bluuebunny/crossref_metadata_2025 huggingface dataset:
French nurses’ and allied health professionals’ perception of research in their fields: A descriptive qualitative study
Authors: Ricci Laetitia , Beguinet Mélanie , Guillemin Francis , Klein Sylvie
Published: September 2021

Aim

To gather information from nurses and allied health professionals in the French context of the emergence of research in the field so as to inform the development of a new tool: The research in nursing and allied health sciences’ Ideas Generator (GénI) capable of sustaining the identification of research ideas from professionals in the field.

Background

In many countries, research in nursing and allied health sciences remains underdeveloped.

Introduction

Before developing the Ideas Generator tool, it was essential to explore professionals’ basis of reference in providing care, then investigate (1) their representation of research in this field of science and (2) their perception of needs for and obstacles to starting a research process.

Methods

The qualitative research design used focus groups. The study population included 24 participants naive to research in four hospitals in eastern France (13 nurses and 11 allied health professionals). Thematic analysis was used to analyze the data. The study was reported in compliance with the consolidated criteria for reporting qualitative research criteria.

Findings

Professionals used tacit knowledge and their experiences to address care, but the culture of scientific evidence was clearly missing (lack of knowledge of the origin of care guidelines, few bibliographic skills). Participation in a research process could hardly be envisaged without a supervised collaboration with a physician. Research was perceived not to be part of professionals’ culture. They self‐censured for lack of methodological competencies.

Discussion

Findings underlined some leverage, obstacles, and need to consider to generate a stimulation in the field, especially in countries where such research is still in its infancy.

Implication for nursing, health, and education policy

Strengthening the field of nursing and allied health research is essential to extend the skills of nurses and allied health workers and to improve the quality of patient care by taking into account results from the literature. The Ideas Generator tool will be implemented to sustain learning the skills of research through education and training.
Death Penalty Statutes and Murder Rates: Evidence From Synthetic Controls
Authors: Parker Brett
Published: September 2021

Public debates over the death penalty in the U.S. have long focused on the punishment's putative deterrent effect. Unsurprisingly, numerous scholars have sought to determine (1) whether the penalty in fact prevents murders, and (2) how many murders it prevents. However, these efforts have deployed a fairly homogeneous set of methodological techniques—primarily OLS and two‐stage least squares with instrumental variables. This article breaks from that tradition by using synthetic controls to assess the deterrent capacity of capital punishment. Applying this technique using seven states that recently abolished the death penalty and 29 states that retained the punishment during the same period, I find no evidence that the presence of a capital punishment statute in a state is sufficient to deter murders. These results are robust to numerous alternative specifications; they also persist when I use stranger homicides—which are theoretically more susceptible to deterrence—as the dependent variable.
The Impact of Employers' Liability on 19th‐Century U.K. Coalmining Fatalities
Authors: Veljanovski Cento
Published: September 2021

The effects of the increase in the employers' liability on work accidents is underresearched. This article investigates the impact using time series analysis of changes brought about by the Employers' Liability Act 1880 and Workmens' Compensation Act 1897 on the U.K. coal mining fatality rates and wages over the period 1873 to 1914. The statistical analysis finds little evidence that these reforms affected coal mining fatality rates. There is some statistical evidence that this may have been due to offsetting wage adjustments as the employers were required to compensate those injured and the survivors of deceased miners.
Prevention of Saprolegniasis in rainbow trout (Oncorhynchus mykiss) eggs using oregano (Origanum onites) and laurel (Laurus nobilis) essential oils
Authors: Özdemir Rahmi Can , Taştan Yiğit , Güney Kerim
Published: September 2021

The present study investigated the antifungal effects of essential oils of oregano (Origanum onites) and laurel (Laurus nobilis) on Saprolegniasis, a disease that occurs in rainbow trout eggs during the incubation period. Oregano and laurel were ground after drying, and essential oils were obtained by water distillation method using a Clevenger apparatus. The essential oils were added to potato dextrose agar (PDA) at the rates of 1–1000 ppm, and the minimum inhibitory concentration (MIC) was determined as 250 ppm whereas the minimum lethal concentration (MLC) was determined to be 500 ppm for both plants. In the in vivo trials, fertilized eggs were treated with predetermined doses either by bathing during water hardening and incubation period or only during incubation period, and death rates were monitored during embryological development. The best larvae hatching rate was determined in 500 ppm oregano and 500 ppm laurel groups treated during water hardening plus daily as 82.11% and 79.87%, respectively. According to the results, it was determined that oregano and laurel essential oils exhibited better results in all doses compared with the negative control group, and 500 ppm dose had a better effect than the positive control group treated with formalin.
Household savings and subjective wellbeing: Evidence from China
Authors: Chen Fuzhong , Jiang Guohai , Gu Mengyi
Published: September 2021

The purpose of this paper is to investigate the association between household savings and subjective wellbeing (SWB) using data from the China Household Finance Survey conducted in 2011, 2013, 2015, and 2017. The results indicate that the association between household savings and SWB is nonlinear, showing an inverted U‐shape, which implies that there may be an optimal amount of household savings to maximize SWB. Furthermore, this study explores the heterogeneity of different groups and finds that the optimal amounts of household savings vary among subsamples in terms of region, income, age, and risk attitude. These findings have implications for consumer educators and policymakers when they help consumers to make rational saving decisions.
Predictors for lower urinary tract symptoms in patients underwent radical prostatectomy: implications for postoperative nursing care
Authors: Yilin Zeng , Fenglian Jiang , Yuanling Wu , Chunye Guo , Shuang Liu , Peizhen Liu
Published: September 2021

Aims and Objectives

The aim of this study was to evaluate the risk factors for lower urinary tract symptoms in prostate cancer patients underwent radical prostatectomy, thus providing therapeutic evidence for post‐operative nursing.

Background

Prostate cancer is one of the most commonly diagnosed male malignancy in recent years. With surgical treatments, patients with prostate cancer indeed have satisfying survival rate. However, the presence of postprostatectomy lower urinary tract symptoms which affect quality of life significantly is more worthy of attention.

Design

Patients underwent surgical therapies were followed up and the symptoms were recorded.

Methods

A total of 65 prostate cancer patients underwent radical prostatectomy from January 2019 to October 2020, and pathologically diagnosed with prostate cancer were enrolled in our study. These patients were followed up 3 months after surgery and their medical records were retrospectively collected and analysed. Results were reported according to the STROBE Statement.

Results

The incidence of post‐operative lower urinary tract symptoms at 3 months after surgery is similar to that of pre‐operation. Univariate and multivariate analyses revealed that the independent risk factor for postprostatectomy lower urinary tract symptoms is body mass index, whereas pelvic floor muscle exercise is a protective factor.

Conclusions

The incidence of postprostatectomy lower urinary tract symptoms is non‐negligible, which significantly affects quality of life. Body mass index is found as an independent risk factor for postprostatectomy lower urinary tract symptoms, while pelvic floor muscle exercise is a strong protector.

Relevance to clinical practice

Patients with prostate cancer would benefit from post‐operative pelvic floor muscle exercise. These findings contribute to tailor post‐operative nursing strategy.
Effects of zinc dosage and particle size on gut morphology, tight junctions and TNF‐α expression in broiler breeder hens
Authors: Barzegar Masoud , Zaghari Mojtaba , Zhandi Mahdi , Sadeghi Mostafa
Published: September 2021

This study was performed to evaluate the effects of different amounts and particle size of zinc oxide (ZnO) on villus height (VH), villus width (VW), crypt depth (CD) and VH to CD ratio (VH: CD), and expression of zonula occludens‐1 (ZO‐1), occludin (OC) and tumour necrosis factor‐α (TNF‐α) in broiler breeders. A total of 350 (Ross 308) broiler breeder hens of 54 weeks randomly assigned to seven treatments, included control basal diet (C) without added Zn, C+ 100, and 130 mg Zn per kg of diet from Large (L) (100–1000 nm) and Small (S) (<100 nm) particle size ZnO (LZnO100 and 130; SZnO100 and 130), C and SZnO100 challenged with lipopolysaccharide (C+LPS and SZnO100+LPS). Each diet was fed to five replicates consisting of ten birds each. The middle part of the duodenum, jejunum and ileum was used for morphological assessments. To assess the gene expression of ZO‐1, OC and TNF‐α in the jejunum samples were excised. Results showed that the supplementing 130 ppm SZnO increased VH:CD in the duodenum (p < 0.05). VW in the duodenum and all the evaluated morphometric indices in jejunum and ileum were not affected by the dietary treatment (p > 0.05). ZO‐1 mRNA abundance in C+LPS group compared to SZnO100+LPS group was significantly decreased and increased by LPS and SZnO100 respectively. The SZnO‐100 increased OC gene expression in compare to C+LPS group. The expression of TNF‐α in C+LPS treatment was higher than other groups (p < 0.05). The lowest and the highest litter moisture and foot‐pad dermatitis (FPD) were observed in LZnO‐130 and C treatments respectively (p < 0.05). Improving the physical properties of ZnO affect on VH:CD. Broiler breeder diet with ZnO enhance ZO‐1, OC and mitigate TNF‐α gene expression in jejunum maintenance of gut health in broiler breeders.
The effects of earplugs and eye masks on sleep quality of patients admitted to coronary care units: A randomised clinical trial
Authors: Khoddam Homeira , Maddah Seyedmahrokh A. , Rezvani Khorshidi Sommayeh , Zaman Kamkar Mohammad , Modanloo Mahnaz
Published: September 2021

Sleep is an essential need for patients admitted to coronary care units. The present clinical trial aimed to determine the effect of using eye masks and earplugs on the sleep quality of patients with coronary heart disease (CHD). A total of 68 eligible patients with CHD were randomly allocated into four groups of 17 (control, eye masks, earplugs, and eye masks with earplugs). All three interventions were performed during the night from 10:00 p.m. to 7:00 a.m. the next day. The outcomes were the quality of sleep, measured by the Verran and Snyder‐Halpern (VSH) Sleep Scale, and the urinary levels of nocturnal melatonin and cortisol, measured by urine samples taken during the night (from 10:00 p.m. to 7:00 a.m.). The study outcomes were measured on the third and fourth days. Sleep disturbance was statistically significantly lower in patients with earplugs (visual analogue scale mean difference [MD]: 74.31 mm, SE: 11.34, p = 0.001). Sleep effectiveness was statistically significantly higher in patients with eye mask (MD: 36.88 mm, SE: 8.75, p = 0.001). The need for sleep supplementation was statistically significantly lower in patients with eye masks (MD: 39.79 mm, SE: 7.23, p = 0.001). There was a significant difference in melatonin levels between eye masks and the control group (p = 0.03). For urinary cortisol levels, there were significant differences between eye masks and the control group (p = 0.007), earplugs and the control group (p = 0.001), and eye masks with earplugs and the control group (p = 0.006). The mean scores for comfort, effectiveness, and ease of use were highest for the group that used eye masks (2.88, 2.94, and 3.18, respectively). As a result, all three interventions improved the sleep quality of patients. However, the interventions had different effects on the three dimensions of the VSH Sleep Scale, as well as the urinary levels of cortisol and melatonin.
Genomic and functional evidence reveals convergent evolution in fishes on the Tibetan Plateau
Authors: Yang Liandong , Wang Ying , Sun Ning , Chen Juan , He Shunping
Published: September 2021

High‐altitude environments are strong drivers of adaptive evolution in endemic organisms. However, little is known about the genetic mechanisms of convergent adaptation among different lineages, especially in fishes. There are three independent fish groups on the Tibetan Plateau: Tibetan Loaches, Schizothoracine fishes and Glyptosternoid fishes; all are well adapted to the harsh environmental conditions. They represent an excellent example of convergent evolution but with an unclear genetic basis. We used comparative genomic analyses between Tibetan fishes and fishes from low altitudes and detected genomic signatures of convergent evolution in fishes on the Tibetan Plateau. The Tibetan fishes exhibited genome‐wide accelerated evolution in comparison with a control set of fishes from low altitudes. A total of 368 positively selected genes were identified in Tibetan fishes, which were enriched in functional categories related to energy metabolism and hypoxia response. Widespread parallel amino acid substitutions were detected among the Tibetan fishes and a subset of these substitutions occurred in positively selected genes associated with high‐altitude adaptation. Functional assays suggested that von Hippel‐Lindau (VHL) tumour suppressor genes from Tibetan fishes enhance hypoxia‐inducible factor (HIF) activity convergently under hypoxia compared to low‐altitude fishes. The results provide genomic and functional evidence supporting convergent genetic mechanisms for high‐altitude adaptation in fishes on the Tibetan Plateau.
Alternative developmental and transcriptomic responses to host plant water limitation in a butterfly metapopulation
Authors: Kahilainen Aapo , Oostra Vicencio , Somervuo Panu , Minard Guillaume , Saastamoinen Marjo
Published: September 2021

Predicting how climate change affects biotic interactions poses a challenge. Plant–insect herbivore interactions are particularly sensitive to climate change, as climate‐induced changes in plant quality cascade into the performance of insect herbivores. Whereas the immediate survival of herbivore individuals depends on plastic responses to climate change‐induced nutritional stress, long‐term population persistence via evolutionary adaptation requires genetic variation for these responses. To assess the prospects for population persistence under climate change, it is therefore crucial to characterize response mechanisms to climate change‐induced stressors, and quantify their variability in natural populations. Here, we test developmental and transcriptomic responses to water limitation‐induced host plant quality change in a Glanville fritillary butterfly (Melitaea cinxia) metapopulation. We combine nuclear magnetic resonance spectroscopy on the plant metabolome, larval developmental assays and an RNA sequencing analysis of the larval transcriptome. We observed that responses to feeding on water‐limited plants, in which amino acids and aromatic compounds are enriched, showed marked variation within the metapopulation, with individuals of some families performing better on control and others on water‐limited plants. The transcriptomic responses were concordant with the developmental responses: families exhibiting opposite developmental responses also produced opposite transcriptomic responses (e.g. in growth‐associated transcripts). The divergent responses in both larval development and transcriptome are associated with differences between families in amino acid catabolism and storage protein production. The results reveal intrapopulation variability in plasticity, suggesting that the FinnishM.cinxiametapopulation harbours potential for buffering against drought‐induced changes in host plant quality.
Closed Reduction for the Treatment of Grade IV Supination‐External Rotation Fracture of the Ankle Joint: A Retrospective Analysis
Authors: Zhao Hong‐zhou , Fan Tong‐shun , Wang Shu‐li , Liu Li‐min , Liu Ming‐jun , Xing Jia‐hui
Published: September 2021

Objective

To investigate the curative effect of closed reduction and external fixation in the treatment of grade IV supination‐external rotation fractures of the ankle joint.

Methods

Fifty‐six patients treated with closed reduction and external fixation from February 2016 to March 2020 were included in this retrospective study, all with sprains. After receiving nerve block anesthesia, the patient underwent closed reduction under C‐arm fluoroscopy, and the ankle joint was fixed in a dorsiflexion‐inversion position with casting and splints after the end of the fracture met the reduction standard by fluoroscopy. One week and four weeks after the reduction treatment, oblique axial and coronal MR scans of the ankle joint were performed to determine the degree of injury and healing of the inferior tibiofibular syndesmosis; anteroposterior and lateral X‐rays of the ankle joint (including the ankle acupoints) were regularly reviewed to observe the fracture alignment and healing. Combined with the images and physical examination, the patients were instructed to undergo ankle weight‐bearing rehabilitation training when they met the clinical healing standard, and at the last follow‐up, the Mazur ankle evaluation and grading system were used for evaluation. After the reduction, the images were evaluated according to the Leeds standard. The image healing of fracture was evaluated by callus growth criteria.

Results

The follow‐up period of patients ranged from 11 to 58 months, with an average of 26.8 months. The clinical healing time was (8.51 ± 2.12) weeks. The excellent and good rating after reduction was 82.1%, and the excellent and good rating during clinical fracture healing was 73.2%, according to the Leeds imaging evaluation. According to the Mazur ankle evaluation and grading system, the excellent and good rating was 75.0%. Pairwise comparison of callus images at 4, 6 and 12 weeks showed statistically significant differences (P < 0.05), suggesting callus growth at different time periods. A total of 56 patients had anterior inferior tibial fibular ligament (AITFL) injuries (grade II‐III), among which 11 patients had AITFL injuries combined with grade II injuries of the interosseous ligament (IOL) and 4 patients had AITFL injuries combined with grade III injuries of the IOL.

Conclusions

Most of the patients with grade IV supination‐external rotation fracture of the ankle joint had good prognosis after closed reduction and plaster combined with splint fixation. For patients with IOL injury who had poor prognosis, open reduction and internal fixation therapy is appropriate.
A Transient Microsphere Model for Nonlinear Viscoelasticity in Dynamic Polymer Networks
Authors: Lamont Samuel , Vernerey Franck J.
Published: September 2021

Viscoelastic material behavior in polymer systems largely arises from dynamic topological rearrangement at the network level. In this paper, we present a physically motivated microsphere formulation for modeling the mechanics of transient polymer networks. By following the directional statistics of chain alignment and local chain stretch, the transient microsphere model (TMM) is fully anisotropic and micro-mechanically based. Network evolution is tracked throughout deformation using a Fokker–Planck equation that incorporates the effects of bond creation and deletion at rates that are sensitive to the chain-level environment. Using published data, we demonstrate the model to capture various material responses observed in physical polymers.
The Dark Side of Modularity: How Decomposing Problems can Increase System Complexity
Authors: Topcu Taylan G. , Mukherjee Suparna , Hennig Anthony I , Szajnfarber Zoe
Published: September 2021

Decomposition is a dominant design strategy because it enables complex problems to be broken up into loosely-coupled modules that are easier to manage and can be designed in parallel. However, contrary to widely held expectations, we show that complexity can increase substantially when natural system modules are fully decoupled from one another to support parallel design. Drawing on detailed empirical evidence from a NASA space robotics field experiment we explain how new information is introduced into the design space through three complexity addition mechanisms of the decomposition process: interface creation, functional allocation, and second order effects. These findings have important implications for how modules are selected early in the design process and how future decomposition approaches should be developed. Although it is well known that complex systems are rarely fully decomposable and that the decoupling process necessitates additional design work, the literature is predominantly focused on reordering, clustering, and/or grouping based approaches to define module boundaries within a fixed system representation. Consequently, these approaches are unable to account for the (often significant) new information that is added to the design space through the decomposition process. We contend that the observed mechanisms of complexity growth need to be better accounted for during the module selection process in order to avoid unexpected downstream costs. With this work we lay a foundation for valuing these complexity-induced impacts to performance, schedule and cost, earlier in the decomposition process.
Loss Characterization of Advanced VIGV Configurations With Adjustable Blade Geometry
Authors: Frank Roman G. , Wacker Christian , Niehuis Reinhard
Published: September 2021

Variable inlet guide vanes (VIGV) are the main control element to adjust the flow rate of industrial centrifugal compressors by customized pre-swirl in the inlet plane of the impeller. The efficient working range of VIGVs is however restricted due to open flow separation occurring at critical stagger angles. In order to overcome the narrow limitations of current blade geometries and to enhance the operating range of the compressor, split blades consisting of a separate front and tail blade segment proved to be particularly promising in previous linear-cascade measurements. Each blade segment is thereby individually staggered. This enables a gradual flow deflection along the chord length. Secondary flow losses, however, were not considered in the previous investigations with linear cascades. To highlight the potential of the split blade concept under more application-oriented conditions including all relevant flow effects, highly resolved field measurements were conducted in the wake of annular VIGVs. Four different blade configurations, a customary reference case and three variations of the split blade with full, partial and missing sealing in the gap between the segments were assessed using five-hole probe measurements. By investigating a wide range of stagger angles, the coverage of the full low-loss working range of the VIGV could be ensured. Especially, the fully sealed split blade configuration proved its capacity to extend the efficient operational range significantly.
Electronic surface reconstruction of TiO2 nanocrystals revealed by resonant inelastic x-ray scattering
Authors: Chuang Cheng-Hao , Chen Chieh-Ming , Shao Yu-Cheng , Yeh Ping-Hung , Chang Chih-Ming , Pong Way-Faung , Kapilashrami Mukes , Glans Per-Anders , Gul Sheraz , Wang Gongming , Li Yat , Zhang Jin , Miyawaki Jun , Niwa Hideharu , Harada Yoshihisa , Chen Jin-Ming , Guo Jinghua
Published: September 2021

The identification of lattice multiphases in TiO2 nanocrystals is studied by high resolution transmission electron microscope and electron diffraction patterns. Based on the spectroscopic analysis using soft x-ray absorption and resonant inelastic soft x-ray scattering, it is believed that the oxygen vacancies at the interface exhibit structural distortion of the TiO68− cluster around the defect site as for the multiphase lattice. We elucidate that the extra 3d electrons nearby induce the inelastic scattering features with the excitation energy dependence owing to different energy relaxation processes, a characteristic of the electron-phonon coupling or the nature of the electron-hole pair at the intermediate state. The manifold dd excitations driven by the strong interaction between Ti-3d and O-2p electrons are noticeably rich, coexisting on both Ti and O sites. This sophisticated experiment can advance the perspective of nanocomposite TiO2 for various interactions of surface Ti3+ in applications of future devices.
Applications of the National Institute of Standards and Technology (NIST) database for the simulation of electron spectra for surface analysis for quantitative x-ray photoelectron spectroscopy of nanostructures
Authors: Werner Wolfgang S. M. , Powell Cedric J.
Published: September 2021

sessa (Simulation of Electron Spectra for Surface Analysis) is a software that was frequently used by the late Charles Fadley, since it provides a convenient means to simulate peak intensities as well as entire spectral regions for photoelectron spectroscopy. X-ray photoelectron spectra can be simulated for several types of nanostructures. sessa can also be utilized in more complex cases, e.g., if the nondipolar terms in the photoelectric ionization cross section need to be taken into account, a typical situation encountered in spectroscopy using synchrotron radiation. The software was initially released in 2005 as a National Institute of Standards and Technology Standard Reference Database. Here, we describe two new features that have recently been added to the newest version (sessa V2.2) of the software, i.e., simulation of surface excitations and an effective approach to account for the energy dependence of the interaction characteristics of emitted photoelectrons. Furthermore, we illustrate some functionalities of sessa by presenting several applications. These include overlayer measurements to determine the effective electron attenuation length, quantitative analysis of impurities in multilayer materials, analysis of ionic liquids, the influence of nondipolar effects for photon energies above a few keV, and analysis of nanoparticles by means of photoelectron spectroscopy.
Population Pharmacokinetics, Exposure-Response, and Probability of Target Attainment Analyses for Tedizolid in Adolescent Patients with Acute Bacterial Skin and Skin Structure Infections
Authors: Li Dan , Sabato Philip E. , Guiastrennec Benjamin , Ouerdani Aziz , Feng Hwa-Ping , Duval Vincent , De Anda Carisa S. , Sears Pamela S. , Chou Margaret Z. , Hardalo Catherine , Broyde Natalya , Rizk Matthew L.
Published: September 2021

Tedizolid phosphate is an oxazolidinone antibacterial agent approved for the treatment of Gram-positive acute bacterial skin and skin structure infections (ABSSSIs) in patients aged ≥12 years. To support the use of tedizolid phosphate in adolescents with ABSSSIs, a population pharmacokinetic (PK) model, developed using adult and pediatric data, was updated to include PK data from a phase 3 clinical trial (PN012) that evaluated the safety and efficacy of once-daily oral or intravenous 200-mg tedizolid phosphate treatment in adolescents (12 to <18 years) with ABSSSIs, along with emerging data from a phase 1 trial (PN013) in children (2 to <12 years).
Redox Sensing Modulates the Activity of the ComE Response Regulator of Streptococcus mutans
Authors: Dhaked Hemendra Pal Singh , Cao Luyang , Biswas Indranil
Published: September 2021

Streptococci are an important species that prefer to grow under anaerobic or microaerophilic environments. Studies have shown that streptococci growth in an aerobic environment generates oxidative stress responses by activating various defense systems, including production of antimicrobial peptides called bacteriocins.
Incidental finding of hereditary multiple osteochondroma causing ischiofemoral impingement
Authors: Elnaggar Ahmed , Abraham Roy , Hasanain Shaher , Al Hamadi Khalid
Published: September 2021

Ischiofemoral impingement (IFI) has been described in the medical literature as a cause of hip pain. IFI occurs due to an abnormal contact or reduced space between the lesser trochanter and the lateral border of the ischium and is an often unrecognised cause of pain and snapping in the hip. Association of multiple exostoses and a skeletal dysplasia characterised by an abnormal modelling of bone metaphysis and osseous deformities is highly characteristic of this disease. Consequently, multiple exostoses may narrow the ischiofemoral space and cause impingement and pain, even in the absence of malignant transformation. Surgical excision of exostosis of the lesser trochanter is a safe and effective method of treatment for patients with IFI. We present a case of left hip pain with incidental finding of hereditary multiple osteochondroma causing IFI and discuss the predisposing factors and review of literature.
Small intestine leiomyosarcoma mimicking gastrointestinal stromal tumour
Authors: Fawaz Mohammed , Kataria Kamal , Singh Ankita , Samadder Saugata
Published: September 2021

Small bowel malignant tumours make only 2% of all gastrointestinal (GI) malignancies. Small bowel leiomyosarcoma (LMS) is further rare, accounts for only 0.1%–3% fraction of these tumours. These cases can present as asymptomatic intra-abdominal mass, anaemia due to GI bleed or acute abdomen such as perforation peritonitis, intussusception and bowel ischaemia. Standard of care is surgical resection. Our case presented as large lobulated exophytic ileal LMS measuring 10.8×11×14.7 cm involving multiple small bowel loops and abutting right iliac vessels and uterus. Patient’s clinical course was complicated with COVID-19 positivity, deep vein thrombosis and pulmonary thromboembolism. She was managed by preoperative anticoagulation followed by resection of the tumour with end ileostomy.
Lowering drug prices and enhancing pharmaceutical affordability: an analysis of the national volume-based procurement (NVBP) effect in China
Authors: Yuan Jing , Lu Z Kevin , Xiong Xiaomo , Jiang Bin
Published: September 2021

To cope with the increasing healthcare costs brought about by the universal health insurance programme, national volume-based procurement (NVBP) was implemented in China to reduce drug prices. However, the impact of NVBP remains unknown. We reported the effects of the NVBP pilot programme on medication affordability and discussed the challenges and recommendations for further reforms. A total of 25 molecules won the bidding in the NVBP pilot programme, and price cuts ranged from 25% to 96%. Medication affordability was measured as the number of days’ wages needed to pay for a course of treatment, and the medication was identified as affordable if the cost of a treatment course was less than the average daily wage. After the NVBP, the proportion of affordable drugs increased from 33% to 67%, and the mean affordability improved from 8.2 days’ wages to 2.8 days’ wages. Specifically, for rural residents, the proportion of affordable drugs increased from 13% to 58%, and the mean affordability improved from 15.7 days’ wages to 5.3 days’ wages. For urban residents, the proportion of affordable drugs increased from 54% to 71%, and the mean affordability improved from 5.9 days’ wages to 2.0 days’ wages. Implementing the NVBP substantially improved medication affordability. In future reforms, a multifaceted approach addressing all issues in the health system is needed to enhance medicine access.
Optimising implementation strategies of the first scaleup of a primary care psychological intervention for common mental disorders in Sub-Saharan Africa: a mixed methods study protocol for the optimised Friendship Bench (OptFB)
Authors: Verhey Ruth , Chitiyo Charmaine , Mboweni Sandra Ngonidzashe , Chiriseri Ephraim , Chibanda Dixon , Healey Andy , Wagenaar Bradley , Araya Ricardo
Published: September 2021

Introduction

Common mental disorders (CMDs) are a leading cause of disability globally. CMDs are highly prevalent in Zimbabwe and have been addressed by an evidence-based, task-shifting psychological intervention called the Friendship Bench (FB). The task-shifted FB programme guides clients through problem-solving therapy. It was scaled up across 36 implementation sites in Zimbabwe in 2016.

Methods and analysis

This study will employ a mixed-method framework. It aims to: (1) use quantitative survey methodologies organised around the Reach, Effectiveness, Adoption and Implementation and Maintenance evaluation framework to assess the current scaleup of the FB intervention and classify 36 clinics according to levels of performance; (2) use qualitative focus group discussions and semistructured interviews organised around the Consolidated Framework for Implementation Research to analyse determinants of implementation success, as well as elucidate heterogeneity in implementation strategies through comparing high-performing and low-performing clinics; and (3) use the results from aims 1 and 2 to develop strategies to optimise the Friendship Bench intervention and apply this model in a cluster randomised controlled trial to evaluate potential improvements among low-performing clinics. The trial will be registered with the Pan African Clinical Trial Registry (www.pactr.org). The planned randomised controlled trial for the third research aim will be registered after completing aims one and two because the intervention is dependent on knowledge generated during these phases.

Ethics and dissemination

The research protocol received full authorisation from the Medical Research Council of Zimbabwe (MRCZ A/242). It is anticipated that changes in data collection tools and consent forms will take place at all three phases of the study and approval from MRCZ will be sought. All interview partners will be asked for informed consent. The research team will prioritise open-access publications to disseminate research results.
Mixed-methods study protocol: do national reporting and learning system medication incidents in palliative care reflect patient and carer concerns about medication management and safety?
Authors: Yardley Sarah , Francis Sally-Anne , Chuter Antony , Hellard Stuart , Abernethy Julia , Carson-Stevens A
Published: September 2021

Introduction

Approximately 20% of serious safety incidents involving palliative patients relate to medication. These are disproportionately reported when patients are in their usual residence when compared with hospital or hospice. While patient safety incident reporting systems can support professional learning, it is unclear whether these reports encompass patient and carer concerns with palliative medications or interpersonal safety.

Aim

To explore and compare perceptions of (un)safe palliative medication management from patient, carer and professional perspectives in community, hospital and hospice settings.

Methods and analysis

We will use an innovative mixed-methods study design combining systematic review searching techniques with cross-sectional quantitative descriptive analysis and interpretative qualitative metasynthesis to integrate three elements: (1) Scoping review: multiple database searches for empirical studies and first-hand experiences in English (no other restrictions) to establish how patients and informal carers conceptualise safety in palliative medication management. (2)Medication incidents from the England and Wales National Reporting and Learning System: identifying and characterising reports to understand professional perspectives on suboptimal palliative medication management. (3) Comparison of 1 and 2: contextualising with stakeholder perspectives.

Patient and public involvement

Our team includes a funded patient and public involvement (PPI) collaborator, with experience of promoting patient-centred approaches in patient safety research. Funded discussion and dissemination events with PPI and healthcare (clinical and policy) professionals are planned.

Ethics and dissemination

Prospective ethical approval granted: Cardiff University School of Medicine Research Ethics Committee (Ref 19/28). Our study will synthesise multivoiced constructions of patient safety in palliative care to identify implications for professional learning and actions that are relevant across health and social care. It will also identify changing or escalating patterns in palliative medication incidents due to the COVID-19 pandemic. Peer-reviewed publications, academic presentations, plain English summaries, press releases and social media will be used to disseminate to the public, researchers, clinicians and policy-makers.
Association between periodontal disease and osteoporosis in postmenopausal women: a protocol for systematic review and meta-analysis
Authors: Qi Jing , Liu E , Guo Yu-Feng , Hu Jie-Mei , Liu Yu-Ting , Chen Guang , Yue Hai-Quan
Published: September 2021

Introduction

Periodontal disease and osteoporosis are common chronic diseases, especially for the postmenopausal women. Several original studies explore the association, but there still controversial. Therefore, we will conduct this systematic review and meta-analysis to assess the association between periodontal disease and osteoporosis in postmenopausal women.

Methods and analysis

This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols. We will systematically search Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and Scopus from inception to August 2021 to collect all relevant publications, with no restrictions on publication date or languages. Study selection, data extraction and risk of bias assessment will be conducted independently by two trained reviewers independently. The Cochrane’s tool for assessing risk of bias, Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality will be used for the risk of bias assessment. OR, HR and risk ratio with 95% CI were considered as the effect size for dichotomous outcomes, weighted mean diﬀerence with 95% CI were calculated as the effect size for continuous outcomes. Random-effects models will be used. Heterogeneity between studies will be assessed via the forest plot and I². Publication bias will detected by funnel plots, Begg’s test and Egger’s test. The subgroup analyses and sensitivity ananlyses will also be used to explore and interpret the heterogeneity.

Ethics and dissemination

This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.

PROSPERO registration number

CRD42021225746.
Health status of individuals referred to first-line intervention for hip and knee osteoarthritis compared with the general population: an observational register-based study
Authors: Gustafsson Kristin , Kvist Joanna , Eriksson Marit , Dell'Isola Andrea , Zhou Caddie , Dahlberg Leif E. , Rolfson Ola
Published: September 2021

Objectives

To describe the prevalence of comorbidities in a population referred to standardised first-line intervention (patient education and exercise) for hip and knee osteoarthritis (OA), in comparison with the general population. Furthermore, we aimed to evaluate if eventual differences were associated with socioeconomic inequalities.

Design

Register-based study.

Setting

Primary healthcare, Sweden.

Participants

Individuals with hip and/or knee OA included in the Better Management for Patients with Osteoarthritis Register between 2008 and 2016 and and an age-matched, sex-matched and residence-matched reference cohort (1:3) from the general Swedish population.

Outcome measures

Comorbidities were identified with the RxRisk Index, the Elixhauser Comorbidity Index and the Charlson Comorbidity Index, and presented with descriptive statistics as (1) individual diseases, (2) disease categories and (3) scores for each index. The prevalence of comorbidities in the two populations was tested using logistic regression, with separate analyses for age groups and the most affected joint. We then adjusted the analyses for socioeconomic status.

Results

In this OA population, 85% had ≥1 comorbidity compared with 78% of the reference cohort (OR; 1.62 (95% CI 1.59 to 1.66)). Cardiovascular/blood diseases were the most common comorbidities in both populations (OA, 59%; reference, 54%), with OR; 1.22 (95% CI 1.20 to 1.24) for the OA population. Younger individuals with OA were more comorbid than their matched references overall, and population differences decreased with age (eg, ≥3 comorbidities, aged ≤45 years OR; 1.74 (95% CI 1.52 to 1.98), ≥81 years OR; 0.95 (95% CI 0.87 to 1.04)). Individuals with knee OA were more comorbid than those with hip OA overall. Adjustment for socioeconomic status did not change the estimates.

Conclusion

Comorbidities were more common among individuals with hip and knee OA than among matched references from the general population. The differences could not be explained by socioeconomic status.

Trial registration number

NCT03438630.
Protocol for a mixed method acceptability evaluation of a codesigned bundled COmmunication intervention for use in the adult ICU during the COVID-19 PandEmic: the COPE study
Authors: Istanboulian Laura , Rose Louise , Yunusova Yana , Dale Craig M
Published: September 2021

Introduction

Patients requiring invasive mechanical ventilation via an artificial airway experience sudden voicelessness placing them at risk for adverse outcomes and increasing provider workload. Infection control precautions during the COVID-19 pandemic, including the use of personal protective equipment (eg, gloves, masks, etc), patient isolation, and visitor restrictions may exacerbate communication difficulty. The objective of this study is to evaluate the acceptability of a codesigned communication intervention for use in the adult intensive care unit when infection control precautions such as those used during COVID-19 are required.

Methods and analysis

This three-phased, prospective study will take place in a medical surgical ICU in a community teaching hospital in Toronto. Participants will include ICU healthcare providers, adult patients and their family members. Qualitative interviews (target n: 20–25) will explore participant perceptions of the barriers to and facilitators for supporting patient communication in the adult ICU in the context of COVID-19 and infection control precautions (phase 1). Using principles of codesign, a stakeholder advisory council of 8–10 participants will iteratively produce an intervention (phase 2). The codesigned intervention will then be implemented and undergo a mixed method acceptability evaluation in the study setting (phase 3). Acceptability, feasibility and appropriateness will be evaluated using validated measures (target n: 60–65). Follow-up semistructured interviews will be analysed using the theoretical framework of acceptability (TFA). The primary outcomes of this study will be acceptability ratings and descriptions of a codesigned COmmunication intervention for use during and beyond the COVID-19 PandEmic.

Ethics and dissemination

The study protocol has been reviewed, and ethics approval was obtained from the Michael Garron Hospital. Results will be made available to healthcare providers in the study setting throughout the study and through publications and conference presentations.
Corneal endothelial cell density loss following glaucoma surgery alone or in combination with cataract surgery: a systematic review protocol
Authors: Fang Clarissa E H , Khaw Peng Tee , Mathew Rashmi G , Henein Christin
Published: September 2021

Objective

We aim to systematically assess and compare corneal endothelial cell density (ECD) loss in patients with glaucoma following glaucoma surgery and cataract surgery.

Introduction

Corneal ECD loss may occur due to intraoperative surgical trauma in glaucoma surgery or postoperatively with chronic endothelial cell trauma or irritation. Corneal oedema and decompensation after aqueous shunt glaucoma surgery has been reported but the long-term ECD loss is still unknown.

Inclusion criteria

Trabeculectomy, glaucoma filtration surgery or microinvasive glaucoma surgery in adults with ocular hypertension, primary and secondary open angle glaucoma, normal tension glaucoma and angle-closure glaucoma. Participants with pre-existing corneal disease will be excluded. Glaucoma laser treatments and peripheral iridotomy will be excluded. The outcomes include preoperative and postoperative corneal ECD, percentage change of corneal ECD and adverse events.

Methods

We will conduct an electronic database search for randomised controlled trials, prospective non-randomised studies, observational studies in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and The International Prospective Register of Systematic Reviews (PROSPERO). Eligibility criteria will include quantitative articles published after and including the year 2000, written in English and containing data on ECD loss. Two independent reviewers will screen titles and abstracts and extract data from full texts, reporting outcomes according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction of key characteristics will be completed using customised forms. Methodological quality will be assessed using the Joanna Briggs Institute critical appraisal forms.

Ethics and dissemination

Ethics approval is not required for this review, as it will only include published data. Findings will be published in a peer-reviewed journal and disseminated across ophthalmic networks.

PROSPERO registration number

PROSPERO CRD42020192303.