bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of Campylobacter jejuni in raccoons (Procyon lotor) on swine farms and in conservation areas in southern Ontario
Authors: Vogt Nadine A. , Pearl David L. , Taboada Eduardo N. , Mutschall Steven K. , Bondo Kristin J. , Jardine Claire M.
Published: November 2020

Campylobacter is a leading cause of foodborne illness in humans worldwide. Sources of infection are often difficult to identify, and are, generally, poorly understood. Recent work suggests that wildlife may represent a source of Campylobacter for human infections. Using a repeated cross‐sectional study design, raccoons were trapped on five swine farms and five conservation areas in southern Ontario from 2011 to 2013. Our objectives were to: (a) assess the impact of seasonal, climatic, location, annual and raccoon demographic factors on the occurrence of Campylobacter jejuni in these animals; and (b) identify clusters of C. jejuni in space, time and space‐time using spatial scan statistics. Multi‐level multivariable logistic regression was used to examine the odds of isolating C. jejuni, with site and animal modelled as random intercepts. The following independent variables were examined: raccoon age and sex, year, location type, season, temperature and rainfall. A total of 1,096 samples were obtained from 627 raccoons; 46.3% were positive for C. jejuni. The following interactions and their main effects were significant (p < .05) and retained in the final model: season × temperature, year × rainfall, year × temperature. Based on the results from our multivariable model and spatial scan statistics, climatic variables (i.e. rainfall, temperature and season) were associated with the carriage of C. jejuni by raccoons, but the effects were not consistent, and varied by location and year. Although raccoons may pose a zoonotic risk due to their carriage of Campylobacter, further work is required to characterize the transmission and movement of this microorganism within the ecosystem.
JOINT DELAY AND AZIMUTH ESTIMATION OF COHERENT WAVES FOR MILLIMETER-WAVE BAND CHANNEL SOUNDING
Authors: Saito Kentaro , Mirfananda Ahmad Salaam , Takada Jun-ichi , Nakamura Mitsuki , Yamada Wataru , Takatori Yasushi
Published: November 2020

The user traffic in the mobile communication area has rapidly increased owing to the widespread of smartphones and various cloud services. To handle the increasing traffic, in the fifth-generation mobile communication system (5G), the millimeter-wave multiple-input and multiple-output (MIMO) communication technology is under development. Because the MIMO transmission performance heavily depends on the radio propagation characteristics, various MIMO channel measurements are needed for the performance evaluation and system design. The accurate and efficient parameter estimation algorithm which estimates the propagation delays and angle of arrivals (AoA) of radio waves is also indispensable for the purpose. In this paper, we extended the joint delay and azimuth estimation (JADE) method based on multiple signal classification (MUSIC) algorithm. In our proposal, the drawback of the MUSIC that the performance degrades for the estimation of coherent waves was solved by applying the smoothing technique in the frequency domain. It also makes the antenna calibration simpler. We implemented the proposed algorithm for the channel sounding system in the 66 GHz band, which is one of the candidate frequency bands for the International Mobile Telecommunications (IMT) system and evaluated the effectiveness through the experiment in an anechoic chamber. The result showed that our proposed method can de-correlate the signal components of coherent waves, and improved the parameter estimation accuracy significantly. The root means square error (RMSE) of the propagation delay estimation was improved from 2.7 ns to 0.9 ns, and the RMSE of the AoA estimation was improved from 20.3 deg. to 7.2 deg. The results are expected to be utilized for the millimeter wave band MIMO channel modeling.
AZOLLA ENHANCES ELECTRICITY GENERATION OF PADDY MICROBIAL FUEL CELL
Authors: Regmi Roshan , Nitisoravut Rachnarin
Published: November 2020

Generation of electricity from plant rhizodeposition with an aid of soil bacteria has gained popularity recently as a source of clean and green energy. Power generation from such biosystems is lower than theoretically achieved value due to many constraints. Supplementing the rhizodeposition with external substrates or in situ complementary mechanism can help to enhance the current generation. Therefore, this study aims to improve current from paddy plants with an amendment of Azolla which is hypothesized to augment the bioelectricity production via two mechanisms. These include an addition of organic matters in the system and nitrogen fixation from Azolla which plays a positive role in biomass growth, thereby increasing current. Single chamber sediment PMFCs were built in a facile way, employing commercially available glass chambers with carbon cloth for electrodes, and paddy soil as substrates and inoculum. To have better insight about the system performance, numerous parameters were monitored including daily power output recordings, nature of electric signals, polarization technique, growth nature of the plant, and change in soil physiochemical characteristics. The results revealed that after a week of transplanting of paddy seedlings, the daily current density increased almost twice as compared to the unplanted system. The maximum power in planted reactors was greater by 84% as depicted by power curve. In addition, amended planted reactors with Azolla enhanced the current generation by almost thrice than only planted reactors without amendment, while planted reactors produced current twice than that of from sediments only. Clear circadian oscillation was observed in power output from closed circuit while there is no such demarcation in open circuit voltage during the start-up period.
Epidemiological Analysis of Penile Neoplasms in Brazil and Its Social Determinants
Authors: Cabral Lamy de Miranda Marcelo , Pereira da Silva Janine , Brunelli Sales Arthur , Ferreira Faria Eliney , De Rezende Coelho Maria Carlota , Sagrillo Pimassoni Lúcia Helena , Ramos-Silva Valmin
Published: November 2020

Introduction: Penile neoplasms, although preventable, are frequent even among young persons. Penile neoplasms have a high risk of not only morbidity and mortality but also important psychosocial repercussions.Objective: To describe the epidemiology of penile neoplasms in Brazil. Method: This was an epidemiological, descriptive and cross-sectional study. Data on all the notified cases of penile neoplasms in Brazil between 1985 and 2015 were obtained from RCPBP/INCA and DATASUS databases.Results: Of 9 625 notified cases of penile neoplasms, a higher proportion of cancer patients was observed among patients aged between 40 and 70 years (63.5%) and among smokers (21%), in Brown and Caucasian patients (80%), those who were married (54.2%), had high alcohol intake levels (16%) and with lower levels of education: illiterate people (21.5%), those with incomplete elementary school education (36.6%) and those with complete elementary school education (10.3%). The lesions were located in the glans (22.6%), prepuce (7.5%) and the penile body (7.5%). Higher mortality rates were observed in the age-group 50 to 80 years and in among patients from the Northeast (31.4%) and Southeast (39.2%) regions of the country.Conclusion: Penile neoplasms, which mainly affect young people that are economically active, are prevalent in Brazil and the majority of patients present with an advanced stage of the disease. They are Brown and Caucasian, married, with poor education and live in the Northeast and Southeast regions of the country.
Hereditary Slavery Shackles Mauritania
Authors: Gabbay Shaul M.
Published: November 2020

This paper exposes the scourge of slavery that continues to thrive in the country of Mauritania in modern times. Though the practice is formally abolished and illegal, and the government continues to claim slavery has been eradicated, the truth lies elsewhere. 90,000 dark-skinned slaves, often referred to as Black Moors, continue to live deplorable lives in servitude to their lighter-skinned masters. The Mauritanian government is helping the scourge of slavery endure by denying its existence and providing it cover. Their task is made easier as the face of slavery changes and becomes hidden in the throes of modern commerce, making it more difficult for an outsider to differentiate between a low-income wage earner and a slave. Other situations are painfully identifiable, such as conducting human trafficking for purposes of prostitution. In all situations, women and children make up the vast majority of indentured servants. Due to a forced dearth of educational opportunity, slaves are often illiterate and therefore largely unable to emancipate themselves without outside help. Deeply entrenched belief systems, practices, and governmental and societal structures that exist in Mauritania secure an environment that allows slavery to continue to thrive. In addition to the Mauritanian government, businesses, educational facilities, NGO’s, and members of society at every level must take decisive action to eradicate the practice and change the beliefs that hold it in place. Foreign governments and businesses hold great power in their willingness to engage with Mauritanian leaders. By withholding financial aid and business deals international players have the opportunity to hasten the eradication of slavery in Mauritania This paper examines the depth of the slavery problem and recommends multiple steps for its elimination.
Ventricular contraction and relaxation rates during muscle metaboreflex activation in heart failure: are they coupled?
Authors: Mannozzi Joseph , Massoud Louis , Kaur Jasdeep , Coutsos Matthew , O'Leary Donal S.
Published: November 2020

New Findings

What is the central question of this study?

Does the muscle metaboreflex affect the ratio of left ventricular contraction/relaxation rates and does heart failure impact this relationship.

What is the main finding and its importance?

The effect of muscle metaboreflex activation on the ventricular relaxation rate was significantly attenuated in heart failure. Heart failure attenuates the exercise and muscle metaboreflex‐induced changes in the contraction/relaxation ratio. In heart failure, the reduced ability to raise cardiac output during muscle metaboreflex activation may not solely be due to attenuation of ventricular contraction but also alterations in ventricular relaxation and diastolic function.

The relationship between contraction and relaxation rates of the left ventricle varies with exercise. In in vitro models, this ratio was shown to be relatively unaltered by changes in sarcomere length, frequency of stimulation, and β‐adrenergic stimulation. We investigated whether the ratio of contraction to relaxation rate is maintained in the whole heart during exercise and muscle metaboreflex activation and whether heart failure alters these relationships. We observed that in healthy subjects the ratio of contraction to relaxation increases from rest to exercise as a result of a higher increase in contraction relative to relaxation. During muscle metaboreflex activation the ratio of contraction to relaxation is significantly reduced towards 1.0 due to a large increase in relaxation rate matching contraction rate. In heart failure, contraction and relaxation rates are significantly reduced, and increases during exercise are attenuated. A significant increase in the ratio was observed from rest to exercise although baseline ratio values were significantly reduced close to 1.0 when compared to healthy subjects. There was no significant change observed between exercise and muscle metaboreflex activation nor was the ratio during muscle metaboreflex activation significantly different between heart failure and control. We conclude that heart failure reduces the muscle metaboreflex gain and contraction and relaxation rates. Furthermore, we observed that the ratio of the contraction and relaxation rates during muscle metaboreflex activation is not significantly different between control and heart failure, but significant changes in the ratio in healthy subjects due to increased relaxation rate were abolished in heart failure.
A.B.C. approach proposal for POCUS in COVID-19 critically ill patients
Authors: Simon Robert , Petrișor Cristina , Bodolea Constantin , Csipak Gabriela , Oancea Cristian , Golea Adela
Published: November 2020

The rapid spread of SARS-CoV-2 (COVID-19) since December 2019 forced Intensive Care Units to face high numbers of patients admitted simultaneously with limited resources. COVID-19 critically ill patients, especially those on mechanical ventilators, demand special attention as they can develop potential complications with critical hemodynamic and respiratory consequences. Point of Care Ultrasound (POCUS) might have important roles in assessing the critically ill SARS-CoV-2 patient. Mostly, lung ultrasound has been presented as having a role in diagnosis and monitoring, but airway examination and hemodynamic evaluation are of interest also. We propose an A.B.C. POCUS approach focusing on A-airway (orotracheal intubation), B-breathing (interstitial syn-dromes, pneumothorax, atelectasis, pneumonia), and C-circulation (cardiac function, pulmonary embolism, volume status, deep veins thrombosis). This A.B.C. approach has emerged during ICU care for 22 adult COVID-19 critically ill patients, along with the analysis of recent papers describing ultrasound in COVID-19 patients including the use of ultrasound that is currently applied in the management of the general critically ill population. This A.B.C- POCUS algorithm parallels the well-established clinical A.B.C. algorithms. There are few extensive ultrasonographic studies in COVID-19 critically ill patients up to now, but techniques extrapolated from non-COVID studies seem reasonable even though comparative studies are not available yet.
Evaluating temporary threshold shift onset levels for impulsive noise in seals
Authors: Sills Jillian M. , Ruscher Brandi , Nichols Ross , Southall Brandon L. , Reichmuth Colleen
Published: November 2020

The auditory effects of single- and multiple-shot impulsive noise exposures were evaluated in a bearded seal (Erignathus barbatus). This study replicated and expanded upon recent work with related species [Reichmuth, Ghoul, Sills, Rouse, and Southall (2016). J. Acoust. Soc. Am. 140, 2646–2658]. Behavioral methods were used to measure hearing sensitivity before and immediately following exposure to underwater noise from a seismic air gun. Hearing was evaluated at 100 Hz—close to the maximum energy in the received pulse, and 400 Hz—the frequency with the highest sensation level. When no evidence of a temporary threshold shift (TTS) was found following single shots at 185 dB re 1 μPa2 s unweighted sound exposure level (SEL) and 207 dB re 1 μPa peak-to-peak sound pressure, the number of exposures was gradually increased from one to ten. Transient shifts in hearing thresholds at 400 Hz were apparent following exposure to four to ten consecutive pulses (cumulative SEL 191–195 dB re 1 μPa2 s; 167–171 dB re 1 μPa2 s with frequency weighting for phocid carnivores in water). Along with these auditory data, the effects of seismic exposures on response time, response bias, and behavior were investigated. This study has implications for predicting TTS onset following impulsive noise exposure in seals.
A Valid Warning or Clinical Lore: an Evaluation of Safety Outcomes of Remdesivir in Patients with Impaired Renal Function from a Multicenter Matched Cohort
Authors: Ackley Tyler W. , McManus Dayna , Topal Jeffrey E. , Cicali Brian , Shah Sunish
Published: November 2020

Per prescribing guidance, remdesivir is not recommended for SARS-CoV-2 in patients with renal disease given the absence of safety data in this patient population. This study was a multicenter, retrospective chart review of hospitalized patients with SARS-CoV-2 who received remdesivir.
Draft Genome Sequence of Oleaginous Yeast
Saitozyma
sp. Strain JCM 24511, Isolated from Soil on Iriomote Island, Okinawa, Japan
Authors: Takashima Masako , Manabe Ri-ichiroh , Ohkuma Moriya
Published: November 2020

Here, we report draft genome sequences of oleaginous yeast strain
Saitozyma
sp. JCM 24511, which is phylogenetically closely related to
Saitozyma podzolica
. These data will have implications not only for the study of the oleaginous activities of yeasts but also for the study of the plant-microorganism microbiome.
High-Quality Draft Genome Sequence of a
Rickettsiales
Bacterium Found in
Acropora tenuis
Coral from Okinawa, Japan
Authors: Ide Keigo , Nishikawa Yohei , Kogawa Masato , Iwamoto Eisuke , Samuel Ashok Zachariah , Nakano Yoshikatsu , Takeyama Haruko
Published: November 2020

Rickettsiales
-like organisms are important for the survival and functioning of corals, prompting an investigation of their complete genomes. Earlier reports of the genomes of these organisms remain incomplete. Here, we report a novel draft genome of
Rickettsiales
bacterial strain SESOKO1, found in
Acropora tenuis
coral, using single-cell genome technology.
Draft Genome Sequence of a Noncognate Bacterium,
Achromobacter
sp. Strain Bel, Associated with a Rhabditid Entomopathogenic Nematode
Authors: Mangowa Don , Serepa-Dlamini Mahloro H.
Published: November 2020

Achromobacter
sp. strain Bel is a noncognate bacterium associated with a rhabditid entomopathogenic nematode of the
Oscheius
genus. Its draft genome sequence is 6.62 Mb with a G+C content of 65.4%. The genome highlights important genes which could play a role in entomopathogenicity.
Draft Genome Sequence of Halomonas titanicae Strain TAT1, a Hydrocarbon-Oxidizing Halophilic Bacterium Isolated from a Petroleum Reservoir in Russia
Authors: Grouzdev Denis S. , Sokolova Diyana S. , Poltaraus Andrey B. , Nazina Tamara N.
Published: November 2020

The draft genome sequence of a moderately halophilic bacterium,
Halomonas titanicae
strain TAT1, isolated from production water of the Romashkinskoe oilfield (Russia) is presented. The genome is annotated for elucidation of the metabolic pathways involved in hydrocarbon degradation and nitrate reduction in petroleum-contaminated hypersaline environments.
The Clostridioides difficile Cysteine-Rich Exosporium Morphogenetic Protein, CdeC, Exhibits Self-Assembly Properties That Lead to Organized Inclusion Bodies in Escherichia coli
Authors: Romero-Rodríguez A. , Troncoso-Cotal S. , Guerrero-Araya E. , Paredes-Sabja D.
Published: November 2020

The endospore of
Clostridioides difficile
is the vehicle for transmission and persistence of the pathogen, and, specifically, the exosporium is the first contact between the host and the spore. The underlying mechanisms that govern exosporium assembly in
C. difficile
remain understudied, in part due to difficulties in obtaining pure soluble recombinant proteins of the
C. difficile
exosporium. Understanding the exosporium assembly’s molecular bases may be essential to developing new therapies against
C. difficile
infection.
Revising the Revisions: James Hutton’s Reputation among Geologists in the Late Eighteenth and Nineteenth Centuries
Authors: Şengör* A. M. Celâl
Published: November 2020

A recent fad in the historiography of geology is to consider the Scottish polymath James Hutton’s Theory of the Earth the last of the “theories of the earth” genre of publications that had begun developing in the seventeenth century and to regard it as something behind the times already in the late eighteenth century and which was subsequently remembered only because some later geologists, particularly Hutton’s countryman Sir Archibald Geikie, found it convenient to represent it as a precursor of the prevailing opinions of the day. By contrast, the available documentation, published and unpublished, shows that Hutton’s theory was considered as something completely new by his contemporaries, very different from anything that preceded it, whether they agreed with him or not, and that it was widely discussed both in his own country and abroad—from St. Petersburg through Europe to New York. By the end of the third decade in the nineteenth century, many very respectable geologists began seeing in him “the father of modern geology” even before Sir Archibald was born (in 1835). Before long, even popular books on geology and general encyclopedias began spreading the same conviction. A review of the geological literature of the late eighteenth and the nineteenth centuries shows that Hutton was not only remembered, but his ideas were in fact considered part of the current science and discussed accordingly. The strange new fashion in the historiography of geology has been promulgated mostly by professional historians rather than geologists and seems based on two main reasons: (1) a misinterpretation of what geology consists of by considering methods rather than theories as the essence of the science, and (2) insufficient attention to the scientific literature of geology through the ages. In only one case, the religious commitment of a historian seems a reason for his attempt to belittle Hutton’s contribution and to exalt those of his Christian adversaries, hitherto considered insignificant. To write a history of geology it is imperative that extra-scientific considerations such as religion or political ideology or even the mental state of the scientist(s) examined must not be mixed, overtly or covertly, into the assessment and the writer should have a good knowledge of, and experience in doing, geology. Social considerations may tell us why science is done or not done in a society, but they cannot tell us anything on the origin and evolution of its content. In understanding the intellectual development of geology, in fact science in general, sociological analysis seems not very helpful.
Definition of tectonic elements in Tehuantepec, southeast Mexico: An integrated geophysical, geochronological, and stratigraphic perspective
Authors: Garza Roberto S. Molina , Pindell James , Coombs Henry , Weber Bodo , Alonso Tomás Peña
Published: November 2020

We redefine the “Chontal arc” of the southern Isthmus of Tehuantepec, Mexico, as the Chontal allochthon. The Chontal assemblage is composed of Upper Cretaceous low-grade metavolcanic and metasedimentary rocks included in the Chivela lithodeme. By means of field observations, laser-ablation detrital zircon geochronology, and trace-element geochemistry, we constrained the provenance and tectonic setting of these rocks. We concluded that they form an allochthon emplaced during a Paleogene transpressive event. Basement structure in the greater Oaxaca-Chiapas area was assessed by qualitative interpretation of Mexican State aeromagnetic maps. Chivela lithodeme sediments include a contribution from Albian–Turonian volcanic arc rocks no longer present in the region, likely sourced from the Chortís block or from the Greater Antilles Arc as it collided with southern Yucatan. Maastrichtian basic intrusive units, basalt flows, and pillow lavas with pelagic sediments in the Chontal are subalkaline, plotting in the normal mid-ocean-ridge basalt (N-MORB) field of discrimination diagrams. The igneous rocks are interpreted as pertaining either to the inception of the paleo–Motagua fault zone (left step in the fault trace), or to local backarc extension behind the Chortís block just before it began to migrate eastward, in a basin we call the Chontal basin. The Chontal allochthon was thrust northward onto parautochthonous strata flanking the Mixtequita and Chiapas Massif basements. Chontal allochthon rocks were later intruded by Miocene granitoids related to the inception of Cocos plate subduction arc magmatism. Rocks of the Chontal allochthon have been previously linked to the Cuicateco belt of eastern Oaxaca, but this is challenged here on the basis of lithologic type, chronology, tectonic associations, structural styles, and discontinuous anomaly trends in aeromagnetic maps.
Improving regional care in the last year of life by setting up a pragmatic evidence-based Plan–Do–Study–Act cycle: results from a cross-sectional survey
Authors: Voltz Raymond , Dust Gloria , Schippel Nicolas , Hamacher Stefanie , Payne Sheila , Scholten Nadine , Pfaff Holger , Rietz Christian , Strupp Julia
Published: November 2020

Objectives

To set up a pragmatic Plan–Do–Study–Act cycle by analysing patient experiences and determinants of satisfaction with care in the last year of life.

Design

Cross-sectional postbereavement survey.

Setting

Regional health services research and development structure representing all health and social care providers involved in the last year of life in Cologne, a city with 1 million inhabitants in Germany.

Participants

351 bereaved relatives of adult decedents, representative for age and gender, accidental and suspicious deaths excluded.

Results

For the majority (89%) of patients, home was the main place of care during their last year of life. Nevertheless, 91% of patients had at least one hospital admission and 42% died in hospital. Only 60% of informants reported that the decedent had been told that the disease was leading to death. Hospital physicians broke the news most often (58%), with their communication style often (30%) being rated as ‘not sensitive’. Informants indicated highly positive experiences with care provided by hospices (89% ‘good’) and specialist palliative home care teams (87% ‘good’). This proportion dropped to 41% for acute care hospitals, this rating being determined by the feeling of not being treated with respect and dignity (OR=23.80, 95% CI 7.503 to 75.498) and the impression that hospitals did not work well together with other services (OR=8.37, 95% CI 2.141 to 32.71).

Conclusions

Following those data, our regional priority for action now is improvement of care in acute hospitals, with two new projects starting, first, how to recognise and communicate a limited life span, and second, how to improve care during the dying phase. Results and further improvement projects will be discussed in a working group with the city of Cologne, and repeating this survey in 2 years will be able to measure regional achievements.

Trial registration number

DRKS00011925.
Postnatal checks and primary care consultations in the year following childbirth: an observational cohort study of 309 573 women in the UK, 2006–2016
Authors: Smith Holly Christina , Saxena Sonia , Petersen Irene
Published: November 2020

Objective

To describe women’s uptake of postnatal checks and primary care consultations in the year following childbirth.

Design

Observational cohort study using electronic health records.

Setting

UK primary care.

Participants

Women aged 16–49 years who had given birth to a single live infant recorded in The Health Improvement Network (THIN) primary care database in 2006–2016.

Main outcome measures

Postnatal checks and direct consultations in the year following childbirth.

Results

We examined 1 427 710 consultations in 309 573 women who gave birth to 241 662 children in 2006–2016. Of these women, 78.7% (243 516) had a consultation at the time of the postnatal check, but only 56.2% (174 061) had a structured postnatal check documented. Teenage women (aged 16–19 years) were 12% less likely to have a postnatal check compared with those aged 30–35 years (incidence rate ratio (IRR) 0.88, 95% CI 0.85 to 0.91) and those living in the most deprived versus least deprived areas were 10% less likely (IRR 0.90, 95% CI 0.88 to 0.92). Women consulted on average 4.8 times per woman per year and 293 049 women (94.7%) had at least one direct consultation in the year after childbirth. Consultation rates were higher for those with a caesarean delivery (7.7 per woman per year, 95% CI 7.7 to 7.8). Consultation rates peaked during weeks 5–10 following birth (11.8 consultations/100 women) coinciding with the postnatal check.

Conclusions

Two in 10 women did not have a consultation at the time of the postnatal check and four in 10 women have no record of receiving a structured postnatal check within the first 10 weeks after giving birth. Teenagers and those from the most deprived areas are among the least likely to have a check. We estimate up to 350 400 women per year in the UK may be missing these opportunities for timely health promotion and to have important health needs identified following childbirth.
Development and validation of a Japanese version of the Patient Centred Assessment Method and its user guide: a cross-sectional study
Authors: Mutai Rieko , Sugiyama Yoshifumi , Yoshida Shuhei , Horiguchi Ryoko , Watanabe Takamasa , Kaneko Makoto , Tominaga Tomokazu , Hayashi Daichi , Matsushima Masato
Published: November 2020

Objectives

The primary objective of this study was to develop the Japanese version of the Patient Centred Assessment Method (PCAM) and its user guide. The secondary objective was to examine the validity and reliability in the primary care setting.

Design

Cross-sectional study.

Setting

Three family physician teaching clinics located in urban residential areas in Tokyo, Japan.

Participants

Patients who were aged 20 years or older, and who had an appointment with physicians at the three participating clinics.

Main outcome measures

Patient complexity measured by PCAM and complexity/burden level measured by a Visual Analogue Scale (VAS).

Results

Although confirmatory factor analysis using a model described in a previous study revealed that the indices did not meet the criteria for good fit, exploratory factor analysis revealed a new three-factor structure of ‘Personal well-being,’ ‘Social interaction’ and ‘Needs for care/service.’ Cronbach’s alpha of PCAM was 0.86. Spearman’s rank correlation coefficients between PCAM scores and VAS scores were 0.51 for complexity (p<0.001) and 0.41 for burden (p<0.001). There were 42 patients (14.3% of total patients) with PCAM scores greater than its mean of 16.5 but with complexity VAS scores less than its mean of 20.8.

Conclusions

The Japanese version of PCAM and its user guide were developed through Japanese translation and cultural adaptation by cognitive debriefing. PCAM is a valid and reliable tool to assess patient complexity in the primary care settings in Japan. Additionally, although the correlation between total PCAM scores and complexity/burden as assessed by VAS was moderate, PCAM can more precisely identify patient complexity than skilled physician’s intuition.
Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia
Authors: Martín-Sánchez Mario , Case Richard , Fairley Christopher , Hocking Jane S , Bradshaw Catriona , Ong Jason , Chen Marcus Y , Chow Eric P F
Published: November 2020

Objectives

In the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.

Design

Repeated cross-sectional study.

Setting

A sexual health centre in Melbourne, Australia.

Participants

MSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.

Primary outcome measures

Demographic characterics, sexual practices and HIV/STI positivity.

Results

Compared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.

Conclusions

MSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.
Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
Authors: Book Stephanie , Ulbrecht Gudrun , Tomandl Johanna , Kuehlein Thomas , Gotthardt Susann , Freiberger Ellen , Graessel Elmar
Published: November 2020

Objectives

Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients’ needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF.

Design

In this exploratory, cross-sectional study, a health professional conducted semi-structured interviews.

Setting

Community-dwelling older adults aged 75 and older in Germany.

Participants

65 participants (mean age=80.2, SD=3.6).

Outcome measures

Extended ICF Checklist V.2.1a, patients prioritised chapters of the ‘activities and participation’ component.

Results

The three most common impairments for ‘body functions’ were visual system functions (ICF-code b210; 89%), blood pressure functions (b420; 80%) and sensations associated with hearing and vestibular functions (b240; 59%). For ‘body structures’, they were eyes, ears and related structures (s2; 81%), structure of mouth (s320; 74%) and structures related to the digestive, metabolic and endocrine systems (s5; 49%). For the ‘activities and participation’ component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was walking (d450; 35%). Participants rated the ‘mobility’ chapter as the most important of all chapters. ‘Environmental factors’ were facilitators of participants’ functioning.

Conclusions

This empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care.

Trial registration details

The trial is registered in ClinicalTrials.gov (NCT03384732).
Informing prevention of stillbirth and preterm birth in Malawi: development of a minimum dataset for health facilities participating in the DIPLOMATIC collaboration
Authors: von Wissmann Beatrix , Wastnedge Elizabeth , Waters Donald , Gadama Luis A , Dube Queen , Masesa Clemens , Chodzaza Elizabeth , Stock Sarah Jane , Reynolds Rebecca M , Norrie John , Makwakwa Enita , Freyne Bridget , Campbell Harry , Norman Jane E , Wood Rachael
Published: November 2020

Objective

The global research group, DIPLOMATIC (Using eviDence, Implementation science, and a clinical trial PLatform to Optimise MATernal and newborn health in low Income Countries), aims to reduce stillbirths and preterm births and optimise outcomes for babies born preterm. Minimum datasets for routine data collection in healthcare facilities participating in DIPLOMATIC (initially in Malawi) were designed to assist understanding of baseline maternal and neonatal care processes and outcomes, and facilitate evaluation of improvement interventions and pragmatic clinical trials.

Design

Published and grey literature was reviewed alongside extensive in-country consultation to define relevant clinical best practice guidance, and the existing local data and reporting infrastructure, to identify requirements for the minimum datasets. Data elements were subjected to iterative rounds of consultation with topic experts in Malawi and Scotland, the relevant Malawian professional bodies and the Ministry of Health in Malawi to ensure relevance, validity and feasibility.

Setting

Antenatal, maternity and specialist neonatal care in Malawi.

Results

The resulting three minimum datasets cover the maternal and neonatal healthcare journey for antenatal, maternity and specialist neonatal care, with provision for effective linkage of records for mother/baby pairs. They can facilitate consistent, precise recording of relevant outcomes (stillbirths, preterm births, neonatal deaths), risk factors and key care processes.

Conclusions

Poor quality routine data on care processes and outcomes constrain healthcare system improvement. The datasets developed for implementation in DIPLOMATIC partner facilities reflect, and hence support delivery of, internationally agreed best practice for maternal and newborn care in low-income settings. Informed by extensive consultation, they are designed to integrate with existing local data infrastructure and reporting as well as meeting research data needs. This work provides a transferable example of strengthening data infrastructure to underpin a learning healthcare system approach in low-income settings.

DIPLOMATIC is funded by the UK National Institute for Health Research.
Impact of allergic rhinitis on the day-to-day lives of children: insights from an Australian cross-sectional study
Authors: Bosnic-Anticevich Sinthia , Smith Peter , Abramson Michael , Hespe Charlotte Mary , Johnson Menai , Stosic Rodney , Price David B
Published: November 2020

Study design and objective

Cross-sectional, observational survey to describe the impact of allergic rhinitis (AR) on Australian children (2 to 15 years).

Methods

Participants (n=1541), parents of children aged 2 to 15 years, provided information on behalf of themselves and one eligible child in their household using a custom-built online questionnaire. Children were allocated to case (AR) or control (No AR) analysis groups based on a validated screening questionnaire.

Statistical methods

The study sample was stratified on age: primary analysis population (6 to 15 years, n=1111; AR=797, No AR=314); exploratory population (2 to 5 years). The primary endpoint, parent-perceived burden, was quantified using a validated measure of health status and analysed via comparison of means.

Results

The majority of AR cases were treated (730/797; 90.3%) and classified as having moderate-severe, intermittent AR (549/797; 68.9%). Half reported adequate symptom control in the prior 2 weeks (389/797; 48.8%; OR=4.04; 95% CI (CI) 2.24 to 7.31). Having AR was associated with worse overall health status (7.4 vs 8.4, mean difference (least squares mean difference (LSMD))=−0.99; 95% CI −1.18 to −0.79), fewer days being happy (22.2 vs 25.9, LSMD=−3.68; 95% CI −4.82 to −2.54) and more days of poor physical (2.82 vs 0.78, LSMD=2.04; 95% CI 1.61 to 2.47) and emotional (2.14 vs 0.67, LSMD=1.47; 95% CI 1.02 to −1.92) health compared with not having AR. All of these outcomes were significantly (p<0.05) worse in children who reported inadequate symptom control. Having AR negatively impacted on schoolwork, sleep and other activities, and increased the likelihood of having comorbidities.

Conclusion

The parent-perceived burden of AR in Australian children is high and it impacts many areas of day-to-day living. Inadequate symptom control is a key driver of the extent of this impact. Opportunities to optimise the management of AR in children include the adoption of self-assessment tools to gauge and monitor adequacy of symptom control.
Protocol for measuring indoor exposure to coal fly ash and heavy metals, and neurobehavioural symptoms in children aged 6 to 14 years old
Authors: Zierold Kristina M , Sears Clara G , Hagemeyer Abby N , Brock Guy N , Polivka Barbara J , Zhang Charlie H , Sears Lonnie
Published: November 2020

Introduction

Fly ash is a waste product generated from burning coal for electricity. It is comprised of spherical particles ranging in size from 0.1 µm to over 100 µm in diameter that contain trace levels of heavy metals. Large countries such as China and India generate over 100 million tons per year while smaller countries like Italy and France generate 2 to 3 million tons per year. The USA generates over 36 million tons of ash, making it one of the largest industrial waste streams in the nation. Fly ash is stored in landfills and surface impoundments exposing communities to fugitive dust and heavy metals that leach into the groundwater. Limited information exists on the health impact of exposure to fly ash. This protocol represents the first research to assess children’s exposure to coal fly ash and neurobehavioural outcomes.

Methods

We measure indoor exposure to fly ash and heavy metals, and neurobehavioural symptoms in children aged 6 to 14 years old. Using air pollution samplers and lift tape samples, we collect particulate matter ≤10 µm that is analysed for fly ash and heavy metals. Toenails and fingernails are collected to assess body burden for 72 chemical elements. Using the Behavioural Assessment and Research System and the Child Behaviour Checklist, we collect information on neurobehavioural outcomes. Data collection began in September 2015 and will continue until February 2021.

Ethics and dissemination

This study was approved by the Institutional Review Boards of the University of Louisville (#14.1069) and the University of Alabama at Birmingham (#300003807). We have collected data from 267 children who live within 10 miles of two power plants. Children are at a greater risk for environmental exposure which justifies the rationale for this study. Results of this study will be distributed at conferences, in peer-reviewed journals and to the participants of the study.
Randomised, double-blind, multicentre, phase Ⅰ/Ⅱ dose escalation and expansion trial of GR1501 in patients with plaque psoriasis: study protocol
Authors: Dong Wenliang , Nie Xiaoyan , Wang Jiaxue , Xia Lin , Cai Lin , Wang Qian , Wang Wei , Fu Weixing , Wang Qi , Shen Tiantian , Fan Huaying , Niu Suping , Cui Yimin , Zheng Qingshan , Zhang Jianzhong , Fang Yi
Published: November 2020

Introduction

Psoriasis is a life-long, immune-mediated disease that greatly reduces the quality of life of patients. Plaque psoriasis is the most common form of psoriasis. Treatment options for plaque psoriasis with good tolerance and sufficient response remain profoundly limited. Based on mechanistic findings that suggest the key pathogenic role of interleukin (IL)-17 in plaque psoriasis, we hypothesise that GR1501, a new monoclonal antibody (IL-17A targeted), will be an efficacious treatment for plaque psoriasis. This phase I/II trial aims to evaluate the safety, tolerability, pharmacokinetics, immunogenicity and preliminary efficacy of GR1501.

Methods and analysis

A multicentre, randomised, double-blind, phase I/II dose escalation and expansion trial will be conducted at four hospitals in China. In total, 226 patients with plaque psoriasis will be enrolled in the study, with 46 cases in the dose-escalation stage and 180 cases randomised to GR1501 or the placebo in a 3:1 ratio in the expansion cohort. The primary outcomes are safety and tolerability; the secondary outcomes include pharmacokinetics, immunogenicity and efficacy.

Ethics and dissemination

The study is in accordance with the Declaration of Helsinki, and the ethics approvals of the protocol have been obtained from the ethics committees of all participating centres, including Peking University People’s Hospital, Chinese PLA General Hospital, The First Affiliated Hospital, College of Medicine, Zhejiang University and the Second Xiangya Hospital of Central South University. The findings of the study will be presented in published journals or at scientific conferences or meetings.

Trial registration number

ChiCTR1800017956.
Theory-based digital intervention to promote weight loss and weight loss maintenance (Choosing Health): protocol for a randomised controlled trial
Authors: Kwasnicka Dominika , Luszczynska Aleksandra , Hagger Martin S , Quested Eleanor , Pagoto Sherry L , Verboon Peter , Robinson Suzanne , Januszewicz Anna , Idziak Paulina , Palacz-Poborczyk Iga , Naughton Felix
Published: November 2020

Introduction

Digital behavioural weight loss interventions have the potential to improve public health; however, these interventions are often not adequately tailored to the needs of the participants. This is the protocol for a trial that aims to determine the effectiveness and cost-effectiveness of the Choosing Health programme as a means to promote weight loss and weight loss maintenance among overweight/obese adults.

Methods and analysis

The proposed study is a two-group randomised controlled trial with a nested interrupted time series (ITS) within-person design. Participants (n=285) will be randomly assigned to either the Choosing Health digital intervention or a control group. For intervention participants, ecological momentary assessment will be used to identify behavioural determinants for each individual in order to tailor evidence-based behaviour change techniques and intervention content.

Control group participants will receive non-tailored weight loss advice via e-book and generic emails. The primary outcome is the mean difference in weight loss between groups at 6 months controlled for baseline. Secondary outcomes include blood pressure and percentage of body fat; self-reported measures of physical activity, sitting time, quality of life, cost and theory-derived correlates of weight loss. Secondary outcomes will be measured at baseline, 3, 6 and 12 months. The primary outcome for ITS will be daily weight loss plan adherence. Data will be analysed using regression and time series analyses.

Ethics and dissemination

Ethics approval was granted by Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland, approval number 03/P/12/2019. The project results will be disseminated through structured strategy implemented in collaboration with the Ministry of Health.

Trial registration details

This trial was registered with www.clinicaltrials.gov; registration number NCT04291482.