bluuebunny/crossref_metadata_2025 huggingface dataset:
Pliocene growth of the Dowlatabad syncline in Frontal Fars arc: Folding propagation across the Zagros Fold Belt, Iran
Authors: Najafi Mahdi , Beamud Elisabet , Ruh Jonas , Mouthereau Frédéric , Tahmasbi Alireza , Bernaola Gilen , Yassaghi Ali , Motamedi Hossein , Sherkati Shahram , Goodarzi Mohammad Ghasem Hassan , Vergés Jaume
Published: November 2020

The integration of biostratigraphy, strontium isotope stratigraphy, and magnetostratigraphy allowed for the precise dating of the >3.0-km-thick marine to non-marine foreland sedimentary succession within the Dowlatabad growth syncline along the Frontal Fars arc in the Zagros Fold Belt that extends from eastern Turkey to southern Iran. This area was the missing link to complete the dating of syntectonic deposits in the Fars arc and quantify the migration of sedimentary belts as well as the propagation of folding across the entire Mesopotamian foreland basin. Both are essential for defining the interplay of basin evolution and sequence of folding.

Deposition of the foreland marine marls in the Mishan Formation started at ca. 11.5 Ma. The transition to a non-marine basin infill occurred at 4.9 Ma by the progradation of thick fluvial deposits of the Aghajari Formation with a fast accumulation rate of 63 cm/k.y. The beginning of growth strata deposition and thus the onset of folding in the Dowlatabad syncline is dated at 4.65 Ma. The first appearance of carbonate conglomerates sourced from the Guri limestone at 2.8 Ma marked the progressive dismantling of the nearby growing anticlines. The tectonic deformation in the front of the Fars arc was active for at least 2.85 m.y. and ceased at 1.8 Ma before the deposition of the discordant and slightly folded Bakhtyari conglomerates characterized by a clast composition derived from the Zagros hinterland.

The compilation of magnetostratigraphic ages reveals that both the migration of the Aghajari-Bakhtyari sedimentary belts and the propagation of the folding front was in-sequence toward the foreland at a rate close to 20 mm/yr in the Fars arc and 15 mm/yr in the Lurestan arc, in the last 20 m.y. These high rates of folding propagation are about one order of magnitude larger than age equivalent shortening rates (∼4 mm/yr in Fars arc and ∼2 mm/yr in Lurestan arc) and thus imply an efficient detachment level at the base of the deformed Arabian sedimentary cover.

Numerical experiments on both the cover and basement sequences are designed to test the influence of inherited basement structures on the deformation propagation within the cover sequence, providing clues on the partly coeval in-sequence deformation of the Zagros Simply Folded Belt and the local out-of-sequence Mountain Frontal Fault system as illustrated by regional and local geology.
Identification of Jurassic mafic arc magmatism in the eastern North China Craton: Geochemical evidence for westward subduction of the Paleo-Pacific slab
Authors: Fang Wei , Dai Li-Qun , Zheng Yong-Fei , Zhao Zi-Fu , Ma Li-Tao , Zhao Kai
Published: November 2020

Subduction of the Paleo-Pacific slab beneath the North China Craton (NCC) has exerted a strong influence on the Mesozoic destruction of the craton. However, no Andean-type arc magmatism has been reliably identified in the eastern NCC. Here we report the occurrence of Jurassic arc-like lamprophyres in the Liaodong Peninsula, providing a snapshot of the Paleo-Pacific slab subduction beneath the NCC in the early Mesozoic. Zircon U-Pb dating of the lamprophyres yields consistent ages of 158–155 Ma for magma crystallization. These lamprophyres all exhibit typical arc-like trace element distribution patterns, but show a series differences in their radiogenic isotope compositions and the other geochemical variables. Type 1 lamprophyres exhibit weakly enriched Sr-Nd-Hf isotopes with (87Sr/86Sr)i ratios of 0.7075–0.7085, εNd(t) values of −3.9 to −1.3 and εHf(t) values of −5.4 to −0.3, whereas Type 2 lamprophyres exhibit moderately enriched radiogenic isotopes with (87Sr/86Sr)i ratios of 0.7096–0.7117, εNd(t) values of −12.2 to −7.6 and εHf(t) values of −12.8 to −4.7. There are also systematic differences in zircon Hf isotopes and whole-rock Ba/Th, Ba/La, Sr/Nd, Th/Nd, Th/Yb, and La/Sm ratios for the two types of lamprophyre. Taken together, these similarities and differences can be accounted for by metasomatic reaction of the cratonic mantle wedge with two properties of liquid phase derived from subducting Paleo-Pacific slab. One is aqueous solutions from the subducting basaltic oceanic crust, and the other is hydrous melts from the subducting terrigenous. The two properties of subduction zone fluids were incorporated in different proportions into the mantle sources of these lamprophyres. Accordingly, the lamprophyres were derived from the metasomatic mantle sources. This qualitative interpretation is verified by quantitative modeling of the geochemical transfer at the slab-mantle interface in a paleo-oceanic subduction zone. Therefore, the Jurassic lamprophyres in the eastern NCC provide the geochemical evidence for the crust-mantle interaction during the Paleo-Pacific slab subduction beneath eastern Asia in the early Mesozoic, when the chemical metasomatism by the slab-derived fluids would have weakened the cratonic mantle for its thinning and destruction in the Early Cretaceous.
Recycling of mercury from the atmosphere-ocean system into volcanic-arc–associated epithermal gold systems
Authors: Deng Changzhou , Sun Guangyi , Rong Yimeng , Sun Ruiyang , Sun Deyou , Lehmann Bernd , Yin Runsheng
Published: November 2020

Photochemical processes generate mass-independent fractionation (MIF) of mercury (Hg) isotopes in the atmosphere-ocean system, and the subduction of marine sediments or hydrated oceanic crust may recycle the resultant Hg isotope signature into the volcanic-arc environment. This environment typically hosts epithermal gold deposits, which are characterized by a specific Hg-Sb-As metal association. We investigated the Hg isotopic composition of seven volcanic-arc–related epithermal gold deposits in northeast China and revisited the isotopic composition of Hg in hydrothermal ore deposits in circum-Pacific and Mediterranean volcanic arcs. The gold ore samples in northeast China mostly display positive Δ199Hg values (0.11‰ ± 0.07‰, 1σ, n = 48) similar to those observed in the Pacific Rim (0.07‰ ± 0.09‰, 1σ, n = 182) and the Mediterranean Cenozoic volcanic belt (0.09‰ ± 0.08‰, 1σ, n = 9). Because Hg in marine sediments and seawater has positive Δ199Hg, we infer that Hg-bearing epithermal deposits in active continental margin settings receive most Hg from recycled seawater in marine sediments, through the release of Hg by dehydration from the subducting oceanic slab. However, negative to near-zero Δ199Hg values were observed in Hg-bearing deposits in the South China craton (−0.09‰ ± 0.05‰, 1σ, n = 105) and in the intraplate magmatic-hydrothermal Almadén Hg deposit in Spain (−0.02‰ ± 0.06‰, 1σ, n = 26), which are considered to relate to basement and mantle sources, respectively. Hg isotopes have the potential to trace lithospheric Hg cycling.
The “earliest tabulate corals” are not tabulates
Authors: Elias Robert J. , Lee Dong-Jin , Pratt Brian R.
Published: November 2020

Putative tabulate-like corals dating to the Cambrian Explosion are not true tabulates. Early Ordovician fossils identified as Lichenaria and previously accepted as the earliest tabulate corals actually belong to Amsassia, which may be a calcareous alga. The earliest definite tabulates appeared in the latest Middle Ordovician as part of the Great Ordovician Biodiversification Event, prior to the earliest confirmed occurrence of tabulate species that do belong to Lichenaria in the Late Ordovician. With Cambrian (Epoch 2) tabulate-like fossils being separated from the appearance of true tabulates by a time span of ∼50 m.y., a direct phylogenetic connection is unlikely. Thus, the prevailing understanding of the origin and evolutionary history of tabulate corals needs to be reconsidered. The appearance of both major groups of Paleozoic corals, tabulates and rugosans, at the same time on separate paleocontinents must be taken into account in determining biological and geological factors involved in the Great Ordovician Biodiversification Event.
Management of pregnancy in case of multiple and giant uterine fibroids
Authors: Reis-de-Carvalho Catarina , Lopes João , Henriques Alexandra , Clode Nuno
Published: November 2020

Uterine fibroids are common among women of reproductive age. During the pregnancy, the potential complications of fibroids, although rare, are of frequent clinical concern. Available studies describing management and obstetrical outcomes in pregnant women with giant fibroids are limited. We present the case of a 39-year-old pregnant woman with multiple and large uterine fibroids. During the pregnancy, there was adequate fetal development, without major maternal complications. Given the characteristics of the fibroids and breech position of the fetus, an elective caesarean section was decided, and postpartum hysterectomy planned. This challenging obstetrical case required a multidisciplinary approach.

We considered crucial discussing five main issues: preconceptional counselling, tailored pregnancy surveillance, decision of time and route of delivery, decision to perform a peripartum hysterectomy and management of decreasing blood loss perioperatively. Given the limitation of the published reports, we believe that sharing our experience, along with a literature review, is beneficial for other clinicians.
Significance of specialised preconception counselling in oocyte donation pregnancy with prior history of postpartum eclampsia
Authors: van Bentem Kim , Lashley Lisa , van der Hoorn Marie-Louise
Published: November 2020

A well-known complication in oocyte donation (OD) pregnancy is preeclampsia. Here, we present a 31-year-old woman, pregnant after OD. She conceived by the reception of the oocyte from her partner (ROPA) and sperm from a sperm donor. She developed preeclampsia with severe features, necessitating caesarean delivery at 29 weeks’ gestation due to deterioration of her clinical condition. Admission at the intensive care unit postpartum was necessary, because of recurrent postpartum eclampsia and administration of high dose magnesium sulphate for convulsion prophylaxis. This case illustrates the importance of preconception counselling for patients who are considering to conceive by OD and double gamete donation. In this specific case an alternative way to conceive was available. However, ROPA was preferred as part of shared lesbian motherhood. The risk of complications in the subsequent pregnancy has led to an alternative decision to accomplish a second pregnancy.
Minimally invasive repair of right-sided blunt traumatic diaphragmatic injury
Authors: Shichiri Keiko , Imamura Kiyotaka , Takada Minoru , Anbo Yoshiyasu
Published: November 2020

Right-sided blunt traumatic diaphragmatic injury (TDI) is a rare injury that is rarely repaired by the minimally invasive approach in the acute setting. Laparoscopic repair of right-sided TDI is challenging because the liver often obstructs access to the injury site. Herein, we report a case wherein acute right-sided blunt TDI was successfully repaired using a combined laparoscopic and thoracoscopic approach. A 30-year-old man presented with shortness of breath after falling on his back while jumping on a snowboard. CT revealed a right-sided TDI. As the patient was haemodynamically stable, laparoscopic repair was planned. Laparoscopy revealed a right-sided diaphragmatic rupture. As the posterior portion was covered by the liver and difficult to access, we added trocars in the chest cavity and closed the diaphragmatic defect with a thoracic approach. A combined laparoscopic and thoracoscopic approach can repair right-sided diaphragmatic injury by a minimally invasive approach even in the acute setting.
Prenatal diagnosis of truncus arteriosus with interrupted aortic arch and abnormal limbs due to an umbilical cord amniotic band: rare entities with an unusual association
Authors: Guarque-Rus Albert , Martín-González Lourdes , Puerto-Tamayo Linda Grace , Landeyro Julieta
Published: November 2020

Truncus arteriosus, interrupted aortic arch and amniotic band syndrome are rare conditions. We report a case of a 38-year-old pregnant woman who was diagnosed on a routine morphological ultrasound scan with a Van Praagh type A4 persistent truncus arteriosus with an aortic arch interruption type B and abnormal limbs (oedematous left hand, hypoplastic fingers on the right hand and right big toe amputation). Elective termination of the pregnancy was carried out and the pathological examination confirmed all the sonographic findings. Furthermore, an amniotic band parallel to the umbilical cord undetected during the ultrasound scans was revealed, and was entangled around the right hand, left wrist and the umbilical cord, causing strangulation. We present the unusual association of these independent pathologies and emphasise the usefulness of fetal autopsy in all cases of pregnancy termination and abnormal ultrasound findings to make the complete diagnosis.
Idiopathic multicentric Castleman disease preceded by cutaneous plasmacytosis successfully treated by tocilizumab
Authors: Aita Tetsuro , Hamaguchi Sugihiro , Shimotani Yoko , Nakamoto Yohei
Published: November 2020

A woman aged 45 years with a 1.5-year history of violaceous plaques on the forehead and chest presented with fever, weight loss and aggravation of the plaques. Inflammatory markers and interleukin-6 level were elevated, and superficial lymphadenopathies and splenomegaly were identified by CT scan. Immunohistochemical findings of the lymph node and the skin showed polyclonal plasmacytosis and follicular hyperplasia, leading to the diagnosis of idiopathic multicentric Castleman disease (iMCD) after human herpesvirus-8 infection was excluded. The patient was successfully treated with anti-interleukin-6 receptor antibody, tocilizumab, following relapse after prednisolone therapy.

Our literature review found 11 case reports of pathologically confirmed iMCD preceded by cutaneous plasmacytosis. The median duration of asymptomatic phase with only skin lesions was 7.5 years, whereas the phase lasted only for 1.5 years in our case. iMCD can develop shortly after asymptomatic cutaneous plasmacytosis. Tocilizumab can be a treatment of choice for this type of iMCD.
Amiodarone-induced neuromyopathy in a geriatric patient
Authors: Stanton Michael Mark , Samii Leyla , Leung Gentson , Pearce Paula
Published: November 2020

Amiodarone is an antiarrhythmic medication with many side effects. Neuromyopathy is a rare adverse effect. We present an 87-year-old woman with bilateral leg pain and weakness in the context of amiodarone. She was admitted to the Acute Geriatric Unit in Calgary, Alberta, Canada. On examination, hip flexor and extensor strength were 2/5 bilaterally while knee flexor and extensor strength were 4/5 and 3/5, respectively. Creatine kinase and C-reactive protein levels were normal. MRI of the lumbar spine showed mild central canal stenosis. Electromyography and nerve conduction testing showed a severe axonal length-dependent polyneuropathy of the left lower extremity. There was evidence of myopathic changes to the left iliopsoas muscle. Overall, a neuromyopathic process affecting the lower extremities was supported. After discontinuation of amiodarone, mobility and function significantly improved. Although a rare complication of amiodarone, neuromyopathy should be considered in patients with compatible symptomatology.
Managing traumatic testicular dislocations: what we know after two centuries
Authors: Subramaniam Sentilnathan , Ab Khalil Muhammad Khairil , Zakaria Jasiah , Hayati Firdaus
Published: November 2020

Traumatic testicular dislocation (TTD) is a rare consequence of blunt scrotal trauma. A 21-year old gentleman presented with inguinal pain following a motorcycle accident and physical examination revealed absence of both testes within a well-formed scrotal sac with bilateral inguinal swellings. Ultrasonography confirmed viability and location of the testes at the superficial inguinal pouch. He underwent emergent surgical reduction with orchidopexy and was discharged the next day. No evidence of testicular dysfunction or atrophy was noted at follow-up. We reviewed reports of TTDs reported in English over the last two centuries and discuss its occurrence, evolution and management.
Continuous acellular material accumulation in the anterior chamber associated with corneal endothelial changes
Authors: Shimazaki Jun , Den Seika , Satake Yoshiyuki , Higa Kazunari
Published: November 2020

This case series included two healthy adults who showed continuous production of acellular materials in the anterior chamber without inflammation. The materials were membrane-like in case 1 and amorphous in case 2; they gradually changed shape and location over several years. During follow-up, there were no changes in vision, the iris or the chamber angle. Anterior segment optical coherence tomography confirmed the attachment of the membrane to the corneal endothelium. Specular microscopy showed normal endothelial counting with reversal of the normal light/dark patterns that occasionally returned to normal appearances. Although acellular materials were observed unilaterally in both cases, abnormal endothelial images were noted in both eyes of case 1. Histopathological examinations demonstrated the absence of cellular components with negative immunostaining for collagen IV, vimentin and α-smooth muscle actin. Serial ophthalmic examinations and histopathological findings suggest that the production of acellular material was associated with alterations of the corneal endothelium.
Extended pulsed radiofrequency as a part of multimodal pain management in a refractory case of Bernhardt-Roth syndrome
Authors: Mishra Priyanka , Tandon Shipra , Nath Amborish
Published: November 2020

Bernhardt-Roth syndrome (BRS) is a neurological condition characterised by pain, burning or numbness in anterolateral thigh due to entrapment of the lateral femoral cutaneous nerve (LFCN). The possible aetiologies can be mechanical, iatrogenic, neuropathic or idiopathic. After consent for possible publication, we are discussing a case of pain management in a 38-year-old patient with BRS secondary to diabetes. The coherent history, uncontrolled glycaemic status and reduced nerve conduction velocity for LFCN helped reach the diagnosis. Initial treatment with pharmacotherapy, steroid LFCN block and conventional pulsed radiofrequency (PRF) provided moderate temporary pain relief. Extended PRF over 8 min provided significant analgesia without any complications. Physical therapy, adequate glycaemic control and extended PRF provided complete pain relief and improved function over 6 months of follow-up duration. Hence, a cautious multifaceted approach targeting the basic aetiology with extended PRF helped achieve significant analgesia in our refractory case of BRS.
Availability and affordability of medicines and cardiovascular outcomes in 21 high-income, middle-income and low-income countries
Authors: Chow Clara Kayei , Nguyen Tu Ngoc , Marschner Simone , Diaz Rafael , Rahman Omar , Avezum Alvaro , Lear Scott A , Teo Koon , Yeates Karen E , Lanas Fernando , Li Wei , Hu Bo , Lopez-Jaramillo Patricio , Gupta Rajeev , Kumar Rajesh , Mony Prem K , Bahonar Ahmad , Yusoff Khalid , Khatib Rasha , Kazmi Khawar , Dans Antonio L , Zatonska Katarzyna , Alhabib Khalid F , Kruger Iolanthe Marike , Rosengren Annika , Gulec Sadi , Yusufali Afzalhussein , Chifamba Jephat , Rangarajan Sumathy , McKee Martin , Yusuf Salim
Published: November 2020

Objectives

We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study.

Methods

We defined high CVD risk as the presence of any of the following: hypertension, coronary artery disease, stroke, smoker, diabetes or age >55 years. Availability and affordability of blood pressure lowering drugs, antiplatelets and statins were obtained from pharmacies. Participants were categorised: group 1—all three drug types were available and affordable, group 2—all three drugs were available but not affordable and group 3—all three drugs were not available. We used multivariable Cox proportional hazard models with nested clustering at country and community levels, adjusting for comorbidities, sociodemographic and economic factors.

Results

Of 163 466 participants, there were 93 200 with high CVD risk from 21 countries (mean age 54.7, 49% female). Of these, 44.9% were from group 1, 29.4% from group 2 and 25.7% from group 3. Compared with participants from group 1, the risk of MACEs was higher among participants in group 2 (HR 1.19, 95% CI 1.07 to 1.31), and among participants from group 3 (HR 1.25, 95% CI 1.08 to 1.50).

Conclusion

Lower availability and affordability of essential CVD medicines were associated with higher risk of MACEs and mortality. Improving access to CVD medicines should be a key part of the strategy to lower CVD globally.
Perfluoroalkyl substances (PFASs) and mercury in never-pregnant women of fertile age: association with fish consumption and unfavorable lipid profile
Authors: Bjorke-Monsen Anne-Lise , Varsi Kristin , Averina Maria , Brox Jan , Huber Sandra
Published: November 2020

Objectives

To examine concentrations of perfluoroalkyl substances (PFASs) and lifestyle factors that may contribute to higher levels of pollutants in never-pregnant women of fertile age.

Design

Observational cross-sectional study.

Setting

Participants were recruited among employees and students at Haukeland University Hospital and the University of Bergen, Norway.

Participants

Healthy, never-pregnant Norwegian women (n=158) of fertile age (18–39 years).

Outcomes

Concentrations of 20 different PFASs, mercury (Hg), lead, cadmium, total, high-density lipoprotein and low-density lipoprotein (LDL) cholesterol, in addition to self-reported data on dietary intake.

Results

Seven PFASs were detected in more than 95% of the women. Women aged 30–39 years had higher concentrations of sum PFAS compared with younger women. Serum PFASs were significantly intercorrelated (rho: 0.34–0.98, p<0.001) and six of them were significantly correlated to whole blood Hg (rho: 0.21–0.74, p<0.01). Fish consumption was the strongest predictor for most serum PFASs and for whole blood Hg. Fish consumption and serum perfluorooctanesulfonic acid (PFOS) concentrations were both positively associated with serum total and LDL cholesterol, established risk factors for cardiovascular disease.

Conclusions

The majority of Norwegian never-pregnant women of fertile age had a mixture of seven different PFASs and Hg detected in their blood. PFAS concentrations were higher in older women and associated with fish intake. As the mean age of women at first birth is increasing, several factors require further consideration including diet, as this may influence the burden of PFAS to the next generation.

Trial registration number

ClinicalTrials.gov ID:NCT03272022, Unique Protocol ID: 2011/2447, Regional Committee for Medical Research Ethics West (2011/2447), 12 January 2012.
Physical activity coaching for adults with mobility limitations: protocol for the ComeBACK pragmatic hybrid effectiveness-implementation type 1 randomised controlled trial
Authors: Hassett Leanne , Tiedemann Anne , Hinman Rana S , Crotty Maria , Hoffmann Tammy , Harvey Lisa , Taylor Nicholas F , Greaves Colin , Treacy Daniel , Jennings Matthew , Milat Andrew , Bennell Kim L , Howard Kirsten , van den Berg Maayken , Pinheiro Marina , Wong Siobhan , Kirkham Catherine , Ramsay Elizabeth , O'Rourke Sandra , Sherrington Catherine
Published: November 2020

Introduction

Mobility limitation is common and often results from neurological and musculoskeletal health conditions, ageing and/or physical inactivity. In consultation with consumers, clinicians and policymakers, we have developed two affordable and scalable intervention packages designed to enhance physical activity for adults with self-reported mobility limitations. Both are based on behaviour change theories and involve tailored advice from physiotherapists.

Methods and analysis

This pragmatic hybrid effectiveness-implementation type 1 randomised control trial (n=600) will be undertaken among adults with self-reported mobility limitations. It aims to estimate the effects on physical activity of: (1) an enhanced 6-month intervention package (one face-to-face physiotherapy assessment, tailored physical activity plan, physical activity phone coaching from a physiotherapist, informational/motivational resources and activity monitors) compared with a less intensive 6-month intervention package (single session of tailored phone advice from a physiotherapist, tailored physical activity plan, unidirectional text messages, informational/motivational resources); (2) the enhanced intervention package compared with no intervention (6-month waiting list control group); and (3) the less intensive intervention package compared with no intervention (waiting list control group). The primary outcome will be average steps per day, measured with the StepWatch Activity Monitor over a 1-week period, 6 months after randomisation. Secondary outcomes include other physical activity measures, measures of health and functioning, individualised mobility goal attainment, mental well-being, quality of life, rate of falls, health utilisation and intervention evaluation. The hybrid effectiveness-implementation design (type 1) will be used to enable the collection of secondary implementation outcomes at the same time as the primary effectiveness outcome. An economic analysis will estimate the cost-effectiveness and cost-utility of the interventions compared with no intervention and to each other.

Ethics and dissemination

Ethical approval has been obtained by Sydney Local Health District, Royal Prince Alfred Zone. Dissemination will be via publications, conferences, newsletters, talks and meetings with health managers.

Trial registration number

ACTRN12618001983291.
Haemolymphatic cancer among children in Sardinia, Italy: 1974–2003 incidence
Authors: Broccia Giorgio , Carter Jonathan , Ozsin-Ozler Cansu , Meloni Federico , Pilia Ilaria , Satta Giannina , Murgia Giulio , Campagna Marcello , Cocco Pierluigi
Published: November 2020

Objectives

To explore the time trend and geographical distribution of childhood leukaemia incidence over the territory of the Italian region of Sardinia.

Setting

All hospitals departments, diagnostic centres and social security agencies in Sardinia were regularly screened in 1974–2003 to identify, register and review the diagnoses of incident cases of haematological malignancies (HM).

Participants

The whole child population aged 0–14 resident in Sardinia.

Primary and secondary outcome measures

Incidence and time trend of childhood HM and childhood acute lymphoblastic leukaemia (ALL) over the study period, and use of Bayesian methods to plot the probability of areas with excess incidence on the regional map.

Results

Overall, 675 HM cases, including 378 ALL cases, occurred among children aged 0–14 years resident in Sardinia in 1974–2003, with an incidence rate of 6.97×10-5 (95% CI 6.47 to 7.51) and 3.85×10-5 (95% CI 3.48 to 4.26), respectively. Incidence of HM and ALL showed an upward trend along the study period especially among females. Three communes out of the 356 existing in 1974, namely Ittiri, Villa San Pietro and Carbonia, stand out as areas with excess incidence of HM and ALL in particular and another, Carloforte, for ALL only.

Conclusions

Our results might serve as convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants in the areas at risk.
Enhancing early detection of neurological and developmental disorders and provision of intervention in low-resource settings in Uttar Pradesh, India: study protocol of the G.A.N.E.S.H. programme
Authors: Toldo Moreno , Varishthananda Swami , Einspieler Christa , Tripathi Neeraj , Singh Anshu , Verma Surendra K , Vishwakarma Kanchan , Zhang Dajie , Dwivedi Agyeya , Gupta Ritika , Karn Sanjay , Kerketta Nirmal , Narayan Ram , Nikam Singh Karuna , Rani Sumitra , Singh Akanksha , Singh Divyanshu , Singh Krishna Pratap , Singh Navin , Singh Neeraj , Singh Rishi , Singh Shyam P , Srivastava Rakesh , Srivastava Sandeep , Srivastava Sanjeev , Yadav Gopal , Yadav Preeti , Yadav Sheshnath , Yadav Sujata , Marschik Peter B
Published: November 2020

Introduction

Around 9% of India’s children under six are diagnosed with neurodevelopmental disorders. Low-resource, rural communities often lack programmes for early identification and intervention. The Prechtl General Movement Assessment (GMA) is regarded as the best clinical tool to predict cerebral palsy in infants <5 months. In addition, children with developmental delay, intellectual disabilities, late detected genetic disorders or autism spectrum disorder show abnormal general movements (GMs) during infancy. General Movement Assessment in Neonates for Early Identification and Intervention, Social Support and Health Awareness (G.A.N.E.S.H.) aims to (1) provide evidence as to whether community health workers can support the identification of infants at high-risk for neurological and developmental disorders and disabilities, (2) monitor further development in those infants and (3) initiate early and targeted intervention procedures.

Methods

This 3-year observational cohort study will comprise at least 2000 infants born across four districts of Uttar Pradesh, India. Community health workers, certified for GMA, video record and assess the infants’ GMs twice, that is, within 2 months after birth and at 3–5 months. In case of abnormal GMs and/or reduced MOSs, infants are further examined by a paediatrician and a neurologist. If necessary, early intervention strategies (treatment as usual) are introduced. After paediatric and neurodevelopmental assessments at 12–24 months, outcomes are categorised as normal or neurological/developmental disorders. Research objective (1): to relate the GMA to the outcome at 12–24 months. Research objective (2): to investigate the impact of predefined exposures. Research objective (3): to evaluate the interscorer agreement of GMA.

Ethics and dissemination

G.A.N.E.S.H. received ethics approval from the Indian Government Chief Medical Officers of Varanasi and Mirzapur and from the Ramakrishna Mission Home of Service in Varanasi. GMA is a worldwide used diagnostic tool, approved by the Ethics Committee of the Medical University of Graz, Austria (27-388 ex 14/15). Apart from peer-reviewed publications, we are planning to deploy G.A.N.E.S.H. in other vulnerable settings.
Family history of non-communicable diseases and associations with weight and movement behaviours in Australian school-aged children: a prospective study
Authors: Downing Katherine L , Hesketh Kylie D , Timperio Anna , Salmon Jo , Moss Katrina , Mishra Gita
Published: November 2020

Objective

To assess differences in weight status and movement behaviour guideline compliance among children aged 5–12 years with and without a family history of non-communicable diseases (NCDs).

Design

Prospective.

Setting and participants

Women born between 1973 and 1978 were recruited to the Australian Longitudinal Study on Women’s Health (ALSWH) via the database of the Health Insurance Commission (now Medicare; Australia’s universal health insurance scheme). In 2016–2017, women in that cohort were invited to participate in the Mothers and their Children’s Health Study and reported on their three youngest children (aged <13 years). Data from children aged 5–12 years (n=4416) were analysed.

Measures

Mothers reported their children’s height and weight, used to calculate body mass index (kg/m2), physical activity, screen time and sleep. In the 2015 ALSWH Survey, women reported diagnoses and family history of type 2 diabetes, heart disease and hypertension. Logistic regression models determined differences between outcomes for children with and without a family history of NCDs.

Results

Boys with a family history of type 2 diabetes had 30% (95% CI: 0.51%–0.97%) and 43% lower odds (95% CI: 0.37%–0.88%) of meeting the sleep and combined guidelines, respectively, and 40% higher odds (95% CI: 1.01%– 1.95%) of being overweight/obese. Girls with a family history of hypertension had 27% lower odds (95% CI: 0.57%–0.93%) of meeting the screen time guidelines. No associations were observed for family history of heart disease.

Conclusions

Children who have a family history of type 2 diabetes and hypertension may be at risk of poorer health behaviours from a young age. Mothers with a diagnosis or a family history of these NCDs may need additional support to help their children develop healthy movement behaviours and maintain healthy weight.
Treatment patterns and medication adherence among newly diagnosed patients with migraine: a drug utilisation study
Authors: Orlando Valentina , Mucherino Sara , Monetti Valeria Marina , Trama Ugo , Menditto Enrica
Published: November 2020

Objectives

Prophylactic drugs currently used for migraine treatment are not specific. Furthermore, few studies in existing literature describe drugs utilisation patterns and adherence to migraine prophylactic treatment. This study is aimed to describe utilisation patterns of migraine drugs, evaluate adherence to prophylactic medications and investigate drug-related costs.

Design

Retrospective population-based study using an administrative health-related database.

Setting

Primary care setting in the Campania region, Southern Italy.

Participants

This study was carried out between 1 January 2016 and 31 December 2018, involving 12 894 subjects with any primary or secondary hospital discharge with migraine diagnosis, or at least two medical dispensations of migraine-specific acute or prophylactic medications (triptans or pizotifen). Subjects were classified into four treatment cohorts: no treatment, acute, prophylactic and both acute and prophylactic. Subjects were followed-up for 1 year.

Outcome measures

Utilisation patterns of migraine drugs at treatment initiation; adherence to prophylactic treatment; discontinuation, restart and switching rates; annual migraine drug costs per patient.

Results

Overall, 81.1% of subjects received acute treatment as their initial migraine treatment regimen, 10.7% prophylactic treatment, 8.2% both acute and prophylactic treatment. 599 patients were treated prophylactically; of these, 26.2% adhered to their initial treatment while 73.8% reported interruptions in treatment. Among the latter, 46.4% of patients discontinued the treatment completely within 103 days (IQR 89.0), 31% restarted treatment 46 days after interruption (IQR 60.0) and 22.6% switched to another treatment within 98 days (IQR 57.5) (p<0.001). The median annual cost of drugs per patient was €103 for those treated acutely, €75 for those treated prophylactically, €163 for those treated both.

Conclusions

Migraine treatment with acute medications is still prevalent in Italy; only few patients received prophylactic treatment with poor adherence to treatment. These findings reflect an unmet need for improved prophylactic therapies in order to provide a better disease management.
Psychometric properties of patient-reported outcome measures of self-management for cancer survivors: a systematic review protocol using COSMIN methodology
Authors: Peng Jian , Chen Yiting , Shen Lanjun , Zhu Zheng , Xing Weijie , Jin Guodong , Hu Yan
Published: November 2020

Introduction

Self-management is an important strategy for cancer survivors. Evaluating self-management is essential for planning nursing interventions that promote self-management and for measuring the contribution of nursing to health outcomes. Many patient-reported outcome measures (PROMs) have been designed and used to assess self-management in cancer survivors. However, it is unclear which PROM has the best reliability and validity. Therefore, the goal is to systematically review the psychometric properties of existing self-management PROMs and determine which PROM is best for cancer survivors.

Methods and analysis

This systematic review will be conducted according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of PROMs. Ten electronic literature databases (PubMed, EMBASE and so on) and two websites for PROMs will be searched from inception to 1 March 2020. Studies testing the psychometric properties of PROMs assessing self-management for cancer survivors, published in either English or Chinese, will be included. Two independent reviewers determined the eligibility of the studies and will independently extract the data. Risk of bias will be assessed using the COSMIN risk-of-bias checklist, and the quality of the results will be assessed using specific COSMIN quality criteria.

Ethics and dissemination

It is not necessary to obtain ethical approval for this systematic review protocol. The results will be published in a peer-reviewed journal and presented at a relevant conference.

PROSPERO registration number

CRD42020149120.
Effects of temperature, humidity, air quality and anthropic activities on the transmission of SARS-CoV-2: a systematic review protocol
Authors: Jeevananthan Chandrika , Muhamad Nor Asiah , Jaafar Mohd Hasni , Hod Rozita , Ab Ghani Rimah Melati , Md Isa Zaleha
Published: November 2020

Introduction

The current global pandemic of the virus that emerged from Hubei province in China has caused coronavirus disease in 2019 (COVID-19), which has affected a total number of 900 036 people globally, involving 206 countries and resulted in a cumulative of 45 693 deaths worldwide as of 3 April 2020. The mode of transmission is identified through airdrops from patients’ body fluids such as during sneezing, coughing and talking. However, the relative importance of environmental effects in the transmission of the virus has not been vastly studied. In addition, the role of temperature and humidity in air-borne transmission of infection is presently still unclear. This study aims to identify the effect of temperature, humidity and air quality in the transmission of SARS-CoV-2.

Methods and analysis

We will systematically conduct a comprehensive literature search using various databases including PubMed, EMBASE, Scopus, CENTRAL and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to latest available studies in 2020. We will include all the observational studies such as cohort case–control and cross-sectional studies that explains or measures the effects of temperature and/or humidity and/or air quality and/or anthropic activities that is associated with SARS-CoV-2. Study selection and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Meta-Analysis of Observational Studies in Epidemiology guideline. All data will be extracted using a standardised data extraction form and quality of the studies will be assessed using the Newcastle-Ottawa Scale guideline. Descriptive and meta-analysis will be performed using a random effect model in Review Manager File.

Ethics and dissemination

No primary data will be collected, and thus no formal ethical approval is required. The results will be disseminated through a peer-reviewed publication and conference presentation.

PROSPERO registration number

CRD42020176756.
Patterns of emergency admissions for ambulatory care sensitive conditions: a spatial cross-sectional analysis of observational data
Authors: Santos Rita , Rice Nigel , Gravelle Hugh
Published: November 2020

Objectives

To examine the spatial and temporal patterns of English general practices’ emergency admissions for Ambulatory Care Sensitive Conditions (ACSCs).

Design

Observational study of practice level annual hospital emergency admissions data for ACSCs for all English practices from 2004-2017.

Participants

All patients with an emergency admission to a National Health Service hospital in England who were registered with an English general practice.

Main outcome measure

Practice level age and gender indirectly standardised ratios (ISARs) for emergency admissions for ACSC.

Results

In 2017, 41.8% of the total variation in ISARs across practices was between the 207 Clinical Commissioning Groups (CCGs) (the administrative unit for general practices) and 58.2% was across practices within CCGs. ACSC ISARs increased by 4.7% between 2004 and 2017, while those for conditions incentivised by the Quality and Outcomes Framework (QOF) fell by 20%. Practice ISARs are persistent: practices with high rates in 2004 also had high rates in 2017. Standardising by deprivation as well as age and gender reduced the coefficient of variation of practice ISARs in 2017 by 22%.

Conclusions

There is persistent spatial pattern of emergency admissions for ACSC across England both within and across CCGs. We illustrate the reduction in ACSCs emergency admissions across the study period for conditions incentivised by the QOF but find that this was not accompanied by a reduction in variation in these admissions across practices. The observed spatial pattern persists when admission rates are standardised by deprivation. The persistence of spatial clusters of high emergency admissions for ACSCs within and across CCG boundaries suggests that policies to reduce potentially unwarranted variation should be targeted at practice level.
Psychiatry peer review groups in Australia: a mixed-methods exploration of structure and function
Authors: Lancaster Jeanette , Prager Shirley , Nash Louise , Karageorge Aspasia
Published: November 2020

Objectives

The purpose of this study was to examine Australian psychiatrists’ experience of participation in a small group learning format of continuing professional development, known as peer review groups (PRGs), with a particular emphasis on group structure and functions.

Method

An exploratory mixed-methods study comprising a survey (n=77) and semistructured interviews (n=6) with Australian psychiatrists participating in a PRG in the previous 12 months.

Results

Qualitative findings indicate that PRGs address experiential learning through a focus on both breadth and specificity of work, as well as participants’ experiences. Participants described using PRGs as a forum to manage difficult and complex work (through critiquing work, learning from one another, considering theory and guidelines, benchmarking, validating, reflecting and generalising learning) and to manage stress and well-being associated with crises, everyday stress and professional isolation. Particular structural aspects of PRGs considered essential to achieve these functions were self-selection of members, self-direction of meeting content and provision of a safe environment. These findings were convergent with the quantitative findings from scale survey data. Difficulties experienced during PRG participation are also described.

Conclusion

Qualitative and quantitative findings from psychiatry PRGs demonstrate how practice-based professional experience functions as both a source of learning and of collegial connection that contributes to well-being and reduction in professional stress. Study limitations and future research directions are discussed.
Effectiveness of individualised nutritional care plans to reduce malnutrition during hospitalisation and up to 3 months post-discharge: a systematic scoping review
Authors: Ingstad Kari , Uhrenfeldt Lisbeth , Kymre Ingjerd Gåre , Skrubbeltrang Conni , Pedersen Preben
Published: November 2020

Objectives

The prevalence of malnutrition after hospitalisation is reported to be 20%–45%, which may lead to adverse outcomes, as malnutrition increases the risk of complications, morbidity, mortality and loss of function. Improving the quality of nutritional treatment in hospitals and post-discharge is necessary, as hospital stays tend to be short. We aimed to identify and map studies that assess the effectiveness of individualised nutritional care plans to reduce malnutrition during hospitalisation and for the first 3 months post-discharge.

Design

This was a systematic scoping review.

Methods

We systematically searched for all types of studies in the following databases: EMBASE, MEDLINE via PubMed, and the Cumulative Index to Nursing and Allied Health Literature, with no restriction on data or publication language. We also reviewed the reference lists of the included studies. The abstracts and full articles were simultaneously screened by two independent reviewers. Differences of opinion were discussed among the two investigators, and a third reviewer assisted with the discussion until consensus was reached. Studies in which the patients received an individual nutritional care plan related to their hospital stay and were followed up post-discharge were included. We then conducted a thematic content analysis of the extracted literature.

Results

Nine randomised controlled trial studies met the inclusion criteria: six were conducted in Scandinavian countries. All studies were mainly conducted among elderly patients (mean ages varied from 75 to 88 years). The review studies measured 10 different outcomes; the most common outcomes were nutritional status and readmission. Six studies reported one or more significant positive intervention effect. Inconsistent results were identified for four outcome variables.

Conclusions

Individualised nutritional care plans and follow-up home visits might improve patients’ nutritional status. However, there is need for a systematic review that assesses study quality and extends the time to 6 months post-discharge.
COVID-19 case-fatality rate and demographic and socioeconomic influencers: worldwide spatial regression analysis based on country-level data
Authors: Cao Yang , Hiyoshi Ayako , Montgomery Scott
Published: November 2020

Objective

To investigate the influence of demographic and socioeconomic factors on the COVID-19 case-fatality rate (CFR) globally.

Design

Publicly available register-based ecological study.

Setting

Two hundred and nine countries/territories in the world.

Participants

Aggregated data including 10 445 656 confirmed COVID-19 cases.

Primary and secondary outcome measures

COVID-19 CFR and crude cause-specific death rate were calculated using country-level data from the Our World in Data website.

Results

The average of country/territory-specific COVID-19 CFR is about 2%–3% worldwide and higher than previously reported at 0.7%–1.3%. A doubling in size of a population is associated with a 0.48% (95% CI 0.25% to 0.70%) increase in COVID-19 CFR, and a doubling in the proportion of female smokers is associated with a 0.55% (95% CI 0.09% to 1.02%) increase in COVID-19 CFR. The open testing policies are associated with a 2.23% (95% CI 0.21% to 4.25%) decrease in CFR. The strictness of anti-COVID-19 measures was not statistically significantly associated with CFR overall, but the higher Stringency Index was associated with higher CFR in higher-income countries with active testing policies (regression coefficient beta=0.14, 95% CI 0.01 to 0.27). Inverse associations were found between cardiovascular disease death rate and diabetes prevalence and CFR.

Conclusion

The association between population size and COVID-19 CFR may imply the healthcare strain and lower treatment efficiency in countries with large populations. The observed association between smoking in women and COVID-19 CFR might be due to the finding that the proportion of female smokers reflected broadly the income level of a country. When testing is warranted and healthcare resources are sufficient, strict quarantine and/or lockdown measures might result in excess deaths in underprivileged populations. Spatial dependence and temporal trends in the data should be taken into account in global joint strategy and/or policy making against the COVID-19 pandemic.