bluuebunny/crossref_metadata_2025 huggingface dataset:
The early marine distribution of Atlantic salmon in the North‐east Atlantic: A genetically informed stock‐specific synthesis
Authors: Gilbey John , Utne Kjell Rong , Wennevik Vidar , Beck Alexander Christian , Kausrud Kyrre , Hindar Kjetil , Garcia de Leaniz Carlos , Cherbonnel Corrine , Coughlan Jamie , Cross Tom F. , Dillane Eileen , Ensing Dennis , García‐Vázquez Eva , Hole Lars R. , Holm Marianne , Holst Jens Christian , Jacobsen Jan Arge , Jensen Arne J. , Karlsson Sten , Ó Maoiléidigh Niall , Mork Kjell Arne , Nielsen Einar Eg , Nøttestad Leif , Primmer Craig R. , Prodöhl Paulo , Prusov Sergey , Stevens Jamie R. , Thomas Katie , Whelan Ken , McGinnity Philip , Verspoor Eric
Published: July 2021

The survival of Atlantic salmon (Salmo salar), an increasingly rare anadromous species, has declined dramatically during its marine phase, with disproportionate impacts on the poorly understood early post‐smolt period. Logistical constraints on collecting oceanic data to inform this issue pose a formidable obstacle. To advance understanding of post‐smolt distributional ecology in the North‐east Atlantic, a comprehensive analysis of existing information was undertaken. Data were synthesized from 385 marine cruises, 10,202 individual trawls, and 9,269 captured post‐smolts, spanning three decades and ~4.75 million km2 of ocean, with 3,423 individuals genetically assigned to regional phylogeographic origin. The findings confirm major migrational post‐smolt aggregations on the continental shelf‐edge off Ireland, Scotland and Norway, and an important marine foraging area in the Norwegian Sea. Genetic analysis shows that aggregational stock composition does not simply reflect distance to natal rivers, with northern phylogeographic stock groups significantly under‐represented in sampled high‐seas aggregations. It identifies a key foraging habitat for southern European post‐smolts located in international waters immediately west of the Vøring Plateau escarpment, potentially exposing them to a high by‐catch mortality from extra‐territorial pelagic fisheries. Evidence of the differential distribution of regional stocks points to fundamental differences in their migration behaviours and may lead to inter‐stock variation in responses to environmental change and marine survival. The study shows that understanding of post‐smolt marine ecology, as regards to stock‐specific variations in habitat utilization, biological performance and exposure to mortality factors, can be significantly advanced by data integration across studies and exploiting genetic approaches.
Experience of patients hospitalized with COVID‐19: A qualitative study of a pandemic disease in Iran
Authors: Jamili Sara , Ebrahimipour Hosein , Adel Amin , Badiee aval Shapour , Hoseini Seyed Javad , Vejdani Marjan , Ebnehoseini Zahra
Published: July 2021

Background

The spread of COVID‐19 as an infectious disease brings about many newly arrived challenges, which call for further research on the scope of its effect on life due to the special conditions of this disease. The present study is, therefore, an attempt to understand the lived experience of inpatients hospitalized with COVID‐19.

Method

In this phenomenological study, among patients with COVID‐19 who were hospitalized in COVID‐19 referral hospitals, 17 people were selected by random sampling method. Data were gathered by interviews and analysed using MAXQDA10 software.

Findings

Analysis revealed 4 main themes and 16 subthemes. Main themes included the (1) denial of the disease, (2) negative emotions upon arrival, (3) perception of social and psychological supports and (4) post‐discharge concerns and problems.

Conclusion

Patients with COVID‐19 experience a different world of stresses, concerns and feelings in the course of their disease. Gaining a deeper insight into patients’ experiences with this disease can help handle this disease more effectively and provide better post‐corona nursing and psychological care and services.
Alinity hq platelet results are equivalent with the international reference method in thrombocytopenic samples
Authors: Lifson Mark A. , Wakui Masatoshi , Arai Tomoko , Mitsuhashi Takayuki , Lakos Gabriella , Murata Mitsuru
Published: July 2021

Introduction

Accurate and precise platelet (PLT) count is critical for the appropriate management of patients with thrombocytopenia. This study evaluated the performance of PLT counting with the Abbott Alinity hq hematology analyzer, which utilizes multi‐dimensional optical technology.

Methods

Imprecision, linearity, and accuracy were assessed per CLSI guidelines. Alinity hq PLT results were compared to the international flow cytometry reference method (IRM) in the concentration range of 6.3 to 103.0 × 109/L. Additional comparisons were made with Sysmex XN‐3000 PLT counts: impedance (PLT‐I), optical (PLT‐O), and optical fluorescent (PLT‐F) methods.

Results

The average within‐run %CV was 4.7% on patient samples with PLT concentrations ranging from 13.1 to 41.7 × 109/L, and the within‐laboratory %CV was 3.6% at the level of 68.2 × 109/L. Linearity evaluation indicated a maximum deviation of 3.1% from the linear fit in the range of 0.1 to 316.8 × 109/L. Comparison between Alinity hq and the IRM PLT counts yielded a correlation coefficient of 0.99 and predicted bias of 0.0 and −0.5 × 109/L at 10.0 and 20.0 × 109/L transfusion thresholds, respectively. Alinity hq PLT counts also correlated well with Sysmex PLT counts, with strongest correlation obtained with PLT‐F and PLT‐O (r = .99) methods.

Conclusion

This study demonstrated excellent analytical performance of Alinity hq PLT counting in thrombocytopenic samples, equivalency with the IRM and strong agreement with Sysmex PLT‐F and PLT‐O methods. The Alinity hq multi‐dimensional optical PLT count is available with every CBC without additional reagents and may help promote efficiency in clinical laboratories.
Clinical evaluation of xenogeneic collagen matrix versus free gingival grafts for keratinized mucosa augmentation around dental implants: A randomized controlled clinical trial
Authors: Huang Jia‐Ping , Liu Jia‐Mei , Wu Yan‐Min , Dai Anna , Hu Hua‐Jiao , He Fu‐Ming , Chen Qian‐Ming , Li Xiao‐Jun , Sun Ping , Ding Pei‐Hui
Published: July 2021

Aim

To evaluate the outcomes of an apically repositioned flap (ARF) plus xenogeneic collagen matrix (XCM) in augmenting keratinized mucosa width (KMW) around dental implants when compared with ARF plus free gingival grafts (FGG).

Materials and methods

Twenty‐six participants with at least one site with KMW ≤2 mm were randomized into FGG or XCM group. Clinical examinations were performed at baseline and at 2 and 6 months after surgery, including KMW, keratinized mucosa thickness, gingival index (GI), and probing depth (PD). Post‐operative pain and patient satisfaction were also evaluated.

Results

At 6 months, FGG attained a greater increase of KMW and thicker mucosa than XCM (4.1 ± 1.6 mm vs. 1.8 ± 1.0 mm, p < .001; 1.7 ± 0.6 mm vs. 1.2 ± 0.3 mm, p < .01). Regarding GI, PD, post‐operative pain, aesthetic outcomes, and patient satisfaction, no significant difference could be detected. Moreover, the operation time of XCM group was shorter (60 ± 9 min vs. 39 ± 8 min, p < .001).

Conclusions

FGG could result in greater increase of KMW than XCM, though both could increase KMW, maintain peri‐implant health, and attain comparable aesthetic outcomes. The use of XCM was associated with reduced operation time.
Practical view of the topical treatment of peripheral venous catheter‐related phlebitis: A scoping review
Authors: Garcia‐Expósito Judith , Masot Olga , Gros Sílvia , Botigué Teresa , Roca Judith
Published: July 2021

Objective

To identify and analyse topical treatments for peripheral venous catheter (PVC)‐related phlebitis.

Design

The methodological framework used to make this scoping review was developed by Arksey and O'Malley (2005; (International Journal of Social Research Methodology, 8, 2005 and 19)).

Data sources

A literature search was performed in various databases such as PubMed, Scopus, CINAHL, Cochrane, Cuiden, Web of Science, WorldWideScience and Joanna Briggs. Additionally, articles from informal sources were incorporated.

Review methods

A search and selection were made of experimental, quasi‐experimental and pre‐experimental studies published between January 2015 and September 2020 that consider the use of topical products for the treatment of hospital in‐patients with PVC‐related phlebitis. Appraisal of the methodological quality of the study was performed independently by pairs of reviewers on the basis of the Cochrane Collaboration tool. The review was based on the guidelines in the PRISMA‐ScR statement.

Results

Twenty‐two articles were selected (8 randomised controlled trials (RCTs), 12 quasi‐RCTs and 2 pre‐experimental studies) which considered treatments applied to a total of 2042 adult patients. The topical treatments described were classified into physical measures and phytotherapeutic and pharmacological treatments. The physical measures are easy to apply, but their effectiveness is limited. The main limitation of the phytotherapeutic treatments is their marketing and use in eastern culture. The best performing pharmacological treatment is the application of magnesium sulphate either with or without glycerine. These products can be presented in different pharmaceutical formulas: ointment, solution and oil.

Conclusions and relevance to clinical practice

The evidence currently available on this issue is limited and often of dubious methodological rigour. Further studies are required on the treatment and follow‐up of intravenous therapy‐related phlebitis in different national and international contexts.
Saturation screening for neonatal hypoxaemia within 6 h of life: Not all about congenital cardiac disease
Authors: Lutz Tracey L , Raynes‐Greenow Camille , Gordon Adrienne
Published: July 2021

Aims

To assess the outcomes of an early oxygen saturation screening programme in apparently healthy newborns for the detection of cardiac and non‐cardiac disease. To describe the aetiology and incidence of infants with oxygen saturations <95% in the first 6 h of life and describe the management to discharge. In addition, we sought to identify any risk factors for failed early saturations.

Methods

This is a retrospective hospital cohort assessing outcomes of an early saturation screening programme performed in apparently healthy newborns. Infants with oxygen saturations less than 95% were identified and their clinical notes were hand‐searched. Descriptive statistics were used to present demographics, proportion of infants who passed or failed screening, subsequent diagnoses and short‐term outcome. Multivariate logistic regression was used to identify independent associations of clinical factors (birthweight, gestation, elective caesarean section and gender) with failed screening.

Results

Between 2014 and 2019, 14 956 healthy newborns were assessed within the first 6 h, 94 (0.63%) failed the early saturation screen. The most common causes for saturation <95% were respiratory disease or delayed transition. There were 31 (33%) infants admitted to the NICU with an additional baby requiring emergency transfer to a cardiac centre. Infants were 28 times more likely to have saturations <95% if born by elective caesarean section (odds ratio 28, conflict of interest (18.54–42.82)).

Conclusion

In apparently healthy newborns, early assessment of oxygen saturation, combined with clinical assessment and subsequent intervention can identify important conditions and should be considered as standard care.
Autoimmune limbic encephalitis due to Hashimoto’s encephalopathy responding to therapeutic plasma exchange: A case report
Authors: Ohnmar Ohnmar , Win Sai Kyaw , Tun Zin Phyu , Aye Yin Minn , Lwin Thandar , Lay Phyu Phyu
Published: July 2021

A 66 years‐old lady presented with acute onset confusion and status epilepticus. MRI (Brain) showed T2 shine through at bilateral hippocampi. Cerebrospinal fluid revealed mild lymphocytic pleocytosis. Screening for infections, autoimmune and paraneoplastic conditions were negative except significantly high anti‐TPO antibody and hyperthyroid state. Her seizures needed multiple antiepileptic drugs. Limbic encephalitis was treated with high‐dose steroid but not responded and plasma exchange was proceeded. At two weeks after plasma exchange, her conscious level and seizure frequency were significantly improved. We present a case of Hashimoto's encephalopathy presenting with limbic encephalitis not responding to steroid but to plasma exchange.
ISLAND DWELLINGS AT 60° NORTH: NEW EVIDENCE FOR CRANNOGS IN IRON AGE SHETLAND
Authors: Stratigos Michael J.
Published: July 2021

Re‐evaluation of recorded sites and new field survey have identified 30 island dwellings in Shetland which are argued to be part of the wider Scottish Iron Age crannog building tradition. Four were subject to field survey above and below water and found to be at least partly artificial. The morphology, distribution and chronology of Shetland’s artificial islands are discussed and compared to the rest of Scotland emphasizing their parallels. The results support the recent move towards considering islet duns and brochs as crannogs. These newly identified sites in Shetland underline the ubiquity of the crannog building tradition in Scotland. Through discussion of the morphology, distribution and chronology of crannogs in Shetland and the rest of Scotland, it is argued that artificial island dwelling is a widely shared cultural practice and an underlying principle of Scottish Iron Age settlement.
Bradyarrhythmias in patients with SARS‐CoV‐2 infection: A narrative review and a clinical report
Authors: Gatto Maria Chiara , Persi Alessandro , Tung Marzia , Masi Rosa , Canitano Stefano , Kol Amir
Published: July 2021

Several cardiovascular diseases and arrhythmic disorders have been described in COVID‐19 era as likely related to SARS‐CoV‐2 infection. The prognostic relevance of bradyarrhythmias during the infection has not been yet described and no data are available about long‐term heart conduction disorders. A review of literature concerning the association between hypokinetic arrhythmias and COVID‐19 from January 2020 to February 2021 was performed. The key‐words used for the research were: “sinus node disfunction,” “sick sinus syndrome (SSS),” “sino‐atrial block,” “atrio‐ventricular block (AVB),” “bradyarrhythmias,” and “COVID‐19″ or ”SARS‐CoV‐2.″ Excluding “relative bradycardia,” a total of 38 cases of bradyarrhythmia related to SARS‐CoV‐2 infection have been described, even in very young people, requiring in many cases a definitive pacemaker implantation. Furthermore, we report a case of non‐hospitalized 47‐years old man with a SSS developed as a consequence of mild SARS‐CoV‐2 infection. While in all described cases heart conduction disorders were found at presentation of the infection or during hospitalization for COVID‐19, in our case the diagnosis of SSS was made after the resolution of the infection. Although rarely, heart conduction disorders may occur during COVID‐19 and the present case highlights that a cardiological follow up may be desirable even after the resolution of infection, especially in the presence of symptoms suggesting a possible heart involvement.
Standard versus strict stability criteria in radiofrequency paroxysmal atrial fibrillation ablation using ablation index
Authors: Zucchelli Giulio , Parollo Matteo , Guarracini Fabrizio , Marini Massimiliano , Di Cori Andrea , Barletta Valentina , De Lucia Raffaele , Segreti Luca , Bonmassari Roberto , Bongiorni Maria Grazia
Published: July 2021

Purpose

To compare the outcome of paroxysmal atrial fibrillation (AF) ablation via pulmonary vein isolation using Ablation Index (AI) with strict or standard stability criteria.

Methods

We enrolled 130 consecutive naive patients affected by paroxysmal AF who underwent PVI at two high‐volume centers. AI target was ≥380 at the posterior wall and ≥500 at the anterior wall. Strict versus standard stability criteria were set for Group 1 (65 patients) and Group 2 (65 patients), respectively. We compared those strategies with a historical cohort of 72 consecutive patients treated at same centers in the VISITALY study, using average force ≥10 g and strict stability criteria as target parameters. Interlesion distance target was <6 mm. Recurrence was defined as any AF, atrial tachycardia (AT) or atrial flutter (AFL) during the 12 months after ablation, excluding a 90‐days blanking period.

Results

Procedure duration (224.05 ± 47.21 vs. 175.61 ± 51.29 min; p < .001), fluoroscopy time (11.85 ± 4.38 vs. 10.46 ± 6.49 min; p = .019) and pericardial effusion rate (9.23% vs. 0%; p = .01) were higher in Group 1 than in Group 2. Freedom from AF/AT/AFL at 12 months was not significantly different (Group 1: 86.15%; Group 2: 90.77%; p = .42). Compared to VISITALY study, there were not significant differences in terms of recurrences.

Conclusion

A strategy of PVI using AI with standard stability criteria performed the best in terms of procedure efficiency and safety. Twelve‐months arrhythmia‐free survival rate was comparable with other strategies pursuing an interlesion distance target <6 mm, regardless of the use of AI.
Adjuvant Photodynamic Therapy, Mediated via Topical Versus Systemic Administration of 5‐Aminolevulinic Acid for Control of Murine Mammary Tumor after Surgical Resection†
Authors: Carter Shirron , Miller Joann , Cramer Gwendolyn , Yuan Min , Guzman Stacy , Putt Mary E. , Cengel Keith A. , Freedman Gary M. , Busch Theresa M.
Published: July 2021

Treatment de‐escalation is sought in the management of precursor lesions of early stage breast cancer, driving the appeal of adjuvant modalities to lumpectomy that reduce toxicity and minimally detract from patient quality of life. We investigate photodynamic therapy (PDT), with the photosensitizing prodrug, 5‐aminolevulinic acid (ALA), as adjuvant therapy to complete resection of murine mammary tumor (propagated from TUBO cells). ALA was delivered either systemically (oral, 250 mg kg−1) at 5 h before 632 nm illumination or topically (20% solution) to the resection site at 10 min before light delivery to 135 J cm−2. Treatment with either oral‐ALA‐PDT (oALA‐PDT) or topical‐ALA‐PDT (tALA‐PDT) to the mammary fat pad after TUBO complete resection (CR) produced long‐term tumor control with 90‐day complete response rates of 21% and 32%, respectively, compared to control rates of 0–5% in mice receiving only CR. Thus, CR/tALA‐PDT was equipotent to CR/oALA‐PDT despite ~10‐fold lower levels of ALA‐induced protoporphyrin XI as photosensitizer after topical versus oral‐ALA administration. CR/oALA‐PDT produced more vascular damage, greater proportion of tissue‐resident neutrophils and stronger inflammation when compared to CR/tALA‐PDT. Collectively, these data provide rationale for ongoing investigation of ALA‐PDT as adjuvant therapy after lumpectomy for increased probability of local control in the treatment of breast cancer.
Spectral and chemical studies of iron and manganese oxyhydroxides in laterite developed on ultramafic rocks
Authors: Tupaz Carmela Alen J. , Watanabe Yasushi , Sanematsu Kenzo , Echigo Takuya
Published: July 2021

Iron (Fe) oxyhydroxides (goethite and hematite) and manganese (Mn)‐oxyhydroxides (lithiophorite, asbolane, lithiophorite‐asbolane intermediate) are typically fine‐grained and poorly crystalline in nature, and as such are difficult to identify by conventional X‐ray powder diffraction. This study employs Raman spectroscopy and electron probe microanalysis (EPMA) to characterize Fe‐ and Mn‐oxyhydroxides found in the Berong Ni–Co laterite deposit at Palawan Island, Philippines. Accurate identification of these minerals is important because these phases contain high Ni and Co contents. Goethite and hematite occur in a wide range of textures, which are related to their compositional variations with respect to Ni, Al, Mn, Cr, and Si. The change in the intensity of the Raman peaks can be linked to the variable concentrations of Ni, Al, Mn, Cr, and Si in goethite. These chemical variations affect the textural transformation of goethite from amorphous to cryptocrystalline. Lithiophorite, asbolane and their intermediates were properly distinguished using Raman spectroscopy. EPMA data shows that these Mn minerals contain appreciable concentrations of Ni, Co, Al, and Fe. The band shift from lithiophorite to asbolane end terms in the 486–593 cm−1 domain indicates the substitution of Al in lithiophorite by Ni, Co, and Fe.
Effective Lockdown and Role of Hospital‐Based COVID‐19 Transmission in Some Indian States: An Outbreak Risk Analysis
Authors: Sardar Tridip , Rana Sourav
Published: July 2021

Several reports in India indicate hospitals and quarantined centers are COVID‐19 hotspots. To study the transmission occurring from the hospitals and as well as from the community, we developed a mechanistic model with a lockdown effect. Using daily COVID‐19 cases data from six states and overall India, we estimated several important parameters of our model. Moreover, we provided an estimation of the effective (RT), the basic (R0), the community (RC), and the hospital (RH) reproduction numbers. We forecast COVID‐19 notified cases from May 3, 2020, till May 20, 2020, under five different lockdown scenarios in the seven locations. Our analysis suggests that 65% to 99% of the new COVID‐19 cases are currently asymptomatic in those locations. Besides, about 1–16% of the total COVID‐19 transmission are currently occurring from hospital‐based contact and these percentage can increase up to 69% in some locations. Furthermore, the hospital‐based transmission rate (β2) has significant positive (0.65 to 0.8) and negative (‐0.58 to ‐0.23) correlation with R0 and the effectiveness of lockdown, respectively. Therefore, a much larger COVID‐19 outbreak may trigger from the hospital‐based transmission. In most of the locations, model forecast from May 3, 2020, till May 20, 2020, indicates a two‐times increase in cumulative cases in comparison to total observed cases up to April 29, 2020. Based on our results, we proposed a containment policy that may reduce the threat of a larger COVID‐19 outbreak in the future.
What drives Chinese overseas M&A investment? Evidence from micro data
Authors: Fuest Clemens , Hugger Felix , Sultan Samina , Xing Jing
Published: July 2021

In recent years Chinese foreign acquisitions have increased significantly. In Europe and the United States, these investments are often criticized. Critics argue that Chinese investors outbid competitors with help from their government, that the acquisitions lead to undesirable technology transfer, or that they may have negative consequences for the employees of the target firm. We use a large deal‐level dataset on cross‐border acquisitions to investigate whether Chinese foreign acquisitions differ from cross‐border investment coming from other countries. We find that relative to non‐Chinese investors, Chinese acquirers indeed appear to be different in some dimensions. They focus on targets with higher debt levels and lower profitability. At the same time, they do not seem to pay more for targets with given characteristics, questioning the view that they are subsidized to outbid other investors. Policy initiatives like the Belt and Road Initiative and Made in China 2025 influence state‐owned but not private Chinese investors, suggesting that geopolitical or technology interests play a role. In the years after the takeover, target companies acquired by Chinese investors exhibit lower growth in capital productivity but a higher growth of employee compensation.
Screening of Retired Lithium-Ion Batteries Using Incremental Capacity Charging Curve-Based Residual Capacity Estimation Method for Facilitating Sustainable Circular Lithium-Ion Battery System
Authors: Li Honglei , Cong Liang , Ma Huazheng , Liu Weiwei , Deng Yelin , Kong Shuai
Published: July 2021

The rapidly growing deployment of lithium-ion batteries in electric vehicles is associated with a great waste of natural resource and environmental pollution caused by manufacturing and disposal. Repurposing the retired lithium-ion batteries can extend their useful life, creating environmental and economic benefits. However, the residual capacity of retired lithium-ion batteries is unknown and can be drastically different owing to various working history and calendar life. In this study, we used the incremental capacity (IC) curve to estimate the residual capacity of waste power batteries. First, through experimental means, the parameters of the battery and the IC charging curve are measured. Second, to achieve rapid capacity estimation, a battery capacity estimation method based on the adaptive genetic algorithm-back propagation neural network (AGA-BPNN) is proposed and compared with other classic machine learning methods. The proposed algorithm reduced the error of capacity estimation to 3%. Finally, through the analysis of the IC curve, a method for identifying aging mechanism of large-scale decommissioned batteries is obtained. This research provides effective support for the capacity-based classification of large-scale decommissioned power batteries.
Cytomegalovirus skin disease in a kidney transplant patient
Authors: Cervera-Hernandez Miguel Enrique , Ikemura Kenji , McCort Margaret E
Published: July 2021

A 44-year-old man with a history of renal transplantation presented with right lower abdominal wall swelling, redness and pain. A bacterial abscess was drained, and he was discharged home with oral antibiotics. After failing to improve, he returned to the hospital, where he was briefly treated with intravenous antibiotics and discharged home again. The patient returned 5 days later, reporting worsening right groin swelling that extended into the ipsilateral scrotum. Imaging revealed a persistent fluid collection in the region, and he was taken for surgical debridement. Tissue immunochemistry and histopathological evaluation identified cytomegalovirus infection. Plasma quantitative PCR for cytomegalovirus demonstrated high viraemia. The patient was successfully treated with intravenous ganciclovir, followed by oral valganciclovir, with resolution of the skin changes. Persistent hydrocele with epididymitis on imaging suggests that this process may have been the source of the cutaneous cytomegalovirus infection.
Thyrotoxicosis: a rare presentation of molar pregnancy
Authors: De Guzman Eison , Shakeel Hira , Jain Rohit
Published: July 2021

A 49-year-old woman, G8P7, presented with 1 week of worsening vaginal bleeding and abdominal cramps in the setting of a recently discovered unplanned pregnancy. Vaginal ultrasound findings and a significantly elevated human chorionic gonadotropin (hCG) level were concerning for molar pregnancy. She developed signs of hyperthyroidism on the night of admission, for which the endocrinology team was consulted. Laboratory data were consistent with hyperthyroidism. The patient was believed to have thyrotoxicosis secondary to molar pregnancy with concern for impending thyroid storm. Her mental health disorder and bacteraemia made taking care of her further challenging. She was started on a beta-blocker, antithyroid agent and intravenous corticosteroids. She underwent an uncomplicated suction dilation and curettage (D&C), with resolution of her symptoms a few days after. At a follow-up appointment, the patient continued to be asymptomatic and was feeling well.
Substance use disorders and adherence to antituberculosis medications in Southwest Ethiopia: a prospective cohort study
Authors: Soboka Matiwos , Tesfaye Markos , Adorjan Kristina , Krahl Wolfgang , Tesfaye Elias , Yitayih Yimenu , Strobl Ralf , Grill Eva
Published: July 2021

Objectives

In Ethiopia, little is known about the association between substance use disorders and adherence to antituberculosis (anti-TB) medications. Therefore, the objective of this study was to assess the effect of substance use disorders on adherence to anti-TB medications in Southwest Ethiopia.

Design

Prospective cohort study.

Settings

Patients were recruited from 22 health centres and four hospitals in Southwest Ethiopia.

Participants

This study was conducted among 268 patients with TB, aged 18–80 in Southwest Ethiopia between October 2017 and October 2018. At baseline, patients who were exposed substance use disorders (134 patients) and unexposed to substance use disorders (134 patients) were recruited. Patients were followed for 6 months, and data were collected on three occasions.

Main outcome measure

Adherence to anti-TB medications.

Results

Patients with substance use disorders had consistently higher prevalence of non-adherence than those without, 16.4% versus 3.0% at baseline, 41.7% versus 14.4% at 2-month follow-up and 45.7% versus 10.8% at 6-month follow-up assessments. Patients with khat use disorder were 3.8 times more likely to be non-adherent to anti-TB medications than patients without khat use disorder (Adjusted odds ratio (aOR)=3.8, 95% CI 1.8 to 8.0). Patients who had alcohol use disorder (AUD) were also 3.2 times likely to have poor adherence compared with their counterparts (aOR=3.2, 95% CI 1.6 to 6.6). In addition, being educated (aOR=4.4, 95% CI 1.7 to 11.3), and being merchant (aOR=6.1, 95% CI 1.2 to 30.8) were associated with non-adherence to anti-TB medications.

Conclusion

Khat and AUDs predict greater likelihood of non-adherence to anti-TB medication. This implies the need to integrate the management for substance use disorders into the existing TB treatment services.
Depression and its correlation with social support and health-promoting lifestyles among Chinese university students: a cross-sectional study
Authors: Tang Zaili , Feng Shuidong , Lin Jing
Published: July 2021

Objectives

To investigate the prevalence of depression in college students and determine how social support and healthy lifestyle factors are associated with depression in this population.

Design

A cross-sectional design.

Setting

A comprehensive university in Changsha, Hunan, South China. The study was conducted from May to June 2019.

Participants

A total of 541 students at the comprehensive university.

Primary and secondary outcome measures

The Zung Self-Rating Depression Scale, Social Support Rating Scale and Health-Promoting Lifestyle Profile-II (HPLP-II) were used to evaluate depression, social support and lifestyles, respectively, and analyse the mutual relationships among them.

Results

Among the 541 participants, 161 (29.8%) experienced depressive symptoms, and there were significant gender-related and academic discipline-related differences in self-rated depression. The average social support score was 38.06 (38.06±7.52). The average HPLP-II score was 71.09 (71.09±11.47). A monofactor analysis showed that depression was correlated with social support and a healthy lifestyle. As demonstrated by logistic regression analysis, being a woman (OR=2.613, 95% CI: 1.541 to 4.43), inadequate social support (OR=0.912, 95% CI: 0.877 to 0.948), poor nutrition (OR=0.87, 95% CI: 0.775 to 0.977) and lack of self-actualisation (OR=0.644, 95% CI: 0.572 to 0.724) were significantly correlated with depression.

Conclusions

Owing to the high prevalence of depression among Chinese university students, educational institutions must take measures such as providing compulsory mental health education courses and improving the psychological counselling services available to students.
Knowledge of blood donation and associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Getie Addisu , Wondmieneh Adam , Bimerew Melaku , Gedefaw Getnet , Demis Asmamaw
Published: July 2021

Objective

To assess the level of knowledge about blood donation and associated factors in Ethiopia.

Design

Systematic review and meta-analysis.

Methods

Both published and unpublished cross-sectional studies on the level of knowledge about blood donation in Ethiopia were included. Articles from different databases such as PubMed/MEDLINE, HINARI, EMBASE, Scopus, Google Scholar and African Journals Online were searched. Cochrane I2statistics were used to check for heterogeneity. Subgroup and sensitivity analyses of evidence of heterogeneity were carried out. Egger’s test with funnel plot was conducted to investigate publication bias.

Result

Twenty cross-sectional studies with a total of 8338 study participants (4712 men and 3626 women) were included. The overall nationwide level of knowledge about blood donation was 56.57% (95% CI 50.30 to 62.84). Being in secondary school and above (adjusted OR=3.12; 95% CI 2.34 to 4.16) and being male (adjusted OR=1.81; 95% CI 1.44 to 2.28) were the factors associated with level of knowledge about blood donation.

Conclusion

More than half of the study participants were knowledgeable about blood donation. Sex and educational status were the factors significantly associated with level of knowledge about blood donation in Ethiopia. Therefore, there is a need for education and dissemination of information about blood donation among the general population to build adequate knowledge and maintain regular blood supply.
Time to market for drugs approved in Canada between 2014 and 2018: an observational study
Authors: Lexchin Joel
Published: July 2021

Objectives

This study examines the length of time between when a patent application is filed in Canada for a new drug and when it is available for patients (time to market) and various components of that time. It also looks at whether various factors explain the time between patent application to New Drug Submission (NDS) and compares Canadian and American times. Drugs approved between 1 January 2014 and 31 December 2018 are examined.

Design

Descriptive study.

Data sources

Websites from Health Canada, Food and Drug Administration, Merck Index, United States Patent and Trademark Office, WHO and previously published articles.

Interventions

None.

Primary and secondary outcomes

The primary outcomes are time to market, time from patent application to NDS (pre-NDS time), review time, time from approval to availability (postapproval time) and factors that may influence the pre-NDS time. The secondary outcome is a comparison of Canadian and American review times and times between patent application and approval.

Results

There were 113 drugs available for analysis. The median time to market was 11.80 years (IQR 9.40–14.05). The component median times were pre-NDS 10 years (IQR 8.05–12.80), review time 0.96 years (IQR 0.75–1.15) and postapproval time 0.15 years (IQR 0.08–0.28). Less than 8% of the pre-NDS time was explained by the factors that were analysed in a multiple linear regression equation. There was no statistically significant difference between Canadian and American pre-NDS times.

Conclusion

Once a drug reaches the market, companies have a median of 8.2 years before the patent expires and generics can reach the market. Most of the time between the filing of a patent application and when a drug is marketed is determined by decisions that are largely under the control of the company.
Efficacy and safety of furosemide for prevention of intradialytic hypotension in haemodialysis patients: protocol for a multicentre randomised controlled trial
Authors: Chen Wenwen , Wang Fang , Zhao Yuliang , Zhang Ling , Chen Zhiwen , Dai Mingjin
Published: July 2021

Introduction

Intradialytic hypotension (IDH) is a frequent and serious complication of maintaining haemodialysis (HD) patients and associated with subsequent cardiovascular events and higher mortality. Furosemide is commonly used in non-dialysis chronic kidney disease patients and can effectively manage the volume and blood pressure. However, these agents are often discontinued on initiation of dialysis. Two large observational studies have demonstrated that furosemide can lower the rate of IDH episodes. However, there is still no randomised controlled trial (RCT) to investigate the efficacy and safety of furosemide for prevention of IDH in HD patients. The purpose of this study was to assess the efficacy of furosemide in reducing IDH in HD patients with residual renal function.

Methods and analysis

A two-arm, parallel, multicente RCT will be conducted at 12 hospitals in China. An estimated sample of 560 HD patients will be recruited. Eligible patients will be randomly assigned to treatment group (patients receive oral furosemide 80 mg/day; after a 2-week treatment, if their urine volume is less than 400 mL/day, the dose of furosemide is adjusted to 160 mg/day) and blank control group via a central randomisation system using 1:1 ratio. The primary outcome is the occurrence of IDH. Outcome assessors and data analysts will be blinded and participants will be asked not to reveal their allocation to assessors. The outcome analyses will be performed both on the intention-to-treat, which includes all patients randomised, and per-protocol population, which includes eligible patients who adhere to the planned treatment and follow-ups.

Ethics and dissemination

The trial protocol has been approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (2019.385)

Results will be presented at national and international conferences and published in peer-reviewed journals.

Trial registration number

ChiCTR2000039724.
Relationship between childhood secondhand smoke exposure and the occurrence of hyperlipidaemia and coronary heart disease among Chinese non-smoking women: a cross-sectional study
Authors: Wang Kewei , Wang Yuanqi , Zhao Ruxing , Gong Lei , Wang Lingshu , He Qin , Chen Li , Qin Jun
Published: July 2021

Objective

The objective of this study was to evaluate the influence of secondhand smoke (SHS) exposure during childhood on type 2 diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease among Chinese non-smoking women.

Methods

In this cross-sectional study, the SHS exposure data in childhood were obtained using a questionnaire survey. Self-reported childhood SHS exposure was defined as the presence of at least one parent who smoked during childhood.

Results

Of the 6522 eligible participants, 2120 Chinese women who had never smoked were assessed. The prevalence of SHS exposure in the entire population was 28.1% (596). SHS exposure during childhood was not significant for the standard risk factors of type 2 diabetes mellitus (p=0.628) and hypertension (p=0.691). However, SHS was positively associated with hyperlipidaemia (p=0.037) after adjusting for age, obesity, education status, physical activity, alcohol consumption, current SHS exposure status, diabetes mellitus and hypertension. In addition, childhood SHS increased the occurrence of coronary heart disease (p=0.045) among non-smokers after further adjusting for hyperlipidaemia.

Conclusion

SHS exposure during childhood is associated with prevalent hyperlipidaemia and coronary heart disease in adulthood among non-smoking Chinese women.
SARS-CoV-2 seroprevalence in healthcare workers of a Swiss tertiary care centre at the end of the first wave: a cross-sectional study
Authors: Meylan Sylvain , Dafni Urania , Lamoth Frederic , Tsourti Zoi , Lobritz Michael A , Regina Jean , Bressin Philippe , Senn Laurence , Grandbastien Bruno , Andre Cyril , Fenwick Craig , D'Acremont Valerie , Croxatto Antony , Guilleret Isabelle , Greub Gilbert , Manuel Oriol , Calandra Thierry , Pantaleo Giuseppe , Lazor-Blanchet Catherine
Published: July 2021

Objective

To assess the SARS-CoV-2 transmission in healthcare workers (HCWs) using seroprevalence as a surrogate marker of infection in our tertiary care centre according to exposure.

Design

Seroprevalence cross-sectional study.

Setting

Single centre at the end of the first COVID-19 wave in Lausanne, Switzerland.

Participants

1874 of 4074 responders randomly selected (46% response rate), stratified by work category among the 13 474 (13.9%) HCWs.

Main outcome measures

Evaluation of SARS-CoV-2 serostatus paired with a questionnaire of SARS-CoV-2 acquisition risk factors internal and external to the workplace.

Results

The overall SARS-CoV-2 seroprevalence rate among HCWs was 10.0% (95% CI 8.7% to 11.5%). HCWs with daily patient contact did not experience increased rates of seropositivity relative to those without (10.3% vs 9.6%, respectively, p=0.64). HCWs with direct contact with patients with COVID-19 or working in COVID-19 units did not experience increased seropositivity rates relative to their counterparts (10.4% vs 9.8%, p=0.69 and 10.6% vs 9.9%, p=0.69, respectively). However, specific locations of contact with patients irrespective of COVID-19 status—in patient rooms or reception areas—did correlate with increased rates of seropositivity (11.9% vs 7.5%, p=0.019 and 14.3% vs 9.2%, p=0.025, respectively). In contrast, HCWs with a suspected or proven SARS-CoV-2-infected household contact had significantly higher seropositivity rates than those without such contacts (19.0% vs 8.7%, p<0.001 and 42.1% vs 9.4%, p<0.001, respectively). Finally, consistent use of a mask on public transportation correlated with decreased seroprevalence (5.3% for mask users vs 11.2% for intermittent or no mask use, p=0.030).

Conclusions

The overall seroprevalence was 10% without significant differences in seroprevalence between HCWs exposed to patients with COVID-19 and HCWs not exposed. This suggests that, once fully in place, protective measures limited SARS-CoV-2 occupational acquisition within the hospital environment. SARS-CoV-2 seroconversion among HCWs was associated primarily with community risk factors, particularly household transmission.
Upskilling health and care workers with augmented and virtual reality: protocol for a realist review to develop an evidence-informed programme theory
Authors: Gasteiger Norina , van der Veer Sabine N , Wilson Paul , Dowding Dawn
Published: July 2021

Introduction

Augmented reality (AR) and virtual reality (VR) are increasingly used to upskill health and care providers, including in surgical, nursing and acute care settings. Many studies have used AR/VR to deliver training, providing mixed evidence on their effectiveness and limited evidence regarding contextual factors that influence effectiveness and implementation. This review will develop, test and refine an evidence-informed programme theory on what facilitates or constrains the implementation of AR or VR programmes in health and care settings and understand how, for whom and to what extent they ‘work’.

Methods and analysis

This realist review adheres to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards and will be conducted in three steps: theory elicitation, theory testing and theory refinement. First, a search will identify practitioner, academic and learning and technology adoption theories from databases (MEDLINE, Scopus, CINAHL, Embase, Education Resources Information Center, PsycINFO and Web of Science), practitioner journals, snowballing and grey literature. Information regarding contexts, mechanisms and outcomes will be extracted. A narrative synthesis will determine overlapping configurations and form an initial theory. Second, the theory will be tested using empirical evidence located from the above databases and identified from the first search. Quality will be assessed using the Mixed Methods Appraisal Tool (MMAT), and relevant information will be extracted into a coding sheet. Third, the extracted information will be compared with the initial programme theory, with differences helping to make refinements. Findings will be presented as a narrative summary, and the MMAT will determine our confidence in each configuration.

Ethics and dissemination

Ethics approval is not required. This review will develop an evidence-informed programme theory. The results will inform and support AR/VR interventions from clinical educators, healthcare providers and software developers. Upskilling through AR/VR learning interventions may improve quality of care and promote evidence-based practice and continued learning. Findings will be disseminated through conference presentations and peer-reviewed journal articles.
Synthesising evidence regarding hospital to home transitions supported by volunteers of third sector organisations: a scoping review protocol
Authors: Nelson Michelle LA , Armas Alana , Thombs Rachel , Singh Hardeep , Fulton Joseph , Cunningham Heather V , Munce Sarah , Hitzig Sander , Bettger Janet Prvu
Published: July 2021

Introduction

Given the risks inherent in care transitions, it is imperative that patients discharged from hospital to home receive the integrated care services necessary to ensure a successful transition. Despite efforts by the healthcare sector to develop health system solutions to improve transitions, problems persist. Research on transitional support has predominantly focused on services delivered by healthcare professionals; the evidence for services provided by lay navigators or volunteers in this context has not been synthesised. This scoping review will map the available literature on the engagement of volunteers within third sector organisations supporting adults in the transition from hospital to home.

Methods and analysis

Using the well-established scoping review methodology outlined by the Joanna Briggs Institute, a five-stage review is outlined: (1) determining the research question, (2) search strategy, (3) inclusion criteria, (4) data extraction and (5) analysis and presentation of the results. The search strategy will be applied to 10 databases reflecting empirical and grey literature. A two-stage screening process will be used to determine eligibility of articles. To be included in the review, articles must describe a community-based programme delivered by a third sector organisation that engages volunteers in the provisions of services that support adults transitioning from hospital to home. All articles will be independently assessed for eligibility, and data from eligible articles will be extracted and charted using a standardised form. Extracted data will be analysed using narrative and descriptive analyses.

Ethics and dissemination

Ethics approval is not required for this scoping review. Members of an international special interest group focused on the voluntary sector will be consulted to provide insight and feedback on study findings, help with dissemination of the results and engage in the development of future research proposals. Dissemination activities will include peer-reviewed publications and academic presentations.