bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengthening ethics committees for health-related research in sub-Saharan Africa: a scoping review protocol
Authors: Thurtle Val , Leather Andy JM , Wurie Haja , Foday Edward , Samai Mohamed , Parmar Divya 
Published: August 2021

IntroductionHealth research in low-income and middle-income countries, which face the greatest burden of disease, is a vital component of efforts to combat global health inequality. With increased research, there has also been concern about ethical and regulatory issues and the state of research ethics committees, with various attempts to strengthen them. This scoping review examines the literature on ethics committees for health-related research in sub-Saharan Africa, with a focus on regulatory governance and leadership, administrative and financial capacity, and conduct of ethical reviews.Methods and analysisWe will use the methodological approach proposed by Arksey and O’Malley and adapted by Levacet aland the Joanna Briggs Institute. Inclusion and exclusion criteria are based on the ‘Population–Concept–Context’ framework. Literature (from January 2000 to December 2020) will be searched in multiple databases including Embase and PubMed and websites of relevant organisations. All records will be screened by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review flowchart: two reviewers will independently screen titles and abstracts, and full text of included records. Using an inductive approach, we will synthesise the literature, identify best practice and gaps in evidence on strengthening research ethics committees.Ethics and disseminationEthical approval is not required as the review will include only published literature. The findings will be published in a peer-reviewed journal and presented at stakeholder meetings and conferences.
Involvement of people who inject drugs in injection initiation events: a cross-sectional analysis identifying similarities and differences across three North American settings
Authors: Marks Charles , Meyers Stephanie A , Jain Sonia , Sun Xiaoying , Hayashi Kanna , Gonzalez-Zuniga Patricia , Strathdee Steffanie A , Garfein Richard S , Milloy M J , DeBeck Kora , Cummins Kevin , Werb Dan 
Published: August 2021

ObjectivesPeople who inject drugs (PWID) play an integral role in facilitating the entry of others into injection drug use (IDU). We sought to assess factors influencing PWID in providing IDU initiation assistance across three distinct North American settings and to generate pooled measures of risk.DesignWe employed data from three PWID cohort studies participating inPReventing Injecting by Modifying Existing Responses(PRIMER), for this cross-sectional analysis.SettingTijuana, Mexico; San Diego, USA; Vancouver, Canada.ParticipantsA total of 2944 participants were included in this study (Tijuana: n=766, San Diego: n=353, Vancouver: n=1825).MeasurementsThe outcome was defined as recently (ie, past 6 months) assisting in an IDU initiation event. Independent variables of interest were identified from previous PRIMER analyses. Site-specific multiple modified Poisson regressions were fit. Pooled relative risks (pRR) were calculated and heterogeneity across sites was assessed via linear random effects models.ResultsEvidence across all three sites indicated that having a history of providing IDU initiation assistance (pRR: 4.83, 95% CI: 3.49 to 6.66) and recently being stopped by law enforcement (pRR: 1.49, 95% CI: 1.07 to 2.07) were associated with a higher risk of providing assistance with IDU initiation; while recent opioid agonist treatment (OAT) enrolment (pRR: 0.64, 95% CI: 0.43 to 0.96) and no recent IDU (pRR: 0.21, 95% CI: 0.07 to 0.64) were associated with a lower risk. We identified substantial differences across site in the association of age (I2: 52%), recent housing insecurity (I2: 39%) and recent non-injection heroin use (I2: 78%).ConclusionWe identified common and site-specific factors related to PWID’s risk of assisting in IDU initiation events. Individuals reporting a history of assisting IDU initiations, being recently stopped by law enforcement, and recently injecting methamphetamine/speedball were more likely to have recently assisted an IDU initiation. Whereas those who reported not recently engaging in IDU and those recently enrolled in OAT were less likely to have done so. Interventions and harm reduction strategies aimed at reducing the harms of IDU should incorporate context-specific approaches to reduce the initiation of IDU.
Quality of care, resource use and patient outcome by use of emergency response team compared with standard care for critically ill medical patients in the emergency department: a retrospective single-centre cohort study from Norway
Authors: Engebretsen Stine , Bogstrand Stig Tore , Jacobsen Dag , Rimstad Rune 
Published: August 2021

ObjectiveThe study aimed to investigate quality of care, resource use and patient outcome in management by an emergency response team versus standard care for critically ill medical patients in the emergency department (ED). The emergency response team was multidisciplinary and had eight members, with a registrar in internal medicine as team leader.DesignRegister-based retrospective cohort study.SettingTertiary hospital in Norway.ParticipantsThe study included 1120 patients with National Early Warning Score 2 (NEWS2) 5–10 points from 2015 and 2016. Patients missing ≥3 NEWS2 part scores, <18 years and with orders ‘Not for ICU’ or ‘Not for resuscitation’ were excluded.Outcome measuresQuality of care: pain assessment documented, analgesics given within 20 min, complete set of vital signs documented and antibiotics within 60 min if sepsis. Resource use: >3 diagnostic interventions, critical care in the ED and ED length of stay (LOS) <180 min. Patient outcome: intensive care unit (ICU) admission, ICU LOS <66 hours, hospital LOS <194 hours and mortality.ResultsThe median age was 66 years, 53.5% were male, 44.3% were admitted to the ICU and the mortality rate was 10.6%. Altogether 691 patients received team management and 429 standard care. Team management had a positive association with ‘complete set of vital signs documented’ (OR 1.720, CI 1.254 to 2.360), ‘analgesics given within 20 minutes’ (OR 3.268, CI 1.375 to 7.767) and ‘antibiotics within 60 minutes if sepsis’ (OR 7.880, CI 3.322 to 18.691), but a negative association with ‘ pain assessment documented’ (OR 0.068, CI 0.037 to 0.128). Team management was also associated with ‘critical care in the ED’ (OR 9.900, CI 7.127 to 13.751), ‘ED LOS <180 min’ (OR 2.944, CI 2.070 to 4.187), ‘ICU admission’ (OR 2.763, CI 1.962 to 3.891) and ‘mortality’ (OR 1.882, CI 1.142 to 3.102).ConclusionsTeam management showed positive results for quality of care and resource use. The results for later outcomes such as mortality, ICU LOS and hospital LOS were more ambiguous.
Antimicrobial stewardship interventions in least developed and low-income countries: a systematic review protocol
Authors: Mzumara Grace Wezi , Mambiya Michael , Iroh Tam Pui-Ying 
Published: August 2021

IntroductionAntimicrobial resistance (AMR) is increasing in low resource settings. It complicates the management of infectious diseases and is an increasing cause of death. This is due to, among other things, lack of health resources for appropriate diagnosis and unregulated access to antimicrobials in the public sphere. Developing context-specific interventions that enable judicious use of antimicrobials is important to curb this problem.MethodsWe will conduct a systematic review of antimicrobial stewardship (AMS) approaches in Development Assistance Committee in least developed and low-income countries. The inclusion criteria are antimicrobial stewardship interventions in hospitalised patients of all age groups and exclusion criteria are community-based trials and studies that solely focus on viral, fungal or parasite infections. Antimicrobial stewardship interventions will be classified as structural, enabling, persuasive, restrictive or combined. Outcomes of included studies will be classified as clinical, microbiological or behavioural outcomes. The studies to be included will be randomised controlled trials, controlled before–after studies, interrupted time series trials, cohort and qualitative studies. Data will be extracted using forms adapted from the Cochrane collaboration data collection form. This systematic review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and risk of bias will be done according to the Integrated quality Criteria for Review of Multiple Study Designs.Ethics and disseminationOur findings will be presented to clinicians and policymakers, to support developing AMS protocols for low resource settings. We will publish our results in peer-reviewed journals.Trial registration numberCRD42020210634.
Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review
Authors: Anil Krithika , Freeman Jennifer A , Buckingham Sarah , Demain Sara , Gunn Hilary , Jones Ray B , Logan Angela , Marsden Jonathan , Playford Diane , Sein Kim , Kent Bridie 
Published: August 2021

ObjectiveTo identify the available guidance and training to implement telerehabilitation movement assessments for people (adults and children) with a physical disability, including those recovering from COVID-19.DesignRapid scoping review.Included sources and articlesPubMed, CINAHL, PsychInfo, Cochrane, Embase, Web of Science, PEDro, UK Health Forum, WHO, National Archives and NHS England were searched using the participant–concept–context framework from 2015 to August 2020. Primary studies that recruited individuals with physical disabilities and guidance documents aimed at providers to implement movement-related telerehabilitation were included.Results23 articles (11 primary research studies, 3 systematic reviews and 9 guidance documents) were included out of 7857 that were identified from the literature search. Two main issues were found: (1) telerehabilitation guidance (from both research studies and guidance documents) was not specific to movement-related assessment and (2) most primary research studies provided neither guidance nor training of movement-specific assessment to practitioners. Of the COVID-19 related guidance, two articles reported COVID-19 management that only referred to identifying COVID-19 status without references to specific movement-related guidance.ConclusionsTelerehabilitation guidance and training have existed pre-COVID-19, yet the lack of specific movement-related information and provider support is surprising. This gap must be addressed to optimise effective implementation of remote assessments for those with physical disabilities.Review registrationOpen Science Framework:osf.io/vm6sp.
Gestational weight gain in a migration context: are migrant women more at risk of inadequate or excessive weight gain during pregnancy?
Authors: Poncet Lorraine , Panjo Henri , Schmitz Thomas , Luton Dominique , Mandelbrot Laurent , Estellat Candice , Andro Armelle , Ringa Virginie , Azria Elie 
Published: August 2021

BackgroundInadequate or excessive gestational weight gain (GWG) is associated with adverse maternal and neonatal outcomes. Little is known on adequacy of GWG in migrant women. This study investigates whether migrant women in France are at higher risk of inadequate or excessive GWG, and what characteristics are associated with GWG in migrant and non-migrant groups.MethodsWe used data from the PreCARE multicentric prospective cohort (N=10 419). The study includes 5403 women with singleton deliveries, with non-migrant (n=2656) and migrant (n=2747) status. We used multinomial logistic regression, adjusting for maternal age and parity, to investigate the association of migrant status, socioeconomic status-related variables and GWG. In stratified analyses, we identified factors associated with GWG in both groups.ResultsCompared with non-migrant women, migrant women had increased risk of inadequate GWG (adjusted odds ratio (aOR) 1.18; 95% CI 1.03 to 1.34). Non-migrant women with foreign origins had increased risk of excessive GWG (aOR 1.58; 95% CI 1.30 to 1.92). Women born in Sub-Saharan Africa had increased risk of both inadequate and excessive GWG. Regardless of migration status, women with lower education and women who did not start pregnancy with a normal weight were less likely to gain adequately. Inadequate prenatal care was associated with inadequate GWG only among non-migrant women.ConclusionMigrant women are at higher risk of inadequate GWG.
Rate of change in acetylcholine receptor antibody levels predicts myasthenia gravis outcome
Authors: Kojima Yuta , Uzawa Akiyuki , Ozawa Yukiko , Yasuda Manato , Onishi Yosuke , Akamine Hiroyuki , Kawaguchi Naoki , Himuro Keiichi , Noto Yu-ichi , Mizuno Toshiki , Kuwabara Satoshi 
Published: August 2021

ObjectiveTo investigate the association between changes in anti-acetylcholine receptor antibody (AChR Ab) levels induced by immunosuppressive treatment and myasthenia gravis (MG) prognosis at 1-year post-treatment in patients with MG.MethodsWe included 53 consecutive AChR Ab-positive patients with MG whose AChR Ab levels were remeasured within 100 days of initiating immunosuppressive treatment (median remeasuring time post-treatment: 71 (55–84) days). The AChR Ab level reduction rate (RR-AChRAb, %/day) adjusted for the time between treatment initiation, and AChR Ab level remeasurement was calculated as follows: (pretreatment–post-treatment AChR Ab level)/pretreatment AChR Ab level/days between therapy initiation and AChR Ab level remeasurement ×100. Participants were divided into two groups based on the cut-off value of RR-AChR Ab, determined using receiver operating characteristic analyses for achieving minimal manifestation (MM) or better status at 1-year postimmunosuppressive treatment. The Myasthenia Gravis Foundation of America postintervention status and MG activity of daily living (MG-ADL) score at 1-year post-treatment were compared between the two groups.ResultsThe RR-AChRAb cut-off value was 0.64%/day. The high RR-AChRAb group had a higher ratio of MM or better status (90% vs 65%, p=0.03) and lower MG-ADL score (median; 1 vs 2, p=0.04) than the low RR-AChRAb group. Kaplan-Meier analyses showed the early MM achievement in the high RR-AChRAb group (p=0.002, log-rank test).ConclusionsHigh RR-AChRAb is associated with a favourable outcome at 1-year post-treatment. AChR Ab remeasurement within 100 days of therapy may be useful for predicting AChR Ab-positive MG outcomes at 1-year post-treatment.
Leadership: an effective human factor during COVID-19
Authors: Dhahri Adeel Abbas , Refson Jonathan 
Published: August 2021

BackgroundA hybrid leader is an individual with a professional background who takes on managerial roles. For surgeons, leadership is a non-technical skill within a domain of a human factor and a diverse role that makes them an effective hybrid leader.ObjectivesWe hypothesised that a surgical leader acts as a link between different departments in an organisation to influence performance at the workplace to bring positive changes in healthcare and patient safety.MethodsWe followed the nine-dimension Healthcare Leadership Model (HLM) and reflected on the leadership roles within our surgical department at the Princess Alexandra Hospital NHS Trust, United Kingdom.ResultsChanges were quickly adopted and monitored while leadership learned adaptability to function quickly. Hierarchical decision making was removed while levelling up communication. Telemedicine was quickly adopted at both elective and ambulatory emergency settings. The local survey also showed trust and co-operation among team members.ConclusionsHybrid surgical leadership is a complex but divergent role that acts as a bridge between the surgical team and others in administrative roles that promotes safer patient outcomes and better well-being for the organisations’ members
Coronal sulcus–based ventral mucosal flap to help penile coverage in severe concealed penis
Authors: Jesus Lisieux , Jamel Flavia Amaro , Gomes Fernanda , Ribeiro Talia Dias , Dekermacher Samuel 
Published: August 2021

IntroductionThere are many techniques to treat congenital concealed penis (CP). Skin resurfacing is the most difficult step in severe cases. We aim to show medium-term results of coronal sulcus–based triangular ventral mucosal flap (CBVMF) as a treatment of prepubertal severe CP, a recently reported technique. We aim to determine whether results are durable and if the technique is associated with persistent mucosal redundancy or with a permanent unequal penile color pattern.MethodsCP cases reconstructed with CBVMF were reviewed. Preoperative complaints, degree of motivation of the child/parent to surgery, satisfaction of parent/child with results, and surgical complications were described.ResultsSeven patients (6 months to 6 years old) were treated with CBVMP. Two patients showed megaprepuce and another was submitted to a limited postectomy 3 years before. One family was not fully satisfied (expected “bigger penis”), but acknowledged that the penis was now well exposed. No child talked about the problem preoperatively, but all of the boys were fully satisfied with the results of the surgery and verbalized this in the interviews. Flap edema resolved after 3 months in all but one patient. The flaps assumed the color of penile skin in the medium term.ConclusionsCBMVP results were satisfactory. Serious complications did not occur. Flap edema does not persist in the medium term, and redundancy was not a problem. The color of the flap tended to evolve into a pattern similar to the penile skin.
Testing the Bethe ansatz with large N renormalons
Authors: Mariño Marcos , Miravitllas Ramon , Reis Tomás 
Published: August 2021

AbstractThe ground-state energy of integrable asymptotically free theories can be conjecturally computed using the Bethe ansatz once the theory has been coupled to an external potential through a conserved charge. This leads to a precise prediction for the perturbative expansion of the energy. We provide a non-trivial test of this prediction in the non-linear sigma model and its supersymmetric extension, by calculating analytically the associated Feynman diagrams at next-to-leading order in the 1/N expansion, and at all loops. By investigating the large order behavior of the diagrams, we locate the position of the renormalons of the theory and we obtain an analytic expression for the large N trans-series associated to each. As a spin-off of our calculation, we provide a direct derivation of the beta function of these theories, at next-to-leading order in the 1/N expansion.
COMPARATIVE STUDY FOR WAVE SPEED ESTIMATION AT A SINGLE AND TWO MEASUREMENT POINTS
Authors: AYADI ASMA , SAHTOUT WASSILA , BALEDENT OLIVIER 
Published: August 2021

Local wave speed is a prognostic detector that allows the analysis of cardiovascular function. Objectives: This study compared wave speed ([Formula: see text] measurements at single-point and two-point techniques. Material and methods: [Formula: see text] were determined from the cepstral analysis of the blood flow velocities, which identified the arrivals times of reflected waves. The blood velocities waveforms were measured by using phase-contrast magnetic resonance (PCMR) for 20 subjects on young and old healthy subjects. Local wave speed was estimated through the arrivals time of reflections waves ([Formula: see text] and the distance separating the measurement site to reflection area ([Formula: see text] or the distance separating the two measurement sites. Results: Our obtained results were in total agreement with reference values reported in the literature. Moreover, the detected results show that there is a high correlation ([Formula: see text]) between the two methods. Conclusion: The analysis of the wave speed variations with advancing age is also achieved out through different regression models.
Biomechanical Characteristics on the Lower Extremity of Three Typical Yoga Manoeuvres
Authors: Whissell Elizabeth , Wang Lin , Li Pan , Li Jing Xian , Wei Zhen 
Published: August 2021

This study was aimed at exploring the biomechanical characteristics of the lower extremity amongst three typical yoga manoeuvres. A total of thirteen experienced female yoga practitioners were recruited in the current study; they were all certified with the Yoga Alliance. A three-dimensional motion capture system with 10 cameras combined with four synchronised force plates was used to collect kinematics of the lower extremity and ground reactive force whilst the participants performed the crescent lunge pose, warrior II pose, and triangle pose. One-way repeated ANOVA was used in exploring the differences amongst the three yoga movements, and the significance was set to

alpha
<
0.05

. The triangle pose performed the largest range of motion (ROM) of the hip (

90.5

°

±

22.9

°

), knee (

68.8

°

±

23.1

°

), and ankle (

46.4

°

±

11.3

°

) in the sagittal plane and the hip (

54.8

°

±

6.5

°

), knee (

42.4

°

±

12.8

°

), and ankle (

4.8

°

±

1.7

°

) in the frontal plane amongst the three manoeuvres (

P
<
0.05

). No significant difference was found for the hip and ankle joint moment amongst the three manoeuvres (

P
>
0.05

). Knee joint travelled into 9.5° of extension and slight adduction of 1.94° whilst expressing the largest knee joint adduction moments (

0.30
±
0.22

Nm
/
kg

) in the triangle pose. The distribution of the angular impulse of the lower limb joints indicated that the hip joint contributed significantly the most in the sagittal and frontal planes of the three yoga manoeuvres (

P
<
0.05

), ranging from 51.67% to 70.56%. Results indicated that triangle pose may be superior to the other two manoeuvres, which improved hip joint ROM, strength, and dynamic stability. However, knee injuries such as osteoarthritis (OA) should be considered because of the large knee extensor angle and adductor moments.