bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the short, intermediate and long-term health effects of COVID-19 on the survivors in Zambia: a prospective quantitative study protocol
Authors: Sialubanje Cephas , Kunka Evaristo , Sumbwa Phyllis Ingutu , Mukumbuta Nawa , Chibowa Margaret , Syakantu Gardner , Chikoya Laston , Mukonka Victor M 
Published: September 2022

IntroductionLittle is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health effects as well as the associated risk factors is scant. This study aims to determine the short, intermediate and long-term health effects of COVID-19 on the survivors and the associated risk factors.Methods and analysisWe propose conducting a 24-month prospective quantitative study in 10 health facilities (2 specialist, 3 regional, 2 mission and 3 subdistrict hospitals) from Lusaka and Southern Province of Zambia. Health facilities will be those which served as COVID-19 treatment centres during the third wave (June–August 2021). Study participants will comprise a randomly selected cohort of 450 COVID-19 survivors who had mild or no symptoms (80%) and severe cases (20%). Using a questionnaire, respondent demographic, clinical and laboratory data will be collected at baseline and at a 3-month interval for 18 months using a questionnaire. Respondents’ medical records will be reviewed and data collected using a checklist. Descriptive statistics will be computed to summarise respondents’ characteristics and clinical outcomes. Bivariate analysis (Χ2 and t-test) will be conducted to test the association between respondent characteristics and clinical outcomes. Multivariate logistic regression analysis will be run to determine the risk factors for short, intermediate and long-term health effects; adjusted ORs will be computed to test the strength of the association (p<0.05).Ethics and disseminationEthical approval was obtained from the University of Zambia Biomedical Research and the National Health Research Authority. Results will be disseminated to key stakeholders in Zambia, international open-access peer-reviewed journals, websites and international conferences, and likely lead to design of evidence-informed strategies to mitigate health effects of COVID-19 on survivors.
Melatonin for the prevention of postoperative delirium in older adults: a protocol for a systematic review and meta-analysis
Authors: Sewart Emma , Barnes Jonathan , Armstrong Richard A , Pufulete Maria , Hinchliffe Robert , Gibbison Ben , Mouton Ronelle 
Published: September 2022

IntroductionPostoperative delirium (POD) is a major cause of morbidity, particularly in elderly patients. Melatonin has been suggested as a low-risk pharmacological intervention to help prevent POD. A previous systematic review found limited high-quality evidence to support the use of melatonin in the prevention of POD. Several further randomised studies have since been published. This systematic review aims to synthesise the evidence from randomised controlled trials (RCTs) examining the effect of melatonin on the prevention of POD in older adults.Methods and analysisA systematic search of RCTs of melatonin (any dose and formulation) in POD will be run across Embase, Medline, CINAHL and PsychInfo. RCTs published from January 1990 until the end of February 2022 and reporting outcomes for melatonin use to prevent POD in patients will be included. Screening of search results and data extraction from included articles will be performed by two independent reviewers. The primary outcome will be incidence of POD in older adults undergoing surgery. Secondary outcomes are delirium duration and length of hospital stay. The review will also describe the dosage, timing and administration regimes of melatonin therapy and as well as the scales and definitions used to describe POD. A registry review of ongoing trials will be also be performed. For the meta-analysis, data will be pooled using a random effects model to generate a forest plot and obtain an odds ratio (OR) for the incidence of POD. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationNo ethical approval is required. This review will be disseminated via peer-reviewed manuscript and conferences. The results will be used as the basis of work to optimise this intervention for future trials in surgical populations.PROSPERO registration numberThis review is registered with PROSPERO (CRD42021285019).
Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020
Authors: Msukwa Malango T , MacLachlan Ellen W , Gugsa Salem T , Theu Joe , Namakhoma Ireen , Bangara Fred , Blair Christopher L , Payne Danielle , Curran Kathryn G , Arons Melissa , Namachapa Khumbo , Wadonda Nellie , Kabaghe Alinune N , Dobbs Trudy , Shanmugam Vedapuri , Kim Evelyn , Auld Andrew , Babaye Yusuf , O'Malley Gabrielle , Nyirenda Rose , Bello George 
Published: September 2022

ObjectivesIn Malawi, a recent infection testing algorithm (RITA) is used to characterise infections of persons newly diagnosed with HIV as recent or long term. This paper shares results from recent HIV infection surveillance and describes distribution and predictors.SettingData from 155 health facilities in 11 districts in Malawi were pooled from September 2019 to March 2020.ParticipantsEligible participants were ≥13 years, and newly diagnosed with HIV. Clients had RITA recent infections if the rapid test for recent infection (RTRI) test result was recent and viral load (VL) ≥1000 copies/mL; if VL was <1000 copies/mL the RTRI result was reclassified as long-term. Results were stratified by age, sex, pregnancy/breastfeeding status and district.Results13 838 persons consented to RTRI testing and 12 703 had valid RTRI test results and VL results after excluding clients not newly HIV-positive, RTRI negative or missing data (n=1135). A total of 12 365 of the 12 703 were included in the analysis after excluding those whose RTRI results were reclassified as long term (n=338/784 or 43.1%). The remainder, 446/12 703 or 3.5%, met the definition of RITA recent infection. The highest percentage of recent infections was among breastfeeding women (crude OR (COR) 3.2; 95% CI 2.0 to 5.0), young people aged 15–24 years (COR 1.6; 95% CI 1.3 to 1.9) and persons who reported a negative HIV test within the past 12 months (COR 3.3; 95% CI 2.6 to 4.2). Factors associated with recent infection in multivariable analysis included being a non-pregnant female (adjusted OR (AOR) 1.4; 95% CI 1.2 to 1.8), a breastfeeding female (AOR 2.2; 95% CI 1.4 to 3.5), aged 15–24 years (AOR 1.6; 95% CI 1.3 to 1.9) and residents of Machinga (AOR 2.0; 95% CI 1.2 to 3.5) and Mzimba (AOR 2.4; 95% CI 1.3 to 4.5) districts.ConclusionsMalawi’s recent HIV infection surveillance system demonstrated high uptake and identified sub-populations of new HIV diagnoses with a higher percentage of recent infections.
Early interventions for post-traumatic stress following musculoskeletal trauma: protocol for a systematic review and meta-analysis
Authors: Jadhakhan Ferozkhan , Evans David , Falla Deborah 
Published: September 2022

IntroductionPost-traumatic stress symptoms (PTSS) can be triggered following exposure to a traumatic event, such as violence, disasters, serious accidents and injury. Little is known about which interventions provide the greatest benefit for PTSS. This systematic review aims to estimate the effects of early interventions on PTSS following musculoskeletal trauma.Methods/analysisDevelopment of this review protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. This review will include randomised controlled trials and non-randomised controlled studies evaluating the effect of early (within 3 months of a traumatic event) non-pharmacological and non-surgical interventions on PTSS in adults (aged ≥18 years). MEDLINE, PsycINFO, Embase, CINAHL, Zetoc, PROSPERO, Web of Science, PubMed and Google Scholar, as well as key journals/grey literature, will be searched from inception to 31 July 2022. Only articles published in English will be considered. Two independent reviewers will search, screen studies, extract data and assess risk of bias using the Cochrane Risk of Bias tool V.2 (RoB 2) and the Risk Of Bias in Non-randomised Studies of Interventions (ROBINS-I), respectively. Mean difference or standardised mean difference (SMD) will be extracted with accompanying 95% CIs and p values where these are reported. Group effect size will be extracted and reported. Symptoms of PTSS will be ascertained using SMDs (continuous) and diagnosis of PTSS using risk ratio (dichotomous). If possible, study results will be pooled into a meta-analysis. A narrative synthesis of the results will be presented if heterogeneity is high. The overall quality of evidence and risk of bias will be assessed using the Grading of Recommendations Assessment, Development and Evaluation, RoB 2 and ROBINS-I guidelines, respectively.Ethics and disseminationEthical approval is not required for this systematic review since data from published studies will be used. This review is expected to provide a better understanding of the effect of early intervention for PTSS following musculoskeletal trauma. Findings of this review will be disseminated in peer-reviewed publications and through national and international conferences.PROSPERO registration numberCRD42022333905
Effect of a mHealth exercise intervention compared with supervised exercise therapy in osteoarthritis management: protocol of the DigiOA trial
Authors: Martinsen Lars , Østerås Nina , Moseng Tuva , Tveter Anne Therese 
Published: September 2022

IntroductionSoaring prevalence of hip and knee osteoarthritis (OA) inflicts high costs on the healthcare system. A further rise in the OA incidence is expected, generating increased demand of care potentially challenging accessibility and threatening to overwhelm the healthcare system. Innovative solutions that may improve accessibility to recommended OA care for patients in primary care and maintain healthcare sustainability are warranted. Digitalising home exercise therapy may be one such solution. The primary aim of this study is to evaluate the effectiveness of a mobile health app providing digitalised home exercises, compared with supervised exercise therapy in patients with OA. Second, we will evaluate the cost-efficiency of the intervention and explore potential differences in outcome and adherence to exercises in the experimental treatment group.Methods and analysisA two-armed non-inferiority randomised controlled trial will be conducted. In total, 156 patients with hip and/or knee OA will be recruited from physiotherapy clinics in primary care in Norway. Following patient education, patients will be randomised to either 6 weeks of standard treatment (2 weekly sessions of supervised exercise therapy) or experimental treatment (home exercises via the Virtual Training (VT) app). Primary outcome is the proportion of Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responders at 6 weeks. Secondary outcomes include physical performance, patient-reported outcomes related to pain, fatigue, disease activity, physical function, mental health, health related quality of life, self-efficacy, utilisation of healthcare services and medication, digital competence and use of apps.Ethics and disseminationPatients will sign an informed consent form before participating in the trial. Approval has been granted by the Regional Ethics Committee (201105) and Data Protection Officer at Diakonhjemmet Hospital (00221). Patient research partners will contribute in all parts of the study.Trial registration numberNCT04767854.
Role of the electrocardiogram in the risk stratification of pulmonary hypertension
Authors: Hendriks Paul M , Kauling Robert M , Geenen Laurie W , Eindhoven Jannet A , Roos-Hesselink Jolien W , Boomars Karin A , van den Bosch Annemien E 
Published: September 2022

IntroductionThe prognosis of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) remains dismal. Better risk prediction is needed. This study investigated the prognostic value of ECG characteristics.MethodsIn this single-centre prospective study, consecutive treatment-naïve patients with PAH or CTEPH were included at time of diagnosis. From the 12-lead ECG, obtained at baseline, the following parameters were collected: heart rate (HR), rhythm, QRS axis, conduction times, P-top amplitudes in II, R-top and S-wave amplitudes in V1 and V5 and repolarisation disorders. Associations between the ECG and transplant-free survival was assessed by Kaplan-Meier curves and Cox-proportional hazard regressions.ResultsIn total, 140 patients were included (median age: 60.7 years, 63.6% female). The ECG was abnormal in 86.2%: sinus rhythm was not present in 9.3%, right QRS axis was observed in 47.8%, mean QRS duration was 101±17 ms. Only 42.5% of the patients had normal repolarisation, 34.5% had right ventricular strain and 14.4% non-specific repolarisation disorders. Over a median follow-up time of 3.49 (IQR: 1.37–6.42) years, 45 patients (32.5%) died or underwent lung transplantation. Transplant-free survival was worse in patients presenting with an abnormal ECG (64.0% vs 86.0%; p=0.037). The following ECG characteristics were associated with all-cause mortality or lung transplantation: heart rate (HR 1.02, 95% CI: 1.00 to 1.05), QRS duration >120 ms (HR 2.61, 95% CI: 1.01 to 6.71) and S-wave amplitude in V5 (HR 1.10, 95% CI: 1.04 to 1.17).ConclusionOnly 13.8% of patients with PAH and CTEPH presented with a normal ECG, which is associated with favourable outcome. The ECG provides additional prognostic value to current clinical parameters and should be considered in risk prediction.
Ground State Solution for a Fourth Order Elliptic Equation of Kirchhoff Type with Critical Growth in

ℝ

N
Authors: Zhou Li , Zhu Chuanxi 
Published: September 2022

In this paper, we consider the following fourth order elliptic Kirchhoff-type equation involving the critical growth of the form

Δ

2

u
−

a
+
b

∫

ℝ

N

∇
u

2

d
x

Δ
u
+
V

x

u
=

I

α

∗
F

u

f

u

+

λ

u

2

∗

∗

−
2

u
,
in

ℝ

N

,

u
∈

H

2

ℝ

N

,

where

a
>
0

,

b
≥
0

,

λ

is a positive parameter,

α
∈

N
−
2
,
N

,

5
≤
N
≤
8

,

V
:

ℝ

N

⟶
ℝ

is a potential function, and

I

α

is a Riesz potential of order

α

. Here,

2

∗

∗

=
2
N
/

n
−
4

with

N
≥
5

is the Sobolev critical exponent, and

Δ

2

u
=
Δ

Δ
u

is the biharmonic operator. Under certain assumptions on

V

x

and

f

u

, we prove that the equation has ground state solutions by variational methods.
Never Let a Good Crisis Go to Waste: Labor Organizing During covid-19
Authors: Schirmer Eleni , Tarlau Rebecca 
Published: September 2022

Abstract
This article explores how crises become opportunities. Through a study of a progressive teachers’ union caucus in New York City during the emergence of covid-19, this piece examines how organizations convert crises into opportunities for political growth. Drawing on sociological theories of political articulation and crisis, this article explores the role of union caucuses to foment political change. We argue that crises become politically significant according to how organizations use events to catalyze competing political narratives to drive new political formations. We examine how union caucuses engage in this work. Using ethnographic methods of participant observation and interviews, our study finds that caucuses with established visions, internal organizational structure, and moral legitimacy are better able to take advantage of crises. These conditions allow caucuses to exercise power, not just petition for it. We conclude that the existence of organizational infrastructure and ideological coherence enables a group to convert crises into opportunities.
An Exploratory Analysis of TED Talks in English and Lithuanian, Portuguese and Turkish Translations
Authors: Zeyrek Deniz , Mendes Amália , Oleškevičienė Giedrė Valūnaitė , Özer Sibel 
Published: September 2022

Abstract
This paper contributes to the question of how discourse relations are realised in TED talks. Drawing on an annotated, multilingual discourse corpus of TED talk transcripts, we examine discourse relations in English and Lithuanian, Portuguese and Turkish translations by concentrating on three aspects: the degree of explicitness in discourse relations, the extent to which explicit and implicit relations are encoded inter- or intra-sententially, and whether top-level discourse relation senses employed in English differ in the target languages. The study shows that while the target languages differ from English in the first two dimensions, they do not display considerable differences in the third dimension. The paper thus reveals variations in the realisation of discourse relations in translated transcripts of a spoken genre in three languages and offers some methodological insights for dealing with the issues surrounding discourse relations.
“It was terrible, I didn’t sleep for two years”: A mixed methods exploration of sleep and its effects among family caregivers of in-home hospice patients at end-of-life
Authors: Starr Lauren T , Washington Karla T , McPhillips Miranda V , Pitzer Kyle , Demiris George , Oliver Debra Parker 
Published: September 2022

Background: Due to overnight caregiving demands; exacerbation of high rates of anxiety, depression, and distress; and inadequate support, millions of family caregivers of patients receiving in-home hospice are at risk of poor sleep and negative health effects. Aim: To describe sleep experiences of family caregivers of in-home hospice patients and perceptions of these experiences on caregivers’ wellbeing in the context of caregiver health and live-in status. Design: Developed using the Symptom Management Model, this mixed methods study featured a concurrent nested design prioritizing qualitative reflexive thematic analysis. Setting/participants: About 47 family caregivers of in-home hospice patients from two randomized clinical trials (NCT03712410, NCT02929108) were interviewed (United States, 2021). Anxiety (GAD-7), depression (PHQ-9), quality-of-life (QOL) (CQLI-R), and self-rated health and energy were reported prior to interviews. Results: Qualitative analysis revealed three themes: compromised sleep quality, factors influencing sleep, effects of sleep. 72.5% of hospice family caregivers described “fair” or “poor” sleep quality, with “ interrupted” sleep and frequent night-waking due to “ on-call” “ vigilance” and anxiety. Negative effects included exhaustion, mental and physical health decline, and reduced caregiver function. Live-in caregivers reported higher mean depression scores (8.4 vs 4.3, p = 0.08), higher mean anxiety scores (7.7 vs 3.3, p = 0.06), and lower mean QOL scores (24.8 vs 33.6, p < 0.001) than live-out caregivers. Anxiety, depression, and QOL worsened as self-reported caregiver sleep quality decreased. Few caregivers had adequate support. Conclusion: End-of-life family caregivers experience disrupted sleep with negative effects and inadequate support. Clinicians must assess sleep, offer sleep interventions, and provide more supports to hospice family caregivers.
Effect of dexmedetomidine on the Montreal Cognitive Assessment in older patients undergoing pulmonary surgery
Authors: Liu Tao , Liu Fang-Chao , Xia Yu , Luo Tai-Jun , Wang Fei , Chen Bin , Wang Chun , Gao Guang-Kuo , Zhai Wen-Ting , Liu Wei 
Published: September 2022

Objective We investigated the effect of dexmedetomidine anesthesia on postoperative cognitive function after pulmonary surgery. Methods A blinded, prospective, randomized, placebo-controlled study was performed on 60 patients (age range 65–74 years) undergoing lobectomy by video-assisted thoracoscopic surgery (29 in the dexmedetomidine group; 31 in the placebo group). Dexmedetomidine group patients received dexmedetomidine, and placebo group patients received an equal volume of physiological saline 20 minutes before anesthesia induction. Cognitive function was evaluated using the Montreal Cognitive Assessment 1 day before surgery and on postoperative day (POD)1, POD3, and POD7. The regional cerebral oxygen saturation (rSO2) was monitored continuously by near-infrared spectroscopy before anesthesia. Results The Montreal Cognitive Assessment score was significantly different between the two groups on POD1 (dexmedetomidine 26.4  ±  0.73 vs. placebo 25.5 ± 0.96) and POD3 (dexmedetomidine 27.1 ± 0.79 vs. placebo 26.6 ± 0.80). Specifically, attention and orientation scores were increased in the dexmedetomidine group on POD1 and POD3. The rSO2 was not significantly different between the dexmedetomidine and placebo groups. Conclusion Dexmedetomidine given before induction of anesthesia could reduce the risk of postoperative cognitive dysfunction and might not decrease rSO2. Hence, dexmedetomidine could be employed in pulmonary surgical procedures, especially for older patients with a high risk of cognitive dysfunction.
MeTooMS: Sexual, physical, and emotional abuse experience among women with multiple sclerosis
Authors: Pol-Patil Jeta , Glanz Bonnie , Safar Laura , Misasi Elizabeth , Manieri Maria Claudia , Shanahan Rachel , Healy Brian , Houtchens Maria 
Published: September 2022

Background: Sexual and physical violence against disabled individuals is widespread and linked to negative public health and social outcomes. The real-world prevalence of abuse in women with multiple sclerosis (MS) has not been well studied. Objectives: To explore abuse prevalence in a real-world cohort of females with MS attending an academic MS Center. Methods: Prospective and retrospective abuse data were confidentially collected during neurology clinic visits and extracted from medical records for women attending an academic MS Center. Self-reported and provider-documented prevalence of abuse experiences were correlated with socio-economic and disease-specific factors. Results: In total, 200 women completed prospective questionnaires, and 121 non-overlapping independent health records were retrospectively reviewed. Mean age ( SD) was 49.055 (11.39). Seventy-six (38%) reported lifetime abuse incidents; 15% were abused within the previous year. Intimate partners were the most likely verbal ( p ⩽ 0.01)) and physical ( p = 0.04) abuse perpetrators. Neurologic disability correlated with greater likelihood of verbal abuse ( p = 0.021) in prospective cohort. There was no billing or encounter documentation for any form of abuse. Conclusion: Intimate partner violence is common in women with MS, correlates with neurologic disability, and is underreported by the health system. Future research needs to focus on abuse detection and mitigation strategies.