bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome and prognosis for canine appendicular osteosarcoma treated with stereotactic body radiation therapy in 123 dogs
Authors: Martin Tiffany Wormhoudt , Griffin Lynn , Custis James , Ryan Stewart D. , Lafferty Mary , Boss Mary‐Keara , Regan Daniel , Rao Sangeeta , Leary Del , Withrow Stephen J. , LaRue Susan M.
Published: January 2021

Canine appendicular osteosarcoma is commonly treated with limb amputation; however, limb‐sparing options are frequently desired or necessary for a subset of patients. We evaluated 123 patients and 130 sites treated with stereotactic body radiation therapy (SBRT). Eighty‐two out of 98 dogs (84%) had maximum lameness improvement at a median of 3 weeks for a median of 6 months duration. Histopathologic evaluation of available samples from amputation or necropsy revealed >80% tumor necrosis in 50% of limbs consistent with local disease control. Of evaluable patients, 41% fractured and 21% pursued an amputation after treatment. Fine needle aspirate (n = 52) and needle core biopsy (n = 28) did not result in increased fracture risk compared to those without tumor sampling (n = 50). Median survival time (MST) was 233 days and time to first event was 143 days. Gross tumor volume and planned target volume were significantly inversely associated with survival and tumor location was significantly associated with survival. Dogs with salvage amputation had a significantly longer MST compared to those without (346 vs 202 days; P = .04). The presence of metastatic disease at the time of treatment in 15 dogs did not significantly impact survival time (200 vs 237 days without metastasis; P = .58). Skin side effects correlated significantly with dose with 33% of patients with acute grade 3 effects developing consequential late grade 3 effects. While SBRT improves lameness in most patients, further investigation is needed to identify candidates with minimal early fracture risk prior to initiating therapy.
Fibro‐Osseous Lesions Of The Craniofacial Complex In Horses: 30 Cases (2001‐2019)
Authors: Nottle Bridget F. , Tatarniuk Dane M. , Caldwell Fred J. , Bell Chris D. , Caston Stephanie S. , Merkatoris Paul T. , Gillen Alex M. , Katzman Scott A.
Published: January 2021

Objective

To describe the presentation, diagnosis, treatment, and outcome for horses with fibro‐osseous lesions of the craniofacial complex.

Study design

Retrospective multicenter case series.

Animals

Thirty horses evaluated for fibro‐osseous lesions of the skull from January 1, 2001 through December 31, 2019 in four centers.

Methods

Medical records were reviewed for signalment, clinical presentation, histological and diagnostic imaging findings, treatment instituted, and outcome. Long‐term outcome information was obtained by owner questionnaire or the medical record.

Results

Diagnoses included ossifying fibroma in 20 of 30 horses, osteoma in eight of 30 horses, and fibrous dysplasia in two of 30 horses. Twelve of 30 lesions were diagnosed in horses <1 year old, and 20 of 30 lesions originated from the rostral mandible. The most common treatment was rostral mandibulectomy. Recurrence was not reported after complete excision. Incomplete excision was confirmed in eight horses (four ossifying fibromas, three osteomas, and one fibrous dysplasia), and follow‐up information was available for seven horses. Recurrence occurred in one horse, while six horses had long‐term resolution of clinical signs. Prognosis for survival and return to use was excellent in 23 horses with long‐term follow‐up.

Conclusion

Fibro‐osseous lesions were uncommon in this multicenter study; they were most commonly diagnosed in young animals and most frequently affected the rostral mandible. Long‐term survival was excellent.

Clinical significance

The definitive diagnosis of fibro‐osseous lesions of the craniofacial complex in horses is made from results of histopathology and cannot be determined on the basis of clinical presentation alone. Surgical excision is indicated, and prognosis can be favorable even when complete surgical margins are not obtained.
Gamasina mite communities (Acari: Mesostigmata) in grain production systems of the southwestern Brazilian Amazon

Authors: De Castro Matheus C. , De Azevedo Emiliano B. , Britto Erika P. J. , Barreto Marliton R. , Pitta Rafael M. , Castilho Raphael C. , De Moraes Gilberto J.
Published: January 2021

Emphasis has been given in the Brazilian state of Mato Grosso to the implementation of more sustainable production practices, including what has been termed agrosilvopastoral production system (ASPS), which involves the integration of different types of land use in a same area along time, seeking increased ecological stability. The Gamasina mite group (order Mesostigmata) is usually diverse and abundant in non-cultivated soils, where they can prey on arthropods and nematodes; some are commercialized for biological pest control. The objective of this study was to evaluate the diversity and abundance of edaphic Gamasina in plots of grain production managed under conventional (alternating cultivation) system and under ASPS, both with the adoption of no-tillage cultivation, in the municipality of Sinop, Mato Grosso state. In samples of soil and litter taken biweekly from August 2015 to May 2016, 762 Gamasina representing 32 species of 21 genera and nine families were collected. Considering both systems together, the dominant Gamasina were quite different from those of other parts of Brazil. Calculated ecological indexes showed no major differences between the two systems, possibly because of the relatively short time since the implementation of ASPS. In both systems, Rhodacaridae was one of the dominant families (37.5% of the Gamasina), followed by Macrochelidae (20.9%) and Laelapidae (18.8%). The most abundant species were Multidentirhodacarus squamosus Karg (Rhodacaridae), a new species of Holostaspella (Macrochelidae) and Cosmolaelaps barbatus Moreira, Klompen and Moraes (Laelapidae). Future studies are warranted, allowing more time for the adoption of ASPS to produce possible ecological changes.
Two new species and three new records of the genus Diplothrombium (Acari: Johnstonianidae) from Turkey

Authors: Buğa Evren , Sevsa Sevgi
Published: January 2021

Diplothrombium tunceliensis sp. nov. and D. sansaensis sp. nov. collected from wet moss by Berlese funnel (off host) in Erzincan and Tunceli Provinces, Turkey, are described and illustrated. In addition, D. longipalpe (Berlese, 1887), D. rackae Wohltmann et al. 2004 and D. zbigniewi Haitlinger, 2001 are reported for the first time from Turkey. Also, species of Diplothrombium known from their larvae are compared.
Two new species of feather mites (Acarina: Psoroptidia) from the Huet's fulvetta, Alcippe hueti (Passeriformes: Leiothrichidae), in China

Authors: Constantinescu Ioana Cristina , Chișamera Gabriel Bogdan , Motoc Rozalia , Gustafsson Daniel R. , Zou Fasheng , Chu Xingzhi , Adam Costică
Published: January 2021

Two new feather mite species collected from the Huet's fulvetta, Alcippe hueti (Passeriformes, Leiothrichidae), in China are described: Proterothrix dinghushani sp. n. (Proctophyllodidae) and Trouessartia pauciseta sp. n. (Trouessartiidae). Males of P. dinghushani have a pair of lateral hysteronotal sclerites and a closed pentagonal sclerotized frame in the postero-median part of propodosoma. Females of this species have the sternum 1/4 of the total length of epimerites, and the terminal cleft exceeds half of the length of the lobar shield. Both sexes of T. pauciseta have a distinctive character, the absence of 3 pairs of hysteronotal setae (d1, d2, and e2), that clearly differs this species from all previously known species of the genus.
Delivery of single-domain antibodies into neurons using a chimeric toxin–based platform is therapeutic in mouse models of botulism
Authors: Miyashita Shin-Ichiro , Zhang Jie , Zhang Sicai , Shoemaker Charles B. , Dong Min
Published: January 2021

A detoxified chimeric toxin–based platform delivers therapeutics into neurons and has therapeutic effects in mouse models of botulism.
Mitochondrial metabolic reprogramming controls the induction of immunogenic cell death and efficacy of chemotherapy in bladder cancer
Authors: Oresta Bianca , Pozzi Chiara , Braga Daniele , Hurle Rodolfo , Lazzeri Massimo , Colombo Piergiuseppe , Frego Nicola , Erreni Marco , Faccani Cristina , Elefante Grazia , Barcella Matteo , Guazzoni Giorgio , Rescigno Maria
Published: January 2021

Immunogenic cell death induced through metabolic reprogramming by intravesical chemotherapy in bladder cancer is associated with treatment success.
Reversible ON- and OFF-switch chimeric antigen receptors controlled by lenalidomide
Authors: Jan Max , Scarfò Irene , Larson Rebecca C. , Walker Amanda , Schmidts Andrea , Guirguis Andrew A. , Gasser Jessica A. , Słabicki Mikołaj , Bouffard Amanda A. , Castano Ana P. , Kann Michael C. , Cabral Maria L. , Tepper Alexander , Grinshpun Daniel E. , Sperling Adam S. , Kyung Taeyoon , Sievers Quinlan L. , Birnbaum Michael E. , Maus Marcela V. , Ebert Benjamin L.
Published: January 2021

Cell-based therapies are emerging as effective agents against cancer and other diseases. As autonomous “living drugs,” these therapies lack precise control. Chimeric antigen receptor (CAR) T cells effectively target hematologic malignancies but can proliferate rapidly and cause toxicity. We developed ON and OFF switches for CAR T cells using the clinically approved drug lenalidomide, which mediates the proteasomal degradation of several target proteins by inducing interactions between the CRL4
CRBN
E3 ubiquitin ligase and a C2H2 zinc finger degron motif. We performed a systematic screen to identify “super-degron” tags with enhanced sensitivity to lenalidomide-induced degradation and used these degradable tags to generate OFF-switch degradable CARs. To create an ON switch, we engineered a lenalidomide-inducible dimerization system and developed split CARs that required both lenalidomide and target antigen for activation. Subtherapeutic lenalidomide concentrations controlled the effector functions of ON- and OFF-switch CAR T cells. In vivo, ON-switch split CARs demonstrated lenalidomide-dependent antitumor activity, and OFF-switch degradable CARs were depleted by drug treatment to limit inflammatory cytokine production while retaining antitumor efficacy. Together, the data showed that these lenalidomide-gated switches are rapid, reversible, and clinically suitable systems to control transgene function in diverse gene- and cell-based therapies.
Neuronal delivery of antibodies has therapeutic effects in animal models of botulism
Authors: McNutt Patrick M. , Vazquez-Cintron Edwin J. , Tenezaca Luis , Ondeck Celinia A. , Kelly Kyle E. , Mangkhalakhili Mark , Machamer James B. , Angeles Christopher A. , Glotfelty Elliot J. , Cika Jaclyn , Benjumea Cesar H. , Whitfield Justin T. , Band Philip A. , Shoemaker Charles B. , Ichtchenko Konstantin
Published: January 2021

Intraneuronal delivery of a therapeutic, single-domain antibody reverses botulism symptoms and increases survival of mice, guinea pigs, and monkeys.
Draft Genome Sequence of the Termite-Associated “Cuckoo Fungus,”
Athelia
(
Fibularhizoctonia
) sp. TMB Strain TB5
Authors: Konkel Zachary , Scott Kelsey , Slot Jason C.
Published: January 2021

Atheliales is a diverse order of crust-forming Basidiomycota fungi. Here, we report the draft genome of the “cuckoo fungus,”
Athelia
(
Fibularhizoctonia
) sp. strain TMB (Atheliales), which forms termite-egg-mimicking sclerotia for which termites care. We further compare its repertoire of psilocybin gene homologs to homologs previously reported for
Fibularhizoctonia psychrophila
.
Complete Genome Sequence of Streptococcus mitis Strain Nm-65, Isolated from a Patient with Kawasaki Disease
Authors: Tabata Atsushi , Ohkuni Hisashi , Itoh Yasuhiko , Fukunaga Yoshitaka , Tomoyasu Toshifumi , Nagamune Hideaki
Published: January 2021

Streptococcus mitis
Nm-65 is a human commensal streptococcal strain of the mitis group that was isolated from the tooth surface of a patient with Kawasaki disease. The complete genome sequence of Nm-65 was obtained by means of hybrid assembly, using two next-generation sequencing data sets. The final assembly size was 2,085,837 bp, with 2,039 coding sequences.
Coding-Complete Genome Sequence of a Yellow Fever Virus Isolated from a Baby Howler Monkey (
Alouatta caraya
) from São Paulo State, Brazil, in 2016
Authors: Siconelli Márcio Junio Lima , Jorge Daniel Macedo de Melo , Castro-Jorge Luiza Antunes de , Lopes da Fonseca Benedito Antonio
Published: January 2021

We report a coding-complete sequence of a yellow fever virus, strain JabSPM02, containing the 3′ untranslated region and all coding regions. The virus was recovered from an infected howler monkey from a rural area in São Paulo State, Brazil. Our findings show that it belongs to the South America 1E genotype.
16S rRNA Gene Amplicon Sequencing of Gut Microbiota in Three Species of Deep-Sea Fish in Suruga Bay, Japan
Authors: Iwatsuki Toshihide , Kanazawa Takahiro , Ogasawara Takato , Hosotani Kento , Tsuchiya Karen , Watanabe Shinichi , Suzuki Tomoko , Moriuchi Ryota , Kanesaki Yu , Dohra Hideo
Published: January 2021

We report here 16S rRNA gene amplicon sequence analysis of the gut microbiota in three species of deep-sea fish collected from Suruga Bay, Japan. Of the three species, two were dominated by the phylum
Proteobacteria
(genus
Photobacterium
), while one was dominated by the phyla
Spirochaetes
(genus
Brevinema
) and
Tenericutes
(unclassified
Mycoplasmataceae
).
Complete Genome Sequence of Paludibaculum fermentans P105
T
, a Facultatively Anaerobic Acidobacterium Capable of Dissimilatory Fe(III) Reduction
Authors: Dedysh Svetlana N. , Beletsky Alexey V. , Kulichevskaya Irina S. , Mardanov Andrey V. , Ravin Nikolai V.
Published: January 2021

Paludibaculum fermentans
P105
T
is a facultatively anaerobic heterotroph of the phylum
Acidobacteria
which is capable of dissimilatory Fe(III) reduction. This bacterium is a common inhabitant of wetlands and groundwater bodies. The finished genome of strain P105
T
is 9.53 Mb in size and contains multiple genes coding for membrane-bound multiheme cytochromes.
Bone marrow necrosis and fat embolism syndrome: a near fatal complication in previously undiagnosed sickle beta + thalassaemia
Authors: Budhathoki Nibash , Timilsina Sunita , Ram Bebu , Marks Douglas
Published: January 2021

Prevalence of haemoglobin sickle-β+thalassaemia (Hb S/β+thal) is variable with geography ranging from 0.2% to 10% among sickle cell patients. Clinical presentation of Hb S/β+thal patients depends on HbA level, with milder disease often going undiagnosed. However, rarely these patients can present with a fulminant vaso-occlusive crisis (VOC). Given VOC can present with non-specific symptoms, the diagnosis and treatment is often delayed. Here, we present a patient who initially developed altered mental status, pancytopenia and multiorgan failure due a critical VOC resulting in bone marrow necrosis and fat embolism. Subsequent workup confirmed that our patient had Sickle-β+thalassaemia, which had gone undiagnosed, despite subclinical evidence of haemolysis on routine lab work for years. Following diagnosis and initiation of RBC exchange, he improved significantly and was discharged home. High index of suspicion and bone marrow biopsy is vital for early diagnosis and management of this rare condition.
Towards an appropriate ethics framework for Health and Demographic Surveillance Systems (HDSS): learning from issues faced in diverse HDSS in sub-Saharan Africa
Authors: Hinga Alex Nginyo , Molyneux Sassy , Marsh Vicki
Published: January 2021

Introduction

Health and Demographic Surveillance Systems (HDSS) collect data on births, deaths and migration from relatively small, geographically defined populations primarily in Africa and Asia. HDSS occupy a grey area between research, healthcare and public health practice and it is unclear how ethics guidance that rely on a research-practice distinction apply to HDSS. This topic has received little attention in the literature. In this paper, based on empirical research across sub-Saharan Africa, we map out key ethical issues for HDSS and assess the relevance of current ethics guidance in relation to these findings.

Methods

We conducted a qualitative study across seven HDSS sites in sub-Saharan Africa, including individual in-depth interviews and informal discussions with 68 research staff, document reviews and non-participant observations of surveillance activities. Qualitative data analysis drew on a framework approach led by a priori and emergent themes, drawing on the wider ethics and social science literature.

Results

There were diverse views on core ethical issues in HDSS, including regarding the strengths and challenges of community engagement, informed consent and data sharing processes. A key emerging issue was unfairness in the overall balance of benefits and burdens for residents and front-line staff when compared with other stakeholders, particularly given the socioeconomic contexts in which HDSS are generally conducted.

Conclusion

We argue that HDSS operate as non-traditional epidemiologic research projects but are often governed using ethics guidance developed for traditional forms of health research. There is a need for specific ethics guidance for HDSS which prioritises considerations around fairness, cost-effectiveness, ancillary care responsibilities, longitudinality and obligations of the global community to HDSS residents.
Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations
Authors: Vu Duong Hoang , Cashin Jennifer , Gribble Karleen , Marinelli Kathleen , Mathisen Roger
Published: January 2021

Introduction

Recommendations for the clinical management of new mothers with suspected or confirmed COVID-19 and their infants are required. Guidance must weigh the risk posed by transmission of SARS-CoV-2 against the protection that maternal proximity and breastfeeding provide infants. Our aim was to review international COVID-19 guidance for maternal and newborn care, assessing alignment with WHO recommendations and the extent to which policy supported or undermined breastfeeding.

Methods

Guidance documents from 33 countries on the care of infants whose mothers were suspected or confirmed as having COVID-19 were assessed for alignment with WHO recommendations regarding: (1) skin-to-skin contact; (2) early initiation of breastfeeding; (3); rooming-in; (4) direct breastfeeding; (5) provision of expressed breastmilk; (6) provision of donor human milk; (7) wet nursing; (8) provision of breastmilk substitutes; (9) psychological support for separated mothers; and (10) psychological support for separated infants.

Results

Considerable inconsistency in recommendations were found. Recommendations against practices supportive of breastfeeding were common, even in countries with high infant mortality rates. None of the guidance documents reviewed recommended all aspects of WHO guidance. The presence of influential guidance conflicting with WHO recommendations and an undervaluing of the importance of maternal proximity and breastfeeding to infant health appeared to contribute to this poor alignment.

Conclusion

Those developing guidance in the COVID-19 pandemic and other infectious disease outbreaks need to appropriately consider the importance of skin-to-skin contact, early initiation of breastfeeding, rooming-in and breastfeeding to maternal and infant physical and psychological health. In weighing the value of recommendations of others in future guidance development, countries should consider past reliability and value placed on breastfeeding. Recommendations against maternal proximity and breastfeeding should not be made without compelling evidence that they are necessary, and less harmful than maintaining dyad integrity.
Choice between implants in knee replacement: protocol for a Bayesian network meta-analysis, analysis of joint registries and economic decision model to determine the effectiveness and cost-effectiveness of knee implants for NHS patients—The KNee Implant Prostheses Study (KNIPS)
Authors: Marques Elsa M R , Dennis Jane , Beswick Andrew D , Higgins Julian , Thom Howard , Welton Nicky , Burston Amanda , Hunt Linda , Whitehouse Michael R , Blom Ashley W
Published: January 2021

Introduction

Knee replacements are highly successful for many people, but if a knee replacement fails, revision surgery is generally required. Surgeons and patients may choose from a range of implant components and combinations that make up knee replacement constructs, all with potential implications for how long a knee replacement will last. To inform surgeon and patient decisions, a comprehensive synthesis of data from randomised controlled trials is needed to evaluate the effects of different knee replacement implants on overall construct survival. Due to limited follow-up in trials, joint registry analyses are also needed to assess the long-term survival of constructs. Finally, economic modelling can identify cost-effective knee replacement constructs for different patient groups.

Methods and analysis

In this protocol, we describe systematic reviews and network meta-analyses to synthesise evidence on the effectiveness of knee replacement constructs used in total and unicompartmental knee replacement and analyses of two national joint registries to assess long-term outcomes. Knee replacement constructs are defined by bearing materials and mobility, constraint, fixation and patella resurfacing. For men and women in different age groups, we will compare the lifetime cost-effectiveness of knee replacement constructs.

Ethics and dissemination

Systematic reviews are secondary analyses of published data with no ethical approval required. We will design a common joint registry analysis plan and provide registry representatives with information for submission to research or ethics committees. The project has been assessed by the National Health Service (NHS) REC committee and does not require ethical review.

Study findings will be disseminated to clinicians, researchers and administrators through open access articles, presentations and websites. Specific UK-based groups will be informed of results including National Institute for Health Research and National Institute for Health and Care Excellence, as well as international orthopaedic associations and charities. Effective dissemination to patients will be guided by our patient–public involvement group and include written lay summaries and infographics.

PROSPERO registration number

CRD42019134059 and CRD42019138015.
Patient experiences and perspectives on hypertension at a major referral hospital in rural southwestern Uganda: a qualitative analysis
Authors: Herbst Austin Gregory , Olds Peter , Nuwagaba Gabriel , Okello Samson , Haberer Jessica
Published: January 2021

Objectives

Novel care models are needed to address the large burden of hypertension globally. We aimed to explore how patients in rural Uganda experience and perceive hypertension in order to understand factors that may inform development of a patient-centred care model for hypertension management in this setting.

Design

We conducted one-time, in-depth qualitative interviews focusing on participants’ experiences and perceptions of the meaning and management of hypertension.

Setting

Outpatient clinic at Mbarara Regional Referral Hospital in Uganda.

Participants

We enrolled patients who had hypertension and had used antihypertensive medication for at least 1 month. We used purposive sampling to recruit 30 participants with similar representation by gender and by absence or presence of comorbid conditions.

Results

Participants had been diagnosed and initiated care at various clinical stages of hypertension, which impacted their understanding of hypertension. Several participants saw hypertension as a chronic disease that can lead to complications if not controlled, while others attributed symptoms typically associated with other diseases to hypertension. Participants described inconsistent access to antihypertensive medications and difficulty with transport to the clinic (time needed and expense) as the major barriers to access to care. Initiation and maintenance of care were facilitated by family support and ready access to health facilities. Many participants identified an understanding of the important lifestyle and dietary changes required to control hypertension.

Conclusions

Patients with hypertension in rural Uganda demonstrated a varied understanding and experience with hypertension. Interventions leveraging family support may help with patient education and clinical management. Integration of patient perspectives into the care model, patient-centred care, may serve as a successful model for hypertension and potentially delivery of care for other non-communicable diseases in Uganda and other similar resource-limited settings.
Excess mortality in adults with documented diabetes in Germany: routine data analysis of all insurance claims in Germany 2013–2014
Authors: Schmidt Christian , Reitzle Lukas , Heidemann Christin , Paprott Rebecca , Ziese Thomas , Scheidt-Nave Christa , Baumert Jens
Published: January 2021

Objectives

Little is known about the age-specific excess mortality pattern of people with diagnosed diabetes in Germany. Thus, our goal was to determine the excess mortality in diagnosed diabetes overall and stratified by age and sex based on claims data.

Design

Routine data analysis using a claims dataset from all statutory health-insured persons in Germany in 2013, which accounts for about 90% of the population.

Participants

We included persons who lived in Germany, were insured at least 360 days, were not self-paying any health services and were aged 30 years or older leading to a total number of 47.3 million insured persons for analyses.

Exposure

Diabetes was determined by the International Classification of Diseases-10 codes E10–E14, which were documented in 2013 in at least two-quarters on an outpatient setting or at least once on an inpatient setting.

Outcome measures

The vital status in the study population was drawn from the claims dataset for the year 2014. We derived the excess mortality estimated as an age-adjusted mortality rate ratio (MRR) by sex and for age groups using a Poisson model.

Main results

We found age-adjusted MRRs (95% CI) for diabetes of 1.52 (1.51 to 1.52) for women and 1.56 (1.56 to 1.56) for men. These figures declined with increasing age and were highest for ages 30–34 years with 6.76 (4.99 to 9.15) for women and 6.87 (5.46 to 8.64) for men, and lowest for age 95 years and older with 1.13 (1.10 to 1.15) for women and 1.11 (1.05 to 1.17) for men.

Conclusions

We derived deeply age-stratified figures on excess mortality in diabetes for Germany. Establishing a sustainable analysis of excess mortality is aimed at within the framework of diabetes surveillance.
Identifying indicators sensitive to primary healthcare nurse practitioner practice: a review of systematic reviews protocol
Authors: Kilpatrick Kelley , Tchouaket Eric Nguemeleu , Chouinard Maud-Christine , Savard Isabelle , Bouabdillah Naima , Houle Julie , St-Louis Geneviève , Jabbour Mira , Atallah Renee
Published: January 2021

Introduction

Primary healthcare nurse practitioners (PHCNPs) practice in a wide range of clinical settings and with diverse patient populations. Several systematic reviews have examined outcomes of PHCNP roles. However, there is a lack of consistency in the definitions used for the PHCNP role across the reviews. The identification of indicators sensitive to PHCNP practice from the perspective of patients, providers and the healthcare system will allow researchers, clinicians and decision-makers to understand how these providers contribute to outcomes of care.

Methods and analysis

A review of systematic reviews is proposed to describe the current state of knowledge about indicators sensitive to PHCNP practice using recognised role definitions. Outcomes of interest include any outcome indicator measuring the effectiveness of PHCNPs. We will limit our search to 2010 onwards to capture the most up-to-date trends. The following electronic databases will be searched: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, EMBASE, Global Health, Health Economics Evaluation Database, Health Evidence, HealthStar, Health Systems Evidence, Joanna Briggs Institute, Medline, PDQ-Evidence, PubMed and Web of Science. The search strategies will be reviewed by an academic librarian. Reference lists of all relevant publications will be reviewed. Grey literature will be searched from 2010 onwards, and will include: CADTH Information Services, CADTH’s Grey Matters tool, OpenGrey, Organisation for Economic Co-operation and Development, ProQuest Dissertation and Theses and WHO. The PROSPERO International Prospective Register of Systematic Reviews will be searched to identify registered review protocols. The review protocol was developed using Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A narrative synthesis will be used to summarise study findings.

Ethics and dissemination

No ethical approval is required for the study. The data used in the study will be abstracted from published systematic reviews. Dissemination strategies will include peer-reviewed publication, conference presentations and presentations to key stakeholders.

PROSPERO registration number

CRD42020198182.
Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
Authors: Petre Maria-Alexandra , Saha Bibek , Kasuya Shugo , Englesakis Marina , Gai Nan , Peliowski Arie , Aoyama Kazuyoshi
Published: January 2021

Objectives

Emergence delirium (ED) occurs in approximately 25% of paediatric general anaesthetics and has significant adverse effects. The goal of the current systematic review was to identify the existing literature investigating performance of predictive models for the development of paediatric ED following general anaesthesia and to determine their usability.

Design

Systematic review using the Prediction model study Risk Of Bias Assessment Tool (PROBAST) framework.

Data sources

Medline (Ovid), PubMed, Embase (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane CENTRAL (Ovid), PsycINFO (Ovid), Scopus (Elsevier) and Web of Science (Clarivate Analytics), ClinicalTrials.gov, International Clinical Trials Registry Platform and ProQuest Digital Dissertations and Theses International through 17 November 2020.

Eligibility criteria for selecting studies

All randomised controlled trials and cohort studies investigating predictive models for the development of ED in children undergoing general anaesthesia.

Data extraction and synthesis

Following title, abstract and full-text screening by two reviewers, data were extracted from all eligible studies, including demographic parameters, details of anaesthetics and performance characteristics of the predictive scores for ED. Evidence quality and predictive score usability were assessed according to the PROBAST framework.

Results

The current systematic review yielded 9242 abstracts, of which only one study detailing the development and validation of the Emergence Agitation Risk Scale (EARS) met the inclusion criteria. EARS had good discrimination with c-index of 0.81 (95% CI 0.72 to 0.89). Calibration showed a non-significant Homer-Lemeshow goodness-of-fit test (p=0.97). Although the EARS demonstrated low concern of applicability, the high risk of bias compromised the overall usability of this model.

Conclusions

The current systematic review concluded that EARS has good discrimination performance but low usability to predict ED in a paediatric population. Further research is warranted to develop novel models for the prediction of ED in paediatric anaesthesia.

PROSPERO registration number

CRD42019141950.
Taking charge of eczema self-management: a qualitative interview study with young people with eczema
Authors: Greenwell Kate , Ghio Daniela , Muller Ingrid , Roberts Amanda , McNiven Abigail , Lawton Sandra , Santer Miriam
Published: January 2021

Objectives

To explore young people’s experiences of eczema self-management and interacting with health professionals.

Design

Secondary qualitative data analysis of data sets from two semistructured interview studies. Data were analysed using inductive thematic analysis.

Setting

Participants were recruited from the UK primary care, dermatology departments and a community-based sample (eg, patient representative groups, social media).

Participants

Data included 28 interviews with young people with eczema aged 13–25 years (mean age=19.5 years; 20 female).

Results

Although topical treatments were generally perceived as effective, young people expressed doubts about their long-term effectiveness, and concerns around the safety and an over-reliance on topical corticosteroids. Participants welcomed the opportunity to take an active role in their eczema management, but new roles and responsibilities also came with initial apprehension and challenges, including communicating their treatment concerns and preferences with health professionals, feeling unprepared for transition to an adult clinic and obtaining treatments. Decisions regarding whether to engage in behaviours that would exacerbate their eczema (eg, irritants/triggers, scratching) were influenced by young people’s beliefs regarding negative consequences of these behaviours, and perceived control over the behaviour and its negative consequences.

Conclusions

Behavioural change interventions must address the treatment concerns of young people and equip them with the knowledge, skills and confidence to take an active role in their own eczema management.
Pain and its impact on functioning and disability in manual wheelchair users with spinal cord injury: a protocol for a mixed-methods study
Authors: Mashola Mokgadi Kholofelo , Korkie Elzette , Mothabeng Diphale Joyce
Published: January 2021

Introduction

Approximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.

Methods and analysis

Community-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).

Ethics and dissemination

Approval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.
Glossary on free trade agreements and health part 2: new trade rules and new urgencies in the context of COVID-19
Authors: McNamara Courtney L , Labonte Ronald , Schram Ashley , Townsend Belinda
Published: January 2021

Part 1 of this glossary provided a brief background on the rise of regional/bilateral free trade agreements (FTAs) and described the health implications of new trade obligations that figure prominently in current and recent trade negotiations, focusing on those provisions that build on previous agreements of the World Trade Organization (WTO). This approach continues into part 2 of the glossary, which also considers components of FTAs that have no precedent within WTO treaties. Following a broader discussion of how the current political context and the COVID-19 pandemic shape the contemporary trade environment, part 2 considers the main areas of trade and health policy incoherence as well as recommendations to address them.
Relationship between loneliness, social isolation and modifiable risk factors for cardiovascular disease: a latent class analysis
Authors: Bu Feifei , Steptoe Andrew , Fancourt Daisy
Published: January 2021

Background

There is growing research into the effects of psychological and social factors such as loneliness and isolation on cardiovascular disease (CVD). However, it is unclear whether individuals with particular clusters of CVD risk factors are more strongly affected by loneliness and isolation. This study aimed to identify latent clustering of modifiable risk factors among adults aged 50+ and explore the relationship between loneliness, social isolation and risk factor patterns.

Methods

Data from 8218 adults of English Longitudinal Study of Ageing were used in latent class analyses to identify latent classes of cardiovascular risk factors and predictors of class membership.

Results

There were four latent classes: low-risk (30.2%), high-risk (15.0%), clinical-risk (42.6%) and lifestyle-risk (12.2%) classes. Loneliness was associated with a greater risk of being in the high-risk class (relative risk ratio (RRR) 2.40, 95% CI 2.40 to 1.96) and lifestyle-risk class (RRR 1.36, 95% CI 1.10 to 1.67) and a lower risk of being in the clinical-risk class (RRR 0.84, 95% CI 0.72 to 0.98) relative to the low-risk class. Social disengagement, living alone and low social contact were also differentially associated with latent class memberships.

Conclusion

These findings supplement our existing knowledge of modifiable risk factors for CVD by showing how risk factors cluster together and how the risk patterns are related to social factors, offering important implications for clinical practice and preventive interventions.
Religious affiliation and COVID-19-related mortality: a retrospective cohort study of prelockdown and postlockdown risks in England and Wales
Authors: Gaughan Charlotte Hannah , Ayoubkhani Daniel , Nafilyan Vahe , Goldblatt Peter , White Chris , TIngay Karen , Bannister Neil
Published: January 2021

Background

COVID-19 mortality risk is associated with demographic and behavioural factors; furthermore, religious gatherings have been linked with the spread of COVID-19. We sought to understand the variation in risk of COVID-19-related death across religious groups in England and Wales both before and after the first national lockdown.

Methods

We conducted a retrospective cohort study of usual residents in England and Wales enumerated at the 2011 Census (n=47 873 294, estimated response rate 94%) for risk of death involving COVID-19 using linked death certificates. Cox regression models were estimated to compare risks between religious groups. Time-dependent coefficients were added to the model allowing HRs before and after lockdown period to be estimated separately.

Results

Compared with Christians, all religious groups had an elevated risk of death involving COVID-19; the largest age-adjusted HRs were for Muslim and Jewish males at 2.5 (95% CI 2.3 to 2.7) and 2.1 (95% CI 1.9 to 2.5), respectively. The corresponding HRs for Muslim and Jewish females were 1.9 (95% CI 1.7 to 2.1) and 1.5 (95% CI 1.7 to 2.1), respectively. The difference in risk between groups contracted after lockdown. Those who affiliated with no religion had the lowest risk of COVID-19-related death before and after lockdown.

Conclusion

The majority of the variation in COVID-19 mortality risk was explained by controlling for sociodemographic and geographic determinants; however, those of Jewish affiliation remained at a higher risk of death compared with all other groups. Lockdown measures were associated with reduced differences in COVID-19 mortality rates between religious groups; further research is required to understand the causal mechanisms.
Effect of familial clustering in the genetic screening of 235 French ALS families
Authors: Corcia Philippe , Camu William , Brulard Celine , Marouillat Sylviane , Couratier Philippe , Camdessanché Jean-Philippe , Cintas Pascal , Verschueren Annie , Soriani Marie-Helene , Desnuelle Claude , Fleury Marie-Céline , Guy Nathalie , Cassereau Julien , Viader Fausto , Pittion-Vouyovitch Sophie , Danel Veronique , Kolev Ivan , Le Masson Gwendal , Beltran Stephane , Salachas Francois , Bernard Emilien , Pradat Pierre-François , Blasco Hélène , Lanznaster Débora , Hergesheimer Rudolph , Laumonnier Frederic , Andres Christian R , Meininger Vincent , Vourc'h Patrick
Published: January 2021

Objectives

To determine whether the familial clustering of amyotrophic lateral sclerosis (ALS) cases and the phenotype of the disease may help identify the pathogenic genes involved.

Methods

We conducted a targeted next-generation sequencing analysis on 235 French familial ALS (FALS), unrelated probands to identify mutations in 30 genes linked to the disease. The genealogy, that is, number of cases and generations with ALS, gender, age, site of onset and the duration of the disease were analysed.

Results

Regarding the number of generations, 49 pedigrees had only one affected generation, 152 had two affected generations and 34 had at least three affected generations. Among the 149 pedigrees (63.4%) for which a deleterious variant was found, an abnormal G4C2 expansion in C9orf72 was found in 98 cases as well as SOD1, TARBP or FUS mutations in 30, 9 and 7 cases, respectively. Considering pedigrees from the number of generations, abnormal G4C2 expansion in C9orf72 was more frequent in pedigrees with pairs of affected ALS cases, which represented 65.2% of our cohort. SOD1 mutation involved all types of pedigrees. No TARDBP nor FUS mutation was present in monogenerational pedigrees. TARDBP mutation predominated in bigenerational pedigrees with at least three cases and FUS mutation in multigenerational pedigrees with more than seven cases, on average, and with an age of onset younger than 45 years.

Conclusion

Our results suggest that familial clustering, phenotypes and genotypes are interconnected in FALS, and thus it might be possible to target the genetic screening from the familial architecture and the phenotype of ALS cases.
Factors associated with syphilis seroprevalence in women with and at-risk for HIV infection in the Women’s Interagency HIV Study (1994–2015)
Authors: Aaron Kristal J , Brill Ilene , Causey-Pruitt Zenoria , Murphy Kerry , Augenbraun Michael , Kassaye Seble , Milam Joel E , Seidman Dominika , French Audrey L , Gange Stephen J , Adimora Adaora A , Sheth Anandi N , Fischl Margaret A , Van Der Pol Barbara , Marrazzo Jeanne , Kempf Mirjam-Colette , Dionne-Odom Jodie
Published: January 2021

Objective

Syphilis rates among women in the USA more than doubled between 2014 and 2018. We sought to identify correlates of syphilis among women enrolled in the Women’s Interagency HIV Study (WIHS) to inform targeted interventions.

Methods

The retrospective cross-sectional analysis of secondary data included women with HIV or at-risk of HIV who enrolled in the multisite US WIHS cohort between 1994 and 2015. Syphilis screening was performed at baseline. Infection was defined serologically by a positive rapid plasma reagin test with confirmatory treponemal antibodies. Sociodemographic and behavioural characteristics stratified by baseline syphilis status were compared for women enrolled during early (1994–2002) and recent (2011–2015) years. Multivariable binomial modelling with backward selection (p>0.2 for removal) was used to model correlates of syphilis.

Results

The study included 3692 women in the early cohort and 1182 women in the recent cohort. Syphilis prevalence at enrolment was 7.5% and 3.7% in each cohort, respectively (p<0.01). In adjusted models for the early cohort, factors associated with syphilis included age, black race, low income, hepatitis C seropositivity, drug use, HIV infection and >100 lifetime sex partners (all p<0.05). In the recent cohort, age (adjusted prevalence OR (aPOR) 0.2, 95% CI 0.1 to 0.6 for 30–39 years; aPOR 0.5, 95% CI 0.2 to 1.0 for 40–49 years vs ≥50 years), hepatitis C seropositivity (aPOR 2.1, 95% CI 1.0 to 4.1) and problem alcohol use (aPOR 2.2, 95% CI 1.1 to 4.4) were associated with infection.

Conclusions

Syphilis screening is critical for women with HIV and at-risk of HIV. Targeted prevention efforts should focus on women with hepatitis C and problem alcohol use.
Heated tobacco product use and combustible cigarette smoking relapse/initiation among former/never smokers in Japan: the JASTIS 2019 study with 1-year follow-up
Authors: Matsuyama Yusuke , Tabuchi Takahiro
Published: January 2021

Background

Use of heated tobacco products (HTPs), which were first launched in Japan, has been rapidly spreading worldwide. The present study aimed to investigate whether HTP use was associated with combustible cigarette smoking relapse/initiation among former/never combustible cigarette smokers.

Methods

A prospective cohort study was conducted by analysing two waves of data from the Japan ‘Society and New Tobacco’ Internet Survey. Among the 7766 never/former combustible cigarette smokers who answered the baseline survey in 2019, 5947 (follow-up rate: 76.6%) responded to the follow-up survey in 2020 (age range 18–73 years old; 50.5% men). The association between HTP use and combustible smoking after 1 year was investigated by multivariable logistic regression analysis adjusting for potential confounders.

Results

Of the respondents, 308 (5.2%) used HTPs at baseline. One year later, 97 (1.7%) non-HTP users and 39 (12.7%) HTP users were smoking combustible cigarettes. Among former smokers who had quit for 1 year or more and among never smokers, HTP use was significantly associated with combustible cigarette smoking 1 year later (OR=2.80, 95% CI 1.42 to 5.52 and OR=9.95, 95% CI 3.39 to 29.16, respectively), while the association was not significant among former smokers who recently quit.

Conclusion

HTP use was associated with relapse/initiation of combustible cigarette smoking after 1 year. The risks of HTP use, including subsequent combustible smoking, should be carefully monitored.