bluuebunny/crossref_metadata_2025 huggingface dataset:
RAISE study protocol: a cross-sectional, multilevel, neurobiological study of resilience after individual stress exposure
Authors: Moreno-López Laura , Sallie Samantha N , Ioannidis Konstantinos , Kaser Muzaffer , Schueler Katja , Askelund Adrian Dahl , Turner Lorinda , van Harmelen Anne-Laura
Published: October 2022

Introduction

This paper describes the protocol for an ongoing project funded by the Royal Society, the Resilience After Individual Stress Exposure (RAISE) study; which aims to examine the factors and mechanisms that facilitate resilient functioning after childhood adversity (CA).

Methods and analysis

We aim to recruit up to 200 participants. We will use dimension reduction techniques (principal component analysis) on standard-normally transformed individual parameters of mental health, social functioning and CA to calculate a composite measure of adaptive (ie, ‘resilient’) psychosocial functioning. To examine the neuroimmune responses to stress and their relationship with the brain and social environment, we will use a well validated functional MRI task; the Montreal imaging stress task and venepuncture. We will run group or dimensional comparisons in multiple levels of biological and psychological outcomes, as well as mediation and moderation analyses to study how key biological systems (ie, the hypothalamic–pituitary–adrenal axis and the immune system) interrelate and interact with brain function and social influences in order to facilitate resilient functioning after CA. We hypothesise that resilient functioning will be facilitated by reduced morning cortisol and cytokine levels before and after the stressor and improved neural responses to such stress, as well as increased gray matter volume in the hippocampus and prefrontal cortex, enhanced inhibitory control and emotion regulation, and more friendship and family support.

Ethics and dissemination

This study has been reviewed and given favourable opinion by the National Research Ethics Service, NRES Committee East of England-Cambridge Central and external reviewers from the Royal Society (RGF\R1\180064 and RGF\EA\180029). The results of the RAISE study will be disseminated through (1) publications in scientific peer reviewed journals, (2) presentations on relevant scientific conferences and meetings, (3) publications and presentations for the general public and (4) through social media.
Development of a computable phenotype to identify a transgender sample for health research purposes: a feasibility study in a large linked provincial healthcare administrative cohort in British Columbia, Canada
Authors: Rich Ashleigh J , Poteat Tonia , Koehoorn Mieke , Li Jenny , Ye Monica , Sereda Paul , Salway Travis , Hogg Robert
Published: October 2022

Objectives

Innovative methods are needed for identification of transgender people in administrative records for health research purposes. This study investigated the feasibility of using transgender-specific healthcare utilisation in a Canadian population-based health records database to develop a computable phenotype (CP) and identify the proportion of transgender people within the HIV-positive population as a public health priority.

Design

The Comparative Outcomes and Service Utilization Trends (COAST) Study cohort comprises a data linkage between two provincial data sources: The British Columbia (BC) Centre for Excellence in HIV/AIDS Drug Treatment Program, which coordinates HIV treatment dispensation across BC and Population Data BC, a provincial data repository holding individual, longitudinal data for all BC residents (1996–2013).

Setting

British Columbia, Canada.

Participants

COAST participants include 13 907 BC residents living with HIV (≥19 years of age) and a 10% random sample comparison group of the HIV-negative general population (514 952 individuals).

Primary and secondary outcome measures

Healthcare records were used to identify transgender people via a CP algorithm (diagnosis codes+androgen blocker/hormone prescriptions), to examine related diagnoses and prescription concordance and to validate the CP using an independent provider-reported transgender status measure. Demographics and chronic illness burden were also characterised for the transgender sample.

Results

The best-performing CP identified 137 HIV-negative and 51 HIV-positive transgender people (total 188). In validity analyses, the best-performing CP had low sensitivity (27.5%, 95% CI: 17.8% to 39.8%), high specificity (99.8%, 95% CI: 99.6% to 99.8%), low agreement using Kappa statistics (0.3, 95% CI: 0.2 to 0.5) and moderate positive predictive value (43.2%, 95% CI: 28.7% to 58.9%). There was high concordance between exogenous sex hormone use and transgender-specific diagnoses.

Conclusions

The development of a validated CP opens up new opportunities for identifying transgender people for inclusion in population-based health research using administrative health data, and offers the potential for much-needed and heretofore unavailable evidence on health status, including HIV status, and the healthcare use and needs of transgender people.
Epidemiology and risk factors for diabetes in the suburbs of Beijing: a retrospective cohort study
Authors: Xie Lingding , Zhao Xu , Zhang Bo , Zhu Haiqing
Published: October 2022

Objective

We aimed to detect the incidence and risk factors of type 2 diabetes mellitus (T2DM) development in the suburbs of Beijing.

Design

Cohort study with record linkage to incidence data.

Setting

We performed a 5-year follow-up study in a randomly selected suburban population including 1114 subjects aged ≥18 years living in the suburbs of Beijing.

Participants

118 subjects with T2DM at baseline according to the 1999 WHO criteria were excluded, and 895 subjects attended the follow-up assessment in 2012. The non-diabetic subjects at baseline were classified into two groups: normal glucose tolerance (NGT) group (n=673) and impaired glucose regulation (IGR) group(n=222).The incidence and risk factors of diabetes development in each group were investigated.

Outcome measures

A structured questionnaire about sociodemographic characteristics, height, weight, waist circumference, hip circumference, blood pressure, oral glucose tolerance test and serum lipid levels.

Results

Out of the 895 non-diabetic subjects, 67 developed diabetes with 29 in the NGT group and 38 in the IGR group, respectively, after a 5-year follow-up, producing an overall 5-year cumulative incidence of diabetes of 13%. The incidence of diabetes was 15.5 cases per 1000 person-years, 8.9 cases per 1000 person-years in the NGT group and 35.7 cases per 1000 person-years in the IGR group (p<0.01; RR 4.03; 95% CI 2.58 to 9.29). Binary logistic regression analysis showed that the risk factors for diabetes development included fasting plasma glucose (FPG) in the NGT group, and sex, the waist-to-hip ratio, FPG and diastolic blood pressure (DBP) in the IGR group.

Conclusions

During a mean follow-up of 5.0 years, the incidence of T2DM in the suburbs of Beijing was 15.5 per 1000 person-years. Early prevention of diabetes should focus on IGR subjects. Elevated FPG predicted diabetes development for both NGT and IGR subjects. Female sex, overweight/obesity and DBP are risk factors for diabetes development in IGR subjects.
Surgical care in district hospitals in sub-Saharan Africa: a scoping review
Authors: Bentounsi Zineb , Sheik-Ali Sharaf , Drury Grace , Lavy Chris
Published: October 2022

Objective

To provide a general overview of the reported current surgical capacity and delivery in order to advance current knowledge and suggest targets for further development and research within the region of sub-Saharan Africa.

Design

Scoping review.

Setting

District hospitals in sub-Saharan Africa.

Data sources

PubMed and Ovid EMBASE from January 2000 to December 2019.

Study selection

Studies were included if they contained information about types of surgical procedures performed, number of operations per year, types of anaesthesia delivered, cadres of surgical/anaesthesia providers and/or patients’ outcomes.

Results

The 52 articles included in analysis provided information about 16 countries. District hospitals were a group of diverse institutions ranging from 21 to 371 beds. The three most frequently reported procedures were caesarean section, laparotomy and hernia repair, but a wide range of orthopaedics, plastic surgery and neurosurgery procedures were also mentioned. The number of operations performed per year per district hospital ranged from 239 to 5233. The most mentioned anaesthesia providers were non-physician clinicians trained in anaesthesia. They deliver mainly general and spinal anaesthesia. Depending on countries, articles referred to different surgical care providers: specialist surgeons, medical officers and non-physician clinicians. 15 articles reported perioperative complications among which surgical site infection was the most frequent. Fifteen articles reported perioperative deaths of which the leading causes were sepsis, haemorrhage and anaesthesia complications.

Conclusion

District hospitals play a significant role in sub-Saharan Africa, providing both emergency and elective surgeries. Most procedures are done under general or spinal anaesthesia, often administered by non-physician clinicians. Depending on countries, surgical care may be provided by medical officers, specialist surgeons and/or non-physician clinicians. Research on safety, quality and volume of surgical and anaesthesia care in this setting is scarce, and more attention to these questions is required.
Community delivery of malaria intermittent preventive treatment in pregnancy: protocol of a quasi-experimental evaluation through multistage cluster sampling household surveys in four sub-Saharan African countries
Authors: Pons-Duran Clara , Llach Mireia , Sanz Sergi , Ramírez Máximo , Méndez Susana , Roman Elaine , Tholandi Maya , Pagnoni Franco , Menendez Clara , González Raquel
Published: October 2022

Background

In sub-Saharan Africa (SSA), millions of pregnant women are exposed to malaria infection. The cornerstone of the WHO strategy to prevent malaria in pregnancy in moderate to high-transmission areas is the administration of intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine at each scheduled antenatal care (ANC) visit. However, overall coverage remains low. ‘Transforming IPT for Optimal Pregnancy’ (TIPTOP) project aims at delivering IPTp at the community level (C-IPTp) to complement ANC provision with the goal of increasing IPTp coverage and improving maternal and infant’s health. This protocol describes the approach to measure the effect of this strategy through household surveys (HHS) in four SSA countries: Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria.

Methods and analysis

A quasi-experimental evaluation has been designed. Delivery of C-IPTp will start first in one area per country, and later it will be extended to two more areas per country. HHS will be carried out before C-IPTp implementation in all study sites, at midterm in initial implementation areas, and after the implementation in all project areas. A multistage cluster sampling method will be followed for the selection of participants. Women of reproductive age who had a pregnancy that ended in the 6 or 12 months prior to the interview, depending on the survey, will be invited to participate by responding to a questionnaire. The main indicators will be coverage of three or more doses of IPTp and attendance to at least four ANC visits. A difference-in-difference analysis will be performed to evaluate the effectiveness of C-IPTp.

Ethics and dissemination

The project has been reviewed by the ethics committees of WHO, Hospital Clinic of Barcelona and all project country boards. Project results will be disseminated to in-country stakeholders and at regional and international meetings. TIPTOP project aims to develop and disseminate global recommendations for C-IPTp delivery.

Trial registration number

NCT03600844; Pre-results.
Prevalence and risk factors for hyperhomocysteinemia: a population-based cross-sectional study from Hunan, China
Authors: Yang Yide , Zeng Yuan , Yuan Shuqian , Xie Ming , Dong Yanhui , Li Jian , He Quanyuan , Ye Xiangli , Lv Yuan , Hocher Carl-Friedrich , Kraemer Bernhard K , Hong Xiuqin , Hocher Berthold
Published: October 2022

Objectives

Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. We aimed to investigate the prevalence and risk factors for hyperhomocysteinemia, especially modifiable lifestyle factors, such as smoking behaviour and dietary factors.

Design

Population-based cross-sectional study.

Setting

Hunan Province, China

Participants

A total of 4012 participants completed the study, between July 2013 and March 2014. The median age is 55 (interquartile range: 45–63) years, with 1644 males (41%) and 2368 females (59%).

Main outcome measures

Homocysteine level were measured by the microplate enzyme immunoassay method. Hyperthomocysteinemia was defined as ≥15 µmol/L. Questionnaire was used to investigate potential risk factors of hyperhomocysteinemia. Crude odd ratio (OR) or adjusted OR with 95% CI were determined by using univariable or multivariable logistic regression models.

Results

The prevalence of hyperhomocysteinemia is 35.4% (45.4% vs 28.5% for men, women, respectively). One-year increase in age is significantly associated with 2% higher risk of hyperhomocysteinemia (OR=1.02, 95% CI: 1.01 to 1.03). One unit increase of BMI is associated with 5% higher risk of hyperhomocysteinemia (OR=1.05, 95% CI: 1.03 to 1.07). Compared with the non-smoker, smoking participants have a 24% higher risk of hyperhomocysteinemia (OR=1.24, 95% CI: 1.006 to 1.53), while the risk for those quitting smoking are not significantly different (OR=1.14, 95% CI: 0.85 to 1.54). compared with those consuming fruit and vegetable at least once every day, those consuming less than once every day had a significantly higher risk of hyperhomocysteinemia (OR=1.29, 95% CI:1.11 to 1.50). In addition, we found there were significant sex interaction with education level or alcohol drinking on the risk of hyperhomocysteinemia (pinteraction<0.05).

Conclusions

Higher BMI and older age are potential risk factors for hyperhomocysteinemia. Current smoking but not quitting smoking is associated with higher risk of hyperhomocysteinemia. Fruit and vegetable consumption may have protective effect against hyperhomocysteinemia. Alcohol consumption or education level might interact to influence the risk of hyperhomocysteinemia.
Webinar-based continuing medical education in otorhinolaryngology during the COVID-19 pandemic in Germany: a longitudinal study
Authors: Walther Leif Erik , Blödow Alexander , Volkenstein Stefan , Dazert Stefan , Löhler Jan
Published: October 2022

Objective

Reliance on webinars for continuing medical education (CME) has increased since the onset of the COVID-19 pandemic. Here, we aimed to evaluate the teaching methods used in these webinars.

Design

Retrospective, longitudinal study.

Setting

20 CME-approved webinars, conducted March–December 2020 in Germany, and lasting 2.25 hours each.

Participants

Otorhinolaryngologists pursuing CME credits.

Interventions

Postwebinar participant assessments of the speaker, effects on practical work, desired scientific content, technical quality, interactions, attention and future training behaviour.

Results

On average, 780 participants joined each webinar. The mean survey response rate was 35% (n=282). When asked how well the speaker had mastered the content, 38% responded ‘very well’, 44% responded ‘well’, 14% indicated ‘satisfactory’ and 4% chose ‘sufficient’. The frequency of webinars was considered appropriate by 92%, too high by 4% and too low by 4% of participants. The measured attention of the participants was 90%. After the COVID-19 pandemic lockdown, 68% of participants preferred online teaching. The average costs per participant were €3.50 (about $4.25 or £3.15) per webinar.

Conclusions

Although the pandemic context likely influenced the results, we conclude that periodic ear, nose and throat webinar training during COVID-19 in 2020 was an effective alternative delivery method. We found high attention rates, high levels of participant satisfaction and low costs. Evaluations and re-evaluations will be necessary to adapt teaching concepts successfully and ensure high levels of teaching and learning efficiency.
MUKtwelve protocol: a phase II randomised, controlled, open, parallel group, multicentre trial of selinexor, cyclophosphamide and prednisolone (SCP) versus cyclophosphamide and prednisolone (CP) in patients with relapsed or refractory multiple myeloma
Authors: Kendall Jessica , Hall Andrew , Roberts Sadie , Brown Sarah , Boyd Kevin , Auner Holger W , Garg Mamta , Kaiser Martin
Published: October 2022

Introduction

Multiple myeloma is a malignancy of plasma cells with around 6000 new cases per year in the UK. Cyclophosphamide plus prednisolone is considered a standard of care for disease and symptom control in the advanced relapsed or refractory myeloma setting within the UK NHS. The selective nuclear export inhibitor, selinexor, has been relatively well tolerated in previous clinical trials and offers promise when used in combination with a wide range of other anti-cancer treatments. Here, we investigate if the addition of selinexor can improve responses to cyclophosphamide plus prednisolone without adding prohibitive toxicity.

Methods and analysis

MUKtwelve is a UK-based, randomised, controlled, open, parallel group, multicentre phase II trial designed to evaluate clinical efficacy of selinexor in combination with cyclophosphamide and prednisolone (SCP) in patients with relapsed or refractory multiple myeloma. A calibration arm will receive cyclophosphamide and prednisolone alone (CP). Participants who experience disease progression on the CP arm may, if eligible, receive SCP.

The MUKtwelvetrial results will be the first to assess clinical efficacy of selinexor with low-dose CP in relapsed/refractory multiple myeloma. It is widely accepted that the relapsing-remitting nature of the disease is accompanied by cellular changes that often result in the requirement for novel agents and drug combinations to regain disease control. Patients also often experience cumulative toxicities throughout their treatments, limiting the treatment intensity that can be given at relapse. Thus, there is a need for novel effective combination therapies with acceptable toxicity profiles.

Ethics and dissemination

Ethics approval is obtained. Results will be submitted for publication in a peer-reviewed journal.

Trial registration number

ISRCTN15028850.
RAPID-2 study protocol: a cluster randomised feasibility trial of a midwife facilitated intervention for pregnant women with symptoms of mild to moderate anxiety
Authors: Evans Kerry , Spiby Helen , Slade Mike , Jomeen Julie , Beckhelling Jacqueline
Published: October 2022

Introduction

Many women experience symptoms during pregnancy. Elevated and prolonged anxiety can have negative effects on the woman and baby. The RAPID intervention aims to provide suitable, timely support for women with mild-moderate anxiety. The RAPID intervention is based on social support, relational continuity, psychological and relaxation response theory, and comprises midwife facilitated group discussions, one-to-one support and directed self-help materials.

Methods and analysis

Four National Health Service Trusts in England that provide maternity care will be cluster randomised to the RAPID intervention plus usual care or usual care. At each intervention site, two midwives and two maternity support workers will facilitate the intervention over a 12-week period. Eligibility includes nulliparous women at 16–20 weeks of pregnancy (n=50) with self-report symptoms of mild-moderate anxiety. Community midwives will signpost women to the study. The aim of the study is to establish the feasibility of conducting a definitive trial to examine the effectiveness of the RAPID intervention in addition to usual care. The objectives are to assess recruitment and completion rates, and a qualitative assessment of women’s and facilitators’ experiences of participation. An estimation of change in the seven-item Generalised Anxiety Disorder scale will inform the sample size for a definitive cluster trial.

Ethics and dissemination

Ethical approval was given by East Midlands—Derby Research Ethics Committee 14 March 2022 (REC Reference: 22/EM/0018). Findings will be made available through publication in peer-reviewed journals, conferences and to participants. A final report will be submitted to HEE/NIHR ICA awards committee for publication.

Trial registration number

ISRCTN12834758.
Depression in older adults during the COVID-19 pandemic: a systematic review protocol
Authors: Silva Celso , Fonseca César , Ferreira Rogério , Pinho Lara , Schneider Brooke C , Weidner Anna , Morgado Bruno , Lopes Manuel José
Published: October 2022

Introduction

Depression is a common mental disorder and is a major cause of years lived with disability. The COVID-19 pandemic has caused an increase in the prevalence of depression worldwide. Our aim is to identify and synthesise the determinants of depression, the diagnostic assessment tools used to evaluate depression, and the interventions carried out since the beginning of the COVID-19 pandemic in the population aged 60 and older.

Methods and analysis

A systematic review of the literature will be conducted. The following databases will be searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and Psychology and Behavioural Sciences Collection. The search strategy will include the following Medical Subject Headings or similar terms: “Depression”, “Depressive Disorder”, “Depressive Symptoms”, “Older Adults”, “Aging”, “Elderly”, Pandemic” and “COVID-19”. Two independent reviewers will ascertain whether the resulting articles meet inclusion and exclusion criteria, and perform the analysis of data quality. Disagreements will be resolved by a third reviewer. All studies reported between December 2019 and March 2022 meeting the following criteria will be included: studies in adults aged 60 and over, and articles written in English, Portuguese, Spanish or German. Information on determinants of depression, assessment instruments used to assess depressive symptoms and/or interventions to decrease depression are reported. Studies will not be excluded based on geographical area study context (eg, community, culture or specific environment). All studies related to diagnostic assessment, care planning and/or intervention strategies specifically for older adults with depression will be included.

Ethics and dissemination

As only secondary data will be analysed, no ethical approval is required for this study. This scientific article is a systematic review protocol for which data have not yet been extracted or analysed. The results will be disseminated through peer-reviewed publications.

PROSPERO registration number

CRD42022299775.
Cross-sectional survey of the Mental health and Addictions effects, Service impacts and Care needs of children, youth and families during the COVID-19 pandemic: the COVID-19 MASC study protocol
Authors: Markoulakis Roula , Khalid Maida , Da Silva Andreina , Kodeeswaran Sugy , Sinyor Mark , Cheung Amy , Redelmeier Donald , MacKillop James , Scarpitti Michael , Laird Hannah , Foot Jeanne , Levitt Anthony
Published: October 2022

Introduction

The COVID-19 pandemic has had a tremendous negative effect on the mental health and well-being of Canadians. These mental health challenges are especially acute among vulnerable Canadian populations. People living in Canada’s most populous province, Ontario, have spent prolonged time in lockdown and under public health measures and there is a gap in our understanding of how this has impacted the mental health system. This protocol describes the Mental health and Addictions Service and Care Study that will use a repeated cross-sectional design to examine the effects, impacts, and needs of Ontario adults during the COVID-19 pandemic.

Methods and analysis

A cross-sectional survey of Ontario adults 18 years or older, representative of the provincial population based on age, gender and location was conducted using Delvinia’s AskingCanadians panel from January to March 2022. Study sample was 2500 in phases 1 and 2, and 5000 in phase 3. The Alcohol, Smoking and Substance Involvement Screening Test and Diagnostic Statistical Manual-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult were used to assess for substance and mental health concerns. Participants were asked about mental health and addiction service-seeking and/or accessing prior to and during the pandemic. Analyses to be conducted include: predictors of service access (ie, sociodemographics, mental illness and/or addiction, and social supports) before and during the pandemic, and χ2tests and logistic regressions to analyse for significant associations between variables and within subgroups.

Ethics and dissemination

Ethics approval was obtained from the Sunnybrook Research Ethics Board. Dissemination plans include scientific publications and conferences, and online products for stakeholders and the general public.
Cluster of symptomatic silicone oil droplets following intravitreal injections: a 1-year observational study
Authors: Sivertsen Magne Sand , Lode Heidrun Elisabeth , Gjølberg Torleif Tollefsrud , Petrovski Goran , Andersen Jan Terje , Jørstad Øystein Kalsnes , Moe Morten Carstens
Published: October 2022

Objective

To describe a cluster of symptomatic intravitreal silicone oil (SiO) droplets following intravitreal injections (IVIs) and assess the effect of switching to a SiO-free syringe.

Methods and analysis

Observational quality registry study of patients receiving IVI at a large Norwegian ophthalmology centre between April 2018 (start of cluster) and November 2019 (1 year after switching to SiO-free syringes). At onset, anti-vascular endothelial growth factor drugs were administered using SiO-containing insulin syringes. From November 2018, SiO-free syringes were implemented. Spontaneously reported symptomatic SiO cases were confirmed by slit-lamp examination. A follow-up interview was performed after 1 year, assessing visual complaints. The prevalence of non-symptomatic cases was assessed in a sample of 50 eyes from 50 consecutive IVI patients.

Results

Among 13 429 IVIs, 50 eyes of 46 patients (29 women) with symptomatic intravitreal SiO droplets were identified. Forty-one patients reported floaters at regular appointments, whereas five patients contacted the department regarding symptoms between scheduled appointments. After 1 year, 34 patients (79%) still experienced floaters, 21 (49%) reported reduced symptoms and 3 (7%) reported worsened symptoms. Eighteen patients (42%) reported being bothered, and eight (18.6%) reported that their lives were negatively affected by the floaters. Among 50 non-symptomatic eyes that had received IVI during the same period, intravitreal SiO was found in 34 (68%). No cases of symptomatic intravitreal SiO droplets were identified after switching to SiO-free syringes.

Conclusion

Symptomatic intravitreal SiO following IVI can cause significant and prolonged distress for affected patients. It can be avoided by using SiO-free syringes.
‘Valve for Life’: tackling the deficit in transcatheter treatment of heart valve disease in the UK
Authors: Ali Noman , Faour Amir , Rawlins John , Dawkins Sam , Appleby Clare E , MacCarthy Philip , Byrne Jonathan , Trivedi Uday , Curzen Nick , Banning Adrian P , Ludman Peter , Blackman Daniel J
Published: October 2022

Transcatheter aortic valve implantation (TAVI) is a proven treatment for life-threatening aortic valve disease, predominantly severe aortic stenosis. However, even among developed nations, access to TAVI is not uniform. The Valve for Life initiative was launched by the European Association of Percutaneous Cardiovascular Interventions in 2015 with the objective of improving access to transcatheter valve interventions across Europe. The UK has been identified as a country with low penetration of these procedures and has been selected as the fourth nation to be included in the initiative. Specifically, the number of TAVI procedures carried out in the UK is significantly lower than almost all other European nations. Furthermore, there is substantial geographical inequity in access to TAVI within the UK. As a consequence of this underprovision, waiting times for TAVI are long, and mortality among those waiting intervention is significant. This article reviews these issues, reports new data on access to TAVI in the UK and presents the proposals of the UK Valve for Life team to address the current problems in association with the British Cardiovascular Intervention Society.
Response of growth performance, blood hematology, organ indexes, and myofiber traits to increasing dietary methionine levels in Jilin White goose
Authors: Dang De Xin , Cui Yan , Zhou Haizhu , Lou Yujie , Li Desheng
Published: October 2022

A total of 240 geese (28 days old; 120 ganders and 120 gooses) with an average initial body weight of 1068.19 ± 6.59 g were used to evaluate the effects of increasing dietary methionine (Met) levels on growth performance, blood hematology, organ indexes, and myofiber traits. The experimental period was 42 days. All birds were randomly assigned to four treatment groups based on the initial body weight. There were six replicate cages per treatment, and 10 geese per cage (5 ganders and 5 gooses). Dietary treatments were based on a basal diet containing 0.25% Met, and extra supplied 0.25%, 0.50%, and 0.75% Met to form different dietary groups (0.25%, 0.50%, 0.75%, and 1.00% Met, as-fed basis). The results of this study indicated that final body weight, body weight gain, and feed efficiency increased quadratically, relative weight of breast muscle and myofiber diameter increased cubically, serum total protein and uric acid concentrations, relative weight of liver and abdominal fat, and myofiber diameter increased linearly, whereas myofiber density decreased linearly, with the level of Met increased. The maximized growth performance and breast muscle parameters were observed in 0.75% Met-containing group.
First evaluation of a novel ionisation chamber for thermal neutron beam monitoring
Authors: Maulerová Vendula , Kanaki Kalliopi , Klein Martin , Schmidt Christian J. , Kadletz Peter M. , Laloni Alessio , Hall-Wilton Richard J.
Published: October 2022

The European Spallation Source ERIC (ESS), currently under construction in Lund, Sweden is a facility established to deliver the highest integrated neutron flux originating from a pulsed source with the aim of supporting an initial fifteen neutron instruments for cutting edge science experiments. This in turn requires reliable monitoring at complex neutron beam lines: in particular, linearity, timing capability, adaptability of the design for various flux ranges (dynamic range) and sensitivity to neutrons within the range of 0.6-10Å are expected from the neutron beam monitors to be installed at the ESS beam lines. Additionally, operational stability and low attenuation are also desirable characteristics for such neutron beam monitoring. A prototype neutron beam monitor based on the ionisation chamber principle and a boron converter, designed by CDT CASCADE Detector Technologies GmbH and ESS, has been investigated at the BER-II research reactor of Helmholtz Zentrum Berlin (HZB). The effort to design and investigate a thermal neutron ionisation beam monitor was initiated by adapting the concept of ionisation chambers previously known elsewhere. So far all the characterised neutron beam monitors discriminate neutron hits on a discrete event basis (pulse mode), whereas the beam monitor prototype introduced in this paper estimates the total flux as a function of current (current mode). While most other neutron beam monitoring devices and detectors rely upon a signal amplifying gain stage, the ionisation chamber operates without any gain and is consequently robust against typical detector ageing effects that compromise the sensitivity over time. The initial tests were performed at the ESS V20 test beam line under realistic conditions resembling those of the future pulses of ESS. The linearity is demonstrated for 3Å pulses in the flux range of 2-3 × 105 n/s/cm2 and for white pulses (0.6-10Å) in the range of 1-5 × 106 n/s/cm2. The timing behaviour resembles the data previously recorded at the V20 beam lines. This novel implementation of a neutron sensitive ionisation chamber shows great promise for beam monitoring and diagnostics at ESS. As the ionisation beam monitor itself is an entirely passive device, it is adequately robust to be employed in areas of high irradiation where no regular servicing or maintenance can be provided.
Physical behavior of nanoparticles-enhanced PCM including transient conduction
Authors: Elqahtani Zainab Mufarreh , Alwadai Norah , Khan Salah Ud-Din , Khan Shahab Ud-Din
Published: October 2022

In this paper, numerical approach has been implemented to depict the promising efficacy of dispersion of alumina nanoparticles for expedition of freezing. The fraction and volume of powders were assumed as variables to evaluate the performance of system. The tank has sinusoidal shape and triangular cold surface has been applied as origins of solidification. The use of adaptive grid leads to better capturing the regions with higher gradient of scalar which gives higher accuracy of modeling. The precision of simulation was checked with associating the outcomes with previous data and good accommodation was reported. As alumina added in water, the period of process declines around 41.18% and optimized size of powder with highest concentration has been utilized. The time changes from 197.25 s to 157.91 s if the [Formula: see text] changes from 30 nm to 40 nm. By changing the radius of powder from 15 nm to 25 nm, the required time augments around 19.33% when [Formula: see text].
Research on Hotel Management Based on Internet of Things and Big Data Analysis
Authors: Jiang Hongyan
Published: October 2022

With one-tap check-ins, digital concierge services, voice-activated gadgets, chatbots, smart in-room technology, and advanced analytics, the hotel sector has been quickly embracing new technologies to meet and exceed consumer expectations and digitize the customer experiences. The traditional hotel management with internet-based customer service could not handle dynamic real-time data efficiently due to increased data volume. Thus, this work analyzes hotel management practices with the internet of things (IoT) and big data. The IoT and big data significantly impact the guest experience since businesses can provide consumers with unique services to their needs. Automated check-in and checkout, pre-booking, registration, and user-chosen payment methods are just a few self-services that improve the visitor experience. For enhancing visitor satisfaction and offering tailored services, this paper looks at how IoT and big data analytics can help the hotel sector. It moreover examines how IoT can be used within the business. This extended research finds excellent results in hotel management through IoT and big data. A client occupancy detection model (CODM) simulation scenario finds the best detection accuracy of 97.51%.
A Systematic Review of the Sensory Outcomes of a Standard Cross-Finger Flap Reconstruction for Fingertip Defects
Authors: CHAKRABORTY Sourabh S. , ACHARYA Sudeshna , GOEL Akhil D. , SAHU Ranjit K. , MIDYA Manojit , KOTU Suresh
Published: October 2022

Background: The standard (dorsal) cross-finger flap (CFF) is one of the common flaps used for fingertip reconstruction. There is little consensus regarding the sensory outcomes associated with this flap. In this systematic review, we evaluated objective sensory outcome parameters of patients who underwent CFF reconstruction.

Methods: This systematic review is reported using the PRISMA protocol and was registered with the International Prospective Register of Systematic Reviews. Literature search was done using the terms ‘cross-finger flap’, ‘heterodigital’, ‘finger-tip’ and ‘transdigital’. Data regarding the number of patients, follow-up duration and sensory outcomes, including 2-point discrimination (2-PD) were extracted from included studies. The analysis was performed using Microsoft Excel with MetaXL add-in software. Certainty assessment and summary of findings table was created using GRADEpro GDT.

Results: This review includes 14 studies with 301 patients. We found a statistically significant difference in static 2-PD of recipient and control fingers (pooled weighted mean difference [WMD]: 1.66; 95%CI: 0.03, 3.29; p = 0.00; I2=92%, n = 7 studies).

Conclusions: Dorsal CFF reconstruction for fingertip defect does not provide adequate sensory recovery.

Level of Evidence: Level III (Therapeutic)
Atypical Ulnar Fracture in an Older Woman with Osteoporosis with a Five-Year History of Denosumab Treatment: A Case Report
Authors: OKUBO Naoki , YOSHIDA Takashi , OHARA Masato , TAKAHASHI Kenji
Published: October 2022

Atypical ulnar fracture (AUF) is a rare condition that may occur in patients treated with bisphosphonates. We describe the clinical course of a patient who had an AUF during treatment with denosumab. An 86-year-old woman treated with denosumab for 5 years experienced a complete transverse fracture of the proximal left ulna after falling from a standing height. Intraoperative photographs showed cortical thickening around the fracture site. Therefore, we diagnosed the patient with AUF and performed internal fixation with a locking plate. However, a re-fracture occurred 2.5 months after surgery, which was treated with locking plate replacement with a longer one with a bone graft. One year after the second surgery, the fracture healed. To our knowledge, this is the second case report of an AUF occurring during denosumab treatment. Our case highlights the importance of careful follow-up of patients receiving not only bisphosphonate, but also denosumab.

Levels of Evidence: Level V (Therapeutic)
Pessimistic Decision-Making for Recommender Systems
Authors: Jeunen Olivier , Goethals Bart
Published: October 2022

Modern recommender systems are often modelled under the sequential decision-making paradigm, where the systemdecideswhich recommendations to show in order to maximise some notion of either imminent or long-term reward. Such methods often require an explicit model of the reward a certain context-action pair will yield – for example, the probability of a click on a recommendation. This common machine learning task is highly non-trivial, as the data-generating process for contexts and actions can be skewed by the recommender system itself. Indeed, when the deployed recommendation policy at data collection time does not pick its actions uniformly-at-random, this leads to a selection bias that can impede effective reward modelling. This in turn makes off-policy learning – the typical setup in industry – particularly challenging. Existing approaches for value-based learning break down in such environments.

In this work, we propose and validate a generalpessimisticreward modelling approach for off-policy learning in recommendation. Bayesian uncertainty estimates allow us to express scepticism about our own reward model, which can in turn be used to generate a conservative decision rule. We show how it alleviates a well-known decision making phenomenon known as the Optimiser’s Curse, and draw parallels with existing work on pessimistic policy learning. Leveraging the available closed-form expressions for both the posterior mean and variance when a ridge regressor models the reward, we show how to apply pessimism effectively and efficiently to an off-policy recommendation use-case. Empirical observations in a wide range of simulated environments show that pessimistic decision-making leads to a significant and robust increase in recommendation performance. The merits of our approach are most outspoken in realistic settings with limited logging randomisation, limited training samples, and larger action spaces. We discuss the impact of our contributions in the context of related applications like computational advertising, and present a scope for future research based on hybrid off-/on-policy bandit learning methods for recommendation.
Accurate Calculation of Euclidean Norms Using Double-word Arithmetic
Authors: Lefèvre Vincent , Louvet Nicolas , Muller Jean-Michel , Picot Joris , Rideau Laurence
Published: October 2022

We consider the computation of the Euclidean (or L2) norm of an
n
-dimensional vector in floating-point arithmetic. We review the classical solutions used to avoid spurious overflow or underflow and/or to obtain very accurate results. We modify a recently published algorithm (that uses double-word arithmetic) to allow for a very accurate solution, free of spurious overflows and underflows. To that purpose, we use a double-word square-root algorithm of which we provide a tight error analysis. The returned L2 norm will be within very slightly more than 0.5 ulp from the exact result, which means that we will almost always provide correct rounding.
ONION: Joint Unsupervised Feature Selection and Robust Subspace Extraction for Graph-based Multi-View Clustering
Authors: Gu Zhibin , Feng Songhe , Hu Ruiting , Lyu Gengyu
Published: October 2022

Graph-based Multi-View Clustering (GMVC)
has received extensive attention due to its ability to capture the neighborhood relationship among data points from diverse views. However, most existing approaches construct similarity graphs from the original multi-view data, the accuracy of which heavily and implicitly relies on the quality of the original multiple features. Moreover, previous methods either focus on mining the multi-view commonality or emphasize on exploring the multi-view individuality, making the rich information contained in multiple features cannot be effectively exploited. In this work, we design a novel GMVC framework via c
O
mmo
N
ality and
I
ndividuality disc
O
vering in late
N
t subspace (
ONION
), seeking for a robust and discriminative subspace representation compatible across multiple features for GMVC. To be specific, our method simultaneously formulates the unsupervised sparse feature selection and the robust subspace extraction, as well as the target graph learning in a unified optimization model, which can help the learning of the discriminative subspace representation and the target graph in a mutual reinforcement manner. Meanwhile, we manipulate the target graph by an explicit structural penalty, rendering the connected components in the graph directly reveal clusters. Experimental results on seven benchmark datasets demonstrate the effectiveness of our proposed method.
Design Thinking and Thinking by Design
Authors: Michaud Damien
Published: October 2022

This article provides a summary and review of "Make It Meaningful: Taking Learning Design from Instructional to Transformational" by Dr. Clark Quinn. The book consists of a section on principles and a section on practices for designing learning experiences that engage learners intellectually and emotionally. The book provides a primer and a playbook for educators to reflect upon and improve their personal practice.
Analysis of Prognostic Factors and Construction of Prognostic Models for Invasive Micropapillary Carcinoma of the Breast
Authors: Wang Xinli , Xue Yan
Published: October 2022

Objective. To compare and analyze the clinical characteristics of invasive micropapillary carcinoma (IMPC) of the breast (IMPC-B) and invasive ductal carcinoma (IDC) of the breast (IDC-B) and establish a prognostic model of IMPC-B. Methods. We retrospectively analyzed data for patients diagnosed with breast cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2018 and screened 581 patients with IMPC and 1325 patients with IDC. We compared age, race, laterality, tumor site, histological grade, type of surgery, radiation, chemotherapy, whether the first primary tumor, T stage, N stage, M stage, and molecular type between IMPC-B and IDC-B and draw survival curves of IMPC-B and IDC-B. The relationship between clinical factors and prognosis was investigated by univariate analysis using the Log-rank test and multivariate analysis of the Cox proportional hazards regression model. A risk scoring model was constructed based on independent risk factors to distinguish high-risk and low-risk patients; in addition, a nomogram was created to predict patient survival. Results. There were differences between the two groups in the age of onset, race, tumor site, histological grade, type of surgery, N stage, and molecular type (

p
<
0.05

). Overall survival was decreased in IMPC-B compared with IDC-B (

p
<
0.05

). The prognosis of IMPC-B was significantly correlated with histological grade, whether the first primary tumor, type of surgery, radiotherapy, chemotherapy, T stage, and N stage. Based on the relationship between the above factors and overall survival prognosis, the risk score model we constructed can effectively distinguish high-risk and low-risk patients (

p
<
0.05

). The established nomogram had better performance in predicting survival in patients with IMPC-B (

C
−
index
=
0.78

). Conclusion. IMPC-B has a worse prognosis than IDC-B, with earlier age of onset, higher histological grade, and later N stage, and luminal breast cancer is the main type. The nomogram can well predict the prognosis of patients with IMPC-B, which has a high clinical reference value and provides a scientific basis for clinical treatment.
An Enhanced Modified Multiport Interleaved Flyback Converter for Photovoltaic-Shunt Active Power Filter (PV-SHAPF) Applications
Authors: Rajakkannu Radhamani , Rangaswamy Balamurugan
Published: October 2022

This paper presents a newly designed modified multiport interleaved flyback converter (MMPIFC) to transfer the photovoltaic (PV) power to the DC bus of the parallel-connected multilevel inverter-based shunt active power filter (SHAPF). The proposed modified multiport interleaved flyback converter (MMPIFC) is designed to interconnect N number of input power sources into the DC bus of the SHAPF to fix the problems with the partial shadow and improve the SHAPF’s ability to compensate. Compared to the commonly used interleaved flyback converter (IFC), the proposed MMPIFC has a larger boost factor toward the DC voltage input. The flow of power between the different power sources and SHAPF is controlled by varying the duty ratio of the main switches. The working principles of the proposed MMPIFC-operated PV-SHAPF are explored in this paper, and essential design concerns are highlighted. A prototype model with 1 kVA, 400 V, and 50 HZ is built and tested under various conditions to validate the theoretical analysis, design, and control method.