bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study on Thermodynamic Characteristics of Composite Thermal Insulation Systems With Liquid Methane, Oxygen, and Hydrogen
Authors: Xu Xiafan , Zheng Jianpeng , Xu Hao , Chen Liubiao , Wang Junjie 
Published: September 2021

AbstractComposite passive insulation technology has been proved to be an effective method to reduce heat leakage into the cryogenic storage tank. However, the current related research mainly focused on liquid hydrogen (LH2). The thermophysical properties of different cryogenic liquids and the thermal insulation materials at different temperatures are significantly different, so whether the results related to LH2 are applicable to other cryogenic liquids remains to be further determined. In fact, the insulation technology of LH2 itself also needs further study. In this paper, a thermodynamic calculation model of a composite insulation system including hollow glass microspheres (HGMs), multilayer insulation (MLI), and self-evaporating vapor cold shield (VCS) has been established. The accuracy of the calculation model was verified by the experimental results, and a comparative study on thermodynamic characteristics of the composite thermal insulation system with liquid methane, liquid oxygen (LO2), and LH2 was carried out. The results show that the heat leakage reduction of the proposed system for liquid methane, LO2, and LH2 is 25.6%, 29.7%, and 64.9%, respectively, compared with the traditional SOFI + MLI system (1 × 10−3 Pa). The type of liquid and the insulation system structure has a relatively large influence on the VCS optimal position. While for a specific insulation system structure, the insulation material thickness, storage pressure, and hot boundary temperature have a weak influence on the VCS optimal position.
Forgotten but not gone: A heuristic literature review of sibling suicide bereavement
Authors: Royden Leah Jane 
Published: September 2021

INTRODUCTION: It is often said that Aotearoa New Zealand suffers from a “culture of silence” around suicide. The sibling experience, it seems, forms a silence within that silence. Suicide- bereaved siblings face what has been termed a “double loss.” Their sibling is gone, and sois their family as they knew it. Typically, they mourn both losses in isolation, the “forgotten bereaved.” Although Aotearoa New Zealand’s suicide rates are amongst the highest inthe developed world, there are currently no academic papers dedicated exclusively to the sibling experience of suicide loss. This has serious implications, as suicide-bereaved siblings experience significantly higher rates of mental illness compared to control groups even when pre-existing psychopathology, health problems, and social disadvantages are taken into consideration. In addition, their own risk of suicide has been found to double.METHOD: This heuristic literature review aims to clarify and summarise what research focused on the sibling experience of suicide bereavement has highlighted so far, drawing on the author’s lived experience to examine key themes of guilt, “unacceptable” anger, social stigmatisation, self-judgement, isolation, and the shattering of relational trust.FINDINGS AND IMPLICATIONS: Siblings cannot be expected to “seek” help, it needs to be offered—strongly and repeatedly. With this in mind, potential implications for mental health practice with suicide-bereaved siblings will be discussed, as well as broader social initiatives and areas in need of future research.
The best interests of the child: More questions about this construct?
Authors: Ainsworth Frank 
Published: September 2021

In this article I examine the best interests of the child construct and raise questions about the utility of the construct. I also draw attention to Winnicott’s good enough parenting proposal as an alternative conceptualisation that addresses the issue of parental child-rearing capacity.The best interests construct that emanates from the US has been the dominant international child-protection paradigm for at least two decades. Associated with this construct is a focus on individual parental pathology and child-rearing deficits. Yet, family poverty is the dominant factor, rather than parental pathology or incapacity, that precipitates many child abuse and neglect cases. The question is, has the best interests construct, one that ignores poverty and social disadvantage, outlived its usefulness? This construct has certainly affected Aboriginal families and led, as evidence shows, to the over-removal of children from these families. A range of alternative interventions and a social model of child protection is then canvassed.
Change in the ophthalmoscopical optic disc size and shape in a 10-year follow-up: the Beijing Eye Study 2001–2011
Authors: Jonas Jost B , Zhang Qi , Xu Liang , Wei Wen Bin , Jonas Rahul A , Wang Ya Xing 
Published: September 2021

BackgroundTo assess prevalence and associated factors of changes in the ophthalmoscopic optic disc size and shape.MethodsThe case–control study included all highly myopic eyes (myopic refractive error ≤−6.0 diopters) and a randomly selected group of non-highly myopic eyes, examined in the population-based Beijing Eye Study 2001 and 2011.ResultsThe study included 89 highly myopic eyes (age:65.0±9.8 years) and 86 non-highly myopic eyes. Reduction in ophthalmoscopic disc size (prevalence, high myopia: 30 (33.7%) eyes; non-high myopia: 7 (8.1%) eyes) was associated with non-circular gamma zone enlargement (OR: 19.4; 95% CI: 6.7 to 56.6; p<0.001) and disc-fovea line elongation (OR: 2.80;95% CI: 1.12 to 6.98; p=0.03). Disc size reduction was correlated with a disc diameter shortening in direction of the widest gamma zone enlargement (correlation coefficient r=34; p=0.01). The perpendicular disc diameter remained mostly unchanged, resulting in an ovalisation of the ophthalmoscopic disc shape. Enlargement of the ophthalmoscopic disc size (prevalence, high myopia: 22 (24.7%) eyes; non-high myopia: 4 (4.7%) eyes) was associated with circular gamma zone enlargement (4.99; 95% CI: 1.95 to 12.8; p=0.001) and high myopia (OR: 4.29; 95% CI: 1.34 to 13.8; p=0.01).ConclusionsMyopic axial elongation may lead first to a Bruch’s membrane (BM) opening (BMO) shift into the foveal direction leading to BM overhanging into the nasal intrapapillary compartment, development and enlargement of gamma zone at the temporal disc side, reduction in the ophthalmoscopically visible disc area and ovalisation of the ophthalmoscopic disc shape. In a second step, an axial elongation-associated BMO enlargement may lead to a circular gamma zone increase and, due to the retraction of BM at the nasal disc border, to an enlargement of the ophthalmoscopically visible optic disc.
Evaluation of microalbuminuria as a prognostic indicator after a TIA or minor stroke in an outpatient setting: the prognostic role of microalbuminuria in TIA evolution (ProMOTE) study
Authors: Strain W David , Elyas Salim , Wedge Nicola , Mounce Luke , Henley William , James Martin , Shore Angela C 
Published: September 2021

ObjectiveTransient ischaemic attacks (TIA) and minor strokes are important risk factors for further vascular events. We explored the role of albumin creatinine ratio (ACR) in improving risk prediction after a first event.SettingRapid access stroke clinics in the UK.Participants2202 patients attending with TIA or minor stroke diagnosed by the attending stroke physician, able to provide a urine sample to evaluate ACR using a near-patient testing device.Primary and secondary outcomesPrimary outcome was major adverse cardiac events (MACE: recurrent stroke, myocardial infarction or cardiovascular death) at 90 days. The key secondary outcome was to determine whether urinary ACR could contribute to a risk prediction tool for use in a clinic setting.Results151 MACE occurred in 144 participants within 90 days. Participants with MACE had higher ACR than those without. A composite score awarding a point each for age >80 years, previous stroke/TIA and presence of microalbuminuria identified those at low risk and high risk. 90% of patients were at low risk (scoring 0 or 1). Their 90-day risk of MACE was 5.7%. Of the remaining ‘high-risk’ population (scoring 2 or 3) 12.4% experienced MACE over 90 days (p<0.001 compared with the low-risk population). The need for acute admission in the first 7 days was twofold elevated in the high-risk group compared with the low-risk group (3.23% vs 1.43%; p=0.05). These findings were validated in an independent historic sample.ConclusionA risk score comprising age, previous stroke/TIA and microalbuminuria predicts future MACE while identifying those at low risk of a recurrent event. This tool shows promise in the risk stratification of patients to avoid the admission of low-risk patients.
Effects of brief exposure to misinformation about e-cigarette harms on twitter: a randomised controlled experiment
Authors: Wright Caroline , Williams Philippa , Elizarova Olga , Dahne Jennifer , Bian Jiang , Zhao Yunpeng , Tan Andy S L 
Published: September 2021

ObjectivesTo assess the effect of exposure to misinformation about e-cigarette harms found on Twitter on adult current smokers’ intention to quit smoking cigarettes, intention to purchase e-cigarettes and perceived relative harm of e-cigarettes compared with regular cigarettes.SettingAn online randomised controlled experiment conducted in November 2019 among USA and UK current smokers.Participants2400 adult current smokers aged ≥18 years who were not current e-cigarette users recruited from an online panel. Participants’ were randomised in a 1:1:1:1 ratio using a least-fill randomiser function.InterventionsViewing 4 tweets in random order within one of four conditions: (1) e-cigarettes are just as or more harmful than smoking, (2) e-cigarettes are completely harmless, (3) e-cigarette harms are uncertain, and (4) a control condition of tweets about physical activity.Primary outcomes measuresSelf-reported post-test intention to quit smoking cigarettes, intention to purchase e-cigarettes, and perceived relative harm of e-cigarettes compared with smoking.ResultsAmong US and UK participants, after controlling for baseline measures of the outcome, exposure to tweets that e-cigarettes are as or more harmful than smoking versus control was associated with lower post-test intention to purchase e-cigarettes (β=−0.339, 95% CI −0.487 to –0.191, p<0.001) and increased post-test perceived relative harm of e-cigarettes (β=0.341, 95% CI 0.273 to 0.410, p<0.001). Among US smokers, exposure to tweets that e-cigarettes are completely harmless was associated with higher post-test intention to purchase e-cigarettes (β=0.229, 95% CI 0.002 to 0.456, p=0.048) and lower post-test perceived relative harm of e-cigarettes (β=−0.154, 95% CI −0.258 to –0.050, p=0.004).ConclusionsUS and UK adult current smokers may be deterred from considering using e-cigarettes after brief exposure to tweets that e-cigarettes were just as or more harmful than smoking. Conversely, US adult current smokers may be encouraged to use e-cigarettes after exposure to tweets that e-cigarettes are completely harmless. These findings suggest that misinformation about e-cigarette harms may influence some adult smokers’ decisions to consider using e-cigarettes.Trial registration numberISRCTN16082420.
Senior medical students as assistants in medicine in COVID-19 crisis: a realist evaluation protocol
Authors: Monrouxe Lynn V , Hockey Peter , Khanna Priya , Klinner Christiane , Mogensen Lise , O"Mara Deborah A , Roach Abbey , Tobin Stephen , Davids Jennifer Ann 
Published: September 2021

IntroductionThe assistant in medicine is a new and paid role for final-year medical students that has been established in New South Wales, Australia, as part of the surge workforce management response to the COVID-19 pandemic. Eligibility requires the applicant to be a final-year medical student in an Australian Medical Council-accredited university and registered with the Australian Health Practitioner Regulation Agency. While there are roles with some similarities to the assistant in medicine role, such as assistantships (the UK) and physician assistants adopted internationally, this is completely new in Australia. Little is known about the functionality and success factors of this role within the health practitioner landscape, particularly within the context of the COVID-19 pandemic. Given the complexity of this role, a realist approach to evaluation has been undertaken as described in this protocol, which sets out a study design spanning from August 2020 to June 2021.Methods and analysisThe intention of conducting a realist review is to identify the circumstances and mechanisms that determine the outcomes of the assistant in medicine intervention. We will start by developing an initial programme theory to explore the potential function of the assistant in medicine role through realist syntheses of critically appraised summaries of existing literature using relevant databases and journals. Other data sources such as interviews and surveys with key stakeholders will contribute to the refinements of the programme theory. Using this method, we will develop a set of hypotheses on how and why the Australian assistants in medicine intervention might ‘work’ to achieve a variety of outcomes based on examples of related international interventions. These hypotheses will be tested against the qualitative and quantitative evidence gathered from all relevant stakeholders.Ethics and disseminationEthics approval for the larger study was obtained from the Western Sydney Local Health District (2020/ETH01745). The findings of this review will provide useful information for hospital managers, academics and policymakers, who can apply the findings in their context when deciding how to implement and support the introduction of assistants in medicine into the health system. We will publish our findings in reports to policymakers, peer-reviewed journals and international conferences.
Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies
Authors: Bäumler Petra , Zhang Wenyue , Stübinger Theresa , Irnich Dominik 
Published: September 2021

ObjectiveOverview on risks of acupuncture-related adverse events (AEs).DesignSystematic review and meta-analyses of prospective studies.Data sourcesPubMed, Scopus and Embase from inception date to 15 September 2019.Eligibility criteria for selecting studiesProspective studies assessing AEs caused by needle acupuncture in humans as primary outcome published in English or German.Data extraction and synthesisTwo independent researchers selected articles, extracted the data and assessed study quality. Overall risks and risks for different AE categories were obtained from random effects meta-analyses.Main outcomesOverall risk of minor AEs and serious adverse events (SAEs) per patients and per treatments.ResultsA total of 7679 publications were identified. Twenty-two articles reporting on 21 studies were included. Meta-analyses suggest at least one AE occurring in 9.31% (95% CI 5.10% to 14.62%, 11 studies) of patients undergoing an acupuncture series and in 7.57% (95% CI 1.43% to 17.95%, 5 studies) of treatments. Summary risk estimates for SAEs were 1.01 (95% CI 0.23 to 2.33, 11 studies) per 10 000 patients and 7.98 (95% CI 1.39 to 20.00, 14 studies) per one million treatments, for AEs requiring treatment 1.14 (95% CI 0.00 to 7.37, 8 studies) per 1000 patients. Heterogeneity was substantial (I2>80%). On average, 9.4 AEs occurred in 100 treatments. Half of the AEs were bleeding, pain or flare at the needle site that are argued to represent intended acupuncture reaction. AE definitions and assessments varied largely.ConclusionAcupuncture can be considered among the safer treatments in medicine. SAEs are rare, and the most common minor AEs are very mild. AEs requiring medical management are uncommon but necessitate medical competence to assure patient safety. Clinical and methodological heterogeneity call for standardised AE assessments tools, clear criteria for differentiating acupuncture-related AEs from therapeutically desired reactions, and identification of patient-related risk factors for AEs.PROSPERO registration numberCRD42020151930.
Cost-effectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for community-based patients with Broca’s aphasia after stroke: a post hoc analysis of data from a randomised controlled trial
Authors: Liu Zhizhen , Huang Jia , Xu Ying , Wu Jingsong , Tao Jing , Chen Lidian 
Published: September 2021

ObjectiveThis study aimed to assess the cost-effectiveness of combined scalp acupuncture therapy with speech and language therapy for patients with Broca’s aphasia after stroke.DesignA within-trial cost-effectiveness analysis.SettingsCommunity health centres.SubjectsA total of 203 participants with Broca’s aphasia after stroke who had been randomly assigned to receive scalp acupuncture with speech and language therapy (intervention) or speech and language therapy alone (control).InterventionBoth groups underwent speech and language therapy (30 min per day, 5 days a week, for 4 weeks), while the intervention group simultaneously received scalp acupuncture.Primary outcomesAll outcomes were collected at baseline, and after the 4-week intervention and 12-week follow-up. Cost-effectiveness measures included the Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and Boston Diagnostic Aphasia Examination (BDAE). Cost–utility was evaluated using quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios were expressed, and sensitivity analysis was conducted.ResultsThe total cost to deliver the intervention was €4001.72, whereas it was €4323.57 for the control group. The incremental cost-effectiveness ratios showed that the intervention was cost-effective (€495.1 per BDAE grade gained; €1.8 per CRRCAE score gained; €4597.1 per QALYs gained) relative to the control over the 12 weeks. The intervention had a 56.4% probability of being cost-effective at the ¥50 696 (€6905.87) Gross Domestic Product (GDP) per capita threshold. Sensitivity analyses confirmed the robustness of the results.ConclusionsCompared with speech and language therapy alone, the addition of scalp acupuncture was cost-effective in Chinese communities. As the costs of acupuncture services in China are likely to differ from other countries, these results should be carefully interpreted and remain to be confirmed in other populations.Trial registration numberChiCTR-TRC-13003703.
Comparison between Custodiol, del Nido and modified del Nido in the myocardial protection - Cardioplegia Trial: a study protocol for a randomised, double-blind clinical trial
Authors: Almeida Adriana Silveira , Ceron Rafael Oliveira , Anschau Fernando , Kopittke Luciane , Lira Kathize Betti , Delvaux Renan Senandes , Rode Juarez , Rey Rafael Antônio Widholzer , Wittke Estefânia Inês , Rombaldi Alfeu Roberto 
Published: September 2021

IntroductionMyocardial protection is essential for successful cardiac surgery, and the search for an ideal cardioplegic solution has continued since its beginning. In this context, Custodiol, del Nido and modified del Nido are single-dose cardioplegic solutions with good safety profiles and great relevance in modern surgical practice. While these solutions have all been evaluated for their impact on patient outcomes independently, limited research exists comparing them directly. Thus, the present study aims to examine the effects of these cardioplegic solutions on myocardial protection and clinical outcomes in adult patients undergoing elective cardiac surgery. The assessment of the increase in myocardial injury biomarkers in patients submitted to all treatment methods may be considered a major strength of our study.Methods and analysisThis is a clinical trial study protocol that will compare myocardial protection and clinical outcomes among three patient groups based on which cardioplegic solution was used. Patients will be randomised to receive del Nido (n=30), modified del Nido (n=30) or Custodiol (n=30). Myocardial injury biomarkers will be measured at the baseline and 2 hours, 12 hours and 24 hours after the cardiopulmonary bypass. Clinical outcomes will be assessed during the trans operative period and the intensive care unit stay, in addition to other haematological parameters.Ethics and disseminationThis protocol and its related documents were approved by the Research Ethics Committee of the Hospital Nossa Senhora da Conceição, Brazil, registered under no. 4.029.545. The findings of this study will be published in a peer-reviewed journal in the related field.Trial registration numberRBR-7g5s66.
Adolescents and age of consent to HIV testing: an updated review of national policies in sub-Saharan Africa
Authors: Barr-DiChiara Magdalena , Tembo Mandikudza , Harrison Lisa , Quinn Caitlin , Ameyan Wole , Sabin Keith , Jani Bhavin , Jamil Muhammad S , Baggaley Rachel , Johnson Cheryl 
Published: September 2021

ObjectivesIn sub-Saharan Africa (SSA) where HIV burden is highest, access to testing, a key entry point for prevention and treatment, remains low for adolescents (aged 10–19). Access may be hampered by policies requiring parental consent for adolescents to receive HIV testing services (HTS). In 2013, the WHO recommended countries to review HTS age of consent policies. Here, we investigate country progress and policies on age of consent for HIV testing.DesignComprehensive policy review.Data sourcesPolicies addressing HTS were obtained through searching WHO repositories and governmental and non-governmental websites and consulting country and regional experts.Eligibility criteriaHTS policies published by SSA governments before 2019 that included age of consent.Data extraction and synthesisData were extracted on HTS age of consent including exceptions based on risk and maturity. Descriptive analyses of included policies were disaggregated by Eastern and Southern Africa (ESA) and Western and Central Africa (WCA) subregions.ResultsThirty-nine policies were reviewed, 38 were eligible; 19/38 (50%) permitted HTS for adolescents ≤16 years old without parental consent. Of these, six allowed HTS at ≥12 years old, two at ≥13, two at ≥14, five at ≥15 and four at ≥16. In ESA, 71% (n=15/21) allowed those of ≤16 years old to access HTS, while only 24% (n=6/25) of WCA countries allowed the same. Maturity exceptions including marriage, sexual activity, pregnancy or key population were identified in 18 policies. In 2019, 63% (n=19/30) of policies with clear age-based criteria allowed adolescents of 12–16 years old to access HIV testing without parental consent, an increase from 37% (n=14/38) in 2013.ConclusionsWhile many countries in SSA have revised their HTS policies, many do not specify age of consent. Revision of SSA consent to HTS policies, particularly in WCA, remains a priority to achieve the 2025 goal of 95% of people with HIV knowing their status.