bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contextualizing evidence‐based nurse‐led interventions for reducing 30‐day hospital readmissions using GRADE evidence to decision framework: A Delphi study
Authors: Zhong Claire C. W. , Wong Charlene H. L. , Hung Chi‐tim , Yeoh Eng‐kiong , Wong Eliza L. Y. , Chung Vincent C. H. 
Published: May 2023

AbstractBackgroundHigh 30‐day readmission rates increase hospital costs and negatively impact patient outcomes in many healthcare systems, including Hong Kong. Evidence‐based and local adaptable nurse‐led interventions have not been established for reducing 30‐day hospital readmissions among general medical patients in Hong Kong's public healthcare system.AimsThe aim of this study was to select and refine evidence‐based nurse‐led interventions for reducing 30‐day hospital readmissions among general medical patients in Hong Kong's public healthcare system using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision (EtD) framework.MethodsEighteen local healthcare stakeholders were recruited to carry out a two‐step process. In step 1, stakeholders were invited to prioritize nurse‐led interventions which were supported by existing evidence and suggest important combinations of different interventions. For all interventions prioritized in step 1, step 2 involved stakeholders performing a two‐round Delphi questionnaire aiming to generate consensus‐based interventions appropriate to the local context. GRADE EtD framework was applied to guide the decision‐making process, taking into account certainty of evidence, benefits and harms, resource use, equity, acceptability, and feasibility.ResultsFour out of eight nurse‐led interventions reached a positive consensus with percentage agreement ranging from 70.6% to 82.4%. GRADE EtD criteria ratings showed that over 70% of stakeholders agreed these four interventions were probably acceptable and feasible, though the certainty of evidence was low or moderate. Half of stakeholders believed their desirable effects compared to undesirable effects were large. However, the resources required and how these nurse‐led interventions might affect health inequities when implemented were uncertain. Preliminary implementation issues included high complexity of delivering multiple nurse‐led intervention components, and challenges of coordinating different involved parties in delivering the interventions. Appropriate resource allocation and training should be provided to address these potential problems, as suggested by stakeholders.Linking Evidence to ActionUsing the GRADE EtD framework, four nurse‐led interventions were recommended by healthcare stakeholders as possible strategies for reducing 30‐day hospital readmissions among general medical patients in Hong Kong. To address preliminary implementation issues, nurses' role as care coordinators should also be strengthened to ensure smooth delivery of nurse‐led intervention components, and to facilitate multidisciplinary collaboration during service delivery.
Recent Advances and Trends in Chiplet Design and Heterogeneous Integration Packaging
Authors: Lau John H. 
Published: May 2023

Abstract
In this study, chiplet design and heterogeneous integration packaging, especially (a) chip partition and heterogeneous integration driven by cost and technology optimization, Figs. 1(a) and 1(b) chip split and heterogeneous integration driven by cost and yield, Figs. 1(b) and 1(c) multiple system and heterogeneous integration with thin-film layers directly on top of a build-up package substrate, Figs. 1(c) and 1(d) multiple system and heterogeneous integration with an organic interposer on top of a build-up package substrate, Figs. 1(d) and 1(e) multiple system and heterogeneous integration with through-silicon via (TSV) interposer on top of a build-up package substrate, Fig. 1(e), will be investigated. Figures 1(c)–1(e) are driven by formfactor and performance. Emphasis is placed on their advantages and disadvantages, design, materials, process, and examples. Some recommendations will also be provided.
Simulated and Experimental Verification of Fuel-Efficient Truck Platooning With Model Predictive Control Under Grade and Traffic Disturbances
Authors: Ard Tyler , Pattel Bibin , Fuhs Karla , Vahidi Ardalan , Borhan Hoseinali 
Published: May 2023

Abstract
Truck platooning closely regulates gaps between heavy-duty freight trucks to exploit slipstream effects for reducing aerodynamic friction—and therefore reducing engine effort and fuel usage. Currently deployed applications of this have been classically actuated through error-correcting PID feedback loops with connectivity amongst trucks in a fleet to form a connected and adaptive cruise control law that attenuates disturbances between trucks to maintain tolerable gaps. Typically, performance of such systems is challenged by difficult, albeit not uncommon, transients when under traffic conditions and when under road grade variations. Because of this, such platooning control requires attentive and trained drivers to disengage the adaptive cruise control—which limits its potentials for reducing driver load. More advanced longitudinal motion planning under predictive optimal control can push for higher levels of autonomy under a larger range of scenarios, as well as improve fuel efficiency. Here, model predictive control for fuel-performant truck platooning is vetted in both simulation and experimentation for representative traffic and road grade routes. Several approaches are used exploiting physics-based models with and without the powertrain system, and neural network-encoded models. The fuel benefits of aerodynamic platooning are isolated from the more general eco-driving approach, which already provides fuel benefit to trucks by smartly selecting truck velocity. Results from simulation and validation in experimentation are presented—showing up to 6% benefit in fuel economy through eco-driving and an additional 3% achievable through platooning. Observed losses in fuel performance are explained by energy dissipation from braking.
In vitro
and
ex vivo
proteomics of
Mycobacterium marinum
biofilms and the development of biofilm-binding synthetic nanobodies
Authors: Hammarén Milka Marjut , Luukinen Hanna , Sillanpää Alina , Remans Kim , Lapouge Karine , Custódio Tânia , Löw Christian , Myllymäki Henna , Montonen Toni , Seeger Markus , Robertson Joseph , Nyman Tuula A. , Savijoki Kirsi , Parikka Mataleena 
Published: May 2023

ABSTRACT

The antibiotic-tolerant biofilms present in tuberculous granulomas add an additional layer of complexity when treating mycobacterial infections, including tuberculosis (TB). For a more efficient treatment of TB, the biofilm forms of mycobacteria warrant specific attention. Here, we used
Mycobacterium marinum
(Mmr) as a biofilm-forming model to identify the abundant proteins covering the biofilm surface. We used biotinylation/streptavidin-based proteomics on the proteins exposed at the Mmr biofilm matrices
in vitro
to identify 448 proteins and
ex vivo
proteomics to detect 91 Mmr proteins from the mycobacterial granulomas isolated from adult zebrafish.
In vitro
and
ex vivo
proteomics data are available via ProteomeXchange with identifiers
PXD033425
and
PXD039416
, respectively. Data comparisons pinpointed the molecular chaperone GroEL2 as the most abundant Mmr protein within the
in vitro
and
ex vivo
proteomes, while its paralog, GroEL1, with a known role in biofilm formation, was detected with slightly lower intensity values. To validate the surface exposure of these targets, we created in-house synthetic nanobodies (sybodies) against the two chaperones and identified sybodies that bind the mycobacterial biofilms
in vitro
and those present in
ex vivo
granulomas. Taken together, the present study reports a proof-of-concept showing that surface proteomics
in vitro
and
ex vivo
proteomics combined is a valuable strategy to identify surface-exposed proteins on the mycobacterial biofilm. Biofilm surface–binding nanobodies could be eventually used as homing agents to deliver biofilm-targeting treatments to the sites of persistent biofilm infection.

IMPORTANCE
With the currently available antibiotics, the treatment of TB takes months. The slow response to treatment is caused by antibiotic tolerance, which is especially common among bacteria that form biofilms. Such biofilms are composed of bacterial cells surrounded by the extracellular matrix. Both the matrix and the dormant lifestyle of the bacterial cells are thought to hinder the efficacy of antibiotics. To be able to develop faster-acting treatments against TB, the biofilm forms of mycobacteria deserve specific attention. In this work, we characterize the protein composition of Mmr biofilms in bacterial cultures and in mycobacteria extracted from infected adult zebrafish. We identify abundant surface-exposed targets and develop the first sybodies that bind to mycobacterial biofilms. As nanobodies can be linked to other therapeutic compounds, in the future, they can provide means to target therapies to biofilms.
Trends in glycemic, blood pressure, and lipid control in adults with diabetes in Switzerland: the CoLaus|PsyCoLaus Study
Authors: Alkandari Abdullah , Vaucher Julien , Marques-Vidal Pedro 
Published: May 2023

AimTo assess the 15-year trends in the level of glycemic, blood pressure, and cholesterol control in adults with diabetes in a Swiss population-based cohort.Research design and methodsCoLaus|PsyCoLaus is a prospective cohort study of 6733 adults aged 35–75 years in Lausanne, Switzerland. Baseline recruitment was conducted in 2003–6 and was followed by three subsequent follow-ups in 2009–12, 2014–17 and 2018–21. In adults with diabetes, glycemic control was defined as fasting plasma glucose <7 mmol/L, blood pressure control as systolic and diastolic pressures of <140/90 mm Hg, and lipid control as non-high-density lipoprotein (non-HDL) cholesterol control <3.4 mmol/L.ResultsRates of glycemic control improved from 23.2% (95% CI 19.5 to 27.3) in 2003–6 to 32.8% (95% CI 28.1 to 37.8) in 2018–21. Blood pressure control also improved, from 51.5% at baseline (95% CI 46.8 to 56.2) to 63.3% (95% CI 58.2 to 68.1) 15 years later. The largest improvement was in cholesterol control, from 29.1% (95% CI 25.1 to 33.6) in 2003–6 to 56.3% (95% CI 51.1 to 61.4) in 2018–21. Overall, simultaneous control of all three improved from 5.5% (95% CI 3.7 to 8.1) at baseline to 17.2% (95% CI 13.7 to 21.5) 15 years later. Improvements in risk factor control tallied with an increase in the use of glucose-lowering agents, blood pressure-lowering medication, and statins. Men were less likely to achieve blood pressure control but presented with a better control of non-HDL cholesterol. Caucasians were less likely to achieve simultaneous control than non-Caucasians.ConclusionCardiovascular risk factor control in adults with diabetes in Switzerland has increased in the last 15 years, but there remains a margin for improvement.
Cost-effectiveness of insulin pumps compared with multiple daily injections both provided with structured education for adults with type 1 diabetes: a health economic analysis of the Relative Effectiveness of Pumps over Structured Education (REPOSE) randomised controlled trial
Authors: Pollard Daniel John , Brennan Alan , Dixon Simon , Waugh Norman , Elliott Jackie , Heller Simon , Lee Ellen , Campbell Michael , Basarir Hasan , White David 
Published: May 2023

Objectives
To assess the long-term cost-effectiveness of insulin pumps and Dose Adjustment for Normal Eating (pumps+DAFNE) compared with multiple daily insulin injections and DAFNE (MDI+DAFNE) for adults with type 1 diabetes mellitus (T1DM) in the UK.

Methods
We undertook a cost–utility analysis using the Sheffield Type 1 Diabetes Policy Model and data from the Relative Effectiveness of Pumps over Structured Education (REPOSE) trial to estimate the lifetime incidence of diabetic complications, intervention-based resource use and associated effects on costs and quality-adjusted life years (QALYs). All economic analyses took a National Health Service and personal social services perspective and discounted costs and QALYs at 3.5% per annum. A probabilistic sensitivity analysis was performed on the base case. Further uncertainties in the cost of pumps and the evidence used to inform the model were explored using scenario analyses.

Setting
Eight diabetes centres in England and Scotland.

Participants
Adults with T1DM who were eligible to receive a structured education course and did not have a strong clinical indication or a preference for a pump.

Intervention
Pumps+DAFNE.

Comparator
MDI+DAFNE.

Main outcome measures
Incremental costs, incremental QALYs gained and incremental cost-effectiveness ratios (ICERs).

Results
Compared with MDI+DAFNE, pumps+DAFNE was associated with an incremental discounted lifetime cost of +£18 853 (95% CI £6175 to £31 645) and a gain in discounted lifetime QALYs of +0.13 (95% CI −0.70 to +0.96). The base case mean ICER was £142 195 per QALY gained. The probability of pump+DAFNE being cost-effective using a cost-effectiveness threshold of £20 000 per QALY gained was 14.0%. All scenario and subgroup analyses examined indicated that the ICER was unlikely to fall below £30 000 per QALY gained.

Conclusions
Our analysis of the REPOSE data suggests that routine use of pumps in adults without an immediate clinical need for a pump, as identified by National Institute for Health and Care Excellence, would not be cost-effective.

Trial registration number

NCT61215213.
A randomised controlled trial of a facilitated home-based rehabilitation intervention in patients with heart failure with preserved ejection fraction and their caregivers: the REACH-HFpEF Pilot Study
Authors: Lang Chim C , Smith Karen , Wingham Jennifer , Eyre Victoria , Greaves Colin J , Warren Fiona C , Green Colin , Jolly Kate , Davis Russell C , Doherty Patrick Joseph , Miles Jackie , Britten Nicky , Abraham Charles , Van Lingen Robin , Singh Sally J , Paul Kevin , Hillsdon Melvyn , Sadler Susannah , Hayward Christopher , Dalal Hayes M , Taylor Rod S 
Published: May 2023

Introduction
Home-based cardiac rehabilitation may overcome suboptimal rates of participation. The overarching aim of this study was to assess the feasibility and acceptability of the novel Rehabilitation EnAblement in CHronic Hear Failure (REACH-HF) rehabilitation intervention for patients with heart failure with preserved ejection fraction (HFpEF) and their caregivers.

Methods and results
Patients were randomised 1:1 to REACH-HF intervention plus usual care (intervention group) or usual care alone (control group). REACH-HF is a home-based comprehensive self-management rehabilitation programme that comprises patient and carer manuals with supplementary tools, delivered by trained healthcare facilitators over a 12 week period. Patient outcomes were collected by blinded assessors at baseline, 3 months and 6 months postrandomisation and included health-related quality of life (primary) and psychological well-being, exercise capacity, physical activity and HF-related hospitalisation (secondary). Outcomes were also collected in caregivers.
We enrolled 50 symptomatic patients with HF from Tayside, Scotland with a left ventricular ejection fraction ≥45% (mean age 73.9 years, 54% female, 100% white British) and 21 caregivers. Study retention (90%) and intervention uptake (92%) were excellent. At 6 months, data from 45 patients showed a potential direction of effect in favour of the intervention group, including the primary outcome of Minnesota Living with Heart Failure Questionnaire total score (between-group mean difference −11.5, 95% CI −22.8 to 0.3). A total of 11 (4 intervention, 7 control) patients experienced a hospital admission over the 6 months of follow-up with 4 (control patients) of these admissions being HF-related. Improvements were seen in a number intervention caregivers' mental health and burden compared with control.

Conclusions
Our findings support the feasibility and rationale for delivering the REACH-HF facilitated home-based rehabilitation intervention for patients with HFpEF and their caregivers and progression to a full multicentre randomised clinical trial to test its clinical effectiveness and cost-effectiveness.

Trial registration number

NCT78539530
Protocol for a definitive randomised controlled trial and economic evaluation of a community-based rehabilitation programme following hip fracture: fracture in the elderly multidisciplinary rehabilitation—phase III (FEMuR III)
Authors: Williams Nefyn , Dodd Susanna , Hardwick Ben , Clayton Dannii , Edwards Rhiannon Tudor , Charles Joanna Mary , Logan Phillipa , Busse Monica , Lewis Ruth , Smith Toby O , Sackley Catherine , Morrison Val , Lemmey Andrew , Masterson-Algar Patricia , Howard Lola , Hennessy Sophie , Soady Claire , Ralph Penelope , Dobson Susan , Dorkenoo Shanaz 
Published: May 2023

IntroductionProximal femoral (hip) fracture is common, serious and costly. Rehabilitation may improve functional recovery but evidence of effectiveness and cost-effectiveness are lacking. An enhanced rehabilitation intervention was previously developed and a feasibility study tested the methods used for this randomised controlled trial (RCT). The objectives are to compare the effectiveness and cost-effectiveness of the enhanced rehabilitation programme following surgical repair of proximal femoral fracture in older people compared with usual care.Methods and analysisProtocol for phase III, parallel-group, two-armed, superiority, pragmatic RCT with 1:1 allocation ratio; allocation sequence by minimisation programme with a built-in random element; secure web-based allocation concealment. The two treatments will be usual care (control) and usual care plus an enhanced rehabilitation programme (intervention). The enhanced rehabilitation will consist of a patient-held information workbook, goal setting diary and up to six additional therapy sessions. Outcome assessment and statistical analysis will be performed blind; patient and carer participants will be unblinded. Outcomes will be measured at baseline, 17 and 52 weeks’ follow-up. Primary outcome at 52 weeks will be the Nottingham Extended Activities of Daily Living scale. Secondary outcomes will measure anxiety and depression, health utility, cognitive status, hip pain intensity, falls self-efficacy, fear of falling, grip strength and physical function. Carer strain, anxiety and depression will be measured in carers. All safety events will be recorded, and serious adverse events will be assessed to determine whether they are related to the intervention and expected. Concurrent economic evaluation will be a cost-utility analysis from a health service and personal social care perspective. An embedded process evaluation will determine the mechanisms and processes that explain the implementation and impacts of the enhanced rehabilitation programme.Ethics and disseminationNational Health Service research ethics approval reference 18/NE/0300. Results will be disseminated by peer-reviewed publication.Trial registration numberNCT28376407; Pre-results registered on 23 November 2018.
Involvement of methodological experts and the quality of clinical practice guidelines: a critical appraisal of clinical practice guidelines and a questionnaire survey of the development groups in Japan
Authors: Hatakeyama Yosuke , Seto Kanako , Onishi Ryo , Hirata Koki , Matsumoto Kunichika , Wu Yinghui , Hasegawa Tomonori 
Published: May 2023

ObjectiveTo evaluate whether the involvement of methodological experts improves the quality of clinical practice guidelines (CPGs) after adjusting for other factors.SettingThe quality of Japanese CPGs published in 2011–2019 was assessed using the Appraisal of Guidelines, Research, and Evaluation (AGREE) II instrument. A questionnaire survey targeting CPG development groups was conducted through postal mail.Participants405 CPGs were retrieved from a Japanese CPG clearinghouse. Questionnaires were distributed to the 405 CPG development groups. Of the 178 respondents, 22 were excluded because of missing values. Finally, 156 participants representing their CPG development groups were included in the analysis.Primary and secondary outcome measuresCPG quality was assessed using the AGREE II tool. The characteristics of CPGs, including publication year, development organisation, versions, number of members in the development group and involvement of methodological experts, were corrected from the description in the CPGs and the questionnaire survey. We performed multiple logistic regressions using the quality of CPGs as the dependent variable and the involvement of experts as the independent variable, adjusting for other possible factors.ResultsA total of 156 CPGs were included. Expert involvement was significantly associated with the AGREE II instrument scores in domains 1 (β=0.207), 2 (β=0.370), 3 (β=0.413), 4 (β=0.289), 5 (β=0.375), 6 (β=0.240) and overall (β=0.344).ConclusionThis study revealed that the involvement of methodological experts in the CPG development process improves the quality of CPGs. The results suggest the importance of establishing a training and certification programme for experts and constructing expert referral systems that meet CPG developers’ needs to improve the quality of CPGs.
Planned improvement actions based on patient safety incident reports in Estonian hospitals: a document analysis
Authors: Uibu Ere , Põlluste Kaja , Lember Margus , Toompere Karolin , Kangasniemi Mari 
Published: May 2023

AimAim of this study was to describe and analyse associations of incidents and their improvement actions in hospital setting.MethodsIt was a retrospective document analysis of incident reporting systems’ reports registered during 2018–2019 in two Estonian regional hospitals. Data were extracted, organised, quantified and analysed by statistical methods.ResultsIn total, 1973 incident reports were analysed. The most commonly reported incidents were related to patient violent or self-harming behaviour (n=587), followed by patient accidents (n=379), and 40% of all incidents were non-harm incidents (n=782). Improvement actions were documented in 83% (n=1643) of all the reports and they were focused on (1) direct patient care, (2) staff-related actions; (3) equipment and general protocols and (4) environment and organisational issues. Improvement actions were mostly associated with medication and transfusion treatment and targeted to staff. The second often associated improvement actions were related to patient accidents and were mostly focused on that particular patient’s further care. Improvement actions were mostly planned for incidents with moderate and mild harm, and for incidents involving children and adolescents.ConclusionPatient safety incidents-related improvement actions need to be considered as a strategy for long-term development in patient safety in organisations. It is vital for patient safety that the planned changes related to the reporting will be documented and implemented more visibly. As a result, it will boost the confidence in managers’ work and strengthens all staff’s commitment to patient safety initiatives in an organisation.