bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of maximum likelihood statistics for the population and family studies of inheritance of the chimpanzee R‐C‐E‐F and V‐A‐B‐D blood groups
Authors: Blancher A. , Clayton J. , Socha W.W. , Ruffié J.
Published: August 2020

Maximum likelihood statistics were applied to the analysis of serological data to confirm the originally proposed genetic models of the chimpanzee R‐C‐E‐F and V‐A‐B‐D systems. Five hundred ninety‐nine chimpanzees, including 81 parents of 114 offspring, were tested for R‐C‐E‐F, and 60 parents of 80 offspring were tested for V‐A‐B‐D blood groups. An estimation‐maximization procedure was used to obtain maximum likelihood estimates and support intervals of the haplotype frequencies. For each haplotype, the null hypothesis of nonexistence was evaluated. The frequencies obtained by this method do not differ significantly from those calculated by the square root formula, but put these estimates on a statistically more rigorous footing.
Seroepidemiology of dengue and other arboviruses in a natural population of toque macaques (Macaca sinica) at Polonnaruwa, Sri Lanka
Authors: Peiris J.S.M. , Dittus W.P.J. , Ratnayake C.B.
Published: August 2020

A seroepidemiological study of arboviruses infecting 115 wild toque macaques (Macaca sinica) at Polonnaruwa, Sri Lanka showed a high prevalence of antibodies to dengue and Lumbo viruses. There was low seroprevalence of Chandipura (2/115) and Batai (1/115) virus antibodies, but no seropositivity to Chikungunya or Sindbis. There was no serological evidence of infection by Japanese encephalitis (JE) virus in spite of large human epidemics in the study area, indicating that toque macaques are unlikely to be an epidemiologically relevant host in the maintenance cycle of JE virus.
Inpatient cardiac monitoring using a patch‐based mobile cardiac telemetry system during the COVID‐19 pandemic
Authors: Braunstein Eric D. , Reynbakh Olga , Krumerman Andrew , Di Biase Luigi , Ferrick Kevin J.
Published: August 2020

Introduction

Coronavirus disease 2019 (COVID‐19) is a worldwide pandemic, and cardiovascular complications and arrhythmias in these patients are common. Cardiac monitoring is recommended for at risk patients; however, the availability of telemetry capable hospital beds is limited. We sought to evaluate a patch‐based mobile telemetry system for inpatient cardiac monitoring during the pandemic.

Methods

A prospective cohort study was performed of inpatients hospitalized during the pandemic who had mobile telemetry devices placed; patients were studied up until the time of discharge or death. The primary outcome was a composite of management changes based on data obtained from the system and detection of new arrhythmias. Other clinical outcomes and performance characteristics of the mobile telemetry system were studied.

Results

Eighty‐two patients underwent mobile telemetry device placement, of which 31 (37.8%) met the primary outcome, which consisted of 24 (29.3%) with new arrhythmias detected and 18 (22.2%) with management changes. Twenty‐one patients (25.6%) died during the study, but none from primary arrhythmias. In analyses, age and heart failure were associated with the primary outcome. Monitoring occurred for an average of 5.3 ± 3.4 days, with 432 total patient‐days of monitoring performed; of these, QT‐interval measurements were feasible in 400 (92.6%).

Conclusion

A mobile telemetry system was successfully implemented for inpatient use during the COVID‐19 pandemic and was shown to be useful to inform patient management, detect occult arrhythmias, and monitor the QT‐interval. Patients with advanced age and structural heart disease may be more likely to benefit from this system.
Secukinumab efficacy in reducing the severity and the psychosocial impact of moderate‐to‐severe psoriasis as assessed by the Simplified Psoriasis Index: results from the IPSI‐PSO study
Authors: Richard M.‐A. , Lacour J.‐P. , Konstantinou M.‐P. , Ruer‐Mulard M. , Joly P. , Aractingi S. , Auquier P. , Pelvet B. , Augustin M.L. , Mahé E. , Chalmers R.J.G.
Published: August 2020

Background

The utility of the Simplified Psoriasis Index (SPI), a recently developed multidomain tool for assessing psoriasis, was investigated in a study assessing response to secukinumab.

Methods

In an open‐label, multicentre study involving 17 French centres, patients with moderate‐to‐severe plaque psoriasis received secukinumab 300 mg subcutaneously once weekly from baseline to W4, then every 4 weeks until W48. Dermatologist‐scored SPI psoriasis severity (proSPI‐s) was compared with Psoriasis Area and Severity Index (PASI). Patient self‐assessed severity (saSPI‐s) and psychosocial impact (SPI‐p) were compared with PASI and Dermatology Life Quality Index (DLQI), respectively.

Results

We included 120 patients (69.2% male; mean age 45.9 years; mean duration of psoriasis 21.6 years). Mean baseline scores were as follows: proSPI‐s 24.9, saSPI‐s 23.5, PASI 23.1, SPI‐p 8.2 and DLQI 13.6. Severity scores achieved by 16 weeks (proSPI‐s 2.3, saSPI‐s 2.2 and PASI 2.2) were maintained to W52. Reductions in mean psychosocial impact scores were maintained to W52 (SPI‐p and DLQI, respectively, 2.1 and 1.5 at W16; 1.5 and 1.9 at W52).

Conclusions

Decrease of PASI scores in response to secukinumab was closely correlated with proSPI‐s, supporting the latter's suitability for assessing response to therapy. Although the correlation between PASI and saSPI‐s was slightly weaker, patients were able to complete a valid assessment of their psoriasis independently, and thus potentially remotely. With the added benefit of psychosocial impact assessment (SPI‐p), SPI provides a valid tool enabling patients to assess their own psoriasis, remotely if necessary.
Longitudinal Coaching and Decision Support Provided by a Patient‐Family Liaison Promotes Goal‐Concordant Care
Authors: Periyakoil Vyjeyanthi S. , Blinderman Craig D. , Schechter William S.
Published: August 2020

This editorial comments on the article by Gupta et al. in this issue.
Hospitalization Risk Among Older Adults with Sensory Impairments: Development of a Prognostic Model
Authors: Deardorff William J. , Sloane Richard J. , Pavon Juliessa M. , Hastings Susan N. , Whitson Heather E.
Published: August 2020

OBJECTIVES

To develop a prognostic model for hospital admissions over a 1‐year period among community‐dwelling older adults with self‐reported hearing and/or vision impairments based on readily obtainable clinical predictors.

DESIGN

Retrospective cohort study.

SETTING

Medicare Current Beneficiary Survey from 1999 to 2006.

PARTICIPANTS

Community‐dwelling Medicare beneficiaries, aged 65 years and older, with self‐reported hearing and/or vision impairment (N = 15,999).

MEASUREMENTS

The primary outcome was any hospital admission over a predefined 1‐year study period. Candidate predictors included demographic factors, prior healthcare utilization, comorbidities, functional impairment, and patient‐level factors. We analyzed the association of all candidate predictors with any hospital admission over the 1‐year study period using multivariable logistic regression. The final model was created using a penalized regression method known as the least absolute shrinkage and selection operator. Model performance was assessed by discrimination (concordance statistic (c‐statistic)) and calibration (evaluated graphically). Internal validation was performed via bootstrapping, and results were adjusted for overoptimism.

RESULTS

Of the 15,999 participants, the mean age was 78 years and 55% were female. A total of 2,567 participants (16.0%) had at least one hospital admission in the 1‐year study period. The final model included seven variables independently associated with hospitalization: number of inpatient admissions in the previous year, number of emergency department visits in the previous year, activities of daily living difficulty score, poor self‐rated health, and self‐reported history of myocardial infarction, stroke, and nonskin cancer. The c‐statistic of the final model was 0.717. The optimism‐corrected c‐statistic after bootstrap internal validation was 0.716. A calibration plot suggested that the model tended to overestimate risk among patients at the highest risk for hospitalization.

CONCLUSION

This prognostic model can help identify which community‐dwelling older adults with sensory impairments are at highest risk for hospitalization and may inform allocation of healthcare resources.
Removal of dental amalgam restorations in patients with health complaints attributed to amalgam: A prospective cohort study
Authors: Björkman Lars , Musial Frauke , Alræk Terje , Werner Erik L. , Weidenhammer Wolfgang , Hamre Harald J.
Published: August 2020

Background

The Norwegian Ministry of Health and Care Services initiated a project including experimental treatment for patients with health complaints attributed to amalgam restorations.

Objective

The aim was to evaluate changes of general health complaints in patients who participated in the project and had all amalgam restorations removed.

Methods

The project was designed as a prospective cohort study and organised by the Dental Biomaterials Adverse Reaction Unit in Bergen, Norway. The dental treatment was provided by the patient's local dentist. The main target group consisted of patients with medically unexplained physical symptoms, attributed to dental amalgam restorations (Amalgam cohort). The primary comparison group consisted of patients with medically unexplained physical symptoms without attribution to dental amalgam restorations (MUPS cohort). Primary outcome was self‐reported general health complaints (GHC index) at follow‐up 12‐months after completed amalgam removal.

Results

In the Amalgam cohort, a significant reduction of GHC index from 43.3 (SD 17.8) at baseline to 30.5 (SD 14.4) at follow‐up (mean reduction 12.8, SD 15.9; n = 32; P < .001) was observed. The change scores for GHC index indicated that the reduction of complaints was significantly higher (P = .004) in the Amalgam cohort compared with the MUPS cohort (mean reduction 1.2, SD 12.3, n = 28). After adjustment for age, gender, education and baseline GHC index, the mean adjusted difference was −8.0 (95% confidence interval from −15.4 to −0.5; P = .036).

Conclusion

In a group of patients with medically unexplained physical symptoms, which they attributed to dental amalgam restorations, removal of amalgam restorations was followed by a significant reduction of health complaints.
Influences of appearance characteristics on consumer acceptance and perception of “gu‐soo” in fermented soybean paste (doenjang)
Authors: Jo Yongwoo , Kim Mina K.
Published: August 2020

Doenjang is a traditional Korean soybean‐based fermented food. Previous research indicates that appearance‐related characteristics, such as color, number of beans, and bean‐to‐paste ratio, and moisture content, influence consumers' perceptions of traditional doenjang. The objective of this study was to determine the influence of appearance characteristics on consumer preference and gu‐soo perception of doenjang. Four commercially available doenjang products from the same brand were selected, and appearance‐related characteristics including color, the number of soybeans in a paste, and electronic eye color measurements were measured. Descriptive sensory analysis using a highly trained panel (n = 5) was conducted, followed by consumer acceptance testing (n = 76). Samples highly liked by consumers had strong sweet taste, and least like doenjang had darker color and greater numbers of beans in a paste. However, doenjang samples that were highly liked by consumers are not necessarily the samples perceived as gu‐soo by consumers. While manufacturers' use of gu‐soo to describe the sensory characteristics of doenjang is a common practice, this study reveals a disparity between consumers' perceptions of gu‐soo and the manufacturer's advertising of gu‐soo. This study reports divergence between the results for overall liking of doenjang and consumers' perception of the product being considered gu‐soo.

Practical Applications

The term “gu‐soo” is widely used in Korea to describe the flavor characteristics of doenjang. This study focuses on factors affecting consumer acceptance and gu‐soo perceptions of doenjang, revealing that the appeal of doenjang to the consumer does not necessarily align with consumers' perception of doenjang being gu‐soo. The divergent sensory directions of consumer acceptance and doenjang being perceived as gu‐soo suggest a potential change in direction in marketing doenjang in Korea.
Parasitism induces negative effects of physiological integration in a clonal plant
Authors: Gao Fang‐Lei , Alpert Peter , Yu Fei‐Hai
Published: August 2020

Clonal integration often increases fitness of clonal plants, but it may decrease it when some but not all connected plants (ramets) within a clone are parasitized.

This hypothesis was synthesized in a conceptual model and tested by growing pairs of connected ramets of two congeneric clonal plants, Sphagneticola trilobata and Sphagneticola calendulacea, with and without parasitizing one ramet with Cuscuta australis and with and without severing the connection (allowing or preventing integration).

Consistent with the model, integration in S. calendulacea did not affect biomass of the parasitized ramet, decreased biomass of its connected, unparasitized ramet by 60% and of the clone by 40%, and increased biomass of the parasite by 50%. By contrast, integration in S. trilobata did not affect biomass of the clone or the parasite. The parasite increased export of nitrogen‐15 from the connected, unparasitized ramet seven‐fold in S. calendulacea but did not affect export in S. trilobata.

Parasitism can cause clonal integration to negatively affect fitness in clonal plants because parasites can import resources from connected, unparasitized ramets, possibly partly through signaling. This is the first experimental demonstration that clonal integration can decrease fitness in plants induced by parasitism and may help explain community‐level effects of parasites.
A molar pregnancy in an embryo donor cow
Authors: Linhares Boakari Yatta , Cofield Lawerence , Waqas Salman , Stockler Jenna , Pope Jenny , Waters Katelyn , Gard Julie
Published: August 2020

A 6‐year‐old Hereford embryo donor cow was referred to Auburn University College of Veterinary Medicine for a mass in the tip of her left uterine horn. The cow had recently undergone an embryo collection which yielded unfertilized, degenerated ova. Transrectal palpation and ultrasound revealed a multi‐locular mass enveloped by two separate compartments that resembled an amniotic and allantoic cavity within the uterus. Tissue was collected via a uterine flush and submitted for histopathology. The tissue was determined to be placenta, confirming the diagnosis of a molar pregnancy. Following treatment, the cow was able to produce numerous viable embryos. Molar pregnancies are rare and characterized by abnormal growth of trophoblastic cells leading to formation of intrauterine cystic masses. It is important to routinely perform an ultrasonographic examination of the cow's reproductive tract approximately 30 days following non‐surgical in vivo embryo collections to detect and treat unwanted conditions such as pregnancy and cystic conditions.
Seed‐enhancement combinations improve germination and handling in two dominant native grass species
Authors: Berto Bianca , Ritchie Alison L. , Erickson Todd E.
Published: August 2020

The use of native grasses for both restoration and commercial purposes is becoming increasingly important globally. Many native grasses have limited success in seed‐based restoration (e.g. post‐mine rehabilitation) and commercial industries (e.g. agriculture) due to poor seed germination and handling. Seed‐enhancement technologies can assist in overcoming these barriers. This study aimed to use combinations of seed enhancements to overcome the germination and handling challenges in two dominant Australian native grass species with demand in restoration and commercial industries (Triodia wiseana C.A Gardner and Rytidosperma caespitosum [Gaudich.] Connor & Edgar). Selected enhancements included hydropriming (including inoculation with karrikinolide [KAR1]), flash flaming, and seed coating. Combinations of these seed enhancements allowed improvements in both germination (by up to 55% and 18% for T. wiseana and R. caespitosum, respectively) and floret geometry (flowability, as measured through a mechanized seeder, improved by up to 6‐fold and 17‐fold for T. wiseana and R. caespitosum, respectively), with the order of enhancement application being important. The responses of each species to enhancements corresponded with key biological processes and ecological cues required for recruitment events in nature, such as fire and rainfall events. Triodia wiseana germination was driven by fire‐related cues (i.e. KAR1, flaming), while R. caespitosum germination was highest in response to moisture‐related cues (i.e. hydro‐priming). Responses to seed enhancements (and combinations of) may have implications for the management and scaled use of the targeted species. This can assist in improving the restoration and commercial success of the study species, and potentially other grasses with germination and handling challenges, into the future.
New era of therapy for endocrine autoimmune disorders
Authors: Oftedal Bergithe E. , Wolff Anette S. B.
Published: August 2020

The new era of immune and reconstitution therapy of autoimmune disorders is ongoing. However, endocrine autoimmune diseases comprise a group of elaborating pathologies where the development of new treatment strategies remains slow. Substitution of the missing hormones is still standard practice, taking care of the devastating symptoms but not the cause of disease. As our knowledge of the genetic contribution to the aetiology of endocrine disorders increases and early diagnostic tools are available, it is now possible to identify persons at risk before they acquire full‐blown disease. This review summarizes current knowledge and treatment of endocrine autoimmune disorders, focusing on type 1 diabetes, Addison's disease, autoimmune thyroid diseases and primary ovarian insufficiency. We explore which new therapies might be used in the different stages of the disease, focus on legalized therapy and elaborate on the ongoing clinical studies for these diseases and the research front, before hypothesizing on the way ahead.
The equine diaphragm: A novel technique for repeatable ultrasound measurement
Authors: Fitzharris Laura E. , Meehan Lucinda J. , Hezzell Melanie J. , Allen Kate J.
Published: August 2020

The diaphragm is an important respiratory muscle, playing a key role during exercise. In humans, diaphragm thickness increases in response to training and is correlated with inspiratory strength. In order to assess respiratory strength in the horse, new evaluation techniques are required and measurement of diaphragm thickness, in a non‐invasive and repeatable manner, is a possible approach. The purposes of this four‐part, prospective, pilot study were to develop and describe a repeatable method to measure the diaphragm thickness, using ultrasonography, in Thoroughbred racehorses. A standardized technique was developed whereby the ultrasound transducer was positioned 1 cm below a line between the cranioventral aspect of the tuber coxae and olecranon. The diaphragm thickness was measured on three occasions 1 week apart, by a single observer to determine the intraobserver repeatability, and by a second observer on one occasion to assess interobserver reproducibility. The diaphragm was observed in all intercostal spaces (ICS) from 7 to 17 on the left side, and 6 to 17 on the right side in a single horse. The thickest measurement (1.42 cm), obtained from 11 horses, was at ICS 11 on the left‐side during inspiration. The narrowest measurement (0.56 cm) was obtained at ICS 16 on the right‐side during expiration. There was no significant difference between the measurements obtained by a single observer on three occasions (P < .05). This is the first study to provide a detailed description of ultrasonographic imaging and measurement of the equine diaphragm. The novel technique developed to position the ultrasound transducer in a standardized location allowed examination and measurement of the diaphragm with good repeatability.
Football Without Football: Creativity in German Football Coverage by TV Broadcasters and Clubs During the Coronavirus Crisis
Authors: Schallhorn Christiana , Kunert Jessica
Published: August 2020

During the COVID-19 pandemic, TV broadcasters and clubs were challenged to provide alternative formats and content for fans of Germany’s favorite sport, football [soccer]. Thus, they emulated matchdays and created a Bundesliga feeling in new ways. The authors focus on this alternative creative sports coverage during the Coronavirus crisis and consider the effect on the audience. TV broadcasters, for instance, recreated Bundesliga matchdays through broadcasting historical matches, sticking with the original fixtures from before the crisis, while offering renewed commentary. Clubs conducted the Bundesliga Home Challenge, that is, FIFA20 videogame matches with their professional and eSport players, covering these matches on Twitter and their website. The authors argue that these efforts of keeping up the beloved structure of daily sports events satisfy social and entertaining belongings that are normally continually recreated through watching and talking about live sports events. Moreover, they discuss the possible sustainability of these innovative ways of sport communication.
The Show Must Go On: The Strategy and Spectacle of Dana White’s Efforts to Promote UFC 249 During the Coronavirus Pandemic
Authors: Butryn Ted M. , Masucci Matthew A. , johnson jay a.
Published: August 2020

While most professional sports quickly postponed their seasons due to COVID-19, the Ultimate Fighting Championship (UFC) took a decidedly contrarian approach as president Dana White continued to promote UFC 249 until pressure forced its cancelation on April 9, 2020. Drawing from work on sport and spectacle and the media as well as sport management scholarship on crisis management, the authors provide a commentary on the mediated spectacle of White’s (eventually successful) efforts to promote UFC 249 during the pandemic. Drawing from numerous media sources, they discuss how White sought to control the public narrative in several key ways. The authors further explore how White decried the seriousness of the pandemic while centralizing the UFC’s place in the U.S. sporting landscape. Finally, the authors discuss how White’s efforts might both help and hinder the UFC as a mainstream sports promotion.
Talking Baseball When There Is No Baseball: Reporters and Fans During the COVID-19 Pandemic
Authors: Curry Alexander L. , Good Tiara
Published: August 2020

The 2020 coronavirus outbreak led Major League Baseball to cancel spring training and postpone the start of the regular season. Although baseball stopped, reporters continued to write about baseball, and fans continued to talk about baseball. But with no games being played, what were they writing and talking about? More than a simple examination of what these two groups are saying, the authors also examined why their focus has turned to particular topics and themes. Through a textual analysis of Entertainment and Sports Programming Network (ESPN) baseball headlines and Reddit posts, the authors found writers jolted out of their routines, yet still framing many of their 2020 stories to focus on the actions of players. For fans, they uncovered conversations that, in many ways, read like friends mourning the loss of a loved one.
Supplemental Material: Regional chronostratigraphic synthesis of the Cenomanian-Turonian Oceanic Anoxic Event 2 (OAE2) interval, Western Interior Basin (USA): New Re-Os chemostratigraphy and 40Ar/39Ar geochronology
Authors: Jones Matthew M. , al. et
Published: August 2020

(1) Complete Ar geochronology data, bentonite correlations, and collection in Kaiparowits Plateau, Cenomanian-Turonian boundary age calculations, core photos and description of hiatuses, and Angus Core depth scale alignment correction. (2) Time scale tables for cores.
Erosive rodent ulcer of the ear secondary to neglect
Authors: Gillanders Sarah Louise , McHugh Alison , Hintze Justin , Donnelly Martin Jude
Published: August 2020

Basal cell carcinomas (BCCs) are slow-growing, locally invasive lesions that rarely metastasise, however, if left untreated can progress to extensive destruction of local structures giving rise to the alternative name ‘the rodent ulcer’. Here we present a case of BCC of the ear progressing to destruction of the pinna and mastoid, involving the facial nerve and breaching dura. This case presentation shows not only the seldom-seen natural progression of the rodent ulcer with impressive imaging and clinical photographs but also highlights a broader topic of capacity and consent in patients displaying maladaptive denial or abnormal illness behaviour, how this can affect patient outcomes and what we as clinicians can do to ensure the best care for our patients.
Treatment-recalcitrant laryngeal sarcoidosis responsive to sirolimus
Authors: Kelleher Karen J , Russell John , Killeen Orla G , Leahy Timothy Ronan
Published: August 2020

A 15-year-old girl presented with gradual-onset dysphonia and dysphagia. Laryngoscopy revealed significant supraglottic airway obstruction with swelling of both the epiglottis and arytenoids. After emergency tracheostomy, biopsy of the epiglottis revealed lymphoid hyperplasia with focal non-necrotising granulomata, leading to a presumed diagnosis of laryngeal sarcoidosis. Treatment with prednisolone and methotrexate produced minimal clinical improvement. A switch to sirolimus was followed by significant reduction in the laryngeal swelling, allowing decannulation of the tracheostomy. Treatment with sirolimus should be considered as a steroid sparing agent in laryngeal sarcoidosis, particularly in the presence of lymphoid hyperplasia on biopsy.
Laparoscopic colectomy in idiopathic colonic varices: a safe endeavour
Authors: Sasmal Prakash Kumar , Sahoo Ankit , Nayak Hemanta Kumar , Mitra Suvradeep
Published: August 2020

A 32-year-old man presented to the emergency department with recurrent episodes of haematochezia and haemodynamic instability. He had no complaints of alteration in bowel habits or mucus discharge in the stool. He was a non-smoker and does not consume alcohol. After stabilising the patient, clinical evaluation and investigations with gastrointestinal endoscopy revealed dilated and tortuous submucosal veins involving the entire colon excepting the distal sigmoid. CT angiography and Doppler ultrasonography revealed normal patency and flow in the mesenteric vessels as well as hepatic, portal vein and inferior vena cava. With the exclusion of the secondary causes, we made the diagnosis of the rare entity of idiopathic colonic varices. He underwent a laparoscopic colectomy with ileorectal anastomosis, without any additional technical challenges intra-op and had an uneventful postoperative recovery. Idiopathic colonic varices can be a differential diagnosis of gastrointestinal bleeding and one can safely proceed with laparoscopic colectomy.
Can we eradicate trachoma? A survey of stakeholders
Authors: Oldenburg Catherine E , Aragie Solomon , Amza Abdou , Solomon Anthony W , Brogdon Jessica , Arnold Benjamin F , Keenan Jeremy D , Lietman Thomas M
Published: August 2020

Background/Aims

Although tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.

Methods

We conducted a survey at the beginning of a trachoma eradication session at the 2019 Coalition for Operational Research on Neglected Tropical Diseases meeting in National Harbor, Maryland, USA. We asked respondents what the most important goal of azithromycin mass drug administration was for trachoma (control, elimination of infection or eradication) and if and when they believed trachoma eradication would occur. We then asked what the biggest obstacles were to global eradication.

Results

Fifty-six surveys were returned (95%). Most (91%) participants reported that the most important goal of azithromycin mass drug administration was control or elimination of infection, and 24% of participants reported that global eradication was not possible. Of the 76% who reported a year by which they believed trachoma could be eradicated, most fell between 2040 and 2050. Commonly cited barriers to global eradication included lack of surveillance tools to confirm eradication or monitor for infection recrudescence (32%) and lack of resources (23%).

Conclusions

Development of alternative indicators for trachoma surveillance and continued investment in trachoma programmes, particularly focused support in the most heavily affected populations, might increase enthusiasm for the feasibility of eradication.
Serum levels of mac-2 binding protein are associated with diabetic microangiopathy and macroangiopathy in people with type 2 diabetes
Authors: Hashimoto Yoshitaka , Hamaguchi Masahide , Kaji Ayumi , Sakai Ryosuke , Kitagawa Noriyuki , Fukui Michiaki
Published: August 2020

Introduction

Non-alcoholic fatty liver disease is reportedly associated with type 2 diabetes and progressive liver fibrosis, as evaluated by transient elastography, and has been linked with micro- and macroangiopathy in people with type 2 diabetes. The purpose of this cross-sectional study was to investigate the association between serum mac-2 binding protein glycosylation isomer (M2BPGi) levels and diabetic complications in people with type 2 diabetes.

Research design and methods

Serum M2BPGi levels were measured in terms of cut-off index (C.O.I.) units. Urinary albumin excretion (UAE) was calculated and nephropathy was graded as normoalbuminuria, microalbuminuria, or macroalbuminuria. Retinopathy was divided into three groups: no-diabetic retinopathy (NoDR), non-proliferative-diabetic retinopathy (NPDR), or proliferative-diabetic retinopathy (PDR) .

Results

The mean age for the 363 studied subjects (212 males) was 66.4±10.6 years, the median serum M2BPGi level was 0.77 (0.57–1.04) C.O.I., and the median UAE was 22 (9–82.1) mg/g creatinine. M2BPGi levels in microalbuminuria (0.83 (0.61 to 1.18) C.O.I.) and macroalbuminuria (0.88 (0.67 to 1.22) C.O.I.) cases were higher than those in normoalbuminuria cases (0.71 (0.54 to 0.92) C.O.I.). M2BPGi levels in NPDR (0.93 (0.68 to 1.28) C.O.I.) and PDR (0.95 (0.71 to 1.31) C.O.I.) cases were higher than in cases with NoDR (0.73 (0.56 to 0.99) C.O.I.). Furthermore, M2BPGi levels in subjects with a history of cardiovascular diseases were higher than in those with no such history (0.82 (0.65 to 1.22) vs 0.76 (0.55 to 1.03) C.O.I., p=0.019). The logarithm of (M2BPGi+1) was associated with the logarithm of UAE values after adjusting for covariates (standardized β=0.107, p=0.031).

Conclusions

This study reveals a close association between serum M2BPGi levels and diabetic microangiopathy and macroangiopathy in people with type 2 diabetes. The results also show that liver fibrosis, evaluated by M2BPGi, is independently associated with an increased risk of albuminuria.
Smartphone-delivered self-management for first-episode psychosis: the ARIES feasibility randomised controlled trial
Authors: Steare Thomas , O’Hanlon Puffin , Eskinazi Michelle , Osborn David , Lloyd-Evans Brynmor , Jones Rebecca , Rostill Helen , Amani Sarah , Johnson Sonia
Published: August 2020

Objectives

To test the feasibility and acceptability of a randomised controlled trial (RCT) to evaluate a Smartphone-based self-management tool in Early Intervention in Psychosis (EIP) services.

Design

A two-arm unblinded feasibility RCT.

Setting

Six NHS EIP services in England.

Participants

Adults using EIP services who own an Android Smartphone. Participants were recruited until the recruitment target was met (n=40).

Interventions

Participants were randomised with a 1:1 allocation to one of two conditions: (1) treatment as usual from EIP services (TAU) or (2) TAU plus access to My Journey 3 on their own Smartphone. My Journey 3 features a range of self-management components including access to digital recovery and relapse prevention plans, medication tracking and symptom monitoring. My Journey 3 use was at the users’ discretion and was supported by EIP service clinicians. Participants had access for a median of 38.1 weeks.

Primary and secondary outcome measures

Feasibility outcomes included recruitment, follow-up rates and intervention engagement. Participant data on mental health outcomes were collected from clinical records and from research assessments at baseline, 4 months and 12 months.

Results

83% and 75% of participants were retained in the trial at the 4-month and 12-month assessments. All treatment group participants had access to My Journey 3 during the trial, but technical difficulties caused delays in ensuring timely access to the intervention. The median number of My Journey 3 uses was 16.5 (IQR 8.5 to 23) and median total minutes spent using My Journey 3 was 26.8 (IQR 18.3 to 57.3). No serious adverse events were reported.

Conclusions

Recruitment and retention were feasible. Within a trial context, My Journey 3 could be successfully delivered to adults using EIP services, but with relatively low usage rates. Further evaluation of the intervention in a larger trial may be warranted, but should include attention to implementation.

Trial registration

ISRCTN10004994.
Developing and implementing a culturally informed FAmily Motivational Engagement Strategy (FAMES) to increase family engagement in first episode psychosis programs: mixed methods pilot study protocol
Authors: Oluwoye Oladunni , Dyck Dennis , McPherson Sterling M , Lewis-Fernández Roberto , Compton Michael T , McDonell Michael G , Cabassa Leopoldo J
Published: August 2020

Introduction

Despite the proven effectiveness of coordinated specialty care (CSC) programmes for first episode psychosis in the USA, CSC programmes often have low levels of engagement in family psychoeducation, and engagement of racial and ethnic minority family members is even lower than that for non-Latino white family members. The goal of this study is to develop and evaluate a culturally informed FAmily Motivational Engagement Strategy (FAMES) and implementation toolkit for CSC providers.

Methods and analysis

This protocol describes a mixed methods, multi-phase study that blends intervention mapping and the Promoting Action on Research in Health Services framework to develop, modify and pilot-test FAMES and an accompanying implementation toolkit. Phase 1 will convene a Stakeholder Advisory Committee to inform modifications based on findings from phases 1 and 2. During phase 1, we will also recruit approximately 200 family members to complete an online survey to assess barriers and motivation to engage in treatment. Phase 2 we will recruit five family members into a 3-month trial of the modified FAMES and implementation toolkit. Results will guide the advisory committee in refining the intervention and implementation toolkit. Phase 3 will involve a 16-month non-randomised, stepped-wedge trial with 50 family members from five CSC programmes in community-based mental health clinics to examine the acceptability, feasibility and initial impact of FAMES and the implementation toolkit.

Ethics and dissemination

This study received Institutional Review Board approval from Washington State University, protocol #17 812–001. Results will be disseminated via peer review publications, presentations at national and international conferences, and to local community mental health agencies and committees.

Trial registration number

ClinicalTrials.gov Registry (NCT04188366).
Gravidity, parity, blood pressure and mortality among women in Bangladesh from the HEALS cohort
Authors: Shih Yu-Hsuan , Scannell Bryan Molly , Parvez Faruque , Uesugi Keriann Hunter , Shahriar Mohammed , Ahmed Alauddin , Islam Tariqul , Ahsan Habibul , Argos Maria
Published: August 2020

Objectives

Despite a hypothesised connection of reproductive history with hypertension and mortality, the nature of this association is poorly characterised. We evaluated the association of parity and gravidity with blood pressure, hypertension and all-cause mortality.

Design

Prospective cohort study.

Setting

Health Effects of Arsenic Longitudinal Study cohort in rural Bangladesh.

Participants

There were 21 634 Bangladeshi women recruited in 2000–2002, 2006–2008 and 2010–2014 included in the present analysis.

Methods

Reproductive history was ascertained through an interviewer-administered questionnaire at the baseline visit. Blood pressure was measured by a trained study physician following a standard protocol at the baseline visit. Vital status was ascertained at the biennial follow-up of study participants through June 2017. Linear and logistic regression models estimated the relationship between parity and gravidity with blood pressure and hypertension, respectively. Cox proportional hazards models estimated the relationship with all-cause mortality only among women aged >45 years.

Results

Diastolic blood pressure was lowest in women with parity one (reference) and elevated in nulliparous women (adjusted % change=3.12; 95% CI 1.93 to 4.33) and women with parity>2 (adjusted % change=1.71; 95% CI 1.12 to 2.31). The associations with nulliparity were stronger for women aged >45 years. Similar association patterns were observed with hypertension. Further, in nulliparous women aged >45 years, 265 deaths (6.6%) were ascertained during the follow-up period (median follow-up time=8 years), and we observed suggestive elevated risks of all-cause mortality (adjusted HR 3.83; 95% CI 0.74 to 19.78). The relationships between reproductive history, blood pressure, hypertension and mortality were similar when modelling reproductive history as gravidity rather than parity.

Conclusions

For women in rural Bangladesh, nulliparity and nulligravidity appear to be associated with higher blood pressure and subsequent elevated risk of mortality.
“Are you ready?” Validation of the Hospital Change Readiness (HCR) Questionnaire
Authors: Pomare Chiara , Ellis Louise A , Long Janet C , Churruca Kate , Tran Yvonne , Braithwaite Jeffrey
Published: August 2020

Objective

Organisational change in hospitals is a frequent, seemingly inevitable occurrence. A critical precursor to successful organisational change is change readiness. This paper presents the adaptation of a self-report measure of change readiness for hospital staff, examines its reliability and validity, and evaluates the relationship between hospital change readiness (HCR) and staff well-being.

Methods

The questionnaire was piloted among 153 staff from a large metropolitan, public hospital in Sydney, Australia. The hospital was undergoing a major change involving a multimillion-dollar development project that included a new building and new models of care. Construct validity was evaluated by confirmatory factor analysis (CFA) and reliability was assessed by internal consistency. Differences between professional groups were examined using regression analyses and structural equation modelling (SEM) was used to test the relationship between change readiness and staff well-being (job satisfaction and burnout).

Results

The HCR Questionnaire was found to reflect theoretically derived and empirically observed domains and have high internal reliability. CFA identified that a two-factor structure demonstrated excellent fit. Cronbach’s alpha for the two subscales (appropriateness and change efficacy) was 0.85 and 0.75, respectively. No statistically significant differences of HCR were identified between professional groups. SEM revealed that perceiving change as appropriate was significantly positively related to job satisfaction (0.33) and significantly negatively related to burnout (−0.30), and feeling capable in implementing the change was significantly negatively related to burnout (−0.40).

Conclusions

The HCR Questionnaire provides reliable information on how prepared hospital staff felt for organisational change and showed significant relationships with staff well-being. This questionnaire is validated for the Australian hospital context, particularly in the case of hospital redevelopment. It can be used to help manage times of hospital organisational change with minimal disruption to the quality and safety of patient care.
Has the reporting quality of published randomised controlled trial protocols improved since the SPIRIT statement? A methodological study
Authors: Tan Zet Wei , Tan Aidan Christopher , Li Tom , Harris Ian , Naylor Justine M , Siebelt Michiel , van Tiel Jasper , Pinheiro Marina , Harris Laura , Chamberlain Kira , Adie Sam
Published: August 2020

Objectives

To determine the reporting quality of published randomised controlled trial (RCT) protocols before and after the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement (2013), and any association with author, trial or journal factors.

Design

Methodological study.

Data sources

MEDLINE, Embase and CENTRAL were electronically searched using optimised search strategies.

Eligibility criteria

Protocols written for an RCT of living humans, published in full text in a peer-reviewed journal and published in the English language.

Main outcome

Primary outcome was the overall proportion of checklist items which were adequately reported in RCT protocols published before and after the SPIRIT statement.

Results

300 RCT protocols were retrieved; 150 from the period immediately before the SPIRIT statement (9 July 2012 to 28 December 2012) and 150 from a recent period after the SPIRIT statement (25 January 2019 to 20 March 2019). 47.9% (95% CI, 46.5% to 49.3%) of checklist items were adequately reported in RCT protocols before the SPIRIT statement and 56.7% (95% CI, 54.9% to 58.5%) after the SPIRIT statement. This represents an 8.8% (95% CI, 6.6% to 11.1%; p<0.0001) mean improvement in the overall proportion of checklist items adequately reported since the SPIRIT statement. While 40% of individual checklist items had a significant improvement in adequate reporting after the SPIRIT statement, 11.3% had a significant deterioration and there were no RCT protocols in which all individual checklist items were complete. The factors associated with higher reporting quality of RCT protocols in multiple regression analysis were author expertise or experience in epidemiology or statistics, multicentre trials, longer protocol word length and publicly reported journal policy of compliance with the SPIRIT statement.

Conclusion

The overall reporting quality of RCT protocols has significantly improved since the SPIRIT statement, although a substantial proportion of individual checklist items remain poorly reported. Continued and concerted efforts are required by journals, editors, reviewers and investigators to improve the completeness and transparency of RCT protocols.
Is there an association between subjective sleep quality and daily delirium occurrence in critically ill adults? A post hoc analysis of a randomised controlled trial
Authors: Duprey Matthew S , Devlin John W , Skrobik Yoanna
Published: August 2020

Objectives

Whether and how delirium and sleep quality in the intensive care unit (ICU) are linked remains unclear. A recent randomised trial reported nocturnal low-dose dexmedetomidine (DEX) significantly reduces incident ICU delirium. Leeds Sleep Evaluation Questionnaire (LSEQ) scores were similar between intervention (DEX; n=50) and control (placebo (PLA); n=50) groups. We measured the association between morning LSEQ and delirium occurrence in the prior 24 hours (retrospective analysis) and the association between morning LSEQ and delirium occurrence in the following 24 hours (predictive analysis).

Design

Post hoc analysis of randomised controlled trial data.

Participants

Adult ICU patients (n=100) underwent delirium screening twice a day using the Intensive Care Delirium Screening Checklist (ICDSC) if Richmond Agitation Sedation Scale (RASS) was ≥−3 and patient-reported sleep quality evaluations at 09:00 daily with the LSEQ if RASS was ≥−1.

Outcomes

The analysis included all 24-hour study periods with LSEQ documentation and matched delirium screening in coma-free patients. Separate logistic regression models controlling for age, baseline Acute Physiology and Chronic Health Evaluation II score and DEX/PLA allocation evaluated the association between morning LSEQ and delirium occurrence for both retrospective and predictive analyses.

Results

The 100 patients spent 1115 24-hour periods in the ICU. Coma, delirium and no delirium occurred in 130 (11.7%), 114 (10.2%) and 871 (78.1%), respectively. In the retrospective analysis, when an LSEQ result was preceded by an ICDSC result (439/985 (44.6%) 24-hour periods), delirium occurred during 41/439 (9.3%) periods. On regression analysis, the LSEQ score had no relationship to prior delirium occurrence (OR (per every 1 point average LSEQ change) 0.97, 95% CI 0.72 to 1.31). For the predictive analysis, among the 387/985 (39.1%) 24-hour periods where an LSEQ result was followed by an ICDSC result, delirium occurred during 56/387 (14.5%) periods. On regression analysis, the LSEQ score did not predict subsequent delirium occurrence (OR (per 1 point LSEQ change) 1.02, 95% CI 0.99 to 1.05).

Conclusions

The sleep quality ICU patients perceive neither affects nor predicts delirium occurrence.

Trial registration number

NCT01791296
Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure
Authors: Patel Maulin , Gangemi Andrew , Marron Robert , Chowdhury Junad , Yousef Ibraheem , Zheng Matthew , Mills Nicole , Tragesser Lauren , Giurintano Julie , Gupta Rohit , Gordon Matthew , Rali Parth , D'Alonso Gilbert , Fleece David , Zhao Huaqing , Patlakh Nicole , Criner Gerard
Published: August 2020

Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of high flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission.This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from 10 March 2020 to 24 April 2020 with moderate-to-severe respiratory failure treated with HFNT. Primary outcome was prevention of intubation. Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African-American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. Saturation to fraction ratio and chest X-ray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital-associated/ventilator-associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of pneumonia was statistically higher in the progressed to intubation group.

Conclusion

HFNT use is associated with a reduction in the rate of invasive mechanical ventilation and overall mortality in patients with COVID-19 infection.