bluuebunny/crossref_metadata_2025 huggingface dataset:
An introgression breakthrough left by an anthropogenic contact between two ascidians
Authors: Le Moan Alan , Roby Charlotte , Fraïsse Christelle , Daguin‐Thiébaut Claire , Bierne Nicolas , Viard Frédérique
Published: September 2021

Human‐driven translocations of species have diverse evolutionary consequences such as promoting hybridization between previously geographically isolated taxa. This is well illustrated by the solitary tunicate, Ciona robusta, native to the North East Pacific and introduced in the North East Atlantic. It is now co‐occurring with its congener Ciona intestinalis in the English Channel, and C. roulei in the Mediterranean Sea. Despite their long allopatric divergence, first and second generation crosses showed a high hybridization success between the introduced and native taxa in the laboratory. However, previous genetic studies failed to provide evidence of recent hybridization between C. robusta and C. intestinalis in the wild. Using SNPs obtained from ddRAD‐sequencing of 397 individuals from 26 populations, we further explored the genome‐wide population structure of the native Ciona taxa. We first confirmed results documented in previous studies, notably (i) a chaotic genetic structure at regional scale, and (ii) a high genetic similarity between C. roulei and C. intestinalis, which is calling for further taxonomic investigation. More importantly, and unexpectedly, we also observed a genomic hotspot of long introgressed C. robusta tracts into C. intestinalis genomes at several locations of their contact zone. Both the genomic architecture of introgression, restricted to a 1.5 Mb region of chromosome 5, and its absence in allopatric populations suggest introgression is recent and occurred after the introduction of the non‐native species. Overall, our study shows that anthropogenic hybridization can be effective in promoting introgression breakthroughs between species at a late stage of the speciation continuum.
Tackling the challenge of treating obesity using design research methods: A scoping review
Authors: Elliott Andrea , Lang Sarah , Truby Helen , Brennan Linda , Gibson Simone
Published: September 2021

Design research methods, including user‐centered design, human‐centered design, and design thinking, are iterative processes and frameworks that engage stakeholders to inform the design of initiatives, programs, or research interventions. Design research methods are not yet widely applied in healthcare. To date, there is a limited understanding of how design research methodologies can be applied to develop client‐centered weight loss interventions. This scoping review explores the extent, range, and nature of research projects that used design research methods to guide the development of an obesity treatment intervention. A systematic search of eight databases identified projects that used design research methods to develop a weight loss intervention or strategy. The method and practical application of design research processes for each eligible article were extracted and explored. Design research methods were used to generate ideas or guide the development of a mobile application (n = 6), mHealth device (n = 1), eHealth solution (n = 1), health promotion program (n = 1), or patient–clinician communication tools (n = 2). There was considerable variation in the application of design research processes between studies. Design research methods may provide an iterative, flexible framework to facilitate the development of client‐centered, inclusive interventions and strategies. Design research methods may support research teams to move away from the one‐size‐fits‐all approach to obesity treatment.
Informed consent challenges and strategies: A qualitative study of the orthodontists’ perspective
Authors: Conduru Fernandes Moreira Narjara , Keenan Louanne , Cummings Greta , Flores‐Mir Carlos
Published: September 2021

Objective

To identify the barriers and strategies perceived by orthodontists when obtaining consent from their adult patients concerning patients’ comprehension or recollection of treatment information.

Settings and Sample Population

The sample comprised 12 orthodontists working in 8 different cities in Alberta, Canada.

Methods

An exploratory investigation using qualitative inquiry was conducted. Participants were recruited through a combination of purposive, maximum variation and snowball sampling. Data were collected through audio‐recorded, semi‐structured interviews until saturation was reached. Then, data were analysed using thematic analysis. Quality and credibility were achieved by employing member checks, memo writing and analyst triangulation strategies.

Results

Two major themes were identified, with subthemes: (1) Challenges that may interfere with patients’ comprehension and recollection of treatment information (i. patients’ internal barriers, ii. patients’ external barriers and iii. financial barriers); and (2) strategies to optimize information delivery and communication (i. tailoring the content to be delivered, ii. communication fashion, iii. communication timing and iv. being accommodative).

Conclusion

The participants reported barriers that may be overlooked in the daily routine of orthodontic practices. Information is provided that may guide orthodontists to overcome or minimize these challenges, increase patient comprehension and improve the quality of informed consent processes.
Attitudes of optometrists in the UK and Ireland to Digital Eye Strain and approaches to assessment and management
Authors: Moore Patrick A , Wolffsohn James S , Sheppard Amy L
Published: September 2021

Purpose

To investigate the attitudes and understanding of optometrists in the UK and Ireland towards Digital Eye Strain (DES), and to examine related practice patterns.

Methods

An anonymous online questionnaire was developed, covering attitude and understanding of DES, examination of patients who may be experiencing DES and approaches to management options. The questionnaire was promoted to UK and Ireland optometrists via professional bodies and local and area optometric committees.

Results

406 responses were included in the analysis. Most respondents agreed that DES was an important concern for optometrists (88.9%). 91.4% reported they felt confident in discussing possible symptoms of DES and management options; this was weakly and negatively associated with number of years qualified (rs = −0.198, p ≤ 0.001). Estimations of the proportion of patients affected by DES were lower than reports in the literature (median 25%, IQR 10%–50%). Most respondents always (60.6%) or frequently (21.9%) inquired about device usage in routine case history taking, and also asked follow‐up questions, although 29.3% only asked about the presence of symptoms half the time or less. Advising on regular breaks (84.0%), lubricants (55.7%) and environment/set up (69.2%) were felt to be extremely or very important by most respondents. Advising on specialist spectacle lenses, specifically blue filtering designs, was considered extremely or very important by 34.2% and 15.2%, respectively.

Conclusion

Given the agreement that DES is a significant issue causing frequent and persistent symptoms, and practitioners reported high levels of confidence in discussing DES, patients can expect to receive advice on symptoms and management from their optometrist. Simple management strategies were felt to be most important to advise on, with more uncertainty linked to specialist spectacle lenses.
Causal Accounts of Harming
Authors: Carlson Erik , Johansson Jens , Risberg Olle
Published: September 2021

A popular view of harming is the causal account (CA), on which harming is causing harm. CA has several attractive features. In particular, it appears well equipped to deal with the most important problems for its main competitor, the counterfactual comparative account (CCA). However, we argue that, despite its advantages, CA is ultimately an unacceptable theory of harming. Indeed, while CA avoids several counterexamples to CCA, it is vulnerable to close variants of some of the problems that beset CCA.
Cigarette smokers’ perceptions of smoking cessation and associated factors in Karachi, Pakistan
Authors: Barolia Rubina , Iqbal Sajid , Virani Salim S. , Khan Faris , Petrucka Pammla
Published: September 2021

Objectives

The study explored the perceptions of adult smokers with cardiovascular and respiratory diseases regarding cigarette smoking cessation. We also explored factors that may hinder or facilitate smoking cessation process.

Design

Qualitative descriptive exploratory design

Sample

Purposive sample of 13 adult smokers with cardiovascular or respiratory diseases visiting outpatient cardiac and respiratory clinics at a private tertiary care hospital

Measurements

In‐depth, face‐to‐face, and semi‐structured interviews were conducted. The interviews were digitally recorded and transcribed verbatim followed by a six steps process of manual thematic analysis of data.

Results

Meaningful statements were assigned codes and grouped into categories. Categories were clustered under three themes representing individual factors, socio‐cultural factors, and institutional factors.

Conclusions

Smoking cessation is influenced by personal, cultural, as well as social aspects. Institutionally, there is a need to recognize that smoking is a learned behavior; hence, prohibiting public smoking will potentially contribute to non‐smoking behaviors. Although the nature of misconceptions varies, this is imperative to ensure consistency in messaging, programming, and supports led by healthcare professionals.
Willingness to Pay for Status Signals in Online Luxury Markets
Authors: Yuan Yue , Deily Mary E. , Yao Yuliang
Published: September 2021

We study consumers’ valuation of status signals by estimating their willingness to pay for a luxury item with a quiet vs. a prominent logo. We collected data from two online markets on sales of two luxury handbags that differ principally in the prominence of their logo. We use these data to estimate the premium in consumers’ willingness to pay for the handbag with the quiet logo, and to estimate how the condition of the handbag affects that premium. We find consumers are willing to pay a sizeable premium of $161–$174, or 17%–18% of the retail price, for quiet handbags as compared to loud handbags. Furthermore, while consumers’ willingness to pay for both types of handbags is less for handbags in worse condition, it diminishes more rapidly with the worsening condition for quiet handbags. Our findings suggest that counter to conventional wisdom, consumers are willing to pay more for quietly marked luxury goods that allow them to signal a more targeted group of peers with similar cultural capital or social connectedness.
Six priorities to advance the science and practice of coral reef restoration worldwide
Authors: Vardi Tali , Hoot Whitney C. , Levy Jessica , Shaver Elizabeth , Winters R. Scott , Banaszak Anastazia T. , Baums Iliana B. , Chamberland Valérie F. , Cook Nathan , Gulko David , Hein Margaux Y. , Kaufman Les , Loewe Michelle , Lundgren Petra , Lustic Caitlin , MacGowan Petra , Matz Mikhail V. , McGonigle Miles , McLeod Ian , Moore Jennifer , Moore Tom , Pivard Sandrine , Pollock F. Joseph , Rinkevich Baruch , Suggett David J. , Suleiman Samuel , Viehman T. Shay , Villalobos Tatiana , Weis Virginia M. , Wolke Chelsea , Montoya‐Maya Phanor H.
Published: September 2021

Coral reef restoration is a rapidly growing movement galvanized by the accelerating degradation of the world's tropical coral reefs. The need for concerted and collaborative action focused on the recovery of coral reef ecosystems coalesced in the creation of the Coral Restoration Consortium (CRC) in 2017. In March 2020, the CRC leadership team met for a biennial review of international coral reef restoration efforts and a discussion of perceived knowledge and implementation bottlenecks that may impair scalability and efficacy. Herein we present six priorities wherein the CRC will foster scientific advancement and collaboration to: (1) increase restoration efficiency, focusing on scale and cost‐effectiveness of deployment; (2) scale up larval‐based coral restoration efforts, emphasizing recruit health, growth, and survival; (3) ensure restoration of threatened coral species proceeds within a population‐genetics management context; (4) support a holistic approach to coral reef ecosystem restoration; (5) develop and promote the use of standardized terms and metrics for coral reef restoration; and (6) support coral reef restoration practitioners working in diverse geographic locations. These priorities are not exhaustive nor do we imply that accomplishing these tasks alone will be sufficient to restore coral reefs globally; rather these are topics where we feel the CRC community of practice can make timely and significant contributions to facilitate the growth of coral reef restoration as a practical conservation strategy. The goal for these collective actions is to provide tangible, local‐scale advancements in reef condition that offset declines resulting from local and global stressors including climate change.
Restoration of a Lake Ontario‐connected fen through invasive Typha removal
Authors: Graham Andie , Mudrzynski Bradley , Polzer Eli , Wilcox Douglas A.
Published: September 2021

Lake‐level regulation that began in 1960 eliminated large fluctuations of Lake Ontario water levels, altering coastal wetland plant communities. More than a half century later, the altered hydroperiod supports dense, monotypic stands of invasive cattail (Typha angustifolia and Typha × glauca), which have diminished overall plant community diversity. As a result, Lake Ontario coastal wetlands are less capable of providing many of their traditional ecological functions. One such wetland is Buttonwood Fen, a floating, lake‐connected peatland on Lake Ontario's southern shore near Rochester, NY. We implemented cattail‐control measures from 2016 to 2018 with the goal of decreasing live and dead cattail biomass and increasing cover of native fen taxa. Site manipulation included removal of dead cattail biomass, cutting new cattail growth when rhizome carbohydrate reserves were at their lowest, and hand‐wicking regrowth with herbicide in early fall. Results showed a decrease in live cattail stem density and cover and dead biomass cover, as well as an increase in cover of fen taxa. Although not a replicated study, our results suggest that removing dead cattail biomass and targeted treatment of live cattail stems via cutting and hand‐wicking with glyphosate can reduce cattail and improve site quality.
Increasing Preparedness for Extreme Events using Plausibility‐Based Scenario Planning: Lessons from COVID‐19
Authors: Derbyshire James
Published: September 2021

A striking feature of COVID‐19 is many countries’ low level of preparedness for it, despite pandemics being a known threat. This raises a question as to the reasons for this underpreparedness. While preparedness should have better reflected pandemics’ long‐run inevitability and potentially catastrophic impact, government‐planning horizons are short term, and the attentiveness of policymakers is bounded and subject to multiple demands. Preparedness is therefore affected by the fundamental uncertainty surrounding the exact nature, timing, and impact of a pandemic. While a subjective probability is attributable to such an event's occurrence, just like it is any other, if founded on scant knowledge and perceived as being low it may inhibit preparedness. Under such circumstances, preparedness may be better served by a focus on plausibility. Moreover, any tendency for policymakers to disregard highly uncertain, low‐probability, yet highly impactful events of this type is exacerbated by their “fat‐tailed” distribution, which obscures their potential extremity. This article considers how plausibility‐based scenario planning can increase preparedness for extreme events like a global pandemic, thereby reducing overconfidence in continued business‐as‐usual in their face, and emphasizing precaution in their wake. In so doing, the article contributes to what in this journal has recently been called “type B,” “generic and fundamental” risk science, which is concerned with identifying better ways to present and communicate uncertainties. In focusing on plausibility‐based scenario planning, the article highlights a method seldom previously discussed in relation to risk science, yet one that can contribute much to this type B component of it.
Hemicellulose‐remodelling transglycanase activities from charophytes: towards the evolution of the land‐plant cell wall
Authors: Franková Lenka , Fry Stephen C.
Published: September 2021

Transglycanases remodel cell‐wall polymers, having a critical impact on many physiological processes. Unlike xyloglucan endotransglucosylase (XET) activity, widely studied in land plants, very little is known about charophyte wall‐modifying enzymes – information that would promote our understanding of the ‘primordial’ wall, revealing how the wall matrix is remodelled in the closest living algal relatives of land plants, and what changed during terrestrialisation. We conducted various in‐vitro assays for wall‐remodelling transglycosylases, monitoring either (a) polysaccharide‐to‐[3H]oligosaccharide transglycosylation or (b) non‐radioactive oligosaccharide‐to‐oligosaccharide transglycosylation. We screened a wide collection of enzyme extracts from charophytes (and early‐diverging land plants for comparison) and discovered several homo‐ and hetero‐transglycanase activities. In contrast to most land plants, charophytes possess high trans‐β‐1,4‐mannanase activity, suggesting that land plants’ algal ancestors prioritised mannan remodelling. Trans‐β‐1,4‐xylanase activity was also found, most abundantly in Chara, Nitella and Klebsormidium. Exo‐acting transglycosidase activities (trans‐β‐1,4‐xylosidase and trans‐β‐1,4‐mannosidase) were also detected. In addition, charophytes exhibited homo‐ and hetero‐trans‐β‐glucanase activities (XET, mixed‐linkage glucan [MLG]:xyloglucan endotransglucosylase and cellulose:xyloglucan endotransglucosylase) despite the paucity or lack of land‐plant‐like xyloglucan and MLG as potential donor substrates in their cell walls. However, trans‐α‐xylosidase activity (which remodels xyloglucan in angiosperms) was absent in charophytes and early‐diverging land plants. Transglycanase action was also found in situ, acting on endogenous algal polysaccharides as donor substrates and fluorescent xyloglucan oligosaccharides as acceptor substrates. We conclude that trans‐β‐mannanase and trans‐β‐xylanase activities are present and thus may play key roles in charophyte walls (most of which possess little or no xyloglucan and MLG, but often contain abundant β‐mannans and β‐xylans), comparable to the roles of XET in xyloglucan‐rich land plants.
Vtc5 Is Localized to the Vacuole Membrane by the Conserved AP-3 Complex to Regulate Polyphosphate Synthesis in Budding Yeast
Authors: Bentley-DeSousa Amanda , Downey Michael
Published: September 2021

Long polymers of inorganic phosphates called polyphosphates are ubiquitous across biological kingdoms. From bacteria to humans, they have diverse functions related to protein homeostasis, energy metabolism, and cell signaling.
Methylation of PhoP by CheR Regulates
Salmonella
Virulence
Authors: Su Yang , Li Jianhui , Zhang Wenting , Ni Jinjing , Huang Rui , Wang Zuoqiang , Cheng Sen , Wang Yue , Tian Zhixin , Zhou Qiuxiang , Lin Donghai , Wu Wenjuan , Tang Christoph M. , Liu Xiaoyun , Lu Jie , Yao Yu-Feng
Published: September 2021

Posttranslational modifications (PTMs) play an important role in regulating enzyme activities, protein-protein interactions, or DNA-protein recognition and, consequently, modulate many biological functions. We demonstrated that PhoP, the response regulator of PhoP/PhoQ two-component system, could be methylated on several evolutionally conserved amino acid residues.
Pivotal Roles for Ribonucleases in Streptococcus pneumoniae Pathogenesis
Authors: Sinha Dhriti , Frick Jacob P. , Clemons Kristen , Winkler Malcolm E. , De Lay Nicholas R.
Published: September 2021

Streptococcus pneumoniae
is a notorious human pathogen that adapts to conditions in distinct host tissues and responds to host cell interactions by adjusting gene expression. RNases are key players that modulate gene expression by mediating the turnover of regulatory and protein-coding transcripts.
MetaFunPrimer: an Environment-Specific, High-Throughput Primer Design Tool for Improved Quantification of Target Genes
Authors: Liu Jia , Villanueva Paul , Choi Jinlyung , Gunturu Santosh , Ouyang Yang , Tiemann Lisa K. , Cole James R. , Glanville Kathryn R. , Hall Steven J. , McDaniel Marshall D. , Lee Jaejin , Howe Adina
Published: September 2021

Amplification-based gene characterization allows for sensitive and specific quantification of functional genes. There is often a large diversity of genes represented for functional gene groups, and multiple primers may be necessary to target associated genes.
Single-Cell Transcriptome Sequencing and Proteomics Reveal Neonatal Ileum Dynamic Developmental Potentials
Authors: Meng Qingshi , Chen Liang , Xiong Bohui , Kang Beining , Zhang Pengfei , Tang Shanlong , Han Hui , Shen Wei , Feng Xiaohui , Feng Shengnan , Zhong Ruqing , Tang Xiangfang , Zhang Sheng , Zhang Hongfu , Zhao Yong
Published: September 2021

We found previously unknown neonatal ileum developmental potentials: specific increases in undifferentiated cells, unique enterocyte differentiation, and time dependent reduction in secretory cells. Specific transcriptional factors (TFs), ligand-receptor pairs, G protein-coupled receptors, transforming growth factor β, bone morphogenetic protein signaling pathways, and the gut mucosal microbiota are involved in this process.
Continental-Scale Paddy Soil Bacterial Community Structure, Function, and Biotic Interaction
Authors: Li Hong-Yi , Wang Hang , Tao Xin-Hua , Wang Xian-Zhe , Jin Wei-Zheng , Gilbert Jack A. , Zhu Yong-Guan , Zhang Zhi-Jian
Published: September 2021

Rice fields provide food for over half of the world’s human population. The ecology of paddy soil microbiomes is shaped by human activities, which can have a profound impact on rice yield, greenhouse gas emissions, and soil health.
Non-syndromic double upper lip with triple frena: cosmetic cheiloplasty
Authors: Gupta Monika , Vig Harshita , Kumar Yajas , Rizvi Aliza
Published: September 2021

Double lip or macrocheilitis is a rare facial anomaly, mostly congenital in origin. It commonly involves the upper lip than the lower lip. It may occur in isolation or as part of the Ascher’s syndrome. It results due to deposition of excessive areolar tissue and non-inflammatory hyperplasia of labial mucosa gland of pars villosa. It may be acquired as a result of injury to the lips or lip-biting habit. The double lip becomes conspicuous when the lips are retracted during smiling resulting in the characteristic ‘cupid’s bow’ appearance. This disfigurement can pose aesthetic and functional problems and may result in psychological distress. A surgical intervention is must for restoration of functions and to address the aesthetic concerns. The present article reports a case of non-syndromic double upper lip with triple labial frena and its surgical management with laser on one side and with scalpel on the other side.
Anal canal mixed adenoneuroendocrine carcinoma in a young patient misdiagnosed as anal abscess
Authors: Tutino Roberta , Battistella Enrico , Bonariol Luca , Massani Marco
Published: September 2021

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare tumours of gastrointestinal tract, extremely rare in anal canal. We report a case of misdiagnosed MiNEN in a 38-year-old woman initially conservatively treated for a supposed anal fistula. In a second proctological evaluation, biopsy of the anal neoformation was performed and the histological specimen diagnosed a MiNEN. The complete staging showed a disseminate disease and the patient started a chemotherapy schedule. After 6 months, stable disease was revealed at the last imaging performed and radical surgery was offered to the patient that is actually on oncological follow-up without recurrence at 1 year.
Essential Emergency and Critical Care: a consensus among global clinical experts
Authors: Schell Carl Otto , Khalid Karima , Wharton-Smith Alexandra , Oliwa Jacquie , Sawe Hendry R , Roy Nobhojit , Sanga Alex , Marshall John C , Rylance Jamie , Hanson Claudia , Kayambankadzanja Raphael K. , Wallis Lee A , Jirwe Maria , Baker Tim
Published: September 2021

Background

Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients are often overlooked in health systems. Essential Emergency and Critical Care (EECC) has been devised as the care that should be provided to all critically ill patients in all hospitals in the world. EECC includes the effective care of low cost and low complexity for the identification and treatment of critically ill patients across all medical specialties. This study aimed to specify the content of EECC and additionally, given the surge of critical illness in the ongoing pandemic, the essential diagnosis-specific care for critically ill patients with COVID-19.

Methods

In a Delphi process, consensus (>90% agreement) was sought from a diverse panel of global clinical experts. The panel iteratively rated proposed treatments and actions based on previous guidelines and the WHO/ICRC’s Basic Emergency Care. The output from the Delphi was adapted iteratively with specialist reviewers into a coherent and feasible package of clinical processes plus a list of hospital readiness requirements.

Results

The 269 experts in the Delphi panel had clinical experience in different acute medical specialties from 59 countries and from all resource settings. The agreed EECC package contains 40 clinical processes and 67 requirements, plus additions specific for COVID-19.

Conclusion

The study has specified the content of care that should be provided to all critically ill patients. Implementing EECC could be an effective strategy for policy makers to reduce preventable deaths worldwide.
Chronic pain and mental health problems among Syrian refugees: associations, predictors and use of medication over time: a prospective cohort study
Authors: Strømme Elisabeth Marie , Igland Jannicke , Haj-Younes Jasmin , Kumar Bernadette Nirmal , Fadnes Lars T , Hasha Wegdan , Diaz Esperanza
Published: September 2021

Objectives

This study aims to examine associations, predictors and pharmacological treatment of chronic pain and mental health problems among Syrian refugees in a longitudinal perspective.

Design

Prospective cohort study.

Setting

We collected survey data among Syrian refugees in Lebanon granted resettlement to Norway (self-administered questionnaires) and at follow-up 1 year after arrival in Norway (structured telephone interviews).

Participants

Adult Syrian refugees attending mandatory pretravel courses in Lebanon in 2017–2018 were invited to participate. In total, 353 individuals participated at both time points.

Primary and secondary outcomes

We examined the cross-sectional associations between pain, mental health and migration-related exposures at baseline and follow-up and assessed whether associations changed significantly with time. Furthermore, we investigated the longitudinal association between mental health at baseline and pain at follow-up. We also evaluated temporal changes in use of analgesics and psychotropic drugs.

Results

While most refugees reported improved health from the transit phase in Lebanon to the early resettlement phase in Norway, a few had persisting and intertwined health problems. Most migration-related stressors were more closely associated with chronic pain and mental health problems after resettlement as compared with the transit phase. In parallel, poor mental health was associated with chronic pain in the follow-up (adjusted risk ratio (ARR) 1.5 (1.0, 2.2)), but not at baseline (ARR 1.1 (0.8, 1.5)). Poor mental health at baseline was a statistically significant predictor of chronic pain at follow-up among thosenotreporting chronic pain at baseline. At both timepoints, one in four of those with chronic pain used analgesics regularly. None with mental health problems used antidepressants daily.

Conclusions

Providers of healthcare services to refugees should be attentive to the adverse effect of postmigration stressors and acknowledge the interrelations between pain and mental health. Possible gaps in pharmacological treatment of pain and mental health problems need further clarification.
Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review
Authors: Simon-Pimmel Jeanne , Foucher Yohann , Léger Maxime , Feuillet Fanny , Bodet-Contentin Laetitia , Cinotti Raphaël , Frasca Denis , Dantan Etienne
Published: September 2021

Objectives

Patients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to methodologically assess prognostic tools for functional outcomes in severe spontaneous intracranial haemorrhages.

Data sources

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we conducted a systematic review querying Medline, Embase, Web of Science, and the Cochrane in January 2020.

Study selection

We included development or validation of multivariate prognostic models for severe intracerebral or subarachnoid haemorrhage.

Data extraction

We evaluated the articles following the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies and Transparent Reporting of multivariable prediction model for Individual Prognosis Or Diagnosis statements to assess the tools’ methodological reporting.

Results

Of the 6149 references retrieved, we identified 85 articles eligible. We discarded 43 articles due to the absence of prognostic performance or predictor selection. Among the 42 articles included, 22 did not validate models, 6 developed and validated models and 14 only externally validated models. When adding 11 articles comparing developed models to existing ones, 25 articles externally validated models. We identified methodological pitfalls, notably the lack of adequate validations or insufficient performance levels. We finally retained three scores predicting mortality and unfavourable outcomes: the IntraCerebral Haemorrhages (ICH) score and the max-ICH score for intracerebral haemorrhages, the SubArachnoid Haemorrhage International Trialists score for subarachnoid haemorrhages.

Conclusions

Although prognostic studies on intracranial haemorrhages abound in the literature, they lack methodological robustness or show incomplete reporting. Rather than developing new scores, future authors should focus on externally validating and updating existing scores with large and recent cohorts.
Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
Authors: Li Yajia , Jing Danrong , Huang Yuzhou , Su Juan , Li Jie , Li Ji , Tao Juan , Shan Shijun , Wang Xiaohui , Kang Xiaojing , Wu Bin , Chen Xiang , Shen Minxue , Xiao Yi
Published: September 2021

Background

Overuse and misuse of antibiotics is a public health problem in low-income and middle-income countries. Although the association of antibiotics with atopic and allergic diseases has been established, most studies focused on prenatal exposure and the occurrence of disease in infants or young children.

Objective

To investigate the association of preschool use of antibiotics with atopic and allergic skin diseases in young adulthood.

Design

Population-based retrospective cohort.

Setting and participants

The first-year college students (n=20 123) from five universities were investigated. The sampled universities are located in Changsha, Wuhan, Xiamen, Urumqi and Hohhot, respectively.

Methods

We conducted a dermatological field examination and a questionnaire survey inquiring the participants about the frequency of upper respiratory tract infection (URTI) and the preschool antibiotics use (prior to 7 years old). The two-level probit model was used to estimate the associations, and adjusted risk ratio (aRR) and 95% CI were presented as the effect size.

Results

A total of 20 123 participants with complete information was included in the final analysis. The frequent antibiotics use intravenously (aRR 1.36, 95% CI 1.14 to 1.62) and orally (aRR 1.18, 95% CI 1.01 to 1.38) prior to 7 years old was significantly associated with atopic dermatitis in young adulthood. Similar trends could be observed in allergic skin diseases among those who use antibiotics orally and intravenously, with RRs of 1.16 (95% CI 1.01 to 1.34) and 1.33 (95% CI 1.13 to 1.57), respectively.

Conclusions

Preschool URTI and antibiotics use significantly increases the risk of atopic and allergic skin diseases in young adulthood.
A continuous PREMs and PROMs Observatory for elective hip and knee arthroplasty: study protocol
Authors: De Rosis Sabina , Pennucci Francesca , Lungu Daniel Adrian , Manca Mario , Nuti Sabina
Published: September 2021

Introduction

Scholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). This protocol describes the methodology behind an innovative observatory implemented in Tuscany, Italy, aiming at continuously and longitudinally collecting PROMs and PREMs for elective hip and knee total replacement.

Methods and analysis

The Observatory is digital. Enrolled patients are invited via SMS or email to online questionnaires, which include the Oxford Hip Score or the Oxford Knee Score. Data are real-time reported to healthcare professionals and managers in a raw format, anonymised and aggregated on a web platform. The data will be used to investigate the relationship between the PROMs trend and patients’ characteristics, surgical procedure, hospital characteristics, and PREMs. Indicators using patient data will be computed, and they will integrate the healthcare performance evaluation system adopted in Tuscany.

Ethics and dissemination

The data protection officers of local healthcare organisations and the regional privacy office framed the initiative referring to the national and regional guidelines that regulate patient surveys. The findings will be reported both in real time and for publication in peer-reviewed journals.
Prevalence and risk factors for SARS-CoV-2 infection in children with and without symptoms seeking care in Managua, Nicaragua: results of a cross-sectional survey
Authors: Huete-Pérez Jorge A , Ernst Kacey C , Cabezas-Robelo Cristiana , Páiz-Medina Lucia , Silva Sheyla , Huete Alejandra
Published: September 2021

Objective

This study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (≤18 years) seeking medical care, between 6 October and 16 November 2020.

Design

In this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures.

Setting

Research was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic.

Participants

Children were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19.

Results

A high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative; OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative; OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms.

Conclusions

This is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.
Exploration of the psychometric properties of the Person-Centred Primary Care Measure (PCPCM) in a Chinese primary care population in Hong Kong: a cross-sectional validation study
Authors: Tse Emily Tsui Yee , Lam Cindy Lo Kuen , Wong Carlos King Ho , Chin Weng Yee , Etz Rebecca S , Zyzanski Stephen J , Stange Kurt C
Published: September 2021

Objectives

To evaluate the validity and psychometric properties of the Chinese Person-Centred Primary Care Measure (PCPCM) in a Chinese-speaking population.

Design

A cross-sectional study.

Setting

A primary care clinic in Hong Kong.

Participants

300 Chinese adult patients (150 males and 150 females) were recruited from a primary care clinic to complete a questionnaire containing the PCPCM, Consultation and Relational Empathy (CARE), Patient Enablement Index (PEI) and Adult (short version) Primary Care Assessment Tool (PCAT). The Chinese PCPCM was readministered to 118 participants after 14 days for test–retest reliability.

Outcome measures

The construct validity, reliability and sensitivity of the Chinese PCPCM.

Results

The Chinese PCPCM was identified to have a one-factor construct, with good item fit and unidimensionality on Rasch analysis. Internal reliability was high (Cronbach’s alpha >0.8) with moderate test–retest reliability (intraclass correlation coefficient=0.622, p<0.001). Significant correlations (0.58, 0.42, 0.48) between the PCPCM and CARE, PEI and Adult (short version) PCAT scores supported good convergent construct validity. PCPCM scores were higher among patients who had known their doctors for a longer period or who were more likely to be able to see the same doctor at every visit, and among those who self-reported to have ‘better health’ rather than ‘worse health’.

Conclusion

The Chinese PCPCM appears to be a valid, reliable and sensitive instrument for evaluating the quality of person-centred care among primary care patients in Hong Kong. Further studies are needed to confirm the utility of this instrument in other Chinese-speaking populations around the world.
Heated tobacco product use and hypertensive disorders of pregnancy and low birth weight: analysis of a cross-sectional, web-based survey in Japan
Authors: Zaitsu Masayoshi , Hosokawa Yoshihiko , Okawa Sumiyo , Hori Ai , Kobashi Gen , Tabuchi Takahiro
Published: September 2021

Objectives

Knowledge on the impact of heated tobacco product (HTP) use in pregnant women with associated maternal and neonatal risks for hypertensive disorders of pregnancy (HDP) and low birth weight (LBW) is limited. We aimed to assess the status of HTP use among pregnant women in Japan and explore the association of HTP use with HDP and LBW.

Design

Cross-sectional study.

Setting

Data from the Japan ‘COVID-19 and Society’ Internet Survey study, a web-based nationwide survey.

Participants

We investigated 558 postdelivery and 365 currently pregnant women in October 2020.

Primary and secondary outcome measures

Information on HDP and LBW was collected from the postdelivery women’s Maternal and Child Health Handbooks (maternal and newborn records). We estimated the age-adjusted ORs and 95% CIs of ever HTP smokers for HDP and LBW and compared them with those of never HTP smokers in a logistic regression analysis.

Results

The prevalence of ever and current HTP use were 11.7% and 2.7% in postdelivery women and 12.6% and 1.1% in currently pregnant women, respectively. Among currently pregnant women who were former combustible cigarette smokers, 4.4% (4/91) were current HTP smokers. Among postdelivery women, ever HTP smokers had a higher HDP incidence (13.8% vs 6.5%, p=0.03; age-adjusted OR=2.48, 95% CI 1.11 to 5.53) and higher LBW incidence (18.5% vs 8.9%, p=0.02; age-adjusted OR=2.36, 95% CI 1.16 to 4.87).

Conclusions

In Japan, the incidence of ever HTP use exceeded 10% among pregnant women, and HTP smoking may be associated with maternal and neonatal risks.
Effectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis: protocol for a randomised controlled trial (HED-Start)
Authors: Griva Konstadina , Chia Jace Ming Xuan , Goh Zack Zhong Sheng , Wong Yen Peng , Loei Job , Thach Thuan Quoc , Chua Wei Bin , Khan Behram A
Published: September 2021

Introduction

Initiation onto haemodialysis is a critical transition that entails multiple psychosocial and behavioural demands that can compound mental health burden. Interventions guided by self-management and cognitive–behavioural therapy to improve distress have been variably effective yet are resource-intensive or delivered reactively. Interventions with a focus on positive affect for patients with end-stage kidney disease are lacking. This study will seek (1) to develop a positive life skills intervention (HED-Start) combining evidence and stakeholder/user involvement and (2) evaluate the effectiveness of HED-Start to facilitate positive life skills acquisition and improve symptoms of distress and adjustment in incident haemodialysis patients.

Methods and analysis

This is a single/assessor-blinded randomised controlled trial (RCT) to compare HED-Start to usual care. In designing HED-Start, semistructured interviews, a codesign workshop and an internal pilot will be undertaken, followed by a two-arm parallel RCT to evaluate the effectiveness of HED-Start. A total of 148 incident HD patients will be randomised using a 1:2 ratio into usual care versus HED-Start to be delivered in groups by trained facilitators between January 2021 and September 2022. Anxiety and depression will be the primary outcomes; secondary outcomes will be positive and negative affect, quality of life, illness perceptions, self-efficacy, self-management skills, benefit finding and resilience. Assessments will be taken at 2 weeks prerandomisation (baseline) and 3 months postrandomisation (2 weeks post-HED-Start completion). Primary analyses will use an intention-to-treat approach and compare changes in outcomes from baseline to follow-up relative to the control group using mixed-effect models.

Ethics and dissemination

Ethics approval was obtained from Nanyang Technological University Institutional Review Board (IRB-2019-01-010). Written informed consent will be obtained before any research activities. Trial results will be disseminated via publications in peer-reviewed journals and conference presentations and will inform revision(s) in renal health services to support the transition of new patients to haemodialysis.

Trial registration number

NCT04774770.
Mental health in the second year of the COVID-19 pandemic: protocol for a nationally representative multilevel survey in Serbia
Authors: Marić Nadja P , Lazarević Ljiljana B , Mihić Ljiljana , Pejovic Milovancevic Milica , Terzić Zorica , Tošković Oliver , Todorović Jovana , Vuković Olivera , Knezevic Goran
Published: September 2021

Introduction

The COVID-19 pandemic is likely to have a prolonged impact on mental health (MH); however, the long-term MH effects of the COVID-19 pandemic remain unknown. The Serbian national survey—CoV2Soul.RS—was launched to document the MH status of the Serbian population following the COVID-19 pandemic and to contribute to an international evidence base about MH prevalence rates during different phases of the pandemic.

Methods and analysis

This cross-sectional study was designed to collect a nationally representative sample (N=1200; age 18–65 years; estimated start/end—June/November 2021) using multistage probabilistic household sampling. Trained staff will conduct in-person diagnostic interviews. A battery of self-report instruments will be administered to assess the quality of life (QoL), general distress and associated protective and harmful psychological and societal factors. Analyses will be conducted to delineate the prevalence rates of MH disorders, how MH conditions and QoL vary with respect to sociodemographic variables, personality, health status and traumatic events during the COVID-19 pandemic, and to test how these relations depend on geographical region. Moreover, this study was designed to explore mechanisms linking personality and the perception of pandemic consequences and associated distress. Prevalence rates of MH disorders will be calculated using descriptive statistics. For additional analyses, we will use correlations, analysis of variance and regression analyses. The hierarchical structure of the data will be explored using multilevel random coefficient modelling. Structural equation modelling will be used to investigate the indirect effects of personality on distress through relevant variables.

Ethics and dissemination

Ethical Committees of the Faculty of Medicine (1322-VII/31) and Faculty of Philosophy in Belgrade (02-33/273) and Faculty of Philosophy in Novi Sad (05-27, br.893/1) approved the protocol. Only respondents able to provide informed consent will participate in the study. Research reports will be submitted to peer-reviewed journals and the results will be placed on the websitewww.cov2soul.rsto be available to funders, researchers, policy-makers and interested laypeople, and will be advertised through social media.

Trial registration number

NCT04896983.