bluuebunny/crossref_metadata_2025 huggingface dataset:
Deciphering changes in the incidence of the Guillain-Barré syndrome during the COVID-19 pandemic: a nationwide time-series correlation study
Authors: Lee Hyunju , Heo Namwoo , Kwon Donghyok , Ha Jongmok
Published: December 2022

Background

Postinfectious autoimmunity is a hallmark of Guillain-Barré syndrome (GBS), and GBS incidence closely parallels that of its immune triggers. Sociobehavioural interventions implemented during the COVID-19 pandemic have altered the infectious disease landscape.

Methods

This nationwide time-series correlation study analysed GBS incidence, sentinel surveillance and SARS-CoV-2 vaccination data from January 2017 to December 2021 in the National Health Insurance Service and Korean Disease Control and Prevention Agency databases. The incidence of GBS and sentinel gastrointestinal and respiratory infectious diseases during the pandemic (2020–2021) was estimated and compared with both prepandemic (2017–2019) and incidence predicted in a time-series forecasting model. Time-series correlation analysis was used to examine the temporal association between GBS, infectious triggers and SARS-CoV-2 vaccination.

Results

During the pandemic, the total crude cumulative incidence rate was 2.1 per 100 000 population, which is lower than the prepandemic incidence, especially in age groups of less than 60 years. Seasonality was briefly interrupted during the winter of 2021. The majority of respiratory and some gastrointestinal conditions had a lower-than-expected incidence during the pandemic. Compared with the prepandemic state, during the pandemic period a higher number of gastrointestinal pathogens (Escherichia coli,Campylobacterspp., Clostridium perfringens, Yersinia enterocoliticaand enteric adenovirus) had significant, moderate-to-strong positive temporal associations with GBS. The temporal association between SARS-CoV-2 infection and GBS was not significant, but SARS-CoV-2 vaccination exhibited a strong positive temporal association with GBS in 2021.

Conclusion

The incidence of GBS and sentinel infectious diseases decreased to below-expected levels during the pandemic, with the former attributable to the decreased incidence of non-COVID-19 respiratory and gastrointestinal infections. The evolving incidence of autoimmune postinfectious phenomena following the pandemic needs attention.
A new ranking index to identify the work-related psychosocial factors most impacting mental health: a cross-sectional study
Authors: Daouda Oumou Salama , Chevance Astrid , Temime Laura , Légeron Patrick , Gaillard Raphaël , Saporta Gilbert , Hocine Mounia N
Published: December 2022

Objectives

In modern professional life, mental health prevention and promotion have become a major challenge for decision-makers. Devising appropriate actions requires better understanding the role played by each work-related psychosocial factor (WPSF). The objective of this study was to present a relevant tool to hierarchise WPSFs that jointly takes into account theirimportance(impact on mental health) and theirprevalence(the proportion of the population exposed to WPSF).

Design

A cross-sectional study was conducted in March 2018 among 3200 French workers which are representative of the French working population.

Setting

France.

Participants

Individuals aged 18–80 years who declared currently having a job (even a part-time job) whatever their occupation or status (employee or self-employed) were eligible. We excluded students, unemployed individuals, housewives/husbands and retired people. The mental health level was assessed using the General Health Questionnaire-28 and 44 items were gathered from theoretical models of WPSFs. We assessed two distinct multivariate methods for calculating WPSF importance: (1) weifila (weighted first last) method in a linear regression context and (2) random forests in a non-linear context. Both methods were adjusted on individual, health and job characteristics.

Results

The WPSF rankings obtained with the two methods to calculate importance are strongly consistent with each other (correlation coefficient=0.88). We highlighted nine WPSFs that are ranked high by both methods. In particular, irrespective of the chosen method, lack of communication, lack of social and hierarchy support and personal–professional life imbalance, emotional demands at work and dissatisfaction with the compensation received came out as top-ranking WPSFs.

Conclusions

A total of nine WPSFs were identified as key for decision-making. The easy-to-use tools we propose can help decision-makers identify priority WPSFs and design effective strategies to promote mental health in the workplace.
Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data
Authors: Erviti Juan , Wright James , Bassett Ken , Ben-Eltriki Mohamed , Jauca Ciprian , Saiz Luis Carlos , Leache Leire , Gutiérrez-Valencia Marta , Perry Thomas L
Published: December 2022

Objective

The FOURIER trial showed a benefit of the PCSK9 inhibitor evolocumab over placebo with respect to cardiovascular outcomes in patients with cardiovascular disease. However, we observed some inconsistencies between the information in the Clinical Study Report (CSR) and that in the 2017 primary trial results publication. We aimed to restore the mortality data in the FOURIER trial based on the information contained in the death narratives in the CSR.

Methods

Mortality data in the primary results publication were compared with that in the CSR. In cases of discrepancy between the sources, an independent committee blindly readjudicated and restored the cause of death according to the information in the CSR narratives.

Results

For 360/870 deaths (41.4%), the cause of death adjudicated by the FOURIER clinical events committee differed from that declared by the local clinical investigator. When comparing the CSR information with the 2017 primary results publication, we found 11 more deaths from myocardial infarction in the evolocumab group (36 vs 25) and 3 less deaths in the placebo group (27 vs 30, respectively). In the CSR, the number of deaths due to cardiac failure in the evolocumab group was almost double those in the placebo group (31 vs 16). While cardiac and vascular deaths were not assessed as separate outcomes in the original trial analysis, after readjudication, we noted that cardiac deaths were numerically, but non-significantly, higher in the evolocumab group (113) than in the placebo group (88; relative risk (RR) 1.28, 95% CI 0.97 to 1.69, p=0.078), whereas non-cardiac vascular deaths were similar between groups (37 in each; RR 1.00, 95% CI 0.63 to 1.58, p=0.999). The reported HR for cardiovascular mortality in the original trial analysis was 1.05 (95% CI 0.88 to 1.25); after readjudication, we found a greater (although still non-significant) relative increase in cardiovascular mortality in the evolocumab treatment group (RR 1.20, 95% CI 0.95 to 1.51, p=0.13).

Conclusion

After readjudication, deaths of cardiac origin were numerically higher in the evolocumab group than in the placebo group in the FOURIER trial, suggesting possible cardiac harm. At the time the trial was terminated early, a non-significantly higher risk of cardiovascular mortality was observed with evolocumab, which was numerically greater in our readjudication. A complete restoration of the FOURIER trial data is required. In the meantime, clinicians should be sceptical about prescribing evolocumab for patients with established atherosclerotic cardiovascular disease.

Trial registration numbers

NCT01764633.
Structural equation modelling analysis on relationships of job demands and resources with work engagement, burnout and work ability: an observational study among physicians in Dutch hospitals
Authors: Debets Maarten , Scheepers Renee , Silkens Milou , Lombarts Kiki
Published: December 2022

Objective

To investigate to what extent work engagement mediates the relationships of job resources with work ability, and to what extent burnout mediates the relationships of job demands and resources with work ability.

Design

Multicentre observational study.

Setting

Academic and non-academic hospitals in the Netherlands.

Participants

Physicians (n=385) participated in this study.

Primary and secondary outcome measures

We measured work ability with selected items from the validated Questionnaire of Experience and Evaluation of Work 2.0 (QEEW V.2.0), work engagement with the Utrecht Work Engagement Scale and burnout with the exhaustion subscale of the Oldenburg Burnout Inventory. The job demand ‘workload’ and job resources ‘development opportunities’, ‘participation in decision-making’, ‘inspirational leadership’ and ‘relationships with colleagues’ were measured using the QEEW V.2.0. The job demand ‘bureaucratic burden’ was measured with the Three Item Red Tape scale. A structural equation model was built to answer our research question.

Results

Work engagement mediated relationships of job resources with physicians’ work ability, and burnout mediated relationships of job resources and demands with work ability. Development opportunities (β=0.39, SE=0.12, p<0.001), participation in decision-making (β=0.18, SE=0.08, p=0.028) and relationships with colleagues (β=0.19, SE=0.19, p=0.002) were positively related to work engagement. Development opportunities (β=−0.20, SE=0.08, p=0.004) were negatively related and workload (β=0.51, SE=0.19, p<0.001) was positively related to burnout. Work engagement (β=0.22, SE=0.04, p<0.001) was positively related and burnout (β=−0.56, SE=0.06, p<0.001) was negatively related to work ability.

Conclusions

Physicians’ work engagement and burnout mediated the relationships of various job demands and resources with their work ability. More work-engaged and less burned-out physicians reported better work ability. Hospitals may attenuate excessive workloads and facilitate development opportunities, participation in decision-making and good collegial relationships to enhance physicians’ occupational well-being and performance.
Impact of COVID-19 pandemic on the mental health of healthcare workers during the first wave in Portugal: a cross-sectional and correlational study
Authors: Duarte Ivone , Pinho Rita , Teixeira Andreia , Martins Vera , Nunes Rui , Morgado Helder , Castro Luísa , Serrão Carla
Published: December 2022

Objectives

The COVID-19 pandemic has had a negative impact on the mental health of healthcare workers (HCWs) worldwide. This study aims to identify the degree to which sociodemographic variables and indicators of subjective well-being and psychological resilience are associated, positively and negatively, with the outcomes of burnout, stress, depression and anxiety among Portuguese HCWs observed during the first wave. It also aims to evaluate the strength of association of these variables and indicators with each outcome.

Design

Cross-sectional quantitative study. The statistical methods used are simple logistic model, multiple logistic regression model and −2*log-likelihood statistic.

Setting

Portuguese HCWs living in Portugal and working in the Portuguese healthcare system.

Participants

The study included 1535 professionals, with a mean age of 38 years.

Primary and secondary outcomes measures

Psychological variables were measured by Copenhagen Burnout Inventory, the Resilience Scale, the Depression, Anxiety and Stress Scales and the Satisfaction with Life Scale.

Results

High levels of personal (55%; n=844), work-related (55.1%; n=846) and client-related burnout (35.4%; n=543) were found. Additionally, participants expressed substantial levels of depression (28.7%; n=441), stress (36.4%; n=558) and anxiety (33.1%; n=508). About 1202 participants (78.3%) demonstrated moderate-to-high levels of resilience. Profession, work regime during the pandemic, having a health problem, resilience and satisfaction with life are independent variables significantly associated with the outcomes of burnout, stress, depression and anxiety. Satisfaction with life was the independent variable that had a major association with all outcomes.

Conclusions

Governments and hospital administrations should take action to promote resilience and satisfaction with life as these variables are protective relating to mental health problems. Interventions as educational sessions, psychological support at work, programmes promoting resilience and coping mechanisms and better work conditions may improve mental health. The implementation of measures to protect healthcare students from developing prejudicial outcomes seams very adequate and important.
Home-based and community-based activities that can improve mental wellness: a protocol for an umbrella review
Authors: Puyat Joseph H , Mohebbian Mana , Gupta Aanchel , Ellis Ursula , Ranote Harmanpreet , Almeida Alberto , Ridgway Lisa , Vila-Rodriguez Fidel , Kazanjian Arminee
Published: December 2022

Introduction

Mental disorders affect about 13% of the world’s population. While evidence-based mental health treatments are available, a significant number of persons with mental illnesses are untreated or do not receive adequate mental healthcare due to various reasons, including costs, stigma and the desire to self-manage symptoms. In the past few years, there has been an increase in the body of evidence regarding leisure activities and mental wellness. However, there is currently no published overview of the state of the evidence on these activities and their potential preventive and therapeutic effects on mental health.

Methods and analysis

Using Joanna Briggs Institute (JBI) review guidelines, an umbrella review will be undertaken to synthesise findings from systematic reviews and meta-analyses on the mental health benefits of home-based and community-based activities. MEDLINE, PsycInfo, Embase, CINAHL, Web of Science, Epistemonikos, Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews and Implementation Reports will be searched for potentially relevant systematic reviews and meta-analyses published from January 1991 to present. Title/abstract screening, full-text review, data extraction and assessment of methodological quality will each be performed independently by two reviewers. A third review author will be available to resolve discrepancies in any of the review tasks. To assess the quality of potentially eligible reviews, the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses will be used. Findings will be presented in table form and will be summarised by study population, type of home-based or community-based activity or intervention, and type of mental health outcomes. Overall assessment of the strength of existing evidence from eligible systematic reviews will be provided following the grading of recommendation, assessment, development and evaluation approach.

Ethics and dissemination

No ethical approval is required. Results of this umbrella review will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42021266989.
Association between statin use during hospitalisation and mortality in patients with intracerebral haemorrhage: a propensity score-matched cohort study
Authors: Yuan Min , Zhou Xinhua , Lu Xiaoqing , Xiao Zhilong , Zhou Huangyan , Wang Xiaohua
Published: December 2022

Objectives

We examined the relationship between statin use during hospitalisation and mortality in patients with intracerebral haemorrhage (ICH).

Design

Retrospective propensity-matched cohort study.

Setting

Patients with ICH (≥18 years old) admitted to Beth Israel Deaconess Medical Center (Boston, Massachusetts, USA) from 2001 to 2012 registered in the Medical Information Mart for Intensive Care III database.

Participants

1043 patients with ICH (≥18 years) were evaluated for the relationship between statin use during hospitalisation and mortality.

Interventions

Statin use.

Primary and secondary outcome measures

The primary outcome was 90-day mortality. We used multivariable Cox regression analyses to calculate the adjusted HR with 95% CI and used propensity score analysis and an inverse probability weighting (IPW) model to ensure the robustness of our findings.

Results

We included 1043 patients with ICH (362 and 681 were statins and non-statin users, respectively) between 2001 and 2012. The overall 90-day mortality was 29.8% (311/1043); it was 33.3% (227/681) and 23.2% (84/362) for non-statin and statin users, respectively. After adjusted for potential confounders, we found that statin use was associated with 29% lower of 90-day mortality (HR=0.71, 95% CI 0.52 to 0.97, p<0.05). IPW also demonstrated a significantly lower 90-day mortality in statin users. The HR was 0.69 (95% CI 0.54 to 0.88, p<0.01). The results remain stable in subgroup analyses and propensity score matching.

Conclusion

Statin use during hospitalisation may be associated with reduced risk-adjusted mortality in patients with ICH. Further randomised controlled trials are needed to clarify this association.
Incidence and causes of stillbirth in the only tertiary referral hospital in the Solomon Islands: a hospital-based retrospective cohort study
Authors: De Silva Manarangi Sajini , Panisi Leeanne , Manubuasa Lenin , Honimae Catherine , Taragwanu Susan , Burggraaf Simon , Ogaoga Divinal , Lindquist Anthea Clare , Walker Susan P , Tong Stephen , Hastie Roxanne
Published: December 2022

Objectives

Stillbirth is a major global health issue, which disproportionately affects families living in low-income and middle-income countries. The Solomon Islands is a Pacific nation with poor perinatal outcomes, however research investigating stillbirth is lacking. Thus, we aimed to investigate the incidence and cause of stillbirth occurring at the National Referral Hospital, Solomon Islands.

Design

We conducted a retrospective cohort study from January 2017 to December 2018.

Setting

At the only tertiary referral hospital in the Solomon Islands, on the main island of Guadalcanal.

Participants

All births occurring in the hospital during the study period.

Outcome measures

Number of, causes and risk factors for stillbirths (fetal deaths before birth at ≥20 estimated gestational weeks, or ≥500 g in birth weight).

Results

Over 2 years 341 stillbirths and 11 056 total births were recorded, giving an institutional incidence of 31 stillbirths per 1000 births. Of the cases with a recorded cause of death, 72% were deemed preventable. Most stillbirths occurred antenatally and 62% at preterm gestations (<37 weeks). 59% had a birth weight below 2500 g and preventable maternal conditions were present in 42% of the cases. 46% of the cases were caused by an acute intrapartum event, and among these 92% did not receive intrapartum monitoring.

Conclusions

Stillbirth affects 31 in every 1000 births at the National Referral Hospital in the Solomon Islands and many cases are preventable. Our findings highlight the urgent need for increased focus on perinatal deaths in the Solomon Islands with universal classification and targeted training, improved quality of obstetrical care and community awareness.
Preventing cardiotoxicity in patients with breast cancer and lymphoma: protocol for a multicentre randomised controlled trial (PROACT)
Authors: Maier Rebecca H , Plummer Chris , Kasim Adetayo S , Akhter Nasima , Ogundimu Emmanuel , Maddox Jamie , Graham Janine , Stewart Michael , Wardley Andrew , Haney Sophie , Vahabi Sharareh , Oxenham Helen , Humphreys Alison , Cresti Nicola , Verrill Mark , Graham Richard , Chang Lisa , Hancock Helen C , Austin David
Published: December 2022

Introduction

Anthracyclines are included in chemotherapy regimens to treat several different types of cancer and are extremely effective. However, it is recognised that a significant side effect is cardiotoxicity; anthracyclines can cause irreversible damage to cardiac cells and ultimately impaired cardiac function and heart failure, which may only be evident years after exposure. The PROACT trial will establish the effectiveness of the ACE inhibitor enalapril maleate (enalapril) in preventing cardiotoxicity in patients with breast cancer and non-Hodgkin’s lymphoma (NHL) receiving anthracycline-based chemotherapy.

Methods and analysis

PROACT is a prospective, randomised, open-label, blinded end-point, superiority trial which will recruit adult patients being treated for breast cancer and NHL at NHS hospitals throughout England. The trial aims to recruit 106 participants, who will be randomised to standard care (high-dose anthracycline-based chemotherapy) plus enalapril (intervention) or standard care alone (control). Patients randomised to the intervention arm will receive enalapril (starting at 2.5 mg two times per day and titrating up to a maximum dose of 10 mg two times per day), commencing treatment at least 2 days prior to starting chemotherapy and finishing 3 weeks after their last anthracycline dose. The primary outcome is the presence or absence of cardiac troponin T release at any time during anthracycline treatment, and 1 month after the last dose of anthracycline. Secondary outcomes will focus on cardiac function measured using echocardiogram assessment, adherence to enalapril and side effects.

Ethics and dissemination

A favourable opinion was given following research ethics committee review by West Midlands—Edgbaston REC, Ref: 17/WM/0248. Trial findings will be disseminated through engagement with patients, the oncology and cardiology communities, NHS management and commissioning groups and through peer-reviewed publication.

Trial registration number

NCT03265574.
Risk factors for severe disease and impact of severity on pregnant women with COVID-19: a case–control study based on data from a nationwide survey of maternity services in Japan
Authors: Arakaki Tatsuya , Hasegawa Junichi , Sekizawa Akihiko , Ikeda Tomoaki , Ishiwata Isamu , Kinoshita Katsuyuki
Published: December 2022

Objective

To identify independent risk factors for severe COVID-19 in pregnant women and to evaluate the impact of disease severity on preterm birth.

Design

A case–control study based on data from a nationwide questionnaire-based survey of maternity services in Japan.

Setting

A questionnaire was mailed to all 2135 delivery institutions in Japan between July and August 2021. A total of 1288 institutions responded (60% of all delivery institutions in Japan). 566 facilities reported having cared for pregnant women with COVID-19, and 722 facilities reported having had no such patients.

Participants

One thousand and forty-three hospitalised and non-hospitalised pregnant women diagnosed with COVID-19 between July 2020 and 30 June 2021.

Primary and secondary outcome measures

The primary outcome was progression to severe COVID-19. The secondary outcome was preterm birth due to COVID-19 infection.

Results

56 cases (5.4%) were severe, and 987 (94.6%) were non-severe. Multivariable logistic regression analysis showed that gestational age≥24 weeks (adjusted OR (aOR) 6.68, 95% CI 2.8 to 16.0) and maternal age≥32 years (aOR 2.40, 95% CI 1.3 to 4.3) were independently associated with severe cases. Using the Kaplan-Meier method, the probability of continued pregnancy at 14 days after diagnosis for severe cases was 0.57 between 24 and 31 weeks’ gestation and 0.27 between 32 and 36 weeks’ gestation. The probability for non-severe cases was 1.0 between 24 and 31 weeks’ gestation and 0.8 between 32 and 36 weeks’ gestation. Among the patients with COVID-19 in the preterm period, preterm birth due to infection was significantly more common in severe than non-severe cases (48% vs 6%, p< 0.0001).

Conclusions

Severe COVID-19 in pregnant women was associated with gestational age≥24 weeks and maternal age≥32. The rate of preterm delivery due to the infection was significantly higher in severe COVID-19 cases.
Mitigating Infectious morbidity and Growth deficits in HIV-exposed uninfected infanTs with human Milk Oligosaccharide (MIGH-T MO): a randomised trial protocol
Authors: Shivakoti Rupak , Slogrove Amy L , Laughton Barbara , Shafiq Mehr , Schoeman Elisma , Glashoff Richard H , Leu Cheng-Shiun , Wang Shuang , Bode Lars , Aldrovandi Grace , Kuhn Louise
Published: December 2022

Introduction

Children who are HIV-exposed uninfected (HEU), that is, children who do not acquire HIV infection despite being born to mothers with HIV, have a higher risk of mortality, infectious morbidity and growth deficits than children who are HIV-unexposed uninfected (HUU). Prior research has focused on breast feeding and has pointed to changes in human milk oligosaccharides (HMOs) associated with maternal HIV that may influence the infant microbiome and thereby lead to these adverse outcomes. However, to our knowledge, no study has attempted to intervene along this pathway to reduce the occurrence of the adverse outcomes in children HEU. We will conduct a double-blind, randomised trial of a synbiotic intervention, which combines an HMO and probiotic, in breastfed infants HEU in South Africa to evaluate whether this intervention has promise to reduce excess infectious morbidity and growth faltering compared with controls.

Methods and analysis

One hundred and forty-four breastfed infants HEU, aged 4 weeks, will be 1:1 randomised to receive either a daily synbiotic or an identical-looking placebo through age 24 weeks. Infants will be followed until age 48 weeks and outcomes of infectious morbidity, growth and biological measurements (eg, microbiota, inflammation and metabolome) will be assessed. Analyses will follow intention-to-treat principles comparing the cohorts as randomised. Infants HEU will be compared across arms with respect to the occurrence of infectious morbidity and growth outcomes through 4–24 weeks and 4–48 weeks using appropriate parametric and non-parametric statistical tests. Additionally, an observational cohort of 40 breastfed infants HUU will be recruited as a comparator group with no intervention.

Ethics and dissemination

Ethical approval for this study has been obtained from the ethics committees at Columbia University and Stellenbosch University. The findings will be disseminated in publications.

Trial registration number

ClinicalTrials.gov Identifier:NCT05282485. SANCTR ID number: DOH-27-122021-6543.
Predicting the future development of diabetic retinopathy using a deep learning algorithm for the analysis of non-invasive retinal imaging
Authors: Rom Yovel , Aviv Rachelle , Ianchulev Tsontcho , Dvey-Aharon Zack
Published: December 2022

Aims

Diabetic retinopathy (DR) is the most common cause of vision loss in the working age. This research aimed to develop an artificial intelligence (AI) machine learning model which can predict the development of referable DR from fundus imagery of otherwise healthy eyes.

Methods

Our researchers trained a machine learning algorithm on the EyePACS data set, consisting of 156 363 fundus images. Referrable DR was defined as any level above mild on the International Clinical Diabetic Retinopathy scale.

Results

The algorithm achieved 0.81 area under receiver operating curve (AUC) when averaging scores from multiple images on the task of predicting development of referrable DR, and 0.76 AUC when using a single image.

Conclusion

Our results suggest that risk of DR may be predicted from fundus photography alone. Prediction of personalised risk of DR may become key in treatment and contribute to patient compliance across the board, particularly when supported by further prospective research.
Efficacy and safety of a fixed combination of 1% brinzolamide and 0.1% brimonidine as treatment for glaucoma: a retrospective study focusing on the number of ingredients
Authors: Aoki Ryota , Terao Etsuko , Dote Saki , Shiraishi Miku , Oogi Satomi , Ueda Kanae , Kimura Yui , Nagata Yuki , Nakakura Shunsuke
Published: December 2022

Objective

To evaluate the intraocular pressure (IOP)-lowering effect based on the number of ingredients and survival rate due to adverse reactions of brinzolamide (1%)/brimonidine (0.1%) fixed combination (BBFC).

Methods and analysis

Among 424 patients newly administered BBFC from June 2020 to May 2021, 406 were retrospectively evaluated for adverse reactions and 299 were evaluated for the IOP-lowering effect of BBFC. Among those evaluated for IOP, group A (n=86) included patients whose treatment was changed to BBFC from other two ingredients, Group B (n=90) included patients who added one ingredient by switching to BBFC, and group C (n=123) included patients who added BBFC in addition to other drugs.

Results

The mean IOP (mm Hg) at BBFC initiation and at 3, 6 and 12 months after BBFC initiation was 14.1, 14.0, 14.3 and 13.8 in group A, 15.9, 14.4, 13.8 and 14.5 in group B and 17.2, 14.0, 14.1 and 14.9 in group C, respectively. Group A showed no significant difference in mean IOP from baseline to any time point after BBFC initiation, whereas groups B and C showed significant IOP reductions at all time points. Seventy-three (18%) patients discontinued treatment due to adverse reactions. The survival rate was 72% at 12 months after the start of BBFC when discontinuation due to adverse reactions was defined as failure.

Conclusion

Using BBFC, sustained IOP or decreasing IOP were observed depending on the number of ingredients. Drop-outs due to the adverse reactions should also be given attention.
Infectious disease screening outcomes and reducing barriers to care for unaccompanied asylum-seeking children: a single-centre retrospective clinical analysis
Authors: Cardoso Pinto Alexandra M , Seery Paula , Foster Caroline
Published: December 2022

Objective

Evaluate the Unity Clinic’s infectious disease screening programme for unaccompanied asylum-seeking children (UASC), calculate rates of infection and identify further health needs.

Design

Retrospective audit of electronic patient data.

Setting and patients

UASC who attended the Unity Clinic between 1 November 2019 and 22 March 2022.

Main outcome measures

Baseline demographics, social, mental health and journey details, infection screening and investigation results.

Results

155 UASC were reviewed: 89% (138 of 155) male, median age 17 years (IQR 16–17). Most frequent countries of origin were Sudan, Eritrea and Afghanistan. Median duration of travel to the UK (n=79) was 2 years (IQR 0.5–4); 35.6% (47 of 132) arrived by boat and 54.5% (72 of 132) by road. 44.8% (69 of 154) had one or more positive infection screening results: 22.7% (35 of 154) and 1.3% (2 of 154) positive for latent and active tuberculosis, respectively; 4.6% (7 of 152) chronic active hepatitis B and 17.1% (26 of 152) for past infection; 1.3% (2 of 154) for HIV; 13.0% (19 of 146) forStrongyloides. There were three cases of syphilis (n=152; 2.0%) and one chlamydia (n=148; 0.7%)—none of whom disclosed prior sexual activity during screening. 39.6% (61 of 154) and 27.9% (43/154) reported disturbances to mood or sleep, respectively. 55.2% (85 of 154) disclosed traumatic incidents during and/or prior to their journey, including physical and sexual assault.

Conclusions

The Unity Clinic provides a thorough infectious disease screening service for UASC following national guidance. Results highlight the need for universal, non-judgemental screening for sexually transmitted infections, as targeted screening would not identify positive cases. High rates of well-being issues and previous abuse emphasise the need for multidisciplinary, collaborative approaches to care.
Perceptions and acceptability of microsampling in children and young people: a single-centre survey
Authors: Chetwynd Andrew J , Marro Julien , Whitty Laura , Ainsworth Sammy , Preston Jennifer , Salama Alan , Oni Louise
Published: December 2022

Background

The use of at home microsampling devices, such as dried aliquots of blood and urine, for scientific research has expanded in recent years. These devices collect small volumes of biofluids which air dry and can be posted to central laboratories. In general, they are cheaper and more convenient, saving patients travel time and freeing up staff. In adult populations, this sampling method is well perceived, with >90% of samples being of adequate size and quality for scientific research. However, little literature on microsampling in paediatric populations exists. The aim of this study was to explore the perceptions and acceptability of microsampling in children and young people.

Methods

Online patient and public involvement was obtained by attending the Generation R Young Person’s Advisory Group Liverpool, to explore the perceptions of at home microsampling. During the session, the rationale and use of microsampling was demonstrated. The participants provided informal feedback during the interactive session and completed a short online questionnaire.

Results

A total of 13 children and young people attended the event and they were aged 10–17 years, of these 10 responded to an online questionnaire. The general feedback on microsampling was positive with 80% of respondents indicating they would be willing to participate in at home microsampling studies. Furthermore, 100% respondents reported being willing to provide both biofluids on a monthly basis and 40% would be willing to provide dried urine samples weekly.

Conclusions

Children and young people are supportive of at home microsampling for research purposes and this offers the possibility of widening participation to research.
Sex-specific and age-specific incidence of ischaemic heart disease, atrial fibrillation and heart failure in community patients with chronic obstructive pulmonary disease
Authors: Groenewegen Amy , Zwartkruis Victor W , Smit Lennart J , de Boer Rudolf A , Rienstra Michiel , Hoes Arno W , Hollander Monika , Rutten Frans H
Published: December 2022

Objective

To estimate the incidence of ischaemic heart disease, atrial fibrillation and heart failure in community patients with or without chronic obstructive pulmonary disease (COPD).

Methods

For this population-based study, we used primary care data of the Julius General Practitioners’ Network. Eligible participants were aged 40–80 years old and contributed data between January 2014 and February 2019. Participants were divided into groups according to COPD status and were followed up for new ischaemic heart disease, atrial fibrillation and/or heart failure. Age-specific and sex-specific incidence and incidence rate ratios were calculated for patients with and without COPD.

Results

Mean follow-up was 3.9 years, 6223 patients were included in the COPD group, and 137 028 individuals in the background group without COPD. Incidence rates of all three heart diseases increased with age and were higher in males, independent of presence of COPD. Incidence rate ratios for patients with COPD, adjusted for age and sex, were 1.69 (95% CI 1.49 to 1.92) for ischaemic heart disease, 1.56 (95% CI 1.38 to 1.77) for atrial fibrillation and 2.96 (95% CI 2.58 to 3.40) for heart failure.

Conclusion

The incidence of all major cardiovascular diseases is higher in patients with COPD, with the highest incidence rate ratio observed for heart failure.
Danish military fatalities in international operations 2002–2018
Authors: Balkert Lise Skyttegaard , Thomsen A H , Knudsen P J T
Published: December 2022

Introduction

This study describes deaths among Danish soldiers in international operations 2002–2018. Having been part of UN and later NATO forces in ex-Yugoslavia, in 2002 the first Danish contingent took part in the International Security Assistance Force mission in Afghanistan as well as Iraq. The changing role of the Danish military in international operations meant casualties, in numbers that had not yet been experienced, and necessitated a review of our procedures for handling fatalities in the military.

Methods

The study is a retrospective review of autopsy reports, Military Police reports and medical reports, and the purpose is to examine all Danish fatalities in international operations in 2002–2018 to identify potential areas of improving treatment and protection and to review the contribution of the autopsies. The mechanism of injury, the fatal injuries and causes of death and the time of death within the chain of evacuation were identified. Casualties dying at any time from site of injury until definitive care were included.

Results

A total of 53 soldiers died from injuries during international operations in the years 2002–2018. The majority of these (43) died from combat injuries and 10 from accidents. Four of the victims with combat injuries were not autopsied. The majority (36) of the combat deaths were caused by blast/explosions (improvised explosive devices, rocket propelled grenades, fragments), while 7 were caused by bullets. 39 combat victims died instantly on the site or at the arrival to the field hospital, 4 were treated in field hospital and 2 of these were transported back to Denmark.

Conclusions

Most combat fatalities result from fragmentation and blast injury. Forensic autopsies provide valuable information regarding injuries, weaponry, the efficiency of protective equipment and the quality of medical intervention in military fatalities and are recommended in all military fatalities in order to prevent avoidable casualties in the future.
Development, design and experience of the UK Military’s return to diving pathway following SARS-CoV-2 infection
Authors: McPhail Stuart , Steed D , Holdsworth D , Nicol E , Bennett A , Phillips S
Published: December 2022

After the emergence of the SARS-CoV-2 virus in early 2020, it quickly became clear that symptomatic or asymptomatic infection had the potential to negatively impact on an individual’s fitness to dive through effects on the respiratory, cardiovascular or neurological systems. The significance of these effects in the military diving environment was initially unclear due to an absence of data concerning incidence, chronology or severity. In order to safely return divers to the water and maintain operational capability, the UK Military developed a pathway for SARS-CoV-2 positive divers that stratified risk of sequelae and extent of required clinical investigation, while minimising reliance on viral testing and hospital-based investigations. We present this process, provide rationale and support for its design and detail the number of SARS-CoV-2 positive divers who have been returned to full diving fitness following infection of varying degrees of severity.
Rational wavelet filter banks from Blaschke product
Authors: Wang Xuefeng
Published: December 2022

This note designs two kinds of rational wavelet filter banks using three basic bricks: the finite Blaschke product, Bezout polynomial and the symbol of the cardinal B-spline. In orthogonal case, the corresponding wavelets are generalization of Daubechies’ wavelets. The role of the Blaschke product is the adjustment of the peaks of wavelet functions.
Cayratia japonica Prevents Ulcerative Colitis by Promoting M2 Macrophage Polarization through Blocking the TLR4/MAPK/NF-κB Pathway
Authors: Sun Jun , Zhao Ping , Ding Xufeng , Li Fang , Jiang Jie , Huang Hua , Ji Lijiang
Published: December 2022

Background and Aims. Several components of Cayratia japonica (CJ) such as rutin and quercetin have shown anti-inflammatory effect, yet its function in ulcerative colitis (UC) remains to be clarified. This study focuses on the modulatory effect of CJ on UC as well as molecular mechanism by which CJ regulates macrophage polarization in UC. Methods. The targets related to CJ components and UC were, respectively, obtained through in silico analysis, and their intersection targets were selected for pathway enrichment analysis. RAW264.7 cells were stimulated with lipopolysaccharide (LPS) to induce M1 macrophages. Expression of the macrophage polarization M1 marker CD11b and M2 marker CD206 was measured to determine the phenotype of macrophages. The mouse model was treated with dextran sodium sulfate (DSS) to induce UC to observe the effects of CJ on UC in vivo. Results. The in silico analysis suggested the crucial significance of TLR4 and its downstream MAPK/NF-κB pathways in the modulatory effect of CJ on UC. Furthermore, experimental data revealed that CJ could promote M2 macrophage polarization but alleviate immune inflammation and reduce colon damage in DSS-evoked UC model. Additionally, CJ can inhibit the expression of TLR4/MAPK/NF-κB signaling pathway to enhance the M2-like polarization. Conclusion. Hence, CJ may exert anti-inflammatory effects and an inhibitory role in UC by inhibiting the TLR4/MAPK/NF-κB pathway and subsequent M1-like macrophage polarization.
Theoretical Investigations of Gyrating Ion Beam-Driven Ion-Acoustic Wave Instability in Plasma Using First Order Perturbation Theory
Authors: Yadav Meena , Kumar Kamal , Sharma Jyotsna
Published: December 2022

A Gyrating ion beam traveling through a plasma cylinder comprising of electrons, positive ions

K

+

, and heavy

C

7

F
14
−

negative ions, through Cerenkov interaction, drive IAWs (ion-acoustic waves) to unstable mode. In this process, two ion-acoustic (IA) unstable wave modes: a fast

K

+

mode and a slow

C

7

F
14
−

mode in the presence of positive and heavy negative ions are observed in the plasma. Numerical calculations of the sound wave phase velocity, unstable mode frequency, and the growth rates have been carried out. The calculations show that the growth rate and unstable wave frequencies for both the IA wave modes increase with the increase in the relative density of used heavy negative ions. Moreover, the growth rate is measured as 1/3rd of ion beam density power and the phase velocity rises with the concentration of heavy negative ions. There is a considerable effect of an increase in the magnetic field on the growth rate. The growth rate of the fast (K+) mode increases with the magnetic field more rapidly as compared to the slow ion mode

C

7

F
14
−

.
The Benefits of Early versus Late Therapeutic Intervention in Fabry Disease
Authors: Furlano Mónica , Ars Elisabet , Matamala Anna , Brossa Vicens , Martí Joan , Prado-Venegas Maria del , Crespi Jaume , Roe Esther , Torra Roser
Published: December 2022

Background. Fabry disease (FD) is an X-linked lysosomal storage disorder caused by pathogenic variants of the GLA gene. Heterozygous female patients may show much more variability in clinical manifestations, ranging from asymptomatic to full-blown disease. Because of this heterogeneous clinical picture in women, the diagnosis of FD has typically been delayed for more than a decade, and the optimal time to initiate treatment remains controversial. Case Presentation. Here, we present two unrelated female patients diagnosed with FD harbouring the same pathogenic GLA variant. We discuss the implications of initiating specific therapy at different stages of the disease, with and without organ involvement (early versus late therapeutic intervention). Conclusions. These clinical cases suggest that initiating specific treatment at an earlier age in women with FD may prevent organ involvement and associated clinical events.
Schiff Base Ligand 3-(-(2-Hydroxyphenylimino) Methyl)-4H-Chromen-4-One as Colorimetric Sensor for Detection of Cu2+, Fe3+, and V5+ in Aqueous Solutions
Authors: Alorabi Ali Q. , Zabin Sami A. , Alam Mohammad Mahboob , Abdelbaset Mohamed
Published: December 2022

The ligand 3-(-(2-hydroxyphenylimino) methyl)-4H-chromen-4-one (SL) has been synthesized and examined as a chemosensor for some metal ions in aqueous solutions based on colorimetric analysis. Color changes were monitored using UV–visible spectroscopy. Binding stoichiometry and limit of detection (LOD) were estimated using titration experimentation based on UV–visible absorbance and Job’s plot. The synthesized ligand was tested for selectivity in the presence of several cations and was examined for possible utility as a chemosensor in real water samples. The results indicated sensing ability and selectivity for Cu2+, Fe3+, and V5+. Stable complexes were formed between SL and Cu2+, Fe3+, and V5+, and the ligand-to-metal binding stoichiometry was found 2 : 1 in the SL-Cu2+ and SL-Fe3+ complexes, and 1 : 1 in the SL-V5+ complex. The results of LOD and bending constant were (7.03 μM, 1.37 × 104 M−1), (5.16 μM, 2.01 × 104 M−1), and (5.94 μM, 1.82 × 104 M−1) for Cu2+, Fe3+, and V5+, respectively.
Trace Elements and Heavy Metal Contents in West Algerian Natural Honey
Authors: Bereksi-Reguig Dalila , Bouchentouf Salim , Allali Hocine , Adamczuk Agnieszka , Kowalska Grażyna , Kowalski Radosław
Published: December 2022

Analysis of trace elements and heavy metals in honey is essential for honey quality and safety and also monitoring environmental pollution. This study aimed to evaluate the composition of thirty-seven honey samples of different botanical origins (14 multifloral and 23 unifloral) obtained from beekeepers located in the west region of Algeria. Inductively coupled plasma-mass spectrometry (ICP-MS) and atomic absorption spectroscopy (AAS) methods were used to determine the levels of 19 elements in honey (K, Na, Ca, Mg, Mn, Cu, Fe, Zn, V, Cr, Co, As, Ru, Rh, Cd, W, Pt, Au, and Pb). Ru, Rh, Pt and, Au were not detected in any of the tested honey samples. The most abundant minerals were K, Ca, Na, and Mg ranging within 153.00–989.00 mg/kg, 33.10–502.00 mg/kg, 13.30–281.00 mg/kg, and 20.80–162.00 mg/kg, respectively. Fe, Mn, Zn, and Cu were the most abundant heavy metals while Pb, V, Cr, W, Co, and Cd were the lowest ones (<1 mg/kg) in the honey samples surveyed. Several honey types, lavender, rosemary, mild white mustard, thyme, milk thistle, carob tree, orange tree, Euphorbia, Eucalyptus, camphor, jujube tree, sage, and harmal, were studied, and the statistical analysis was carried out using principal component analysis (PCA) and hierarchical cluster analysis (HCA) techniques to evaluate the data. The results showed that the analyses of mineral content were sufficient to determine the floral origin and their variability may be related to geochemical and geographical differences. On other hand, all elements detected were at levels below safe thresholds.
Deployment and Operation of Battery Swapping Stations for Electric Two-Wheelers Based on Machine Learning
Authors: Feng Yu , Lu Xiaochun
Published: December 2022

Battery swapping stations effectively address the challenges of long charging times, lack of charging stations, and safety hazards for electric two-wheelers. With the rapid development of shared electric bicycles and takeaways, the scale of electric two-wheeler users is expanding while generating a huge demand for battery swapping. The research on the planning and operation of battery swapping stations (BSSs) for electric two-wheelers has yet to be widely discussed. This study developed a data-driven optimization model based on machine learning algorithms using Beijing’s battery swapping stations and point of interest (POI) dataset. First, through the spatial features of BSS analyzed by ArcGIS, we found that the coverage of BSSs was mainly concentrated within the fifth ring road, and the utilization rate was unbalanced. Then, on a 3000 m grid scale, a prediction model of BSS quantity with random forest, support vector regression, and gradient-boosting decision tree algorithm was built. The final stacking model was constructed by strengthening three single models with an accuracy of 86.21%. Compared with the original BSSs layout, the machine-learning algorithm proposed in this study can cover more factors and avoid the subjectivity of site selection. Finally, the queuing model for BSSs based on the Monte Carlo simulation was proposed. Through two scenarios, we found that the key parameters

m

(the number of charging slots) and

λ

(the user arrival rate) were influential to the outputs of service capability.