bluuebunny/crossref_metadata_2025 huggingface dataset:
Age at Human Papillomavirus Vaccine Initiation Among Adolescents and Young Adults From 22 Pediatric Practices in the Northeastern United States
Authors: Kim Kyounghae , Zhang Yiming , Lee Joochul , Meehan Thomas P. , Gans Kim
Published: December 2020

Purpose

To examine trends in human papillomavirus (HPV) vaccine initiation and its determinants.

Design

This retrospective correlational study involved 12,260 individuals born between 1996 and 2000 receiving care from one of 22 pediatric practices in the northeastern region of the United States between 2016 and 2017.

Methods

We extracted data about HPV vaccination status and date, birth year, race, ethnicity, language, and geographic regions. Mean age at initiation was estimated using descriptive statistics. Multiple linear regression with weighted least squares was used to examine its correlates.

Findings

Of 12,260 individuals, about 76% initiated the HPV vaccination series at 9 to 17 years of age. While the initiation age decreased overall for both females and males (e.g., 14.3 vs. 16.2 years and 13.8 vs. 14.4 years in the 1996 vs. 2000 birth cohorts, respectively), a greater reduction was noted for males. Individuals tended to delay initiation if they were non‐Hispanic or Asian and resided in urban areas.

Conclusions

Most adolescents in our sample started HPV vaccination later than the recommended age, with variations in different demographic groups. Rapid improvement in on‐time HPV vaccination is occurring, especially for males.

Clinical Relevance

The findings of this analysis emphasize continuous efforts to increase on‐time HPV vaccination rates for all groups, including non‐Hispanic whites and female adolescents, to eliminate current and possible disparities.
Occurrence of workplace violence and the psychological consequences of it among nurses working in psychiatric outpatient settings
Authors: Konttila Jenni , Holopainen Arja , Pesonen Hanna‐Mari , Kyngäs Helvi
Published: December 2020

Accessible summary

What is known on the subject?

There is a scarcity of studies concerning violence in psychiatric outpatient settings in the 2010s in spite of the deinstitutionalization of psychiatric services.

Previous research on violence in psychiatric outpatient settings has failed to consider the association between the psychological consequences of violence, exposures to violence and background factors.

What the paper adds to existing knowledge?

It has been known for some time that exposures to violence are harmful for psychiatric inpatient nurses; the paper demonstrates that psychiatric outpatient nurses are also at risk.

The psychological consequences of exposure to violence are highly individualized and influenced by background factors.

Nurses who face harassment have a greater risk of suffering psychological symptoms.

What are the implications for practice?

De‐escalation interventions should be implemented in psychiatric outpatient settings.

Organizations should consider the possibility of internal violence occurring when planning preventive interventions to manage and reduce workplace violence.

Education targeted at violence prevention, management and debriefing should be organized systematically in psychiatric outpatient units and be taken into consideration in the mental health nursing curriculum.

Introduction

There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting.

Aim

This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings.

Method

Research followed a cross‐sectional survey design. Data were collected with the VIA‐Q instrument.

Results

During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified.

Discussion

Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing.

Implications for Practice

De‐escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence.
Fine‐scale north‐to‐south genetic admixture profile in Shaanxi Han Chinese revealed by genome‐wide demographic history reconstruction
Authors: He Guang‐Lin , Wang Meng‐Ge , Li Ying‐Xiang , Zou Xing , Yeh Hui‐Yuan , Tang Ren‐Kuan , Yang Xiao‐Min , Wang Zheng , Guo Jian‐Xin , Luo Ting , Zhao Jing , Sun Jin , Hu Rong , Wei Lan‐Hai , Chen Gang , Hou Yi‐Ping , Wang Chuan‐Chao
Published: December 2020

The Han Chinese are the world's largest ethnic group residing across China. Shaanxi province in northern China was a pastoral–agricultural interlacing region sensitive to climate change since Neolithic times, which makes it a vital place for studying population dynamics. However, genetic studies of Shaanxi Han are underrepresented due to the lack of high‐density sampling and genome‐wide data. Here, we genotyped 700 000 single nucleotide polymorphisms (SNPs) in 200 Han individuals from nine populations in Shaanxi and compared with available modern and ancient Eurasian individuals. We revealed a north–south genetic cline in Han Chinese with Shaanxi Han locating at the northern side of the cline. We detected the western Eurasian‐related admixture in Shaanxi populations, especially in Guanzhong and Shanbei Han Chinese in proportions of 2%–4.6%. Shaanxi Han were suggested to derive a large part of ancestry (39%–69%) from a lineage that also contributed largely to ancient and present‐day Tibetans (85%) as well as southern Han, supporting the common northern China origin of modern Sino‐Tibetan‐speaking populations and southwestward expansion of millet farmers from the middle‐upper Yellow River Basin to the Tibetan Plateau and to southern China. The rest of the ancestry of Shaanxi Han was from a lineage closely related to ancient and present‐day Austronesian and Tai‐Kadai speaking populations in southern China and Southeast Asia. We also observed a genetic substructure in Shaanxi Han in terms of north–south‐related ancestry corresponding well to the latitudes. Maternal mitochondrial DNA and paternal Y‐chromosome lineages further demonstrated the aforementioned admixture pattern of Han Chinese in Shaanxi province.
Individual Differences in Religious Motivation Influence How People Think
Authors: Michaels Jay L. , Petrino John , Pitre‐Zampol Tiffany
Published: December 2020

Motives matter and may have implications for how people cognitively experience meaning through religion and spirituality. Specifically, intrinsically motivated people perceive religion and spirituality are more central to meaning in life, which should promote a tendency to adopt more coherent, expansive cognitive representations. In contrast, extrinsically motivated people may adopt narrower cognitive representations since their motivation is more proximally oriented. The present study tests these possibilities by examining how religious motivation relates to action identification (tendency to use coherent, higher‐level cognitive representations). Results from 630 participants revealed that among religious people, intrinsic and extrinsic‐personal religious motivations indirectly influence higher‐level action identification through strength of spiritual beliefs. These relationships were not evident among nonreligious people. Furthermore, extrinsic‐social religious motivation and religious service attendance did not relate to action identification. These findings demonstrate that religious motivation differences are consequential for the action identities people rely upon to form a sense of meaning.
Safety and effectiveness of omalizumab for the treatment of chronic urticaria in pediatric patients
Authors: Dekkers Coco , Alizadeh Aghdam Mehran , de Graaf Marlies , Knulst André C. , Meijer Yolanda , van den Reek Juul M. P.A. , Stadermann Marike B. , Röckmann Heike
Published: December 2020

Background

Evidence on safety and effectiveness of omalizumab for treatment of chronic urticaria in pediatric patients is scarce and limited to case reports. In particular, drug survival of omalizumab has not yet been investigated, which is a key element in the evaluation of its clinical performance. The aim of this study was to investigate safety, effectiveness, and drug survival rates of omalizumab in a daily practice cohort of pediatric patients with chronic urticaria (CU).

Methods

This is a multicenter study including all pediatric patients from an academic center (Wilhelmina Children's Hospital) and a general center (Diakonessenhuis Hospital) in the Netherlands, who started omalizumab treatment before the age of 18 years. Data on safety, effectiveness, time to discontinuation, and reasons for discontinuation of treatment were assessed. Drug survival of omalizumab was estimated using the Kaplan‐Meier survival analysis.

Results

A total of 38 patients, who started treatment between January 2014 and January 2020, were included. Most patients (68.4%) used omalizumab without reporting any side effects and a complete or good response to treatment was achieved in 76.3% of patients. The 1‐ and 2‐year drug survival rates were 62% and 50%, respectively, with well‐controlled disease activity as the most frequent reason for discontinuation in 69.2% of patients, followed by ineffectiveness in 23.1% and side effects in 7.7% of patients.

Conclusions

This study demonstrates high safety and effectiveness of omalizumab treatment in pediatric patients with CU, which will aid clinical decision making and management of expectations when choosing omalizumab treatment for pediatric patients with CU.
Human TYRP1: Two functions for a single gene?
Authors: Gautron Arthur , Migault Mélodie , Bachelot Laura , Corre Sébastien , Galibert Marie‐Dominique , Gilot David
Published: December 2020

In the animal kingdom, skin pigmentation is highly variable between species, and it contributes to phenotypes. In humans, skin pigmentation plays a part in sun protection. Skin pigmentation depends on the ratio of the two pigments pheomelanin and eumelanin, both synthesized by a specialized cell population, the melanocytes. In this review, we explore one important factor in pigmentation: the tyrosinase‐related protein 1 (TYRP1) gene which is involved in eumelanin synthesis via the TYRP1 protein. Counterintuitively, high TYRP1 mRNA expression is associated with a poor clinical outcome for patients with metastatic melanomas. Recently, we were able to explain this unexpected TYRP1 function by demonstrating that TYRP1 mRNA sequesters microRNA‐16, a tumor suppressor miRNA. Here, we focus on actors influencing TYRP1 mRNA abundance, particularly transcription factors, single nucleotide polymorphisms (SNPs), and miRNAs, as they all dictate the indirect oncogenic activity of TYRP1.
Drought responsiveness in black pepper (Piper nigrum L.): Genes associated and development of a web‐genomic resource
Authors: Negi Ankita , George Kokkat Johnson , Jasrotia Rahul S. , Madhavan Soumya , Jaiswal Sarika , Angadi Ulavappa Basavanneppa , Iquebal Mir Asif , Kalathil Palliyarakkal Manju , Palaniyandi Umadevi , Rai Anil , Kumar Dinesh
Published: December 2020

Black pepper (Piper nigrum L.; 2n = 52; Piperaceae), the king of spices, is a perennial, trailing woody flowering vine and has global importance with widespread dietary, medicinal, and preservative uses. It is an economically important germplasm cultivated for its fruit and the major cash crop in >30 tropical countries. Crop production is mainly affected by drought stress. The present study deals with the candidate gene identification from drought‐affected black pepper leaf transcriptome generated by Illumina Hiseq2000. It also aims to mine putative molecular markers (namely SSRs, SNPs, and InDels) and generate primers for them. The identification of transcription factors and pathways involved in drought tolerance is also reported here. De novo transcriptome assembly was performed with trinity assembler. In total, 4914 differential expressed genes, 2110 transcriptional factors, 786 domains and 1137 families, 20,124 putative SSR markers, and 259,236 variants were identified. At2g30105 (unidentified gene containing leucine‐rich repeats and ubiquitin‐like domain), serine threonine protein kinase, Mitogen‐activated protein kinase, Nucleotide Binding Site‐Leucine Rich Repeat, Myeloblastosis‐related proteins, basic helix–loop–helix are all found upregulated and are reported to be associated with plant tolerance against drought condition. All these information are catalogued in the Black Pepper Drought Transcriptome Database (BPDRTDb), freely accessible for academic use at http://webtom.cabgrid.res.in/bpdrtdb/. This database is a good foundation for the genetic improvement of pepper plants, breeding programmes, and mapping population of this crop. Putative markers can also be a reliable genomic resource to develop drought‐tolerant variety for better black pepper productivity.
Erosion, deposition and contamination by high‐magnitude subaqueous debris flows and turbidity currents: Insights from the failure of a tailings dam near Quesnel Lake, British Columbia
Authors: Kostaschuk Ray , Aden Ayana , Desloges Joseph R.
Published: December 2020

The 4 August 2014 failure of Mount Polley mine tailings dam in central British Columbia, Canada, is the worst environmental disaster in British Columbia history. Around 25 million m3 of water, tailings solids and dam construction materials travelled as a slurry flow down nearby Hazeltine Creek. About 18.6 million m3 of tailings and displaced coarse sediment entered into the narrow, deep, fjord‐like Quesnel Lake. Multibeam echosounding, sub‐bottom profiling, sediment cores and theoretical models are used to examine erosion and deposition on the Hazeltine Creek fan‐delta and the bed of Quesnel Lake by subaqueous sediment density flows generated from the slurry. Strong to very strong subaqueous debris flows eroded two deep subaqueous channels on the fan‐delta in a period of less than 12 h. A model for subaerial debris‐flow erosion overestimates submerged delta‐front erosion rates in the channels because of evolution of the subaqueous debris flows and incomplete liquefaction of the eroding bed. The debris flows deposited a localized debrite with a hummocky surface composed of fine tailings and coarse displaced fan‐delta and fluvial sediment. A flat, featureless, surface composed of fine‐grained sediment adjacent to the debrite is interpreted as debrite/turbidite resulting from debris flows proximally and turbidity currents distally. Copper concentrations in cores are highly elevated compared to background concentrations in pre‐event native lacustrine sediment. Deposits from subaqueous sediment flows generated by earthquakes and glacial lake outburst floods are generally thinner than those in Quesnel Lake caused by the tailings dam failure.
Identification of 11 novel HLA‐A, ‐B, ‐C, ‐DRB1, and ‐DQB1 alleles in the 1000 Genomes Project panel
Authors: Di Cristofaro Julie , Gouret Philippe , Chiaroni Jacques , Abi‐Rached Laurent , Paganini Julien
Published: December 2020

We isolated 11 novel HLA alleles in the 1000 Genomes Project using PolyPheMe software.
Two new HLA alleles, HLA‐B*18:200 and HLA‐C*04:435 detected in Russian donors
Authors: Loginova Maria , Smirnova Daria , Kutyavina Svetlana , Paramonov Igor , Belyaev Andrey
Published: December 2020

Two novel alleles, HLA‐B*18:200 and HLA‐C*04:435, are characterized.
English in Russian musical reviews
Authors: Gritsenko Elena , Aleshinskaya Evgeniya
Published: December 2020

This paper seeks to contribute to the current discussion of world Englishes by showing how English is used in popular music reviews in Russia, a context that has not been addressed in previous research. Drawing on sets of textual and ethnographic data, we argue that English and Anglicisms contribute to the expressiveness and precision of musical reviews, enhance promotion of musical products and become part of the unique identity that ties Russian music fans together. We show how English evokes connections to global contexts in the local community and how Russian speakers use English resources creatively, adapting them to local needs and modifying English musical terms through Russian word‐formation mechanisms, to make them more local.
Mixed Ax–Schanuel for the universal abelian varieties and some applications
Authors: Gao Ziyang
Published: December 2020

In this paper we prove the mixed Ax–Schanuel theorem for the universal abelian varieties (more generally any mixed Shimura variety of Kuga type), and give some simple applications. In particular, we present an application for studying the generic rank of the Betti map.
La urgencia de la paz
Authors: Leyva Pablo
Published: December 2020

La encíclica Laudato si’ es un llamado del papa Francisco a la humanidad, es un llamado al diálogo y al análisis de los verdaderos problemas que debemos enfrentar, un llamado en el que la paz es necesaria. Es una reflexión sobre las razones que afirman la creencia en un creador del universo. Es un documento profundamente religioso que invita a pensar sobre los principios, especialmente del cristianismo y sus raíces judías. Es una invitación a todas las religiones a tener un acercamiento que permita superar los antagonismos y la radicalización. Y es también un documento científico que reconoce los fundamentos de la ciencia y la necesidad que tiene la religión de aproximarse a esta, entenderla, aceptarla, acogerla y evidenciar sus limitaciones.
Computational and Experimental Studies of Cellular Samples Manufactured Using Additive Methods for Use in Advanced Lightweight Designs of Engine Parts
Authors: Magerramova Liubov , Volkov Michael , Volgin Oleg , Kolos Pavel
Published: December 2020

The use of cellular structures is one way to reduce the weight of engine parts. However, the deformation behavior of cellular metallic structures differs significantly from that of conventional homogeneous materials. Samples with cellular structures are themselves designs. Therefore, procedures for strength testing and interpretation of experimental results for cellular structures differ from those for samples derived from homogeneous materials. The criteria for determining the properties of cellular structures include density, stiffness, ability to accumulate energy, etc. These parameters depend on the configuration of the cells, the size of each cell, and the thickness of the connecting elements. Mechanical properties of cellular structures can be established experimentally and confirmed numerically. Special cellular specimens have been designed for uniaxial tensile, bending, compression, shear, and low-cycle fatigue testing. Several variants of cell structures with relative densities ranging from 13 to 45% were considered. Specifically, this study examined the stress–strain states of cell structures from brands “CobaltChrome MP1” powder compositions obtained by laser synthesis on an industrial three-dimensional printer Concept Laser M2 Cusing Single Laser 400 W. Numerical simulations of the tests were carried out by the finite element method. Then, the most rational cellular structures in terms of mass and strength were established on the basis of both real and numerical experiments.
Piwi suppresses transcription of Brahma-dependent transposons via Maelstrom in ovarian somatic cells
Authors: Onishi Ryo , Sato Kaoru , Murano Kensaku , Negishi Lumi , Siomi Haruhiko , Siomi Mikiko C.
Published: December 2020

Brahma is functionally involved in Piwi-piRISC–mediated transposon silencing in
Drosophila
ovarian somatic cells.
Ceramide chain length–dependent protein sorting into selective endoplasmic reticulum exit sites
Authors: Rodriguez-Gallardo Sofia , Kurokawa Kazuo , Sabido-Bozo Susana , Cortes-Gomez Alejandro , Ikeda Atsuko , Zoni Valeria , Aguilera-Romero Auxiliadora , Perez-Linero Ana Maria , Lopez Sergio , Waga Miho , Araki Misako , Nakano Miyako , Riezman Howard , Funato Kouichi , Vanni Stefano , Nakano Akihiko , Muñiz Manuel
Published: December 2020

3D high-resolution live imaging reveals the importance of ceramide chain length for protein sorting in selective export sites.
Exploiting the diphtheria toxin internalization receptor enhances delivery of proteins to lysosomes for enzyme replacement therapy
Authors: Sugiman-Marangos Seiji N. , Beilhartz Greg L. , Zhao Xiaochu , Zhou Dongxia , Hua Rong , Kim Peter K. , Rini James M. , Minassian Berge A. , Melnyk Roman A.
Published: December 2020

Engineering lysosomal enzymes to bind the diphtheria toxin receptor with high affinity increases uptake into cells and tissues.
Size-transformable antigen-presenting cell–mimicking nanovesicles potentiate effective cancer immunotherapy
Authors: Yang Weijing , Deng Hongzhang , Zhu Shoujun , Lau Joseph , Tian Rui , Wang Sheng , Zhou Zijian , Yu Guocan , Rao Lang , He Liangcan , Ma Ying , Chen Xiaoyuan
Published: December 2020

We provide a generalizable approach of using size-transformable artificial antigen-presenting cells for cancer immunotherapy.
Calmodulin acts as a state-dependent switch to control a cardiac potassium channel opening
Authors: Kang Po Wei , Westerlund Annie M. , Shi Jingyi , White Kelli McFarland , Dou Alex K. , Cui Amy H. , Silva Jonathan R. , Delemotte Lucie , Cui Jianmin
Published: December 2020

Calmodulin controls KCNQ1 potassium channel pore opening by competing with PIP2in the KCNQ1 voltage-sensing domain.
The
Roseobacter
-Group Bacterium
Phaeobacter
as a Safe Probiotic Solution for Aquaculture
Authors: Sonnenschein Eva C. , Jimenez Guillermo , Castex Mathieu , Gram Lone
Published: December 2020

Phaeobacter inhibens
has been assessed as a probiotic bacterium for application in aquaculture. Studies addressing the efficacy and safety indicate that
P. inhibens
maintains it antagonistic activity against pathogenic vibrios in aquaculture live cultures (live feed and fish egg/larvae), while having no or a positive effect on the host organisms and a minor impact on the host microbiomes.
Intranasal Immunization with Acellular Pertussis Vaccines Results in Long-Term Immunity to Bordetella pertussis in Mice
Authors: Wolf M. Allison , Boehm Dylan T. , DeJong Megan A. , Wong Ting Y. , Sen-Kilic Emel , Hall Jesse M. , Blackwood Catherine B. , Weaver Kelly L. , Kelly Claire O. , Kisamore Caleb A. , Bitzer Graham J. , Bevere Justin R. , Barbier Mariette , Damron F. Heath
Published: December 2020

Bordetella pertussis
colonizes the respiratory mucosa of humans, inducing an immune response seeded in the respiratory tract. An individual, once convalescent, exhibits long-term immunity to the pathogen.
Effect of therapeutic suggestions during general anaesthesia on postoperative pain and opioid use: multicentre randomised controlled trial
Authors: Nowak Hartmuth , Zech Nina , Asmussen Sven , Rahmel Tim , Tryba Michael , Oprea Guenther , Grause Lisa , Schork Karin , Moeller Manuela , Loeser Johannes , Gyarmati Katharina , Mittler Corinna , Saller Thomas , Zagler Alexandra , Lutz Katrin , Adamzik Michael , Hansen Ernil
Published: December 2020

Objective

To investigate the effect of therapeutic suggestions played to patients through earphones during surgery on postoperative pain and opioid use.

Design

Blinded randomised controlled study.

Setting

Five tertiary care hospitals in Germany.

Participants

385 of 400 patients consecutively recruited from January to December 2018 who were to undergo surgery for 1-3 hours under general anaesthesia. In the per protocol analysis 191 patients were included in the intervention group and 194 patients in the control group.

Intervention

The intervention comprised an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence to patients through earphones during general anaesthesia. Patients in the control group were assigned to a blank tape.

Main outcome measures

The main outcome was dose of opioid administered by patient controlled analgesia or nurse controlled analgesia within the first postoperative 24 hours, based on regular evaluation of pain intensity on a numerical rating scale (range 0-10, with higher scores representing more severe pain).

Results

Compared with the control group, the intervention group required a significantly (P=0.002) lower opioid dose within 24 hours after surgery, with a median of 4.0 mg (interquartile range 0-8) morphine equivalents versus 5.3 (2-12), and an effect size (Cohen’s d) of 0.36 (95% confidence interval 0.16 to 0.56). The number of patients who needed opioids postoperatively was significantly (P=0.001) reduced in the intervention group: 121 of 191 (63%, 95% confidence interval 45% to 70%) patients in the intervention group versus 155 of 194 (80%, 74% to 85%) in the control group. The number needed to treat to avoid postoperative opioids was 6. Pain scores were consistently and significantly lower in the intervention group within 24 hours after surgery, with an average reduction of 25%. No adverse events were reported.

Conclusions

Therapeutic suggestions played through earphones during general anaesthesia could provide a safe, feasible, inexpensive, and non-drug technique to reduce postoperative pain and opioid use, with the potential for more general use. Based on the finding of intraoperative perception by a considerable number of patients, surgeons and anaesthetists should be careful about background noise and conversations during surgery.

Trial registration

German Clinical Trial Register DRKS00013800.
The shared risk of diabetes between dog and cat owners and their pets: register based cohort study
Authors: Delicano Rachel Ann , Hammar Ulf , Egenvall Agneta , Westgarth Carri , Mubanga Mwenya , Byberg Liisa , Fall Tove , Kennedy Beatrice
Published: December 2020

Objective

To investigate whether dog and cat owners and their pets share a risk of developing diabetes.

Design

Cohort study.

Setting

Register based longitudinal study, Sweden.

Participants

208 980 owner-dog pairs and 123 566 owner-cat pairs identified during a baseline assessment period (1 January 2004 to 31 December 2006).

Main outcome measures

Type 2 diabetes events in dog and cat owners and diabetes events in their pets, including date of diagnosis during the follow-up period (1 January 2007 to 31 December 2012). Owners with type 2 diabetes were identified by combining information from the National Patient Register, the Cause of Death Register, and the Swedish Prescribed Drug Register. Information on diabetes in the pets was extracted from veterinary care insurance data. Multi-state models were used to assess the hazard ratios with 95% confidence intervals and to adjust for possible shared risk factors, including personal and socioeconomic circumstances.

Results

The incidence of type 2 diabetes during follow-up was 7.7 cases per 1000 person years at risk in dog owners and 7.9 cases per 1000 person years at risk in cat owners. The incidence of diabetes in the pets was 1.3 cases per 1000 dog years at risk and 2.2 cases per 1000 cat years at risk. The crude hazard ratio for type 2 diabetes in owners of a dog with diabetes compared with owners of a dog without diabetes was 1.38 (95% confidence interval 1.10 to 1.74), with a multivariable adjusted hazard ratio of 1.32 (1.04 to 1.68). Having an owner with type 2 diabetes was associated with an increased hazard of diabetes in the dog (crude hazard ratio 1.28, 1.01 to 1.63), which was attenuated after adjusting for owner’s age, with the confidence interval crossing the null (1.11, 0.87 to 1.42). No association was found between type 2 diabetes in cat owners and diabetes in their cats (crude hazard ratio 0.99, 0.74 to 1.34, and 1.00, 0.78 to 1.28, respectively).

Conclusions

Data indicated that owners of a dog with diabetes were more likely to develop type 2 diabetes during follow-up than owners of a dog without diabetes. It is possible that dogs with diabetes could serve as a sentinel for shared diabetogenic health behaviours and environmental exposures.
Patient mortality after surgery on the surgeon’s birthday: observational study
Authors: Kato Hirotaka , Jena Anupam B , Tsugawa Yusuke
Published: December 2020

Objective

To determine whether patient mortality after surgery differs between surgeries performed on surgeons’ birthdays compared with other days of the year.

Design

Retrospective observational study.

Setting

US acute care and critical access hospitals.

Participants

100% fee-for-service Medicare beneficiaries aged 65 to 99 years who underwent one of 17 common emergency surgical procedures in 2011-14.

Main outcome measures

Patient postoperative 30 day mortality, defined as death within 30 days after surgery, with adjustment for patient characteristics and surgeon fixed effects.

Results

980 876 procedures performed by 47 489 surgeons were analyzed. 2064 (0.2%) of the procedures were performed on surgeons’ birthdays. Patient characteristics, including severity of illness, were similar between patients who underwent surgery on a surgeon’s birthday and those who underwent surgery on other days. The overall unadjusted 30 day mortality on the operating surgeon’s birthday was 7.0% (145/2064) and that on other days was 5.6% (54 824/978 812). After adjusting for patient characteristics and surgeon fixed effects (effectively comparing outcomes of patients treated by the same surgeon on different days), patients who underwent surgery on a surgeon’s birthday exhibited higher mortality compared with patients who underwent surgery on other days (adjusted mortality rate, 6.9%
v
5.6%; adjusted difference 1.3%, 95% confidence interval 0.1% to 2.5%; P=0.03). Event study analysis of patient mortality by day of surgery relative to a surgeon’s birthday found similar results.

Conclusions

Among Medicare beneficiaries who underwent common emergency surgeries, those who received surgery on the surgeon’s birthday experienced higher mortality compared with patients who underwent surgery on other days. These findings suggest that surgeons might be distracted by life events that are not directly related to work.
Epidemiology of depressive disorders in people living with hypertension in Africa: a systematic review and meta-analysis
Authors: Endomba Francky Teddy , Mazou Temgoua Ngou , Bigna Jean Joel
Published: December 2020

Objectives

Better knowledge of epidemiology of depressive disorders in people living with hypertension can help to implement pertinent strategies to address its burden. The objective was to estimate the prevalence of depressive disorders and symptoms in people living with hypertension in Africa.

Design

Systematic review and meta-analysis.

Data sources

PubMed, EMBASE, African Index Medicus, African Journals OnLine were searched up to 31 January 2020, regardless of the language of publication.

Eligibility criteria

We included studies conducted among adult patients with hypertension (≥18 years) living in Africa and reporting the prevalence of depressive disorders and symptoms.

Data extraction and synthesis

Two independent investigators selected studies, extracted data and assessed the methodological quality of included studies by using the tools developed by Joanna Briggs Institute. Multivariate random-effects meta-analysis served to pool data by considering the variability between diagnostic tools used to identify patients with depressive disorders or symptoms.

Results

We included 11 studies with 5299 adults with hypertension. Data were collected between 2002 and 2017, from South Africa, Nigeria, Ghana, Ethiopia and Burkina Faso. The mean age varied between 50.3 years and 59.6 years. The proportion of men ranged from 28% to 54%. The adjusted prevalence of depressive disorders taking into account the variance between diagnostic tools was 17.9% (95% CI 13.0% to 23.4%). The prevalence of depressive symptoms and major depressive symptoms was 33.3% (95% CI 9.9% to 61.6%) and 7.8% (95% CI 3.0% to 14.5%), respectively. There was heterogeneity attributable to the diagnostic tools for depressive disorders and symptoms. There was no publication bias.

Conclusion

Notwithstanding the representativeness lack of some (sub) regions of Africa, weakening the generalisability of findings to the entire region; depressive disorders and symptoms are prevalent in people living with hypertension in Africa, indicating that strategies from clinicians, researchers and public health makers are needed to reduce its burden in the region.
Individual and societal risk factors of attitudes justifying intimate partner violence against women: a multilevel cross-sectional study
Authors: Serrano-Montilla Celia , Lozano Luis M. , Bender Michael , Padilla Jose-Luis
Published: December 2020

Objectives

Attitudes justifying intimate partner violence against women (IPVAW) can play an essential role in explaining the prevalence of such public health problem. The study aim was to explain attitudes justifying IPVAW identifying individual and societal risk factors.

Design and setting

A multilevel cross-sectional study of the World Values Survey (WVS) in 54 global countries.

Participants

A representative transnational community-based sample of 81 516 participants (47.8% male, 52.1% female), aged mean of 42.41.

Measures

Attitudes justifying IPVAW, sociodemographic, sexism, self-transcendence and conservation values were measured using questions from WVS. Country and regional gender inequality were assessed by Gender Inequality Index.

Results

Around 16% (intraclass correlation=0.16) of individual differences in attitudes justifying IPVAW are explained by countries. Statistically significant predictors at individual and country level were: sex (B=−0.24, 95% CI −0.27 to −0.22), age (B=−0.08 to −0.25, 95% CI −0.34 to −0.03), marital status (B=0.09 to 0.23, 95% CI 0.002 to 0.33), educational level (B=−0.10 to −0.14, 95% CI −0.20 to −0.04), self-transcendence values (B=−0.10, 95% CI −0.20 to −0.12), sexism (B=0.21, 95% CI 0.15 to 0.28), country (B=2.18, 95% CI 1.09 to 3.26) and regional (B=2.23, 95% CI 1.04 to 3.42) gender inequality. Country gender inequality (B=−0.18, p=0.12) and regional gender inequality (B=−0.21, p=0.10) did not moderate the associations between self-transcendence values and attitudes justifying IPVAW. In the same way for sexism, data did not provide support for a moderating role of country gender inequality (B=0.22, p=0.26) and regional gender inequality (B=0.10, p=0.66).

Conclusions

Individual and country predictors accounted for differences in attitudes justifying IPVAW. However, neither gender inequality of country nor gender inequality of region interacted with sexism and self-transcendence values. Theoretical and methodological implications are discussed.
Use of surveys to evaluate an integrated oral cholera vaccine campaign in response to a cholera outbreak in Hoima district, Uganda
Authors: Bwire Godfrey , Roskosky Mellisa , Ballard Anne , Brooks W Abdullah , Okello Alfred , Rafael Florentina , Ampeire Immaculate , Orach Christopher Garimoi , Sack David A
Published: December 2020

Objectives

To evaluate the quality and coverage of the campaign to distribute oral cholera vaccine (OCV) during a cholera outbreak in Hoima, Uganda to guide future campaigns of cholera vaccine.

Design

Survey of communities targeted for vaccination to determine vaccine coverage rates and perceptions of the vaccination campaign, and a separate survey of vaccine staff who carried out the campaign.

Setting

Hoima district, Uganda.

Participants

Representative clusters of households residing in the communities targeted for vaccination and staff members who conducted the vaccine campaign.

Results

Among 209 households (1274 individuals) included in the coverage survey, 1193 (94%; 95% CI 92% to 95%) reported receiving at least one OCV dose and 998 (78%; 95% CI 76% to 81%) reported receiving two doses. Among vaccinated individuals, minor complaints were reported by 71 persons (5.6%). Individuals with ‘some’ education (primary school or above) were more knowledgeable regarding the required OCV doses compared with non-educated (p=0.03). Factors negatively associated with campaign implementation included community sensitisation time, staff payment and problems with field transport. Although the campaign was carried out quickly, the outbreak was over before the campaign started. Most staff involved in the campaign (93%) were knowledgeable about cholera control; however, 29% did not clearly understand how to detect and manage adverse events following immunisation.

Conclusion

The campaign achieved high OCV coverage, but the surveys provided insights for improvement. To achieve high vaccine coverage, more effort is needed for community sensitisation, and additional resources for staff transportation and timely payment for campaign staff is required. Pretest and post-test assessment of staff training can identify and address knowledge and skill gaps.
Comprehensive public health evaluation of lockdown as a non-pharmaceutical intervention on COVID-19 spread in India: national trends masking state-level variations
Authors: Salvatore Maxwell , Basu Deepankar , Ray Debashree , Kleinsasser Mike , Purkayastha Soumik , Bhattacharyya Rupam , Mukherjee Bhramar
Published: December 2020

Objectives

To evaluate the effect of four-phase national lockdown from March 25 to May 31 in response to the COVID-19 pandemic in India and unmask the state-wise variations in terms of multiple public health metrics.

Design

Cohort study (daily time series of case counts).

Setting

Observational and population based.

Participants

Confirmed COVID-19 cases nationally and across 20 states that accounted for >99% of the current cumulative case counts in India until 31 May 2020.

Exposure

Lockdown (non-medical intervention).

Main outcomes and measures

We illustrate the masking of state-level trends and highlight the variations across states by presenting evaluative evidence on some aspects of the COVID-19 outbreak: case fatality rates, doubling times of cases, effective reproduction numbers and the scale of testing.

Results

The estimated effective reproduction number R for India was 3.36 (95% CI 3.03 to 3.71) on 24 March, whereas the average of estimates from 25 May to 31 May stands at 1.27 (95% CI 1.26 to 1.28). Similarly, the estimated doubling time across India was at 3.56 days on 24 March, and the past 7-day average for the same on 31 May is 14.37 days. The average daily number of tests increased from 1717 (19–25 March) to 113 372 (25–31 May) while the test positivity rate increased from 2.1% to 4.2%, respectively. However, various states exhibit substantial departures from these national patterns.

Conclusions

Patterns of change over lockdown periods indicate the lockdown has been partly effective in slowing the spread of the virus nationally. However, there exist large state-level variations and identifying these variations can help in both understanding the dynamics of the pandemic and formulating effective public health interventions. Our framework offers a holistic assessment of the pandemic across Indian states and union territories along with a set of interactive visualisation tools that are daily updated at covind19.org.
The BDS checklist as measure of illness severity: a cross-sectional cohort study in the Danish general population, primary care and specialised setting
Authors: Petersen Marie Weinreich , Rosendal Marianne , Ørnbøl Eva , Fink Per , Jørgensen Torben , Dantoft Thomas Meinertz , Schröder Andreas
Published: December 2020

Objective

The bodily distress syndrome (BDS) checklist has proven to be useful in the diagnostic categorisation and as screening tool for functional somatic disorders (FSD). This study aims to investigate whether the BDS checklist total sum score (0–100) can be used as a measure of physical symptom burden and FSD illness severity.

Design

Cross-sectional.

Setting

Danish general population, primary care and specialised clinical setting.

Participants

A general population cohort (n=9656), a primary care cohort (n=2480) and a cohort of patients with multiorgan BDS from specialised clinical setting (n=492).

Outcome measures

All data were self-reported. Physical symptoms were measured with the 25-item BDS checklist. Overall self-perceived health was measured with one item from the 36-item Short-Form Health Survey (SF-36). Physical functioning was measured with an aggregate score of four items from the SF-36/SF-12 scales ‘physical functioning’, ‘bodily pain’ and ‘vitality’. Emotional distress was measured with the mental distress subscale (SCL-8) from the Danish version of the Hopkins Symptom Checklist-90. Illness worry was measured with the six-item Whiteley Index.

Results

For all cohorts, bifactor models established that despite some multidimensionality the total sum score of the BDS checklist adequately reflected physical symptom burden and illness severity. The BDS checklist had acceptable convergent validity with measures of overall health (r=0.25–0.58), physical functioning (r=0.22–0.58), emotional distress (r=0.47–0.62) and illness worry (r=0.36–0.55). Acceptability was good with a low number of missing responses to items (<3%). Internal consistency was high (α ≥0.879). BDS score means varied and reflected symptom burden across cohorts (13.03–46.15). We provide normative data for the Danish general population.

Conclusions

The BDS checklist total sum score can be used as a measure of symptom burden and FSD illness severity across settings. These findings establish the usefulness of the BDS checklist in clinics and in research, both as a diagnostic screening tool and as an instrument to assess illness severity.
Attitudes to radiation safety and cholangiogram interpretation in endoscopic retrograde cholangiopancreatography (ERCP): a UK survey
Authors: Siau Keith , Webster George , Wright Mark , Maher Ben , Stedman Brian , Johnson Gavin , Ahmad Saqib , Tehami Nadeem
Published: December 2020

Background

Fluoroscopy during endoscopic retrograde cholangiopancreatography (ERCP) exposes staff and patients to potentially harmful ionizing radiation. We performed a UK survey to explore trainee and trainer attitudes to radiation protection and cholangiogram interpretation in ERCP.

Methods

An electronic 10-point survey was prospectively distributed to endoscopy unit leads, training programme directors between October and November 2019. Only UK-based ERCP trainees and trainers with hands-on procedural exposure were eligible for the survey.

Results

The survey was completed by 107 respondents (58 trainees and 49 trainers), with an estimated overall response rate of 46%. Overall, 49% of respondents were up to date with their radiation protection course, 38% were aware of European Basic safety standards directive (BSSD), 38% wore radiation protection goggles, and 40% were aware of the average radiation screening dose per ERCP procedure. Compared with trainers, trainees were less likely to routinely wear thyroid protection shields (76% vs 92%; p=0.028), have awareness of the BSSD (20% vs 49%; p=0.037) or know their average procedural radiation dosages (21% vs 63%; p<0.001). With regard to cholangiogram interpretation, only 26% had received formal training, with 97% of trainees expressing a desire for further training.

Conclusion

This survey highlights a relative complacency in safety attitudes to radiation protection during ERCP. These data provide impetus to improve training and quality assurance in radiation protection, which should be regarded as a mandatory safety aspect prior to commencing hands-on ERCP training.
Balloon-mounted stenting for ICAS in a multicenter registry study in China: a comparison with the WEAVE/WOVEN trial
Authors: Kang Kaijiang , Zhang Yong , Shuai Jie , Jiang Changchun , Zhu Qiyi , Chen Kangning , Liu Li , Li Baomin , Shi Xiangqun , Gao Lianbo , Liu Yajie , Wang Feng , Li Yongli , Liu Tieyan , Zheng Hongbo , Mo Dapeng , Gao Feng , Feng Lei , Wang Yilong , Wang YongJun , Miao Zhongrong , Ma Ning
Published: December 2020

Background

The outcome of deploying balloon-mounted stents for symptomatic intracranial atherosclerotic stenosis (ICAS) has not been fully investigated. In this study we evaluate the safety and long-term outcome of using balloon-mounted stents to treat symptomatic ICAS in comparison with the WEAVE/WOVEN study.

Methods

In a multicenter registry study of stenting for symptomatic intracranial artery stenosis in China, 159 patients treated with an intracranial balloon-mounted stent approved by the China Food and Drug Administration were evaluated. The morphological features of the lesions were categorized by Mori classification. The endpoints, including periprocedural and long-term clinical and radiological outcomes, were the same as those in the WEAVE/WOVEN study.

Results

In the present study the mean percent stenosis before and after stenting was 84.0% and 6.1%, respectively. The proportions of Mori A, Mori B, and Mori C lesions were 33.3%, 52.2%, and 14.5%, respectively. The 72-hour rates of stroke and mortality after the procedure were 0%. The 1-year rates of any stroke, ischemic stroke, hemorrhagic stroke, and death were 6.3% (10/159), 5.7% (9/159), 0.6% (1/159), and 0.6% (1/159), respectively. The 1-year rate of in-stent restenosis (ISR) was 23.4% (15/64). The rate of ISR in Mori C lesions (53.8%, 7/13) was significantly higher than that in Mori A (15.8%, 3/19) or Mori B lesions (15.6%, 5/32) (p=0.024).

Conclusions

The short-term and long-term outcomes of using a balloon-mounted stent for symptomatic ICAS with focal and non-angular lesions (Mori A and B type) and smooth arterial access were comparable to the results of the WEAVE/WOVEN trial.
No relationship between bone mineral density and syndesmophyte formation at the same level in the lumbar spine of patients with radiographic axial Spondyloarthritis
Authors: Marques Mary Lucy , Ramiro Sofia , Machado Pedro M , van der Heijde Desirée , van Gaalen Floris A
Published: December 2020

Objective

To investigate if in radiographic axial Spondyloarthritis (r-axSpA) low vertebral bone mineral density (BMD) is associated with development of new syndesmophytes at the same vertebral level.

Methods

In a post-hoc analysis from the ASSERT trial (infliximab vs placebo), dual-energy X-ray absorptiometry was used to measure baseline BMD (g/cm2) of the lumbar spine L1 to L4. Syndesmophyte formation was assessed in the same vertebrae on conventional radiographs defined as an increase in modified Stoke Ankylosing Spondylitis Spine Score from 0 or 1 to 2 or 3 after 2 years. Radiographs were scored by two readers. Generalised estimating equations (GEE) adjusted for within-patient correlation across multiple vertebrae, taking potential confounders into account.

Results

We analysed 599 vertebrae in 165 r-axSpA patients (78% male, mean (SD) age 38 (10) years, 67% with at least one syndesmophyte anywhere in the spine). In total, 24 to 74 new syndesmophytes developed in 9 (5%) to 30 (18%) patients and 13 (2%) to 39 (7%) vertebrae, if either a syndesmophyte was seen by both or only one of the readers (ie, specific and sensitive definitions) respectively. In multivariable analyses, no association was found between baseline local vertebral BMD and new syndesmophyte formation after 2 years: adjOR (95% CI): 0.56 (0.01, 44.45) (specific definition) and 0.26 (0.03, 2.63) (sensitive definition).

Conclusion

In patients with active and established r-axSpA, with an observed low incidence of lumbar spine syndesmophyte formation over 2 years, no relationship was found between baseline BMD and new radiographic syndesmophyte formation at the same vertebra.