-subtype I BKPyV, as determined by amplification, next-generation sequencing, and phylogenetic analysis.
A rare cause of chest pain in paediatric age: a teenager with acute myocardial infarction due to spontaneous coronary artery dissection
Authors: Costa Cascais Filipa , Pereira Ana Rita , Almeida Ana Rita , Rocha Luísa
Published: January 2022

A healthy 17-year-old boy was admitted to the emergency department presenting with a pressure-like sternal pain that started during exercise. His physical examination was normal. Twelve-lead ECG and transthoracic echocardiogram suggested a myocardial infarction. The patient was submitted to an invasive coronary angiography, which revealed a distal occlusion of the left anterior descending artery, due to a spontaneous coronary artery dissection. A balloon angioplasty was performed, with good results. Aetiological study did not discover any pathologic condition. Chest pain in paediatric age is a frequent complaint, despite not being usually caused by a serious condition. However, it is important to remember warning signs in order to diagnose life-threatening diseases, as soon as possible.
Co-learning during the co-creation of a dengue early warning system for the health sector in Barbados
Authors: Stewart-Ibarra Anna M , Rollock Leslie , Best Sabu , Brown Tia , Diaz Avriel R , Dunbar Willy , Lippi Catherine A , Mahon Roché , Ryan Sadie J , Trotman Adrian , Van Meerbeeck Cedric J , Lowe Rachel
Published: January 2022

Over the past decade, the Caribbean region has been challenged by compound climate and health hazards, including tropical storms, extreme heat and droughts and overlapping epidemics of mosquito-borne diseases, including dengue, chikungunya and Zika. Early warning systems (EWS) are a key climate change adaptation strategy for the health sector. An EWS can integrate climate information in forecasting models to predict the risk of disease outbreaks several weeks or months in advance. In this article, we share our experiences of co-learning during the process of co-creating a dengue EWS for the health sector in Barbados, and we discuss barriers to implementation as well as key opportunities. This process has involved bringing together health and climate practitioners with transdisciplinary researchers to jointly identify needs and priorities, assess available data, co-create an early warning tool, gather feedback via national and regional consultations and conduct trainings. Implementation is ongoing and our team continues to be committed to a long-term process of collaboration. Developing strong partnerships, particularly between the climate and health sectors in Barbados, has been a critical part of the research and development. In many countries, the national climate and health sectors have not worked together in a sustained or formal manner. This collaborative process has purposefully pushed us out of our comfort zone, challenging us to venture beyond our institutional and disciplinary silos. Through the co-creation of the EWS, we anticipate that the Barbados health system will be better able to mainstream climate information into decision-making processes using tailored tools, such as epidemic forecast reports, risk maps and climate-health bulletins, ultimately increasing the resilience of the health system.
Exploratory randomised trial of face-to-face and mobile phone counselling against usual care for tobacco cessation in Indian primary care: a randomised controlled trial protocol for project CERTAIN
Authors: Panda Rajmohan , Omar Rumana , Hunter Rachael , Prabhu Rajath R , Mishra Arti , Nazareth Irwin
Published: January 2022

Introduction

Despite widespread use of smokeless tobacco products by people within the Indian subcontinent, there is little awareness among Indians of its health hazards when compared with smoked tobacco. We hypothesise that mobile phone counselling will be feasible and effective for smokeless tobacco cessation intervention in India. This paper presents the protocol of the development and conduct of an exploratory trial before progression to a full randomised controlled trial.

Methods and analysis

An exploratory randomised controlled trial will be conducted in urban primary health centres in the state of Odisha, India. A total of 250 smokeless tobacco users will be recruited to the study (125 in each arm). Participants in the intervention arm will receive routine care together with a face-to-face counselling intervention followed by advice and reminder mobile messages. The control arm will receive routine care, delivered by a primary care physician based on ‘Ask’ and ‘Advice’. All participants will be followed up for 3 months from the first counselling session. The primary outcome of this trial is to assess the feasibility to carry out a full randomised controlled trial.

Ethics and dissemination

Ethical approvals were obtained from the Institutional Ethics Committee of Public Health Foundation of India, Health Ministry’s Screening Committee, Odisha State Ethics Board and also from University College London Research Ethics Committee, UK. The study findings will be published in a peer-reviewed scientific journal.

Trial registration number

CTRI/2019/05/019484.
Do baseline characteristics and treatments account for geographical disparities in the outcomes of patients with newly diagnosed atrial fibrillation? The prospective GARFIELD-AF registry
Authors: Fox Keith A A , Virdone Saverio , Bassand Jean-Pierre , Camm A John , Goto Shinya , Goldhaber Samuel Z , Haas Sylvia , Kayani Gloria , Koretsune Yukihiro , Misselwitz Frank , Oh Seil , Piccini Jonathan P , Parkhomenko Alex , Sawhney Jitendra Pal Singh , Stepinska Janina , Turpie Alexander G G , Verheugt Freek W A , Kakkar Ajay K
Published: January 2022

Objective

In patients with newly diagnosed atrial fibrillation (AF), do baseline risk factors and stroke prevention strategies account for the geographically diverse outcomes.

Design

Global Anticoagulant Registry in the FIELD-Atrial Fibrillation is a prospective multinational non-interventional registry of patients with newly diagnosed AF (n=52 018 patients).

Setting

Investigator sites (n=1317) were representative of the care settings/locations in each of the 35 participating countries. Treatment decisions were all determined by the local responsible clinicians.

Participants

The patients (18 years and over) with newly diagnosed AF had at least 1 investigator-determined stroke risk factor and patients were not required to meet specific thresholds of risk score for anticoagulant treatment.

Main outcomes and measures

Observed 1-year event rates and risk-standardised rates were derived.

Results

Rates of death, non-haemorrhagic stroke/systemic embolism and major bleeding varied more than three-to-four fold across countries even after adjustment for baseline factors and antithrombotic treatments. Rates of anticoagulation and antithrombotic treatment varied widely. Patients from countries with the highest rates of cardiovascular mortality and stroke were among the least likely to receive oral anticoagulants. Beyond anticoagulant treatment, variations in the treatment of comorbidities and lifestyle factors may have contributed to the variations in outcomes. Countries with the lowest healthcare Access and Quality indices (India, Ukraine, Argentina, Brazil) had the highest risk-standardised mortality.

Conclusion

The variability in outcomes across countries for patients with newly diagnosed AF is not accounted for by baseline characteristics and antithrombotic treatments. Residual mortality rates were correlated with Healthcare Access and Quality indices. The findings suggest the management of patients with AF needs to not only address guideline indicated and sustained anticoagulation, but also the treatment of comorbidities and lifestyle factors.

Trial registration number

NCT01090362.
Residents transitioning between hospital and care homes: protocol for codesigning a systems-level response to safety issues (SafeST study)
Authors: Scott Jason , Brittain Katie , Byrnes Kate , Dawson Pam , Mulrine Stephanie , Spencer Michele , Waring Justin , Young-Murphy Lesley
Published: January 2022

Introduction

The aim of this study is to develop a better understanding of incident reporting in relation to transitions in care between hospital and care home, and to codesign a systems-level response to safety issues for patients transitioning between hospital and care home.

Methods and analysis

Two workstreams (W) will run in parallel. W1 will aim to develop a taxonomy of incident reporting in care homes, underpinned by structured interviews (N=150) with care home representatives, scoping review of care home incident reporting systems, and a review of incident reporting policy related to care homes. The taxonomy will be developed using a standardised approach to taxonomy development. W2 will be structured in three phases (P). P1a will consist of ≤40 interviews with care home staff to develop a better understanding of their specific internal systems for reporting incidents, and P1b will include ≤30 interviews with others involved in transitions between hospital and care home. P1a and P1b will also examine the impact of the SARS-CoV-2 pandemic on safe transitions. P2 will consist of a retrospective documentary analysis of care home data relating to resident transitions, with data size and sampling determined based on data sources identified in P1a. A validated data extraction form will be adapted before use. P3 will consist of four validation and codesign workshops to develop a service specification using National Health Service Improvement’s service specification framework, which will then be mapped against existing systems and recommendations produced. Framework analysis informed by the heuristic of systemic risk factors will be the primary mode of analysis, with content analysis used for analysing incident reports.

Ethics and dissemination

The study has received university ethical approval and Health Research Authority approval. Findings will be disseminated to commissioners, providers and regulators who will be able to use the codesigned service specification to improve integrated care.
Concerns and desires of healthcare workers caring for patients with COVID-19 in April and July 2020 in Japan: a qualitative study of open-ended survey comments
Authors: Kayama Mami , Aoki Yumi , Matsuo Takahiro , Kobayashi Daiki , Taki Fumika
Published: January 2022

Objectives

The prolonged effects of the COVID-19 pandemic continue to have a serious impact on healthcare workers. We described and compared the experiences of healthcare workers in Japan during the first wave of the COVID-19 pandemic from March to May 2020, and during the lull from June to July 2020.

Design

In this qualitative study, we used a web-based survey to obtain comments from healthcare workers about their experiences during the pandemic, and explored these using inductive content analysis.

Setting

A tertiary emergency hospital in Tokyo, in April and July 2020.

Participants

Participants were staff in the hospital, including physicians, nurses, pharmacists, radiological technicians and laboratory medical technicians. Many, but not all, had directly cared for patients with COVID-19.

Results

In total, 102 participants in the first survey and 154 in the second survey provided open-ended comments. Three themes were extracted: concerns, requests and gratitude. There were four subthemes under concerns: the hospital infection control system, fear of spreading infection to others, uncertainty about when the pandemic would end and being treated as a source of infection. There were 53 requests in the first survey and 106 in the second survey. These requests were divided into seven subthemes: compensation, staffing, information, facilities, leave time, PCR tests and equitable treatment. The theme on gratitude had two subthemes: information and emotional support, and material support. The fears and desires of healthcare workers included two types of uncertainty-related concerns, and requests were very different across the two surveys.

Conclusions

It is important to apply a balance of information to help staff adjust to their new work environment, as well as support to minimise the burden of infection and impact on their families.
Innovative approach to improve information accuracy in a two-district cross-sectional study in Bihar, India
Authors: Jeffery Caroline , Pagano Marcello , Devkota Baburam , Valadez Joseph J
Published: January 2022

Objective

Combine Health Management Information Systems (HMIS) and probability survey data using the statistical annealing technique (AT) to produce more accurate health coverage estimates than either source of data and a measure of HMIS data error.

Setting

This study is set in Bihar, the fifth poorest state in India, where half the population lives below the poverty line. An important source of data, used by health professionals for programme decision making, is routine health facility or HMIS data. Its quality is sometimes poor or unknown, and has no measure of its uncertainty. Using AT, we combine district-level HMIS and probability survey data (n=475) for the first time for 10 indicators assessing antenatal care, institutional delivery and neonatal care from 11 blocks of Aurangabad and 14 blocks of Gopalganj districts (N=6 253 965) in Bihar state, India.

Participants

Both districts are rural. Bihar is 82.7% Hindu and 16.9% Islamic.

Primary outcome measures

Survey prevalence measures for 10 indicators, corresponding prevalences using HMIS data, combined prevalences calculated with AT and SEs for each type of data.

Results

The combined and survey estimates differ by <0.10. The combined and HMIS estimates differ by up to 84.2%, with the HMIS having 1.4–32.3 times larger error. Of 20 HMIS versus survey coverage estimate comparisons across the two districts only five differed by <0.10. Of 250 subdistrict-level comparisons of HMIS versus combined estimates, only 36.4% of the HMIS estimates are within the 95% CI of the combined estimate.

Conclusions

Our statistical innovation increases the accuracy of information available for local health system decision making, allows evaluation of indicator accuracy and increases the accuracy of HMIS estimates. The combined estimates with a measure of error better informs health system professionals about their risks when using HMIS estimates, so they can reduce waste by making better decisions. Our results show that AT is an effective method ready for additional international assessment while also being used to provide affordable information to improve health services.
The effects of health behaviours and beliefs based on message framing among patients with chronic diseases: a systematic review
Authors: Gao Ruitong , Guo Hui , Li Fei , Liu Yandi , Shen Meidi , Xu Linqi , Yu Tianzhuo , Li Feng
Published: January 2022

Objective

The effectiveness of integrating message framing into educational interventions to promote the health behaviour of patients with chronic diseases is still being debated in nursing research. The objective of this study was to assess the impact of educational interventions based on gain and loss frames on the health behaviours and beliefs of patients with chronic diseases and to identify the frame that achieves better outcomes.

Design

The systematic review was based on PRISMA guidelines for comprehensively searching, appraising and synthesising research evidence.

Data sources

We searched the PubMed, Web of Science, PsycINFO and CINAHL databases for reports published from database inception until 26 March 2021.

Eligibility criteria

Intervention studies, published in English, with adult patients with chronic disease conditions, and with intervention contents involved in the implementation of message framing, were considered. The outcomes were health behaviours or beliefs, such as knowledge, self-efficacy, intention or attitudes.

Data extraction and synthesis

Data extraction and entry were performed using a predesigned data extraction form and assessed independently by two reviewers using the Cochrane Collaboration Risk of Bias I.

Results

A total of 11 intervention studies were included. We found that educational intervention based on both gain and loss frames could enhance the positive effects of communication, and promote healthy behaviours and beliefs in patients with chronic disease. Many of the studies we included here showed the advantage of loss framing messages. Due to the limited number of articles included and without quantitative analysis, this result should be interpreted cautiously.

Conclusions

Integrating message framing into health education might be a promising strategy to motivate patients with chronic disease to improve their health behaviours and beliefs. More extensive and well-designed trials are needed to support the conclusions and discuss the effective framing, moderators and mediators of framing.

PROSPERO registration number

CRD42021250931.
Validity and reliability of Psychiatric Nurse Self-Efficacy Scales: cross-sectional study
Authors: Yada Hironori , Odachi Ryo , Adachi Keiichiro , Abe Hiroshi , Yonemoto Fukiyo , Fujiki Toshiya , Fujii Mika , Katoh Takahiko
Published: January 2022

Objectives

To develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity.

Design

We developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity.

Setting

The study’s setting was psychiatric facilities in three prefectures in Japan.

Participants

Data from 514 valid responses were extracted of the 786 responses by psychiatric nurses.

Outcome measures

The study measured the reliability and validity of the scales.

Results

The ISES has two factors (‘Positive changes in the patient’ and ‘Prospect of continuing in psychiatric nursing’) and the DSES has three (‘Devaluation of own role as a psychiatric nurse’, ‘Decrease in nursing ability due to overload’ and ‘Difficulty in seeing any results in psychiatric nursing’). With regard to scale reliability, the Cronbach’s alpha coefficient was 0.634–0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ2/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ2/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149–0.446 (p<0.01) for ISES and r=−0.154 to −0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=−0.128 to 0.168 for ISES, r=0.214–0.398 for DSES (p<0.01).

Statistical analyses showed the scales to be reliable and valid measures.

Conclusions

The ISES and DSES can accurately assess psychiatric nurses’ self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses’ feelings of self-efficacy.
Protocol for data extraction: how real-world data have been used in the National Institute for Health and Care Excellence appraisals of cancer therapy
Authors: Kang Jiyeon , Cairns John
Published: January 2022

Introduction

Due to the limitations of relying on randomised controlled trials, the potential benefits of real-world data (RWD) in enriching evidence for health technology assessment (HTA) are highlighted. Despite increased interest in RWD, there is limited systematic research investigating how RWD have been used in HTA. The main purpose of this protocol is to extract relevant data from National Institute for Health and Care Excellence (NICE) appraisals in a transparent and reproducible manner in order to determine how NICE has incorporated a broader range of evidence in the appraisal of oncology medicines.

Methods and analysis

The appraisals issued between January 2011 and May 2021 are included following inclusion criteria. The data extraction tool newly developed for this research includes the critical components of economic evaluation. The information is extracted from identified appraisals in accordance with extraction rules. The data extraction tool will be validated by a second researcher independently. The extracted data will be analysed quantitatively to investigate to what extent RWD have been used in appraisals. This is the first protocol to enable data to be extracted comprehensively and systematically in order to review the use of RWD.

Ethics and dissemination

This study is approved by the Ethics Committee of the London School of Hygiene and Tropical Medicine on 14 November 2019 (17315). Results will be published in peer-reviewed journals.
Understanding challenges of using routinely collected health data to address clinical care gaps: a case study in Alberta, Canada
Authors: McGuckin Taylor , Crick Katelynn , Myroniuk Tyler W , Setchell Brock , Yeung Roseanne O , Campbell-Scherer Denise
Published: January 2022

High-quality data are fundamental to healthcare research, future applications of artificial intelligence and advancing healthcare delivery and outcomes through a learning health system. Although routinely collected administrative health and electronic medical record data are rich sources of information, they have significant limitations. Through four example projects from the Physician Learning Program in Edmonton, Alberta, Canada, we illustrate barriers to using routinely collected health data to conduct research and engage in clinical quality improvement. These include challenges with data availability for variables of clinical interest, data completeness within a clinical visit, missing and duplicate visits, and variability of data capture systems. We make four recommendations that highlight the need for increased clinical engagement to improve the collection and coding of routinely collected data. Advancing the quality and usability of health systems data will support the continuous quality improvement needed to achieve the quintuple aim.