bluuebunny/crossref_metadata_2025 huggingface dataset:
An Improved One-Dimensional Flow Model for Side Chambers of Centrifugal Pumps Considering the Blade Slip Factor
Authors: Gu Yandong , Li Jiaxu , Wang Peng , Cheng Li , Qiu Yong , Wang Chuan , Si Qiaorui
Published: March 2022

The blade slip factor significantly influences the prediction accuracy of the self-closure one-dimensional flow model for side chambers of centrifugal pumps. Wiesner's and Stodola's slip factors, which are used to formulate the blade outlet pressure and served as the boundary condition for the model, are examined, which is an improvement of the previous study (Gu et al., 2020, “A Pressure Model for Open Rotor–Stator Cavities: An Application to an Adjustable-Speed Centrifugal Pump With Experimental Validation,” ASME J. Fluids Eng., 142(10), p. 101301). Both computational fluid dynamics (CFD) simulations and experiments for the centrifugal pump are conducted to support the improvement. A good agreement exists between the performance at the best efficiency points (BEPs) of different rotating speeds obtained by simulations and experiments. Through the CFD analysis, the flow in the impeller remarkably deviates from the blade-congruent flow, especially in the quasi-triangular regions downstream of the throats. Meanwhile, the reason for pressure over-predictions of the side chamber one-dimensional flow model that embeds Wiesner's slip factor (FMW) is that Wiesner's expression underestimates the impeller flow deflection and overestimates pressure boundary. By contrast, the side chamber one-dimensional flow model with Stodola's slip factor (FMS) is closer to CFD in terms of relative flow angle and chamber inlet pressure. Compared with the side chamber pressure measurements, the accuracy of FMS is upgraded approximately by 3.5% than FMW. At the BEPs of different rotating speeds, FMS generates lower shroud thrust coefficients but slightly greater volumetric efficiencies than FMW. This work provides a simple approach to better calculate flow characteristics in the side chambers.
Understanding Physical Education Teachers’ Help-Seeking Behaviors in a Facebook Professional Learning Community
Authors: Xie Xiuye , Chen Yung-Ju
Published: March 2022

Purpose: Social media has become a popular platform for forming professional learning communities (PLCs) for educators. However, few studies have been conducted to understand physical educators’ behaviors in these social media-based PLCs. This study aimed to investigate physical educators’ help-seeking behaviors in a social media-based PLC on Facebook. Method: A case study was conducted to explore physical educators’ help-seeking behaviors. A total of 4,323 posts were collected and analyzed using content analysis procedures. Both descriptive and qualitative analyses were performed. Findings: More than half (51.45%) of posts published in this Facebook PLC aimed to seek help. Six themes reflecting the types of help that physical educators sought were generated: teaching ideas and materials, equipment and technology, classroom management and discipline, extracurricular event and program development, career and professional development, and social and emotional support. Conclusion: The findings suggest that social media-based PLCs can provide physical educators at all levels opportunities to seek help.
Membrane repair triggered by cholesterol-dependent cytolysins is activated by mixed lineage kinases and MEK
Authors: Ray Sucharit , Roth Robyn , Keyel Peter A.
Published: March 2022

Repair of plasma membranes damaged by bacterial pore-forming toxins, such as streptolysin O or perfringolysin O, during septic cardiomyopathy or necrotizing soft tissue infections is mediated by several protein families. However, the activation of these proteins downstream of ion influx is poorly understood. Here, we demonstrate that following membrane perforation by bacterial cholesterol-dependent cytolysins, calcium influx activates mixed lineage kinase 3 independently of protein kinase C or ceramide generation. Mixed lineage kinase 3 uncouples mitogen-activated kinase kinase (MEK) and extracellular-regulated kinase (ERK) signaling. MEK signals via an ERK-independent pathway to promote rapid annexin A2 membrane recruitment and enhance microvesicle shedding. This pathway accounted for 70% of all calcium ion-dependent repair responses to streptolysin O and perfringolysin O, but only 50% of repair to intermedilysin. We conclude that mixed lineage kinase signaling via MEK coordinates microvesicle shedding, which is critical for cellular survival against cholesterol-dependent cytolysins.
Spectroscopy signatures of electron correlations in a trilayer graphene/hBN moiré superlattice
Authors: Yang Jixiang , Chen Guorui , Han Tianyi , Zhang Qihang , Zhang Ya-Hui , Jiang Lili , Lyu Bosai , Li Hongyuan , Watanabe Kenji , Taniguchi Takashi , Shi Zhiwen , Senthil Todadri , Zhang Yuanbo , Wang Feng , Ju Long
Published: March 2022

ABC-stacked trilayer graphene/hexagonal boron nitride moiré superlattice (TLG/hBN) has emerged as a playground for correlated electron physics. We report spectroscopy measurements of dual-gated TLG/hBN using Fourier transform infrared photocurrent spectroscopy. We observed a strong optical transition between moiré minibands that narrows continuously as a bandgap is opened by gating, indicating a reduction of the single-particle bandwidth. At half-filling of the valence flat band, a broad absorption peak emerges at ~18 milli–electron volts, indicating direct optical excitation across an emerging Mott gap. Similar photocurrent spectra are observed in two other correlated insulating states at quarter- and half-filling of the first conduction band. Our findings provide key parameters of the Hubbard model for the understanding of electron correlation in TLG/hBN.
Running birds reveal secrets for legged robot design
Authors: Rubenson Jonas , Sawicki Gregory S.
Published: March 2022

Recapitulating avian locomotion opens the door for simple and economical control of legged robots without sensory feedback systems.
Draft Genome Sequence of Riemerella anatipestifer Strain xi1
Authors: Wei Xiaona , Yan Zhuanqiang , Zhou Qingfeng
Published: March 2022

Riemerella anatipestifer
is an important bacterial pathogen associated with epizootic infections in waterfowl and various other birds. The complete genome sequence of
Riemerella anatipestifer
xi1, isolated in China, was sequenced. The genome consisted of 2,062,911 bp carrying 1,879 predicted genes.
Geology of Frenchman Mountain and Rainbow Gardens, southern Nevada, USA
Authors: Rowland Stephen M.
Published: March 2022

This field guide synthesizes more than a half century of research by many geologists and paleontologists on Frenchman Mountain and Rainbow Gardens, southern Nevada, USA. The field-trip consists of seven stops to be visited in one day. The guide was written not only for field-trip participants on the occasion of the 2022 ­Cordilleran/Rocky Mountain Geological Society of America Joint Section Meeting in Las Vegas, but also with future users in mind.

The Frenchman Mountain/Rainbow Gardens block of crust exposes an extraordinary sample of Earth history. The geologic features include (1) Proterozoic crystalline rocks, (2) the Great Unconformity, (2) a Paleozoic interval that is essentially a ­tilted section of the western Grand Canyon, (3) a Mesozoic interval that preserves strata that were eroded off the southern Colorado Plateau during the Miocene “Great Denudation” episode, and (4) a Cenozoic section that records a wealth of paleo­climatic, paleontological, and tectonic data.

Among the many stories that are recorded in the rocks of the Frenchman Mountain/Rainbow Gardens block, I have chosen three to emphasize in this field guide: (1) the history recorded in the Proterozoic Vishnu Basement Complex and the Great Unconformity; (2) the stratigraphy, sedimentology, paleontology, and geochronology of the Cambrian Tonto Group [with a focus on (a) trilobite biostratigraphy in the Bright Angel Formation, (b) the significance of the abundance of glauconite in the Tonto Group, and (c) the Frenchman Mountain Dolostone]; and (3) the tectonic story recorded in the Thumb Member of the Horse Spring Formation. The basement rocks record events and processes associated with the assembly of supercontinents Nuna and Rodinia. The Great Unconformity records the breakup of Rodinia and the associated denudation interval that played a role in triggering the Cambrian explosion. The Tonto Group, which was recently expanded to include the Frenchman Mountain Dolostone, records the Sauk Transgression. And the Thumb Member of the Horse Spring Formation contains rock avalanche deposits that have played a key role in sorting out the tectonic history of the southern Nevada region and the translational history of the Frenchman Mountain/Rainbow Gardens block.
Supplemental Material: Compositional and metamorphic controls on tectonic erosion along a continental subduction-collision zone: Implications from mafic granulites in the northern Sulu orogen
Authors: Liu Lishuang , al. et
Published: March 2022

Analytical methods, P-T estimation methods, and supplementary Figures S1–S3 and Tables S1–S10.
Impact of fetal alcohol spectrum disorder on families
Authors: Phillips Natalie Lynette , Zimmet Marcel David , Phu Amy , Rattan Meenakshi , Zurynski Yvonne , Elliott Elizabeth J
Published: March 2022

Objective

To evaluate the impact of fetal alcohol spectrum disorder (FASD) on child and family functioning.

Design

Prospective survey.

Setting

Multidisciplinary FASD assessment service.

Patients

Caregivers of 35 children with FASD.

Main outcome measures

Child-health-related functioning (Royal Alexandra Hospital for Children Measure of Function (MOF)), family impact (Impact on Family (IOF) Scale), impact on siblings and caregiver stress.

Results

Most caregivers were foster carers (74%). Children with FASD (median age 8.7 years; 54% male) were a median of 7.0 years at diagnosis. Regarding child-health-related functioning, 43% reported moderate, severe or major problems in at least one area on the MOF. IOF was moderate (60%) or high (34%). Poorer child-health-related functioning was associated with greater impact on family. Unaffected siblings received less parental attention and displayed anger or frustration about the affected child’s needs. Caregivers reported frequent and high levels of stress.

Conclusions

FASD impacts children’s health, and function of the family and unaffected siblings. These novel findings highlight the need for family-oriented service development.
Intraretinal pigmented cells in retinal degenerative disease
Authors: Yasvoina Marina , Yang Qian , Woods Sasha M , Heeren Tjebo , Comer Grant M. , A. Egan Catherine , Fruttiger Marcus
Published: March 2022

Purpose

Invasion of pigmented cells into the retina occurs in retinal degenerative diseases, such as macular telangiectasia type 2 (MacTel) and retinitis pigmentosa (RP). These intraretinal pigmented cells may be derived from the retinal pigment epithelium (RPE), but differences and similarities between intraretinal pigmented cells and RPE have so far not been well characterised.

Clinicopathologic case report.

Method

Here, we compared intraretinal pigment cells with RPE cells by immunohistochemistry. Immunohistological stains for classic RPE markers (RPE65, CRALBP and KRT18) and blood vessel markers (lectin and collagen 4) were done on sections from postmortem eye tissue from two MacTel donors, an RP donor and a control donor.

Main outcome measures

Presence of specific immunohistochemistry markers on intraretinal pigmented and RPE cells.

Results

We found that intraretinal pigmented cells did not express RPE65 and CRALBP, with a small subset expressing them weakly. However, they all expressed KRT18, which was also present in normal RPE cells. Interestingly, we also found clusters of KRT18-positive cells in the retina that were not pigmented.

Conclusions

Our findings suggest that RPE cells invading the retina dedifferentiate (losing classic RPE markers) and can be pigmented or unpigmented. Therefore, the number of RPE cells invading the retina in retinal degenerative disease may be underappreciated by funduscopy.
Impact of prior biliary stenting on diagnostic performance of endoscopic ultrasound for mesenteric vascular staging in patients with head of pancreas and periampullary malignancy
Authors: Oppong Kofi W , Nayar Manu K , Bekkali Noor L H , Maheshwari Pardeep , Haugk Beate , Darne Antony , Manas Derek M , French Jeremy J , White Steven , Sen Gourab , Pandanaboyana Sanjay , Charnley Richard M , Leeds John S
Published: March 2022

Objective

The diagnostic performance of endoscopic ultrasound (EUS) for stratification of head of pancreas and periampullary tumours into resectable, borderline resectable and locally advanced tumours is unclear as is the effect of endobiliary stents. The primary aim of the study was to assess the diagnostic performance of EUS for resectability according to stent status.

Design

A retrospective study was performed. All patients presenting with a solid head of pancreas mass who underwent EUS and surgery with curative intent during an 8-year period were included. Factors with possible impact on diagnostic performance of EUS were analysed using logistic regression.

Results

Ninety patients met inclusion criteria and formed the study group. A total of 49 (54%) patients had an indwelling biliary stent at the time of EUS, of which 36 were plastic and 13 were self-expanding metal stents (SEMS). Twenty patients underwent venous resection and reconstruction (VRR). Staging was successfully performed in 100% unstented cases, 97% plastic stent and 54% SEMS, p<0.0001. In successfully staged patients, sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for classification of resectability were 70%, 70%, 70%, 42% and 88%. For vascular involvement (VI), sensitivity, specificity, accuracy, PPV and NPV were 80%, 68%, 69%, 26% and 96%. Increasing tumour size OR 0.53 (95% CI, 0.30 to 0.95) was associated with a decrease in accuracy of VI classification.

Conclusions

EUS has modest diagnostic performance for stratification of staging. Staging was less likely to be completed when a SEMS was in situ. Staging EUS should ideally be performed before endoscopic retrograde cholangiopancreatography and biliary drainage.
Fifteen days in December: capture and analysis of Omicron-related travel restrictions
Authors: Schermerhorn Jordan , Case Alaina , Graeden Ellie , Kerr Justin , Moore Mackenzie , Robinson-Marshall Siobhan , Wallace Trae , Woodrow Emily , Katz Rebecca
Published: March 2022

Following the identification of the Omicron variant of the SARS-CoV-2 virus in late November 2021, governments worldwide took actions intended to minimise the impact of the new variant within their borders. Despite guidance from the WHO advising a risk-based approach, many rapidly implemented stringent policies focused on travel restrictions. In this paper, we capture 221 national-level travel policies issued during the 3 weeks following publicisation of the Omicron variant. We characterise policies based on whether they target travellers from specific countries or focus more broadly on enhanced screening, and explore differences in approaches at the regional level. We find that initial reactions almost universally focused on entry bans and flight suspensions from Southern Africa, and that policies continued to target travel from these countries even after community transmission of the Omicron variant was detected elsewhere in the world. While layered testing and quarantine requirements were implemented by some countries later in this 3-week period, these enhanced screening policies were rarely the first response. The timing and conditionality of quarantine and testing requirements were not coordinated between countries or regions, creating logistical complications and burdening travellers with costs. Overall, response measures were rarely tied to specific criteria or adapted to match the unique epidemiology of the new variant.
Association between growth of the SARS-CoV-2 epidemic and increased coughing rate in cold temperatures: surveillance in Hokkaido, Japan
Authors: Inaida Shinako , Paul Richard
Published: March 2022

Objective

Although the transmissibility of SARS-CoV-2 in winter is thought to increase through viral droplets when coughing, current epidemiological data in this regard are limited.

Setting

Using the national epidemiological surveillance data in the autumn and winter seasons in Hokkaido, Japan, between February 2020 and February 2021, we analysed the relationship between case increase ratio and prevalence rate of coughing in patients with PCR-confirmed SARS-CoV-2 in two age groups (0—40s and 50—100s) with concomitant air temperature and humidity.

Participants

The 7893 cases of symptomatic PCR-positive patients consisted of 5361 cases in the young age group and 2532 cases in the older age group.

Primary and secondary outcome measures

Pearson’s correlation analysis and regression models were used to assess the relationships. Sex-adjusted OR of having cough in the young and old age groups in the autumn and winter seasons was calculated using logistic regression analysis.

Results

The monthly prevalence rate of coughing in the young age group was negatively correlated with temperature (r=−0.77, p<0.05), and in the old age group it was negatively correlated with humidity (r=−0.71, p<0.05). Quadratic regression models were fitted for the relationship between cold temperatures and rate of coughing rate in the young age group and case increase ratios. The sex-adjusted OR of having a cough in the young age group in winter was 1.18 (95% CI 1.05 to 1.31) as compared with autumn.

Conclusions

The results suggest increased rate of coughing contributes to the epidemic of SARS-CoV-2 in the winter. An effective control with a focus on these trends should be considered.
Effectiveness and safety of weekly therapy versus 3-weekly therapy of paclitaxel plus carboplatin in women with ovarian cancer: a protocol of systematic review and meta-analysis
Authors: Qiu Weitao , Fu Yu , Dang Yun , Cai Bingxin , Tuo Shumei , Mao Baohong , Lin Ru , Liu Qing , Li Yilin
Published: March 2022

Introduction

Network meta-analyses have confirmed that paclitaxel plus carboplatin could improve progression-free survival (PFS) and overall survival (OS) compared with platinum alone. However, detailed implementation schedule (weekly or 3-weekly therapy) was not specified in clinical practice guidelines. Evidence from studies is also inconsistent. We will conduct a systematic review and meta-analysis to evaluate the benefits and harms of weekly therapy and 3-weekly therapy of paclitaxel combined with carboplatin in women with ovarian cancer.

Methods

We will search PubMed, EMBASE and the Cochrane Library databases to include relevant randomised controlled trials comparing weekly therapy versus 3-weekly therapy of paclitaxel combined with carboplatin for women with ovarian cancer. Random-effects model will be used to pool data for patient-reported outcomes including survival rate, OS, PFS and adverse events. Grading of Recommendation, Assessment, Development and Evaluation approach will be used to rate the quality of evidence.

Ethics and dissemination

This systematic review and meta-analysis will be based on published data and does not therefore require specific ethical approval or consent for participation. The results will be published in a peer-reviewed journal.

OSF registration number

10.17605/OSF.IO/GJUMA.
Deficits in attention, motor control and perception from childhood to age 30 years: prospective case–control study of outcome predictors
Authors: Landgren Valdemar , Fernell Elisabeth , Gillberg Christopher , Landgren Magnus , Johnson Mats
Published: March 2022

Objective

Investigate predictors of adverse outcome in children with and without attention-deficit/hyperactivity disorder (ADHD) combined with developmental coordination disorder (DCD) at 6 years of age.

Design

Prospective population-based cohort study.

Setting

Western Sweden.

Participants

From a screening-based population cohort of 589 individuals, 62 (11 female) diagnosed with ADHD+DCD at mean age 6.6 years, and a comparison group of 51 population-matched (10 female) children were followed prospectively.

Outcome measures

Drawn from a clinical reassessment at age 9 years of 110 of the 113 individuals, neuropsychiatric symptoms, continuous performance test results and measures of motor function were used as predictors of outcome in linear regression models. Participants were followed in national registers up to 30–31 years of age for outcomes in adulthood. Predictors were regressed onto an adverse outcome score (range 0–7) comprising seven binary endpoints, and when applicable onto each continuous outcome separately (low educational attainment, low occupation level, psychiatric disorder, psychotropic medication prescription, sick pension, high dependence on social benefits and criminal conviction).

Results

Of the 110 individuals, 3 had died. In univariable regression onto the adverse outcome score, the strongest predictors at age 9 years were symptoms of conduct disorder, oppositional defiant disorder, ADHD and motor dysfunction, with an R2around 25%, followed by autistic traits (R2=15%) and depressive symptoms (R2=8%). Combining these six strongest predictors in a multivariable model yielded an adjusted R2=38%. Subgroup analyses were similar, except for a strong association of autistic traits with the adverse outcome score in females (n=20, R2=50%).

Conclusion

Several neurodevelopmental symptoms, including ADHD severity at age 9 years, accounted for a considerable amount of the variance in terms of adulthood adverse outcome. Broad neurodevelopmental profiling irrespective of diagnostic thresholds should inform research and clinical practice. The study highlights the importance of considering associated comorbidities and problems in ADHD.
Impact of residual risk messaging to reduce false reassurance following test-negative results from asymptomatic coronavirus (SARS-CoV-2) testing: an online experimental study of a hypothetical test
Authors: Batteux Eleonore , Bonfield Stefanie , Jones Leah Ffion , Carter Holly , Gold Natalie , Amlot Richard , Marteau Theresa , Weston Dale
Published: March 2022

Objectives

Individuals who receive a negative lateral flow coronavirus test result may misunderstand it as meaning ‘no risk of infectiousness’, giving false reassurance. This experiment tested the impact of adding information to negative test result messages about residual risk and the need to continue protective behaviours.

Design.

4 (residual risk) × 2 (post-test result behaviours) between-subjects design.

Setting.

Online.

Participants

1200 adults from a representative UK sample recruited via Prolific (12–15 March 2021).

Interventions

Participants were randomly allocated to one of eight messages. Residual risk messages were: (1) ‘Your coronavirus test result is negative’ (control); (2) message 1 plus ‘It’s likely you were not infectious when the test was done’ (current NHS Test & Trace (T&T); (3) message 2 plus ‘But there is still a chance you may be infectious’ (elaborated NHS T&T); and (4) message 3 plus infographic depicting residual risk (elaborated NHS T&T+infographic). Each message contained either no additional information or information about the need to continue following guidelines and protective behaviours.

Outcome measures

(1) Proportion understanding residual risk of infectiousness and (2) likelihood of engaging in protective behaviours (scales 1–7).

Results

The control message decreased understanding relative to the current NHS T&T message: 54% versus 71% (Adjusted Odds Ratio (AOR)=0.56 95% CI 0.34 to 0.95, p=0.030). Understanding increased with the elaborated NHS T&T (89%; AOR=3.25 95% CI 1.64 to 6.42, p=0.001) and elaborated NHS T&T+infographic (91%; AOR=5.16 95% CI 2.47 to 10.82, p<0.001) compared with current NHS T&T message. Likelihood of engaging in protective behaviours was unaffected by information (AOR=1.11 95% CI 0.69 to 1.80, χ2(1)=0.18, p=0.669), being high (M=6.4, SD=0.9) across the sample.

Conclusions

A considerable proportion of participants misunderstood the residual risk following a negative test result. The addition of a single sentence (‘But there is still a chance you may be infectious’) to current NHS T&T wording increased understanding of residual risk.

Trial registration number

OSF: https://osf.io/byfz3/
Usual source of primary care and preventive care measures in the COVID-19 pandemic: a nationwide cross-sectional study in Japan
Authors: Aoki Takuya , Fujinuma Yasuki , Matsushima Masato
Published: March 2022

Objectives

To assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan.

Design

Nationwide cross-sectional study.

Setting

Japanese general adult population.

Participants

1757 adult residents.

Primary outcome measures

Fourteen preventive care measures aggregated the overall screening, immunisation and counselling composites.

Results

Depression screening, zoster vaccination and tetanus vaccination had low implementation rates even among participants with a usual source of primary care. After adjustment for possible confounders, having a usual source of primary care was positively associated with all preventive care composites. Primary care performance assessed by the Japanese version of Primary Care Assessment Tool Short Form was also dose dependently associated with an increase in all composites. Results of the sensitivity analyses using a different calculation of preventive care composite were similar to those of the primary analyses.

Conclusions

Receipt of primary care, particularly high-quality primary care, contributed to increased preventive care utilisation even during the COVID-19 pandemic. However, the rate of mental health screening in primary care was at a very low level. Therefore, addressing mental health issues should be a major challenge for primary care providers during and after the pandemic.
AlzEye: longitudinal record-level linkage of ophthalmic imaging and hospital admissions of 353 157 patients in London, UK
Authors: Wagner Siegfried Karl , Hughes Fintan , Cortina-Borja Mario , Pontikos Nikolas , Struyven Robbert , Liu Xiaoxuan , Montgomery Hugh , Alexander Daniel C , Topol Eric , Petersen Steffen Erhard , Balaskas Konstantinos , Hindley Jack , Petzold Axel , Rahi Jugnoo S , Denniston Alastair K , Keane Pearse A
Published: March 2022

Purpose

Retinal signatures of systemic disease (‘oculomics’) are increasingly being revealed through a combination of high-resolution ophthalmic imaging and sophisticated modelling strategies. Progress is currently limited not mainly by technical issues, but by the lack of large labelled datasets, a sine qua non for deep learning. Such data are derived from prospective epidemiological studies, in which retinal imaging is typically unimodal, cross-sectional, of modest number and relates to cohorts, which are not enriched with subpopulations of interest, such as those with systemic disease. We thus linked longitudinal multimodal retinal imaging from routinely collected National Health Service (NHS) data with systemic disease data from hospital admissions using a privacy-by-design third-party linkage approach.

Participants

Between 1 January 2008 and 1 April 2018, 353 157 participants aged 40 years or older, who attended Moorfields Eye Hospital NHS Foundation Trust, a tertiary ophthalmic institution incorporating a principal central site, four district hubs and five satellite clinics in and around London, UK serving a catchment population of approximately six million people.

Findings to date

Among the 353 157 individuals, 186 651 had a total of 1 337 711 Hospital Episode Statistics admitted patient care episodes. Systemic diagnoses recorded at these episodes include 12 022 patients with myocardial infarction, 11 735 with all-cause stroke and 13 363 with all-cause dementia. A total of 6 261 931 retinal images of seven different modalities and across three manufacturers were acquired from 1 54 830 patients. The majority of retinal images were retinal photographs (n=1 874 175) followed by optical coherence tomography (n=1 567 358).

Future plans

AlzEye combines the world’s largest single institution retinal imaging database with nationally collected systemic data to create an exceptional large-scale, enriched cohort that reflects the diversity of the population served. First analyses will address cardiovascular diseases and dementia, with a view to identifying hidden retinal signatures that may lead to earlier detection and risk management of these life-threatening conditions.
Association between maternal perceived capacity in life and physical punishment of teenage children: a longitudinal analysis of a population-based cohort in Tokyo, Japan
Authors: Nakanishi Miharu , Yamasaki Syudo , Niimura Junko , Endo Kaori , Nakajima Naomi , Stanyon Daniel , Baba Kaori , Oikawa Nao , Hosozawa Mariko , Ando Shuntaro , Hiraiwa-Hasegawa Mariko , Kasai Kiyoto , Nishida Atsushi
Published: March 2022

Objectives

Perceived capacity denotes a subjective sense of having resources to cope with strains and hardships, and hence maternal perceived capacity may be protective against risk factors for child maltreatment. This study investigated the longitudinal association between maternal perceived capacity in life and child maltreatment.

Design

This population-based longitudinal study used self-reported questionnaires from the Tokyo Teen Cohort study (TTC), a large community-based cohort study conducted in Japan between 2014 and 2019.

Setting

Mother–child pairs were randomly recruited from the resident registries of three municipalities in Tokyo, Japan.

Methods

A total of 2515 mothers participated. Mothers’ perceived capacity in life was evaluated using the self-reported TTC wave 2 survey when their children were 12 years old. Mothers rated the extent to which they had capacity in terms of time, finance, physical well-being, mental well-being and life in general. Physical punishment, which is linked to more severe childhood maltreatment, was assessed using a question about the use of physical punishment at the wave 3 survey when children were 14 years old.

Results

After controlling for baseline covariates (including maternal social support, age, marital status, annual household income, educational attainment, child’s age, gender, sibling and birth order, and behavioural difficulties), higher perceived capacity in finance (OR 0.95, 95% CI 0.90 to 0.99, p=0.026) and mental well-being (OR 0.93, 95% CI 0.88 to 0.98, p=0.005) were associated with less frequent use of physical punishment with 14-year-old children.

Conclusions

Maternal perceived capacity in finance and mental well-being may decrease the risk of frequent use of physical punishment at the 2-year follow-up. Child maltreatment prevention strategies should aim to empower mothers and promote their perceived capacity in financial management and mental health.
Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial
Authors: Beijers Rosanne JHCG , van Iersel Lieke E J , Schuurman Lisanne T , Hageman Robert J J , Simons Sami O , van Helvoort Ardy , Gosker Harry R , Schols Annemie MWJ
Published: March 2022

Introduction

Physical and mental health are often affected in chronic obstructive pulmonary disease (COPD) adversely affecting disease course and quality of life. Abnormalities in whole body and cellular energy metabolism, dietary and plasma nutrient status and intestinal permeability have been well established in these patients as systemic determinants of functional decline and underexplored treatable traits. The aim of this study is to investigate the efficacy of 1 year targeted nutrient supplementation on physical activity level and health-related quality of life in patients with COPD.

Methods and analysis

This study is a single-centre randomised, placebo-controlled, double-blind trial in 166 patients with COPD recruited from multiple hospitals in the Netherlands. The intervention group will receive a multinutrient supplement, including vitamin D, tryptophan, long-chain polyunsaturated fatty acids and prebiotic dietary fibres as main components (94 kCal per daily dose). The control group will receive an isocaloric isonitrogenous placebo. Both groups will ingest one portion per day for at least 12 months and will additionally receive counselling on healthy lifestyle and medical adherence over the course of the study. Coprimary outcomes are physical activity assessed by triaxial accelerometry and health-related quality of life measured by the EuroQol-5 dimensions questionnaire. Secondary outcomes are cognitive function, psychological well-being, physical performance, patient-reported outcomes and the metabolic profile assessed by body composition, systemic inflammation, plasma nutrient levels, intestinal integrity and microbiome composition. Outcomes will be measured at baseline and after 12 months of supplementation. In case patients are hospitalised for a COPD exacerbation, a subset outcome panel will be measured during a 4-week recovery period after hospitalisation.

Ethics and dissemination

This study was approved by the local Ethics Committee of Maastricht University. Subjects will be included after written informed consent is provided. Study outcomes will be disseminated through presentations at (inter)national conferences and through peer-reviewed journals.

Trial registration

NCT03807310.
Getting palliative medications right across the contexts of homes, hospitals and hospices: protocol to synthesise scoping review and ethnographic methods in an activity theory analysis
Authors: Yardley Sarah , Francis Sally-Anne , Dean Franklin Bryony , Ogden Margaret , Kajamaa Anu , Mattick Karen
Published: March 2022

Introduction

Prescribing and medication use in palliative care is a multistep process. It requires systems coordination and is enacted through activities of patients, informal carers and professionals. This study compares practice to idealised descriptions of what should happen; identifying when, how and why process disturbances impact on quality and safety. Our objectives are to:

Document an intended model (phase 1, scoping review).

Refine the model with study of practice (phase 2, ethnography).

Use the model to pinpoint ‘hot’ (viewed as problematic by participants) and ‘cold’ spots (observed as problematic by researchers) within or when patients move across three contexts-hospice, hospital and community (home).

Create learning recommendations for quality and safety targeted at underlying themes and contributing factors.

Methods and analysis

The review will scope Ovid Medline, CINAHL and Embase, Google Scholar and Images—no date limits, English language only. The Population (palliative), Concept (medication use), Context (home, hospice, hospital) framework defines inclusion/exclusion criteria. Data will be extracted to create a model illustrating how processes ideally occur, incorporating multiple steps of typical episodes of prescribing and medication use for symptom control. Direct observations, informal conversations around acts of prescribing and medication use, and semistructured interviews will be conducted with a purposive sample of patients, carers and professionals. Drawing on activity theory, we will synthesise analysis of both phases. The analysis will identify when, how and why activities affect patient safety and experience. Generating a rich multivoiced understanding of the process will help identify meaningful targets for improvement.

Ethics and dissemination

Ethical approval granted by the Camden & Kings Cross NHS Regional Ethics Committee (21/LO/0459). A patient and public involvement (PPI) coinvestigator, a multiprofessional steering group and a PPI engagement group are working with the research team. Dissemination of findings is planned through peer-reviewed publications and a stakeholder (policymakers, commissioners, clinicians, researchers, public) report/dissemination event.
Emergency department utilisation by homeless children in Dublin, Ireland: a retrospective review
Authors: O' Brien Niamh , Quinn Nuala , Joyce Birgitta , Bedford Helen , Crushell Ellen
Published: March 2022

Introduction

Despite increasing prevalence, European family homelessness remains under-researched.

Methods

A retrospective review was performed of homeless children attending a paediatric emergency department in Dublin, Ireland, from 1 January 2017 to 31 December 2020. Comparison was made with a random cohort of 1500 non-homeless paediatric attendances in 2019. Homelessness was defined using the European Typology of Homelessness and Housing Exclusion, including those with addresses of no fixed abode, government homeless accommodation and certain residential settings. The objectives were to compare presentations between homeless and non-homeless children. We were interested in determining differences regarding demographics, healthcare utilisation, clinical presentation and outcomes.

Results

Of 197 437 attendances 3138 (1.59%) were homeless. Compared with the non homeless, homeless children were less likely to be ethnically Irish (37.4% vs 74.6%, p<0.001) or have been born in Ireland (82.3% vs 96.2%, p<0.001). Irish Travellers (3% vs 0.8%), Roma (22.5% vs 2.4%) and black (21.1% vs 4.2%) ethnicities were over-represented (p<0.001) in the homeless cohort.

Homeless children were younger (age <12 months: 26% vs 16%; p<0.001), less likely to be fully vaccinated (73.6% vs 81.9%, p<0.001) and have registered general practitioners (89.7% vs 95.8%, p<0.001). They were more likely to represent within 2 weeks (15.9% vs 10.5%, p<0.001), and use ambulance transportation (13.2% vs 6.7%, p<0.001). Homeless children had lower acuity presentations (triage category 4–5: 47.2% vs 40.7%, p<0.001) and fewer admissions (5.9% vs 8.4%, p<0.001) than non-homeless children.

Discussion

Infants, Irish Travellers, Roma and black ethnicities were over-represented in homeless presentations. Homeless children had increased reliance on emergency services for primary healthcare needs.
Management of patent ductus arteriosus in very preterm infants in England and Wales: a retrospective cohort study
Authors: Al-Turkait Asma , Szatkowski Lisa , Choonara Imti , Ojha Shalini
Published: March 2022

Objective

To describe the diagnosis and treatment of patent ductus arteriosus (PDA) in infants born at <32 weeks’ gestational age (GA) in England and Wales between 2010 and 2017.

Study design

Retrospective cohort study using routinely recorded data from the National Neonatal Research Database of infants born at <32 weeks admitted to neonatal units in England and Wales from 2010 to 2017.

Results

Among 58 108 infants born at <32 weeks’ GA, 28.3% (n=16 440) had a PDA diagnosed clinically or with echocardiographic confirmation. Of these, 34.8% (n=5721; 9.8% of total <32 weeks’ infants included) had PDA treatment including 7.6% (n=1255) with indomethacin, 23.5% (n=3857) with ibuprofen and 5.6% (n=916) with surgical closure. The highest incidence of PDA was among infants born at 24 and 25 weeks’ GA (70.2% and 70.8%, respectively), decreasing to 6.1% among infants born at 31 weeks’ GA. The percentage of infants with a PDA increased over the study period (25.5% in 2010 to 28.5% in 2017). The percentage of infants who received ibuprofen or indomethacin or had PDA surgery decreased from 41.3% in 2010 to 33.7% in 2017, with an increase in use of ibuprofen from 20.2% to 27.3% while use of indomethacin decreased from 20.0% to 8.8%. Surgical closure of PDA decreased from 9.1% to 3.0%. Indomethacin was used for median (IQR) 3 (2–5) days while ibuprofen was given for 3 (2-4) days, at a median of 8 and 10 days after birth, respectively; surgical treatment was used later at 33 (24–45) days after birth.

Conclusions

Ibuprofen is the preferred drug and surgical interventions are becoming less frequent for PDA closure among very preterm infants in England and Wales.

Trial registration number

NCT03773289.
Endovascular thrombectomy for anterior circulation stroke beyond 6 hours of onset in Sweden 2015 to 2020: rates and outcomes in a nationwide register-based study
Authors: Ullberg Teresa , von Euler Mia , Wester Per , Arnberg Fabian , Norrving Bo , Andersson Tommy , Wassélius Johan
Published: March 2022

Background

Endovascular thrombectomy (EVT) for ischemic stroke (IS) beyond 6 hours has been proven effective in randomized controlled trials. We present data on implementation and outcomes for EVT beyond 6 hours in Sweden.

Methods

We included all cases of anterior circulation IS caused by occlusion of the intracranial carotid artery, and the M1 or M2 segment of the middle cerebral artery, registered in two nationwide quality registers for stroke in 2015–2020. Three groups were defined from onset-to-groin-puncture (OTG) time: early window (<6 hours), late window (6–24 hours) known onset, late window last seen well (LSW). Favorable outcome (modified Rankin Scale (mRS) 0–2) and all-cause mortality at 90 days were the main outcomes, and symptomatic intracerebral hemorrhage (sICH) was the safety outcome.

Results

Late window EVT increased from 0.3% of all IS in 2015 to 1.8% in 2020, and from 17.4% of all anterior circulation EVTs in 2015 to 32.9% in 2020. Of 2199 patients, 76.9% (n=1690) were early window EVTs and 23.1% late window EVTs (n=509; 141 known onset, 368 LSW). Median age was 73 years, and 46.2% were female, with no differences between groups. Favorable outcome did not differ between groups (early window 42.4%, late window known onset 38.9%, late window LSW 37.3% (p=0.737)) and remained similar when adjusted for baseline differences. sICH rates did not differ (early window 4.0%, late window known onset 2.1%, late window LSW 4.9% (p=0.413)).

Conclusion

Late window EVTs have increased substantially over time, and currently account for one third of anterior circulation treatments. Early and late window patients had similar outcomes.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be superior to resuscitative thoracotomy (RT) in patients with traumatic brain injury (TBI)
Authors: Brenner Megan , Zakhary Bishoy , Coimbra Raul , Morrison Jonathan , Scalea Thomas , Moore Laura J , Podbielski Jeanette , Holcomb John B , Inaba Kenji , Cannon Jeremy W , Seamon Mark , Spalding Chance , Fox Charles , Moore Ernest E , Ibrahim Joseph Abdellatif
Published: March 2022

Background

The effects of aortic occlusion (AO) on brain injury are not well defined. We examined the impact of AO by resuscitative endovascular balloon occlusion of the aorta (REBOA) and resuscitative thoracotomy (RT) on outcomes in the setting of traumatic brain injury (TBI).

Methods

Patients sustaining TBI who underwent RT or REBOA in zone 1 (thoracic aorta) from September 2013 to December 2018 were identified. The indication for REBOA or RT was hemodynamic collapse due to hemorrhage below the diaphragm. Primary outcomes included mortality and systemic complications.

Results

282 patients underwent REBOA or RT. Of these, 76 had mild TBI (40 REBOA, 36 RT) and 206 sustained severe TBI (107 REBOA, 99 RT). Overall, the mean (±SD) age was 42±17 years, with an Injury Severity Score (ISS) of 40±17 and mean systolic blood pressure (SBP) at the time of REBOA or RT of 81±34 mm Hg. REBOA patients had a mean SBP at the time of AO of 78.39±29.45 mm Hg, whereas RT patients had a mean SBP of 83.18±37.87 mm Hg at the time of AO (p=0.24). 55% had ongoing cardiopulmonary resuscitation (CPR) at the time of AO, and the in-hospital mortality was 86%. Binomial logistic regression controlling for TBI severity, age, ISS, SBP at the time of AO, crystalloid infusion, and CPR during AO demonstrated that the odds of mortality are 3.1 times higher for RT compared with REBOA. No significant differences were found in systemic complications between RT and REBOA.

Discussion

Patients with TBI who receive REBOA may have improved survival, but no difference in systemic complications, compared with patients who receive RT for the same indication. Although some patients are receiving RT prior to arrest for extrathoracic hemorrhagic shock, these results suggest that REBOA should be considered as an alternative to RT when RT is chosen for the sole purpose of resuscitation in the setting of TBI.

Level of evidence

4.
Socioeconomic factors associated with helmet use in pediatric ATV and dirt bike trauma
Authors: Vittetoe Kelly L , Allen Jackson H , Unni Purnima , McKay Katlyn G , Yengo-Kahn Aaron M , Ghani Owais , Mummidi Pradeep , Greeno Amber L , Bonfield Christopher M , Lovvorn Harold N "Bo"
Published: March 2022

Objectives

Recreational off-road vehicle crashes can produce severe injury and death among children, often from head trauma sustained while riding unhelmeted. Although required for competition, recreational riders commonly forego helmets. This study aimed to identify socioeconomic factors associated with unhelmeted injuries among children riding all-terrain vehicles (ATVs) and dirt bikes recreationally, thus informing injury prevention efforts.

Methods

A retrospective review was completed of patients younger than 18 years who presented after recreational ATV or dirt bike crash to a single American College of Surgeons-verified level 1 pediatric trauma center (2010–2019). Demographic, injury, and outcome data were collected. US Census data regarding median and per capita income, poverty prevalence, and scholastic graduation rates were recorded for each patient’s home county. Relationships between helmet use at the time of injury, demographics, and socioeconomic variables were examined.

Results

The cohort comprised 680 injured recreational ATV (n=510; 75%) and dirt bike (170; 25%) riders. Unhelmeted riders (n=450) were significantly older (median age 13 vs 11 years; p=0.008) and more often rode ATVs (n=399). Significantly greater percentages of females (77.9%; p<0.001) and passengers (89.5%; p<0.001) were unhelmeted at the time of injury. Residents of counties with lower median and per capita income, higher poverty prevalence, and lower high school and college graduation rates were significantly more likely to be unhelmeted at the time of their crash (p=0.003). In multivariable analysis, unhelmeted injuries were independently associated with ATV use (OR=6.757; p<0.0001), passenger status (OR=6.457; p<0.0001), and older age (OR=1.219; p<0.0001).

Conclusion

In children, ATV use, passenger status, and older age associated independently with unhelmeted riding in recreational vehicle crash. Residence in a county with both lower median income and scholastic graduation rates associated with unhelmeted crashes, and lower median income significantly predicted unhelmeted crashes. This study revealed socioeconomic factors that identify communities with greatest need for injury prevention initiatives.

Level of evidence

III—retrospective comparative epidemiological study.