bluuebunny/crossref_metadata_2025 huggingface dataset:
Rural–urban differentials in the influences of individual and geospatial preparedness on institutional childbirth: a cross-sectional study in Bangladesh
Authors: Rahman Md Mahabubur , Ara Tasnim , Aninda M H Hasib Mahmud Khan , Nurul Alam , Haider M Moinuddin
Published: September 2022

Objective

This study aims to explore the rural–urban differentials in the influences of individual and geospatial preparedness on institutional childbirth in Bangladesh. A related aim of this paper is to derive estimates to measure geospatial preparedness for institutional births, through statistical modelling, when no data are available for measuring this areal indicator.

Design, settings and participants

The paper used data from a large-scale nationally representative Bangladesh Multiple Indicator Cluster Survey 2019. The analytical sample included 9203 currently married women of reproductive age who had a live birth in the 2 years preceding the survey.

Methods

Mixed effect logistic regression models were employed to explore the rural–urban differentials in influences of individual and geospatial preparedness on institutional childbirth. The district-level random effect estimation was done to measure geospatial preparedness. The conditional autoregressive model was used to examine the association of geospatial preparedness with areal variation in institutional births.

Results

In rural settings, women who gave birth to a female newborn were 18% less likely to have facility births compared with women who gave birth to a male newborn. Also, women from households in the highest wealth quintile were twice as likely to have facility births compared with those from households in the poorest wealth quintile. In contrast, in urban areas, facility births did not vary by sex of the fetus or by households’ socioeconomic status. The geospatial preparedness explained 8% and 9% of the variability in institutional births in rural and urban areas, respectively. Geospatial mapping revealed low preparedness in the hill tracts. Findings identified geospatial preparedness as a potential source of areal variation in facility births.

Conclusion

Findings suggest improving district-level preparedness and developing differential programme strategies for urban and rural areas to increase the national prevalence and more equitable use of institutional childbirth in Bangladesh.
Towards definitions of critical illness and critical care using concept analysis
Authors: Kayambankadzanja, Raphael Kazidule , Schell Carl Otto , Gerdin Wärnberg Martin , Tamras Thomas , Mollazadegan Hedi , Holmberg Mats , Alvesson Helle Molsted , Baker Tim
Published: September 2022

Objective

As ‘critical illness’ and ‘critical care’ lack consensus definitions, this study aimed to explore how the concepts’ are used, describe their defining attributes, and propose potential definitions.

Design and methods

We used the Walker and Avant approach to concept analysis. The uses and definitions of the concepts were identified through a scoping review of the literature and an online survey of 114 global clinical experts. We used the Arksey and O’Malley framework for scoping reviews and searched in PubMed and Web of Science with a strategy including terms around critical illness/care and definitions/etymologies limited to publications in English between 1 January 2008 and 1 January 2020. The experts were selected through purposive sampling and snowballing, with 36.8% in Africa, 25.4% in Europe, 22.8% in North America, 10.5% in Asia, 2.6% in South America and 1.8% in Australia. They worked with anaesthesia or intensive care 59.1%, emergency care 15.8%, medicine 9.5%, paediatrics 5.5%, surgery 4.7%, obstetrics and gynaecology 1.6% and other specialties 3.9%. Through content analysis of the data, we extracted codes, categories and themes to determine the concepts’ defining attributes and we proposed potential definitions. To assist understanding, we developed model, related and contrary cases concerning the concepts, we identified antecedents and consequences to the concepts, and defined empirical referents.

Results

Nine and 13 articles were included in the scoping reviews of critical illness and critical care, respectively. A total of 48 codes, 14 categories and 4 themes were identified in the uses and definitions of critical illness and 60 codes, 13 categories and 5 themes for critical care. The defining attributes of critical illness were a high risk of imminent death; vital organ dysfunction; requirement for care to avoid death; and potential reversibility. The defining attributes of critical care were the identification, monitoring and treatment of critical illness; vital organ support; initial and sustained care; any care of critical illness; and specialised human and physical resources. The defining attributes led to our proposed definitions of critical illness as, ‘a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and the potential for reversibility’, and of critical care as, ‘the identification, monitoring and treatment of patients with critical illness through the initial and sustained support of vital organ functions.’

Conclusion

The concepts critical illness and critical care lack consensus definitions and have varied uses. Through concept analysis of uses and definitions in the literature and among experts, we have identified the defining attributes of the concepts and proposed definitions that could aid clinical practice, research and policy-making.
What can lead to late diagnosis of HIV in an illegal gold mining environment? A qualitative study at the French Guiana’s border with Brazil
Authors: Floersheim Charlotte , Musso Sandrine , Eubanks August , Douine Maylis , Spire Bruno , Sagaon-Teyssier Luis , Parriault Marie Claire , Girard Gabriel , Mosnier Emilie
Published: September 2022

Objective

The present study aimed to understand what factors can lead to late HIV diagnosis of illegal gold miners at French Guiana’s border with Brazil.

Design

An exploratory qualitative study with in-depth interviews and observations was conducted between November 2019 and February 2020.

Setting

The study was conducted in the main medical healthcare service and two non-governmental organisation premises in the Oyapock border region, which is a supply area for illegal gold mining sites.

Participants

Fifteen people living with HIV diagnosed with CD4 count <350 cells 106/L were interviewed. Seven women and eight men participated; they were between 31 and 79 years old, and the median time since HIV diagnosis was 6 years. Eight had links to illegal gold mining.

Findings

Three key themes for late HIV diagnosis emerged: (1) the presence of economic and political structural factors which constitute risks for this illegal activity, specifically the repression of gold mining sites by French Armed Forces and the distance from healthcare facilities; (2) representations of the body and health, related to the living conditions of this population; prioritisation of health emergencies and long-term self-medication; and (3) gender roles shaping masculinity and heterosexuality contributing to a perception of not being at risk of HIV and delaying testing.

Conclusion

This study highlights structural, group-based and individual factors that reduce access to HIV testing and healthcare in general for a population of migrant workers in an illegal gold mining area. Faced with harsh living conditions and state repression, these workers develop a vision of health which prioritises the functionality of the body. Associated with gender roles which are partly shaped both by the mining activity and its geographical location, this vision can lead to late HIV diagnosis.
Quality of reporting of randomised controlled trials of artificial intelligence in healthcare: a systematic review
Authors: Shahzad Rida , Ayub Bushra , Siddiqui M A Rehman
Published: September 2022

Objectives

The aim of this study was to evaluate the quality of reporting of randomised controlled trials (RCTs) of artificial intelligence (AI) in healthcare against Consolidated Standards of Reporting Trials—AI (CONSORT-AI) guidelines.

Design

Systematic review.

Data sources

We searched PubMed and EMBASE databases for studies reported from January 2015 to December 2021.

Eligibility criteria

We included RCTs reported in English that used AI as the intervention. Protocols, conference abstracts, studies on robotics and studies related to medical education were excluded.

Data extraction

The included studies were graded using the CONSORT-AI checklist, comprising 43 items, by two independent graders. The results were tabulated and descriptive statistics were reported.

Results

We screened 1501 potential abstracts, of which 112 full-text articles were reviewed for eligibility. A total of 42 studies were included. The number of participants ranged from 22 to 2352. Only two items of the CONSORT-AI items were fully reported in all studies. Five items were not applicable in more than 85% of the studies. Nineteen per cent (8/42) of the studies did not report more than 50% (21/43) of the CONSORT-AI checklist items.

Conclusions

The quality of reporting of RCTs in AI is suboptimal. As reporting is variable in existing RCTs, caution should be exercised in interpreting the findings of some studies.
Multicountry study protocol of COCOON: COntinuing Care in COVID-19 Outbreak global survey of New, expectant, and bereaved parent experiences
Authors: Loughnan Siobhan A , Gautam Rupesh , Silverio Sergio A , Boyle Frances M , Cassidy Jillian , Ellwood David , Homer Caroline , Horey Dell , Leisher Susannah H , de Montigny Francine , Murphy Margaret , O'Donoghue Keelin , Quigley Paula , Ravaldi Claudia , Sandall Jane , Storey Claire , Vannacci Alfredo , Wilson Alyce N , Flenady Vicki
Published: September 2022

Introduction

Globally, the COVID-19 pandemic has significantly disrupted the provision of healthcare and efficiency of healthcare systems and is likely to have profound implications for pregnant and postpartum women and their families including those who experience the tragedy of stillbirth or neonatal death. This study aims to understand the psychosocial impact of COVID-19 and the experiences of parents who have accessed maternity, neonatal and bereavement care services during this time.

Methods and analysis

An international, cross-sectional, online and/or telephone-based/face-to-face survey is being administered across 15 countries and available in 11 languages. New, expectant and bereaved parents during the COVID-19 pandemic will be recruited. Validated psychometric scales will be used to measure psychosocial well-being. Data will be analysed descriptively and by assessing multivariable associations of the outcomes with explanatory factors. In seven of these countries, bereaved parents will be recruited to a nested, qualitative interview study. The data will be analysed using a grounded theory analysis (for each country) and thematic framework analysis (for intercountry comparison) to gain further insights into their experiences.

Ethics and dissemination

Ethics approval for the multicountry online survey, COCOON, has been granted by the Mater Misericordiae Human Research Ethics Committee in Australia (reference number: AM/MML/63526). Ethics approval for the nested qualitative interview study, PUDDLES, has been granted by the King’s College London Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference number: HR-19/20-19455) in the UK. Local ethics committee approvals were granted in participating countries where required. Results of the study will be published in international peer-reviewed journals and through parent support organisations. Findings will contribute to our understanding of delivering maternity care services, particularly bereavement care, in high-income, lower middle-income and low-income countries during this or future health crises.
Impact of COVID-19 on college students at one of the most diverse campuses in the USA: a factor analysis of survey data
Authors: Liu Bowen , Huynh Edward , Li Chengcheng , Wu Qing
Published: September 2022

Objective

This survey study is designed to understand the impact of the COVID-19 pandemic on stress among specific subpopulations of college students.

Design, settings and participants

An online questionnaire was sent to the students from University of Nevada, Las Vegas, between October 2020 and December to assess the psychological impact of COVID-19. A total of 2091 respondents signed the consent form online and their responses were collected.

Main outcome measures

Measures of psychological stress, as prescribed by the Perceived Stress Scale (PSS-10). An explanatory factor analysis was carried out on the PSS-10 results. We subsequently analysed each factor using stepwise linear regression that focused on various sociodemographic groups.

Results

A two-factor model was obtained using the explanatory factor analysis. After comparing with the past studies that investigated the factor structure of the PSS-10 scale, we identified these two factors as ‘anxiety’ and ‘irritability’. The subsequent stepwise linear regression analysis suggested that gender and age (p<0.01) are significantly associated with both factors. However, the ethnicities of students are not significantly associated with both factors.

Conclusions

To our knowledge, this is the first study that assessed the perceived stress of university students in the USA during the COVID-19 pandemic. Through exploratory factor analysis, we showed that the PSS-10 scale could be summarised as a two-factor structure. A stepwise regression approach was used, and we found both of the factors are significantly associated with the gender of the participants. However, we found no significant association between both factors and ethnicity. Our findings will help identify students with a higher risk for stress and mental health issues in pandemics and future crises.
Developing a risk stratification tool for predicting opioid-related respiratory depression after non-cardiac surgery: a retrospective study
Authors: Roy Sounak , Bruehl Stephen , Feng Xiaoke , Shotwell Matthew S , Van De Ven Thomas , Shaw Andrew D , Kertai Miklos D
Published: September 2022

Objectives

Accurately assessing the probability of significant respiratory depression following opioid administration can potentially enhance perioperative risk assessment and pain management. We developed and validated a risk prediction tool to estimate the probability of significant respiratory depression (indexed by naloxone administration) in patients undergoing noncardiac surgery.

Design

Retrospective cohort study.

Setting

Single academic centre.

Participants

We studied n=63 084 patients (mean age 47.1±18.2 years; 50% men) who underwent emergency or elective non-cardiac surgery between 1 January 2007 and 30 October 2017.

Interventions

A derivation subsample reflecting two-thirds of available patients (n=42 082) was randomly selected for model development, and associations were identified between predictor variables and naloxone administration occurring within 5 days following surgery. The resulting probability model for predicting naloxone administration was then cross-validated in a separate validation cohort reflecting the remaining one-third of patients (n=21 002).

Results

The rate of naloxone administration was identical in the derivation (n=2720 (6.5%)) and validation (n=1360 (6.5%)) cohorts. The risk prediction model identified female sex (OR: 3.01; 95% CI: 2.73 to 3.32), high-risk surgical procedures (OR: 4.16; 95% CI: 3.78 to 4.58), history of drug abuse (OR: 1.81; 95% CI: 1.52 to 2.16) and any opioids being administered on a scheduled rather than as-needed basis (OR: 8.31; 95% CI: 7.26 to 9.51) as risk factors for naloxone administration. Advanced age (OR: 0.971; 95% CI: 0.968 to 0.973), opioids administered via patient-controlled analgesia pump (OR: 0.55; 95% CI: 0.49 to 0.62) and any scheduled non-opioids (OR: 0.63; 95% CI: 0.58 to 0.69) were associated with decreased risk of naloxone administration. An overall risk prediction model incorporating the common clinically available variables above displayed excellent discriminative ability in both the derivation and validation cohorts (c-index=0.820 and 0.814, respectively).

Conclusion

Our cross-validated clinical predictive model accurately estimates the risk of serious opioid-related respiratory depression requiring naloxone administration in postoperative patients.
Methodologic attributes of quality improvement studies in neonatology: a systematic survey
Authors: Hu Zheng Jing , Fusch Gerhard , Hu Catherine , Wang Jie Yi , Munroe Maleeka , el Helou Salhab , Thabane Lehana
Published: September 2022

Introduction

Quality improvement (QI) is a growing field of inquiry in healthcare, including neonatology. However, there is limited information on the study setting, and the methodologic approaches used to develop, implement and evaluate QI interventions in neonatology studies. In this study, we describe these intervention characteristics and approaches.

Methods

Articles were taken from a previous publication. There, we searched MEDLINE for publications of QI studies from 2016 to 16 April 2020. We retrieved all relevant full-text publications and sampled 100 of these articles for data abstraction, stratified by the year of publication. For each QI study, we described several methodological characteristics that included: the clinical topic of QI, setting, whether the study was multicentre, stakeholder engagement, root cause analysis and related problem identification methods, implementation techniques for QI interventions, types of outcomes and statistical analysis methods used.

Results

We assessed 100 studies; most were conducted in the USA (56%). Academic settings and multicentre settings comprised 44% and 24% of studies, respectively. Most studies reported stakeholder engagement (81%), but infrequently reported engagement with leadership (32%) and caregivers (10%). Frequently used techniques for implementing interventions include provider education (82%), formal QI methods (42%) and audit, feedback and benchmarking (40%). Both patient-important clinical outcomes (78%) and process outcomes (89%) were frequently reported. P values were frequently reported (80%), but other statistical techniques were infrequently used.

Conclusion

QI studies in neonatology use diverse multicomponent interventions. Reporting of these methodologic details can be useful in designing, implementing and evaluating QI studies in clinical practice.
Cone beam CT-guided navigation bronchoscopy: a cost-effective alternative to CT-guided transthoracic biopsy for diagnosis of peripheral pulmonary nodules
Authors: Kops Stephan E P , Verhoeven Roel L J , Vermeulen Robin J , Rovers Maroeska M , van der Heijden Erik H F M , Govers Tim M
Published: September 2022

Objectives

To determine if cone beam CT-guided navigation bronchoscopy (CBCT-NB) is a cost-effective diagnostic procedure in patients with a pulmonary nodule (PN) with an intermediate risk for lung cancer.

Materials and methods

Two decision analytical models were developed to compare the long-term costs, survival and quality of life. In the first model, CBCT-NB was compared with CT-guided transthoracic needle biopsy (TTNB) in TTNB eligible patients. In the second model, CBCT-NB was compared with direct treatment (without pathology proven lung cancer) in patients for whom TTNB is not suitable. Input data were gathered in-house, from literature and expert opinion. Effects were expressed in quality-adjusted life years (QALYs). Sensitivity analyses were used to assess uncertainty.

Results

CBCT-NB can be cost-effective in TTNB eligible patients with an incremental cost-effectiveness ratio of €18 416 in an expert setting. The probabilistic sensitivity analysis showed that in 69% and 90% of iterations CBCT-NB remained cost-effective assuming a willingness to pay (WTP) of €20 000 and €80 000 per QALY. CBCT-NB dominated in the treatment strategy in which TTNB is not suitable. The probabilistic sensitivity analysis showed that in 95% of iterations CBCT-NB remained the dominant strategy, and CBCT-NB remained cost-effective in 100% of iterations assuming a WTP limit of €20 000. In the comparison between CBCT NB and TTNB, the deterministic sensitivity analysis showed that the diagnostic properties and costs of both procedures have a large impact on the outcome.

Conclusions

CBCT-NB seems a cost-effective procedure when compared with TTNB and when compared with a direct treatment strategy in patients with an intermediate risk PN.
Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study
Authors: Ogungbe Oluwabunmi , Gilotra Nisha A , Davidson Patricia M , Farley Jason E , Dennison Himmelfarb Cheryl R , Post Wendy S , Commodore-Mensah Yvonne
Published: September 2022

Objective

To examine risk factors for cardiac-related postacute sequelae of SARS-CoV-2 infection (PASC) in community-dwelling adults after acute COVID-19 infection.

Methods

We performed a cross-sectional analysis among adults who tested positive for COVID-19. Outcomes were self-reported cardiac-related PASC. We conducted stepwise multivariable logistic regression to assess association between the risk factors (existing cardiovascular disease (CVD), pre-existing conditions, days since positive test, COVID-19 hospitalisation, age, sex, education, income) and cardiac-related PASC.

Results

In a sample of 442 persons, mean (SD) age was 45.4 (16.2) years, 71% were women, 13% were black, 46% had pre-existing conditions, 23% had cardiovascular (CV) risk factors and 4% had CVD. Prevalence of cardiac PASC was 43% and newly diagnosed cardiac conditions were 27%. The odds for cardiac-related PASC were higher among persons with underlying pre-existing conditions (adjusted OR (aOR): 2.00, 95% CI: 1.28 to 3.10) and among those who were hospitalised (aOR: 3.03, 95% CI: 1.58 to 5.83).

Conclusions

More than a third of persons with COVID-19 reported cardiac-related PASC symptoms. Underlying CVD, pre-existing diseases, age and COVID-19 hospitalisation are possible risk factors for cardiac-related PASC symptoms. COVID-19 may exacerbate CV risk factors and increase risk of complications.
Association of serum uric acid levels with cardiovascular and all-cause mortality in hypertensive patients in China: a cohort study
Authors: Zhang Shu-Xian , Yu Yu-Ling , Tang Song-Tao , Lo Kenneth , Feng Ying-Qing , Chen Ji-Yan
Published: September 2022

Purpose

The present study aimed to assess the association of elevated serum uric acid (SUA) and hypouricemia with all-cause mortality and cardiovascular mortality in Chinese hypertensive patients.

Methods

In the present prospective cohort, 9325 hypertensive patients from Dongguan, China were enrolled from 2014 to 2018 for analysis. Participants were categorised by quintiles of SUA. The HRs and 95% CIs for the association between SUA, all-cause and cardiovascular mortality were evaluated using the multivariate Cox regression model. After adjusting for multiple confounders, restricted cubic spline analysis was conducted to demonstrate the shape of relationship.

Results

After a median follow-up of 4.18 years for 9325 participants, there were 409 (4.4%) and 151 (1.6%) reported cases of all-cause and cardiovascular mortality, respectively. By using the third quintile of SUA (6.68 mg/dL to <7.55 mg/dL for men, 5.63 mg/dL to <6.42 mg/dL for women) as reference, the highest quintiles of SUA were associated with an elevated risk of all cause (HR: 1.34, 95% CI 1.00 to 1.80) in the crude model, but the association was not significant after adjusting for multiple comparisons. The association between low SUA and mortality and the dose–response analysis on the non-linearity of SUA–mortality relationship were not statistically significant.

Conclusions

Although the association between SUA levels, all-cause and cardiovascular disease mortality did not appear to be significant among Chinese hypertensive patients, the findings might be confounded by their medical conditions. Further studies are needed to verify the optimal SUA levels for hypertensive patients.
Prevalence of macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in metropolitan and overseas France
Authors: Pereyre Sabine , Laurier-Nadalié Cécile , Le Roy Chloé , Guiraud Jennifer , Dolzy Amandine , Hénin Nadege , Gardette Marie , Bébéar Cécile
Published: September 2022

Objective

Limited macrolide and fluoroquinolone resistance data are available in France for Mycoplasma genitalium. We performed a multicentre cross-sectional study to investigate the prevalence of macrolide and fluoroquinolone resistance-associated mutations in M. genitalium-positive patients in metropolitan France between 2018 and 2020 and in overseas France in 2018 and 2019.

Methods

Each year, a 1-month prospective collection of M. genitalium-positive specimens was proposed to metropolitan French microbiology diagnostic laboratories, and a similar 3-month collection was proposed to overseas French laboratories. Resistance-associated mutations were detected using commercial kits and sequencing.

Results

A total of 1630 M. genitalium-positive specimens were analysed. In metropolitan France, the prevalence of macrolide resistance-associated mutations ranged between 34.7% (95% CI 29.4% to 40.4%) and 42.9% (95% CI 37.1% to 49.0%) between 2018 and 2020 and was significantly higher in men (95% CI 52.4% to 60.2%) than in women (95% CI 15.9% to 22.2%) (p<0.001). These prevalences were significantly higher than those of 6.1% (95% CI 3.7% to 10.3%) and 14.7% (95% CI 10.9% to 19.6%) observed in overseas France in 2018 and 2019 (p<0.001), where no difference between genders was noted. The prevalence of fluoroquinolone resistance-associated mutations was also significantly higher in metropolitan France (14.9% (95% CI 11.2% to 19.5%) to 16.1% (95% CI 12.1% to 21.2%)) than in overseas France (1.3% (95% CI 0.4% to 3.7%) and 2.6% (95% CI 1.3% to 5.3%) in 2018 and 2019, respectively) (p<0.001), with no difference between men and women regardless of the location.

Conclusion

This study reports the high prevalence of macrolide and fluoroquinolone resistance-associated mutations in M. genitalium in metropolitan France and highlights the contrast with low prevalence in overseas France. In metropolitan France, macrolide resistance-associated mutation prevalence was three times higher in men than in women, which was likely to be driven by the proportion of men who have sex with men. This suggests that gender and sexual practice should also be taken into account for the management of M. genitalium infections.
Determinants of adherence to daily PrEP measured as intracellular tenofovir diphosphate concentrations over 24 months of follow-up among men who have sex with men
Authors: van den Elshout Mark AM , Hoornenborg Elske , Coyer Liza , Anderson Peter L , Davidovich Udi , de Vries Henry JC , Prins Maria , Schim van der Loeff Maarten F
Published: September 2022

Objectives

Adherence is key to the effectiveness of oral pre-exposure prophylaxis (PrEP) to prevent HIV. Therefore, we aimed to explore factors associated with adherence to daily PrEP (dPrEP).

Methods

Men who have sex with men (MSM) using dPrEP (emtricitabine/tenofovir disoproxil) within the Amsterdam PrEP demonstration project at the Public Health Service of Amsterdam, provided dried blood spots (DBS) 12 and 24 months after PrEP initiation. From DBS, we determined intracellular tenofovir diphosphate (TFV-DP) concentrations to assess adherence; TFV-DP ≥700 fmol/punch was considered adequate. We assessed associations of sociodemographic, clinical and behavioural characteristics with TFV-DP concentrations using multivariable linear regression.

Results

Of 263 participants who attended 12-month or 24-month study visits while on dPrEP, 257 (97.7%) provided DBS at one or both visits (492 DBS in total). Median TFV-DP concentration was 1299 (IQR 1021–1627) fmol/punch (12 months: 1332 (1087–1687); 24 months: 1248 (929–1590]). Higher TFV-DP concentrations were associated with: older age (p=0.0008), condomless anal sex with a casual partner in 6 months preceding PrEP initiation (+166 fmol/punch; 95% CI 36.5 to 296) and using a mobile application providing visualised feedback on PrEP use and sexual behaviour (+146 fmol/punch; 95% CI 28.1 to 263). Lower TFV-DP concentrations were associated with longer duration of PrEP use (24 vs 12 months; −91.5 fmol/punch; 95% CI −155 to −28.1). Time-updated number of sex partners, diagnosed STIs and chemsex were not associated with TFV-DP concentrations.

Conclusions

Overall, TFV-DP concentrations were high among MSM using dPrEP, indicating excellent adherence. Especially older participants, those who reported condomless anal sex with a casual partner prior to PrEP initiation and those who used an app with visualised feedback showed higher levels of adherence. As TFV-DP concentrations had decreased slightly at 2 years of PrEP use when compared with 1 year, we emphasise the importance of adherence counselling to those who continue using PrEP.

Trial registration number

NL5413.
Resuscitation code status among emergency department patients: decision support education video pilot study
Authors: Finch Alexander S , Stanich Jessica A , Spadaro Maria J , Tschautscher Craig F , Walker Laura E , Loprinzi Brauer Caitlin E
Published: September 2022

Objectives

Establishment of code status can be challenging in the acute care setting. The primary objective of the present study was to evaluate whether patients or their surrogate decision-makers were comfortable watching an educational video about resuscitation.

Methods

This interventional pilot study involved a pre- and a postintervention survey of a convenience sample of emergency department (ED) patients who were admitted to the hospital. The study was conducted at an academic level-1 trauma centre within the normal flow of patient care over 4 months in 2017.

Results

In total, 50 patients enrolled in the study. Among them, 82% were ‘very comfortable’ and 14% were ‘moderately comfortable’ watching the video. Overall, 61% of respondents were ‘very comfortable’ recommending the video to others. Watching the video resulted in a change in code status for 9 patients.

Conclusions

Our results indicate that patients felt comfortable watching the video and recommending the video for further use. Watching the video did not result in a change in code status for most patients in this study. The study results indicate that a standardised patient education video on resuscitation code status was acceptable to patients and their family members and has potential for increased use in the ED.
Evolution properties of the knot’s defect
Authors: Morozov A. , Tselousov N.
Published: September 2022

The defect of differential (cyclotomic) expansion for colored HOMFLY-PT polynomials is conjectured to be invariant under any antiparallel evolution and change linearly with the evolution in any parallel direction. In other words, each $${{\mathcal {R}}}$$
R
-matrix can be substituted by an entire 2-strand braid in two different ways: the defect remains intact when the braid is antiparallel and changes by half of the added length when the braid is parallel.
Duality between operator ordering factor and massless scalar field
Authors: He Dongshan , Cai Qing-yu
Published: September 2022

In order to investigate the role of quantum effects in the evolution of the universe, one can either use the Wheeler–DeWitt equation (WDWE) that contains an operator ordering factor, or add an item called massless scalar field to WDWE. In this paper, we study the relationship between operator ordering factor and massless scalar field, by applying de Broglie–Bohm quantum trajectory approach to WDWE. In theory, the evolution of the universe is determined by action, i.e., the phase part of the wavefunction of the universe. For the case of operator ordering factor and the case of massless scalar field, the functions that determine the phase part of the wavefunction of the universe satisfy the same differential equation, both in the minisuperspace model and in the Kantowski–Sachs model. This shows the equivalence of using operator ordering factor or massless scalar field to study evolution of the universe. Since there is no accelerating solution of WDWE with operator ordering factor for a grownup universe in the minisuperspace model, the equivalence of the operator ordering factor and the massless scalar field rules out the possibility of a massless scalar field as the candidate for dark energy, if the current universe is indeed homogeneous and isotropic.
Causal structure of accelerating black holes
Authors: Cembranos Jose A. R. , Garay Luis J. , Ortega Sergio A.
Published: September 2022

Accelerating black holes are described by the so-called C-metric. In this work, we analyse the causal structure of such black holes by using null geodesics. We construct explicitly the relevant Penrose diagrams. First, we recover well-known results associated with the sub-accelerating black holes. Then, we extend the study to the super-accelerating case, in which an additional essential singularity appears. In addition, we consider accelerating black holes with negative masses. We show that they are equivalent to the geometry described by the black hole metric beyond conformal infinity. We compare our results with the Schwarzschild geometry to facilitate understanding and to highlight the interest of the new features.
Primordial black holes and gravitational waves in teleparallel Gravity
Authors: El Bourakadi K. , Asfour B. , Sakhi Z. , Bennai M. , Ouali T.
Published: September 2022

In this paper, we consider the possible effect of the teleparallel gravity on the production of the primordial black holes (PBH) and on the gravitational waves (GWs). We investigate the relationship between the slow roll, the e-folds number and the teleparallel parameters. We show that in the case of the teleparallel parameter $$\delta =3$$

δ
=
3

, the e-folds number reaches the values 50 and 60 in consistency with the contour plot of the $$(r,n_{s})$$

(
r
,

n
s

)

plane obtained by Planck data at $$1\sigma $$

1
σ

and $$2\sigma $$

2
σ

C.L. Furthermore, we use the fraction of the energy density and the variance of the density perturbations approach to study the abundance of the production PBH. We find that the PBH overproduction can be satisfied for specific values of parameters of the non-adiabatic curvature power spectrum at some narrow parametric resonance. Moreover, to explain the GWs expected by observations, the duration of preheating should be bounded by values less or equal to 2. This bound is in agreement with values of the tensor-to-scalar ratio and the spectral index constrained by Planck data.
INVESTIGATION OF INTEGRAL BOUNDARY VALUE PROBLEM WITH IMPULSIVE BEHAVIOR INVOLVING NON-SINGULAR DERIVATIVE
Authors: SHAH KAMAL , ABDELJAWAD THABET , ALI ARSHAD , ALQUDAH MANAR A.
Published: September 2022

This paper is devoted to investigating a class of impulsive fractional order differential equations (FODEs) with integral boundary condition. For the proposed paper, we use non-singular type derivative of fractional order which has been introduced by Atangana, Baleanu and Caputo (ABC). The aforesaid type problems have numerous applications in fluid mechanics and hydrodynamics to model various problems of flow phenomenons. We establish some sufficient conditions for the existence and uniqueness of solution to the proposed problem by using classical fixed point results due to Banach and Krasnoselskii. Further, on using tools of the nonlinear analysis, sufficient conditions are developed for Hyers–Ulam (HU) type stability results. A pertinent example is given to justify our results.
Path Planning for UAV Communication Networks: Related Technologies, Solutions, and Opportunities
Authors: Luo Junhai , Wang Zhiyan , Xia Ming , Wu Linyong , Tian Yuxin , Chen Yu
Published: September 2022

Path planning has been a hot and challenging field in unmanned aerial vehicles (UAV). With the increasing demand of society and the continuous progress of technologies, UAV communication networks (UAVCN) are also flourishing. The mobility of UAV nodes allows for flexible network deployment, but some challenges are brought, such as power constraints, throughput, cost, and time efficiency. Therefore, path planning is significant for UAVCN. This article presents a review of UAVCN path planning. We first introduce the network structure and performance evaluation of UAVCN. We then investigate the generic UAV path planning algorithms and the path planning algorithms in UAVCN. In this article, the advantages and disadvantages of each path planning algorithm and the functional problems. The challenges faced in path planning for UAVCN, the solutions, state-of-the-art, and representative results are also presented. In addition, we illustrate future research directions for UAVCN path planning as well, which can provide some help to researchers.
Sex-specific effects of chronic hypoxia on routine cardiovascular function and metabolism in CD-1 mice
Authors: Wearing Oliver H. , Scott Graham R.
Published: September 2022

Hypoxia can have significant impacts on cardiovascular physiology, but the effects of chronic exposure to moderate hypoxia and how they differ between sexes remain poorly understood. We used physiological telemetry to examine this issue in CD-1 mice. Adult mice were chronically exposed to normoxia or hypobaric hypoxia (12 kPa O2) for 6 wk and then subjected to telemetry measurements of routine physiology across the diel cycle. Heart rate ( fH), mean arterial blood pressure ( Pmean), body temperature ( Tb), and activity were greater during the nighttime active phase than the daytime inactive phase. Chronic hypoxia had no effect on these traits at night but had sex-specific effects during the day, when chronic hypoxia reduced fH, Tb, and activity in males but not females. These differences existed without any effect of chronic hypoxia on α-adrenergic or nitric oxide tone on the vasculature (assessed as Pmean response to pharmacological blockade). Responses to acute hypoxia were then measured during stepwise reductions in inspired O2 from 21 to 8 kPa O2. O2 consumption rate, fH, Pmean, and Tb declined in severe hypoxia, but the O2 tension at which this began was lower in mice held in chronic hypoxia. However, the hypoxic ventilatory response was augmented by exposure to chronic hypoxia in females but not in males. Females also exhibited larger increases in lung mass and less right ventricle hypertrophy than males in chronic hypoxia. Our results support the growing evidence that there can be considerable sex differences in the cardiorespiratory responses to hypoxia.
Natural Compounds for SIRT1-Mediated Oxidative Stress and Neuroinflammation in Stroke: A Potential Therapeutic Target in the Future
Authors: Fang Chaoyou , Xu Houshi , Yuan Ling , Zhu Zhengyang , Wang Xiaoyu , Liu Yibo , Zhang Anke , Shao Anwen , Lou Meiqing
Published: September 2022

Stroke is a fatal cerebral vascular disease with a high mortality rate and substantial economic and social costs. ROS production and neuroinflammation have been implicated in both hemorrhagic and ischemic stroke and have the most critical effects on subsequent brain injury. SIRT1, a member of the sirtuin family, plays a crucial role in modulating a wide range of physiological processes, including apoptosis, DNA repair, inflammatory response, and oxidative stress. Targeting SIRT1 to reduce ROS and neuroinflammation might represent an emerging therapeutic target for stroke. Therefore, we conducted the present review to summarize the mechanisms of SIRT1-mediated oxidative stress and neuroinflammation in stroke. In addition, we provide a comprehensive introduction to the effect of compounds and natural drugs on SIRT1 signaling related to oxidative stress and neuroinflammation in stroke. We believe that our work will be helpful to further understand the critical role of the SIRT1 signaling pathway and will provide novel therapeutic potential for stroke treatment.
Clinical Value of Contrast-Enhanced Ultrasound in Breast Cancer Diagnosis
Authors: Yuan Yingying , Xu Ming , Ren Yi , He Lili , Chen Jiejie , Sun Li
Published: September 2022

Breast cancer (BC) ranks first in morbidity and mortality among female malignant tumors worldwide. This study is aimed at clarifying clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis and differentiation of BC. A total of 108 BC patients admitted to our hospital from January 2019 to December 2021 were enrolled. All patients underwent conventional color Doppler ultrasound and CEUS imaging examination. All ultrasound images were analyzed by a senior (5+ years) sonographer. The lesion location, echo, size, and color Doppler flow imaging (CDFI) blood flow distribution of benign and malignant BC were assessed. The transverse and longitudinal diameters of malignant BC presented significant elevation compared with the control group (

P
<
0.05

). CEUS is more reliable than conventional ultrasound in the differentiation of benign and malignant breast lesions, and CEUS has the best reliability. The comparison of CEUS observation indicators between benign and malignant groups demonstrated that CEUS enhancement patterns (time and intensity) and morphological features (lesion boundary, shape, range, homogeneity, and filling defect) presented statistical significance (

P
<
0.01

). Irregular shape and range expansion were high-specificity indicators (all >90.00%); fast-forward, high enhancement, clear boundary, and range expansion were high-sensitivity (all >90.00%); and fast-forward, high enhancement, and clear boundary were low-specificity indicators (all <50.00%); moderate sensitivity is as follows: homogeneous enhancement and range expansion (all >80.00%). The area under curve of CEUS (

0.735
±
0.053

) presented elevation relative to conventional ultrasound (

0.901
±
0.024

), with statistical significance (

Z
1
=
2.462

,

P
<
0.05

). Relative to conventional ultrasound, the specificity and positive predictive value of CEUS presented elevation (

P
<
0.05

). In conclusion, in the differentiation of benign and malignant breast lesions, CEUS has better diagnostic accuracy and reliability than conventional ultrasound. The diagnostic advantages of CEUS are to elevate the diagnostic specificity and positive predictive value and reduce the misdiagnosis rate.
Normality Test for Influence Function of Mining Surface Subsidence Based on Network Observation Station
Authors: Li Pengyu , Hu Zhenqi , Fu Yaokun , Li Gensheng , Guo Jiaxin , Yuan Dongzhu
Published: September 2022

Coal is the primary energy source in China, while underground mining is the mainstream way of coal mining. By triggering surface movement and deformation, underground mining can cause damage to arable land, buildings, roads, and so on, which is detrimental to the ecological environment in the mining area. In order to assess the severity of damage caused by this to the ground buildings and ecological environment in the mining area, it is necessary to predict mining-induced surface subsidence before the mining activities are carried out. Currently, the most used prediction method is the Probability Integral Method. It is based on probabilistic theory to mathematically demonstrate that the surface downwelling caused by underground extraction conforms to normal distribution. However, there is a lack of validation with measured subsidence basin data. Since the 1960s, China has been paying increased attention to the study of mining subsidence. However, there are still few network stations built across China to monitor subsidence basin. Herein, SPSS software is applied to re-analyze these valuable historical data. By analyzing the observation results and comparing them with the calculation results as obtained by using the probability integral method, it can be found out that the surface subsidence in the center of the subsidence basin conforms to normal distribution, not the subsidence at the edge of the subsidence basin. Therefore, it is inevitable for errors to occur at the edge of the subsidence basin when the normal distribution function is used as the mining influence function to calculate the surface subsidence. This conclusion is expected to provide practical reference for the prediction of surface subsidence in coal mines, and this experience can be extended to the mining of other solid minerals.
Chronostratigraphic Studies of the Ootun Area Revealing the Late Holocene Plume Volcanism of the Oldoinyo Lengai, Ngorongoro, Tanzania
Authors: Makongoro Mohamed Zengo , Vegi Maheswara Rao , Vuai Said Ali Hamad , Msabi Michael Mwita
Published: September 2022

Oldoinyo Lengai has been a subject of international attention for geoscientists because of its uniqueness. The mountain is the world’s only active natrocarbonatite volcano whose recent activities are well documented. However, little is known about its eruptive history during the Holocene. One way of uncovering past volcanic activities is through chronostratigraphic studies. A rare stratigraphic sequence in the Ootun area containing buried tephra beds and paleosols is presented in this article. The beds suggest that the nearby active Oldoinyo Lengai volcano experienced the main plume volcanism during the late Holocene. This work presents the lithology of the area, estimated deposition period, and elemental and mineralogical compositions of strata, and establishing similarities between ash properties and information from previously reported chemistry and eruptions of the Oldoinyo Lengai volcano. Energy dispersive X-ray fluorescence, X-ray diffractometry, and accelerated mass spectrometry techniques were used for elemental, mineralogical, and radiocarbon dating analyses. A 1.3-m vertical soil profile revealed three major strata: topsoil, tephra bed, and paleosols. The paleosols are presumed to have been topsoil of the Ootun area during the Holocene. Subsurface tephra layers were found to contain similar properties to the volcanic material of the Oldoinyo Lengai. Based on the experimental findings and literature data, the study reports the occurrence of two major plume eruption events from the Oldoinyo Lengai, which happened around the minimum (oldest) age of490±10 BCand 771 AD. This work is essentially important in demonstrating the relevance of the region’s tephra chronostratigraphic studies by revealing the prospect of collecting additional scientific data on past geological processes and paleoenvironmental conditions of northern Tanzania.