bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recruitmentmanoeuvres during mechanical ventilation with sequential high-flow nasal oxygen after extubation to prevent postoperative pulmonary complications in patients undergone thoracic surgery: a protocol, prospective randomised controlled trial
Authors: Wang Zhen , Wang Bo , Xia Wenxi , Wang Peng , Liang Guopeng , Mei Jian Dong , Zhang Yong-Gang , Yan Kang 
Published: October 2022

IntroductionThe incidence of postoperative pulmonary complications (PPCs) following thoracic surgery is high, which increases the mortality rate, prolongs the length of hospital stay and increases medical costs. Some studies have confirmed that preoperative risk assessment, intraoperative anaesthesia methods and intraoperative mechanical ventilation strategies, including recruitment manoeuvres (RMs), can reduce the incidence of PPCs. Despite these improved strategies, the incidence of PPCs remains high. However, mechanical ventilation strategies have not been studied in the postoperative period.Methods and analysisWe assume that RM during mechanical ventilation with sequential high-flow nasal oxygen therapy (HFNO) after extubation can maintain the opening of the postoperative alveoli and ultimately reduce the incidence of PPCs after thoracic surgery. We will include thoracic surgery patients and divide them into the RM with sequential HFNO group and the control group. They will be given RMs and sequential HFNO or be given conventional treatment. The sample size is 654 adult patients (327 per group) undergone thoracic surgery and presenting to the intensive care unit.Ethics and disseminationThis study was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (REC2019-730). It is expected that this study will lead to a randomised controlled trial. We assume that the findings will provide more evidence about PPCs and improve the management of patients undergone thoracic surgery.Trial registration numberChiCTR2100046356.
Effects of fun-seeking and external locus of control on smoking behaviour: a cross-sectional analysis on a cohort of working men in Singapore
Authors: Lee Kar Fye Alvin , Lee Eun Hee , Roberts Adam Charles , Car Josip , Soh Chee Kiong , Christopoulos Georgios 
Published: October 2022

ObjectivesWe examined the combined effects of behavioural inhibition and behavioural activation, on one hand, and locus of control, on the other hand, on different categories of smoking behaviour (non-smoking, ex-smoking, occasional smoking, daily smoking).DesignThis study adopted a cross-sectional design. Participants completed questionnaires regarding demographics, smoking patterns, behavioural inhibition/behavioural activation systems and locus of control.SettingThe study was conducted across four companies from the transportation, cooling plant and education sectors in Singapore.ParticipantsThree hundred sixty-nine male working adults were included in the final sample.ResultsCorroborating previous research, a logistic regression model examining behavioural inhibition/behavioural activation systems revealed that the fun-seeking aspect of behavioural activation was a unique predictor in distinguishing non-smokers from daily smokers (OR=1.24, p=0.012). By contrast, in a separate model examining locus of control, external locus of control was found to be a unique predictor in distinguishing non-smokers from daily smokers (OR=1.13, p<0.001). In addition, a third model combining both behavioural inhibition/behavioural activation systems and locus of control found that only external locus of control remained a significant predictor (OR=1.12, p<0.001). Further analyses revealed a mediating effect of external locus of control on the relationship between fun-seeking and smoking behaviour. That is, the increase in the odds of daily smoking due to fun-seeking was explained by external locus of control (direct pathway OR=1.20, p=0.058; indirect pathway OR=1.04, p<0.050).ConclusionsOverall, fun-seeking through its influence on external locus of control indirectly affects daily smoking behaviour, suggesting a more complex relationship than shown in previous research.
Framework to assess the quality of mHealth apps: a mixed-method international case study protocol
Authors: Tan Yong Yu , Woulfe Fionn , Chirambo Griphin Baxter , Henn Patrick , Cilliers Liezel , Fadahunsi Kayode Philip , Taylor-Robinson Simon D , O'Donoghue John 
Published: October 2022

IntroductionHealthcare professionals (HCPs) often recommend their patients to use a specific mHealth app as part of health promotion, disease prevention and patient self-management. There has been a significant growth in the number of HCPs downloading and using mobile health (mHealth) apps. Most mHealth apps that are available in app stores employ a ‘star rating’ system. This is based on user feedback on an app, but is highly subjective. Thus, the identification of quality mHealth apps which are deemed fit for purpose can be a difficult task for HCPs. Currently, there is no unified, validated standard guidelines for assessment of mHealth apps for patient safety, which can be used by HCPs. The Modified Enlight Suite (MES) is a quality assessment framework designed to provide a means for HCPs to evaluate mHealth apps before they are recommended to patients. MES was adapted from the original Enlight Suite for international use through a Delphi method, followed by preliminary validation process among a population predominantly consisting of medical students. This study aims to evaluate the applicability and validity of the MES, by HCPs, in low, middle and high income country settings.Methods and analysisMES will be evaluated through a mixed-method study, consisting of qualitative (focus group) and quantitative (survey instruments) research, in three target countries: Malaŵi (low income), South Africa (middle income) and Ireland (high income). The focus groups will be conducted through Microsoft Teams (Microsoft, Redmond, Washington, USA) and surveys will be conducted online using Qualtrics (Qualtrics International, Seattle, Washington, USA). Participants will be recruited through the help of national representatives in Malawi (Mzuzu University), South Africa (University of Fort Hare) and Ireland (University College Cork) by email invitation. Data analysis for the focus group will be by the means of thematic analysis. Data analysis for the survey will use descriptive statistics and use Cronbach alpha as an indicator of internal consistency of the MES. The construct validity of the mHealth app will be assessed by computing the confirmatory factor analysis using Amos.Ethics and disseminationThe study has received ethical approval from the Social Research Ethics Committee (SREC) SREC/SOM/03092021/1 at University College Cork, Ireland, Malaŵi Research Ethics Committee (MREC), Malaŵi MZUNIREC/DOR/21/59 and Inter-Faculty Research Ethics Committee (IFREC) of University of Fort Hare (REC-2 70 710-028-RA). The results of the study will be disseminated through the internet, peer-reviewed journals and conference presentations.
Accuracy of a self-report prescription opioid use diary for patients discharge from the emergency department with acute pain: a multicentre prospective cohort study
Authors: Daoust Raoul , Paquet Jean , Williamson David , Perry Jeffrey J , Iseppon Massimiliano , Castonguay Véronique , Morris Judy , Cournoyer Alexis 
Published: October 2022

ObjectivesSelf-reported approaches that assess opioid usage can be subject to social desirability and recall biases that may underestimate actual pill consumption. Our objective was to determine the accuracy of patient self-reported opioid consumption using a 14-day daily paper or electronic diary.DesignProspective cohort study.SettingMulticentre study conducted in four Québec (Canada) emergency departments (ED): three university-affiliated centres, two of them Level I trauma centres and one urban community hospital.ParticipantsED patients aged ≥18 years with acute pain (≤2 weeks) who were discharged with an opioid prescription. Patients completed a 14-day daily diary (paper or electronic) assessing the quantity of opioids consumed. On diary completion, a random sample from the main cohort was selected for a follow-up visit to the hospital or a virtual video visit where they had to show and count the remaining pills. Patients were blinded to the main objective of the follow-up visit.OutcomesQuantity of opioid pills consumed during the 2-week follow-up period self-reported in the 14-day diary (paper or electronic) and calculated from remaining pills counted during the follow-up visit. Intraclass correlation coefficient (ICC) and Bland-Altman plots were used to assess accuracy.ResultsA total of 166 participants completed the 14-day diary as well as the in-person or virtual visit; 49.4% were women and median age was 47 years (IQR=21). The self-reported consumed quantity of opioid in the 14-day diary and the one calculated from counting remaining opioid pills during the follow-up visit were very similar (ICC=0.992; 95% CI: 0.989 to 0.994). The mean difference between both measures from Bland-Altman analysis was almost zero (0.048 pills; 95% CI: −3.77 to 3.87).ConclusionSelf-reported prescription opioid use in a 14-day diary is an accurate assessment of the quantity of opioids consumed in ED discharged patients.Trial registration numberNCT03953534.
Association of meteorological factors with paediatric intussusception in Hangzhou: an 8-year retrospective cohort study
Authors: Feng Yuqing , Zhou Haichun , Shu Qiang , Li Haomin 
Published: October 2022

ObjectivesThis study aimed to investigate the seasonality of paediatric intussusception and the associations between meteorological factors and paediatric intussusception in Hangzhou, as well as aimed to compare the variance in sex and disease type.DesignAn 8-year retrospective study was conducted from January 2014 to December 2021 in the Children’s Hospital of Zhejiang University, Hangzhou, China.SettingThis was a single-centre retrospective study review of intussusception cases in a large Children’s Hospital in Hangzhou.ParticipantsThere were 17 674 patients with intussusception in this study.MethodsA Spearman correlation analysis and Poisson regression analysis were used to determine the association between weekly intussusception cases and meteorological factors. The seasonality of paediatric intussusception was demonstrated via the t-test and visualised.ResultIn January, May and December, there were relatively more intussusception patients. In February, there was a trough in the number of intussusception patients. Both the Spearman correlation analysis and Poisson regression analysis proved that weekly intussusception cases had significant associations with temperature (λ=−0.205, p<0.01; β=−0.080, p<0.01), feels-like temperature (λ=−0.214, p<0.01; β=−0.012, p<0.01), dew (λ=−0.249, p<0.01; β=0.095, p<0.01), humidity (λ=−0.230, p<0.01; β=−0.037, p<0.01), precipitation (λ=−0.148, p<0.01; β=−0.001, p<0.01), windspeed (λ=−0.135, p<0.01; β=0.005, p<0.01), visibility (λ=−0.206, p<0.01; β=−0.066, p<0.01), sea level pressure (λ=0.171, p<0.01; β=−0.004, p<0.01) and a total of 20 of 25 dynamic meteorological factors (p<0.05). These associations reflected gender differences but showed stronger associations in groups that were prone to recurrence.ConclusionsPaediatric intussusception in Hangzhou showed a seasonal tendency. Additionally, intussusception was significantly associated with certain meteorological factors in all of the cases. These findings suggest that parents and paediatricians should be more vigilant about the occurrence of intussusception in children regarding seasonal change times and climate change times.
Use of over-the-scope clip (OTSC) versus standard therapy for the prevention of rebleeding in large peptic ulcers (size ≥1.5 cm): an open-labelled, multicentre international randomised controlled trial
Authors: Chan Shannon , Pittayanon Rapat , Wang Hsiu-Po , Chen Jiann-Hwa , Teoh Anthony YB , Kuo Yu Ting , Tang Raymond SY , Yip Hon Chi , Ng Stephen Ka Kei , Wong Sunny , Mak Joyce Wing Yan , Chan Heyson , Lau Louis , Lui Rashid N , Wong Marc , Rerknimitr Rungsun , Ng Enders K , Chiu Philip Wai Yan 
Published: October 2022

IntroductionOver-the-scope clip (OTSC) has been used recently for primary haemostasis of peptic ulcers. This study aimed to compare the efficacy of OTSC to standard endoscopic therapy in primary treatment of patients with peptic ulcer bleeding that are of size ≥1.5 cm. The target population accounts for only 2.5% of all upper GI bleeders.MethodsThis was a multicentre international randomised controlled trial from July 2017 to October 2020. All patients with Forest IIa or above peptic ulcers of ≥1.5 cm were included. Primary outcome was 30-day clinical rebleeding. Secondary endpoints include 3-day all-cause mortality, transfusion requirement, hospital stay, technical and clinical success, and further interventions. 100 patients are needed to yield a power of 80% to detect a difference of −0.15 at the 0.05 significance level (alpha) using a two-sided Z-test (pooled).Results100 patients were recruited. Success in achieving primary haemostasis was achieved in 46/50 (92%) and 48/50 (96%) in the OTSC and conventional arm, respectively. Among patients who had success in primary haemostasis, 2/46 (4.35%) patients in the OTSC arm and 9/48 (18.75%) patients in the conventional arm developed 30-day rebleeding (p=0.03). However, in an intention-to-treat analysis, there was no difference in rebleeding within 30 days (5/50 (10%) OTSC vs 9/50 (18%) standard, p=0.23) or all-cause mortality (2/50 (4%) OTSC vs 4/50 (8%) standard, p=0.68; OR=2.09, 95% CI 0.37 to 11.95). There was also no difference in transfusion requirement, hospital stay, intensive care unit admission and further interventions.ConclusionThe routine use of OTSC as primary haemostasis in large bleeding peptic ulcers was not associated with a significant decrease in 30-day rebleeding.Trial registration numberNCT03160911.
Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: results from the EPoS trials
Authors: Juul Frederik Emil , Garborg Kjetil , Nesbakken Eugen , Løberg Magnus , Wieszczy Paulina , Cubiella Joaquín , Kalager Mette , Kaminski Michael F , Erichsen Rune , Adami Hans-Olov , Ferlitsch Monika , Furholm Siv K B , Zauber Ann G , Quintero Enrique , Bugajski Marek , Holme Øyvind , Dekker Evelien , Jover Rodrigo , Bretthauer Michael 
Published: October 2022

ObjectiveHigh-quality colonoscopy (adequate bowel preparation, whole-colon visualisation and removal of all neoplastic polyps) is a prerequisite to start polyp surveillance, and is ideally achieved in one colonoscopy. In a large multinational polyp surveillance trial, we aimed to investigate clinical practice variation in number of colonoscopies needed to enrol patients with low-risk and high-risk adenomas in polyp surveillance.DesignWe retrieved data of all patients with low-risk adenomas (one or two tubular adenomas <10 mm with low-grade dysplasia) and high-risk adenomas (3–10 adenomas, ≥1 adenoma ≥10 mm, high-grade dysplasia or villous components) in the European Polyp Surveillance trials fulfilling certain logistic and methodologic criteria. We analysed variations in number of colonoscopies needed to achieve high-quality colonoscopy and enter polyp surveillance by endoscopy centre, and by endoscopists who enrolled ≥30 patients.ResultsThe study comprised 15 581 patients from 38 endoscopy centres in five European countries; 6794 patients had low-risk and 8787 had high-risk adenomas. 961 patients (6.2%, 95% CI 5.8% to 6.6%) underwent two or more colonoscopies before surveillance began; 101 (1.5%, 95% CI 1.2% to 1.8%) in the low-risk group and 860 (9.8%, 95% CI 9.2% to 10.4%) in the high-risk group. Main reasons were poor bowel preparation (21.3%) or incomplete colonoscopy/polypectomy (14.4%) or planned second procedure (27.8%). Need of repeat colonoscopy varied between study centres ranging from 0% to 11.8% in low-risk adenoma patients and from 0% to 63.9% in high-risk adenoma patients. On the second colonoscopy, the two most common reasons for a repeat (third) colonoscopy were piecemeal resection (26.5%) and unspecified reason (23.9%).ConclusionThere is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden.Trial registration numberNCT02319928.
Irritable bowel syndrome: treatment based on pathophysiology and biomarkers
Authors: Camilleri Michael , Boeckxstaens Guy 
Published: October 2022

ObjectiveTo appraise the evidence that pathophysiological mechanisms and individualised treatment directed at those mechanisms provide an alternative approach to the treatment of patients with irritable bowel syndrome (IBS).DesignA PubMED-based literature review of mechanisms and treatment of IBS was conducted independently by the two authors, and any differences of perspective or interpretation of the literature were resolved following discussion.ResultsThe availability of several noninvasive clinical tests can appraise the mechanisms responsible for symptom generation in IBS, including rectal evacuation disorders, abnormal transit, visceral hypersensitivity or hypervigilance, bile acid diarrhoea, sugar intolerances, barrier dysfunction, the microbiome, immune activation and chemicals released by the latter mechanism. The basic molecular mechanisms contributing to these pathophysiologies are increasingly recognised, offering opportunities to intervene with medications directed specifically to food components, receptors and potentially the microbiome. Although the evidence supporting interventions for each mechanism is not at the same level of proof, the current state-of-the-art provides the opportunity to advance the practice from treatment based on symptoms to individualisation of treatment guided by pathophysiology and clinically identified biomarkers.ConclusionThese advances augur well for the implementation of evidence-based individualised treatment for patients with IBS based on actionable biomarkers or psychological disturbances.
Epidemiology of cruciate ligament reconstruction in the Australian Defence Force and predictors of outcome
Authors: Williams Olivia , Ross V R , Lau C L , Mayfield H J 
Published: October 2022

BackgroundThe ability to predict the risk of poor outcome following knee cruciate ligament reconstruction in the Australian Defence Force (ADF) population would help direct individual rehabilitation programmes and workforce planning. This study describes the epidemiology of cruciate ligament reconstruction in the ADF and demonstrates the use of Bayesian networks (BN) to predict the likelihood of fitness for ongoing service under different scenarios.MethodsMembers who had knee cruciate ligament reconstruction through ADF were identified from billing data and matched to electronic medical records to extract demographic and clinical data. Outcome measure was medical fitness for ADF service up to 24 months after reconstruction. BN models were used to compare outcomes between (1) age groups according to military service, and (2) sexes according to body mass index (BMI).ResultsFrom November 2012 to June 2019, a total of 1199 individuals had knee cruciate ligament reconstruction (average 169 reconstructions/year). Following reconstruction and rehabilitation, 89 (7.4%) were medically unfit for service. Scenario analysis using a tree-augmented naïve BN model showed that, compared with Navy and Air Force, Army members had a higher probability of being unfit in those aged <35 years and a lower probability in those aged ≥35 years. In both sexes, those with obese BMI had the greatest probability of being unfit.ConclusionWhile most ADF members were fit for ongoing military service following cruciate ligament reconstruction, service type, age, sex and BMI influenced outcome. BNs provided an interactive and intuitive method to demonstrate the impact of different variables on the outcome.
Assessment of behavioral energetics model on Puma concolor using doubly labeled water
Authors: Barceló Gonzalo , Pauli Jonathan N. , Alldredge Mathew , Karasov William H. 
Published: October 2022

The estimation of energy expenditure is key to resolve ecological questions and conservation strategies. The puma ( Puma concolor (Linnaeus, 1771)) has been the subject of several efforts to measure the daily energy expenditure (DEE). Most of the estimations have been made using movement or activity models that have been questioned because of discrepancies with kill rates. This study looks at one movement model estimation and validates it using doubly labeled water (DLW), which can also account for energy expenditures beyond those associated with activity. We captured six pumas (51.5 ± 9.9 (SD) kg) during the winter in Colorado that were GPS collared and injected with DLW for an approximately 3-week trial. We found that DEE obtained from the DLW (14.5 ± 6.1 MJ·day−1) did not differ from that estimated using the movement model or from the predicted allometric equation based on DLW studies on other mammals. Decreasing air temperature and increasing daily distance movement were correlated with increasing DEE for monitored pumas. Both DLW and movement models provide a reasonable proxy to estimate DEE at the population level but exhibit low precision in estimating individual values for free-ranging puma.
Grain-size analysis of the Late Pleistocene sediments in the Corinth Rift: insights into strait-influenced hydrodynamics and provenance of an active rift basin
Authors: Kang Wenjun , Li Shunli , Gawthorpe Robert L. , Ford Mary , Collier Richard E. Ll. , Yu Xinghe , Janikian Liliane , Nixon Casey W. , Hemelsdaël Romain , Sergiou Spyros , Gillespie Jack , Pechlivanidou Sofia , De Gelder Gino 
Published: October 2022

Abstract

Grain-size analysis of the sediments in borehole M0079A, located in the Corinth Rift, was used to explore hydrodynamic conditions and provenance in the Late Pleistocene Corinth Rift. Grain-size populations that were sensitive to the sedimentary environments were characterized by frequency distribution, particle size–standard deviation and probability cumulative curves. Our results indicate the grain-size population component in the range 0.15–0.25 µm may be used as a sensitive proxy for hyperpycnal flows, which have commonly been triggered by river floods from the southern margin of the rift since
c.
0.593–0.613 Ma. The high-density plumes derived from the longer rivers of the southern rift that were prevalent before
c.
0.593–0.613 Ma. When sediment is supplied as hemipelagic deposition, the proportion of the total grain-size population that is in the 0.3–0.5 µm range becomes an index for suspension fall-out deposits. The core shows coarser sediments during the marine periods, and this may be linked to the current circulation related to the Ishtmia Strait opening. The study thus illustrates how the establishment of interbasinal straits can influence the details of sedimentary hydrodynamics in the deep-water axis of an adjacent depocentre.