bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting treatment adherence regimens in children with epilepsy: A randomized clinical trial
Authors: Modi Avani C. , Guilfoyle Shanna M. , Glauser Tracy A. , Mara Constance A.
Published: May 2021

Objective

This study was undertaken to examine the efficacy of a family‐tailored education and problem‐solving behavioral intervention, Supporting Treatment Adherence Regimens (STAR), in young children (2–12 years old) with new onset epilepsy compared to an attention control (i.e., education only [EO]) intervention. Participants randomized to the STAR intervention were hypothesized to demonstrate significantly improved adherence at postintervention and 3‐, 6‐, and 12‐month follow‐up visits compared to the EO intervention. Seizure and health‐related quality of life (HRQOL) outcomes were also examined.

Methods

Two hundred children with new onset epilepsy and their caregivers were recruited during routine epilepsy clinic visits. Baseline questionnaires were completed, and electronic adherence monitors were provided. Participants with adherence less than 95% during the run‐in period were randomized to either STAR or EO intervention. Active intervention was provided to both groups for 4 months. Questionnaires were completed at conclusion of the active intervention phase and three follow‐up time points (3, 6, and 12 months). Group differences in adherence, seizure outcomes, and HRQOL were examined using regression‐based analyses of covariance and longitudinal mixed effect linear or logistical models.

Results

Adherence at 12‐month follow‐up was significantly different between the STAR (mean = 82.34, SD = 21.29) and EO intervention groups (mean = 61.77, SD = 28.29), with the STAR group demonstrating 20.6% greater adherence (b = 19.11, p = .04, 95% confidence interval = 1.00–37.22, d = .83). No significant differences were found between groups in seizure and HRQOL outcomes.

Significance

A family‐based behavioral adherence intervention demonstrated sustained adherence improvements 1 year following epilepsy diagnosis compared to an epilepsy‐specific education intervention. STAR is an efficacious adherence intervention that can easily be implemented into routine epilepsy care.
Minimum wage, firm dynamics, and wage inequality: Theory and evidence​
Authors: Chao Chi‐Chur , Ee Mong Shan , Nguyen Xuan , Yu Eden S. H.
Published: May 2021

This paper investigates the distributive and welfare impacts of increasing minimum wage in an economy with imperfect competition. In the short run without entry/exit of manufacturing firms, an increase in the urban minimum wage reduces the skilled–unskilled wage gap but worsens unemployment and welfare in the economy. In the long run, a higher minimum wage induces firms to exit the urban manufacturing sector, thereby releasing capital to the rural agricultural sector. This can yield double dividends by further narrowing wage inequality and improving social welfare. Empirical results based on data from 43 selected countries confirm our theoretical findings.
Adaptation of the Quality of Life Adolescent Cleft Questionnaire for Spanish children and adolescents with cleft lip and/or palate
Authors: Ruiz‐Guillén Ana , Suso‐Ribera Carlos , Romero‐Maroto Martín , Gallardo Carmen , Peñacoba Cecilia
Published: May 2021

Background

The Quality of Life Adolescent Cleft Questionnaire is a measure of quality of life in cleft lip/palate (CL/P) and includes items on pre‐treatment and post‐treatment status. Items, however, were originally organized in a factor structure that prevents a formal pre‐treatment to post‐treatment comparison. Additionally, the questionnaire was tested in older patients.

Aim

We aimed to explore a factor structure that allows a comparison of pre‐ to post‐treatment status in children and adolescents with CL/P.

Design

The sample comprised 60 children and adolescents with CL/P. The scale was divided into two groups of items (24 comparing pre‐treatment and post‐treatment status and 26 measuring current quality of life). Two different exploratory and confirmatory analyses were conducted (one for each group of items). Sources of criterion validity were investigated with measures of self‐esteem and self‐efficacy.

Results

The results supported a 6‐factor structure for the pre‐treatment and post‐treatment items. In the second group of items, 9 items were removed due to inadequate functioning and a final 4‐factor solution was obtained. The criterion validity of factors was good.

Conclusion

The proposed factor solution might be more useful to detect the perceived satisfaction in different areas and can be used in younger patients.
Cobalt‐containing spherical glass nanoparticles for therapeutic ion release
Authors: Barrioni Breno R. , de Carvalho Sandhra M. , Naruphontjirakul Parichart , Norris Elizabeth , Kelly Nicole L. , Hanna John V. , Jones Julian R. , Pereira Marivalda de M.
Published: May 2021

Bioactive glass nanoparticles (BGNPs) can be internalized by cells, allowing the intracellular release of dissolution products with therapeutic benefit. Different therapeutic ions can be incorporated into the glass network that can promote angiogenesis via simulation of hypoxia conditions and consequent activation of pro‐angiogenic genes. Here, novel monodispersed spherical dense BGNPs were obtained by a modified Stöber method with the SiO2–CaO–CoO composition, with diameters of 92 ± 1 nm, with cobalt as the pro‐angiogenic ion. The presence of Co2+ species and the role of Co and Ca as network modifiers in the silica glass were confirmed by X‐ray photoelectron spectroscopy and 29Si solid‐state magic‐angle spinning nuclear magnetic resonance, respectively. Controlled Co2+ ion release was observed in culture media, and no cytotoxicity was observed by (4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl tetrazolium bromide cell viability assay on human osteosarcoma cells in direct contact with the nanoparticles. This study demonstrated that Co2+ ions can be incorporated into dense and spherical BGNPs, and these materials exhibit great potential as intracellular ion delivery systems with therapeutic properties.
Targeting LIMK1 with luteolin inhibits the growth of lung cancer in vitro and in vivo
Authors: Zhang Man , Wang Rui , Tian Jie , Song Mengqiu , Zhao Ran , Liu Kangdong , Zhu Feng , Shim Jung‐Hyun , Dong Zigang , Lee Mee‐Hyun
Published: May 2021

Lung cancer is the leading cause of cancer‐related deaths. LIM domain kinase (LIMK) 1 is a member of serine/threonine kinase family and highly expressed in various cancers. Luteolin, a polyphenolic plant flavonoid, has been reported to suppress tumour proliferation through inducing apoptosis and autophagy via MAPK activation in glioma. However, the mechanism of luteolin on suppressing lung cancer growth is still unclear. We found that luteolin targeted LIMK1 from the in silico screening and significantly inhibited the LIMK1 kinase activity, which was confirmed with pull‐down binding assay and computational docking models. Treatment with luteolin inhibited lung cancer cells anchorage‐independent colony growth and induced apoptosis and cell cycle arrest at G1 phase. Luteolin also decreased the expression of cyclin D1 and increased the levels of cleaved caspase‐3 by down‐regulating LIMK1 signalling related targets, including p‐LIMK and p‐cofilin. Furthermore, luteolin suppressed the lung cancer patient‐derived xenograft tumour growth by decreasing Ki‐67, p‐LIMK and p‐cofilin expression in vivo. Taken together, these results provide insight into the mechanism that underlies the anticancer effects of luteolin on lung cancer, which involved in down‐regulation of LIMK1 and its interaction with cofilin. It also provides valuable evidence for translation towards lung cancer clinical trials with luteolin.
The preferences of people with asthma or chronic obstructive pulmonary disease for self‐management support: A qualitative descriptive study
Authors: O'Connell Selena , McCarthy Vera J. C. , Queally Michelle , Savage Eileen
Published: May 2021

Aims and objectives

The aim of this study was to explore and describe the self‐management support (SMS) preferences of adults with asthma and/or chronic obstructive pulmonary disease (COPD).

Background

Self‐management support interventions have had beneficial outcomes for people with asthma and people with COPD, though challenges remain in their implementation. Increased understanding of the support preferences of people with asthma/COPD can help inform the development of future interventions to address patients' preferences.

Design

A qualitative descriptive design was used.

Methods

Semi‐structured focus group and individual interviews were conducted with 20 adult participants who had asthma and/or COPD in Ireland. Qualitative content analysis was used to analyse interviews. The SRQR reporting guideline was used.

Results

Three themes were identified. Support accessibility included having access to routine and unscheduled support from healthcare professionals with specialist knowledge. Consultation content described the need for comprehensive and person‐centred support. The person–provider relationship described the value of healthcare professionals acknowledging patient concerns, noted as a challenge for people with asthma, and continuity in relationships over time.

Conclusions

Routine support for people with asthma/COPD needs to be comprehensive in addressing the individual patient's challenges. Access to timely advice during exacerbations was a priority for people with asthma/COPD, suggesting that flexible access to services as well as routine review may be optimal for supporting self‐management of asthma/COPD. Feeling listened to regarding symptoms experienced may be of intrinsic value to people with asthma/COPD.

Relevance to clinical practice

The study emphasises the importance of continued training in communications skills for healthcare professionals supporting people with asthma/COPD, particularly acknowledging the patient's concerns in the context of symptom changes/flare‐up. A respiratory nurse specialist was valued as being a care coordinator who could support routine management as well as managing exacerbations, having specialist knowledge and knowing the patient over time.
When can I hold my baby? An audit of time to first cuddle for preterm babies (<32 weeks) pre introduction and post introduction of a Family‐Integrated Care model
Authors: Murdoch Jamee , Hauck Yvonne , Aydon Laurene , Sharp Mary , Zimmer Margo
Published: May 2021

Aim

The audit examined time to first cuddle between preterm babies (born < 32 weeks) and their parent pre‐ and post‐introduction of a family‐integrated care model. Secondary outcomes included time to full feeds and length of neonatal intensive care stay.

Background

Parental separation due to neonatal intensive care unit admission is known to negatively affect parental and baby wellbeing.

Design

A “before‐after” design compared outcomes for babies admitted pre‐ (2015) and post (2018)‐implementation of the model in a Western Australian neonatal intensive care unit.

Methods

A retrospective medical record audit included babies from two gestational age groups in 2015 and 2018, born ≤27 + 6 weeks and 28–31 + 6 weeks. SQUIRE checklist guided reporting of the audit.

Results

One hundred fifty‐three babies were included in the audit, 79 from 2015 (≤27 + 6 weeks n = 39 and 28–31 + 6 weeks n = 40) and 74 from 2018 (≤27 + 6 weeks n = 35 and 28–31 + 6 weeks n = 39). Babies in both years were born at similar median gestational ages with comparable birthweights. Babies born ≤27 + 6 weeks in 2018 were cuddled earlier (median = 141 h old) compared with those in 2015 (median = 157 h old). Median time to reach full feeds decreased and was significant in the ≤27 + 6‐week group: 288 h (12 days) in 2015 to 207.5 h (8.6 days) in 2018. Length of stay was longer for the ≤27 + 6‐week gestation 2018 group (median = 64 days) and 28–31 + 6‐week gestation 2018 group (median = 22 days).

Conclusion

Family‐integrated care models may decrease the time to first cuddle and full feeds. Further research on outcomes such as breastfeeding, infant weight gain and length of stay can extend existing knowledge.

Relevance to clinical practice

Family‐integrated care models may offer benefits to families of hospitalised preterm babies and investigating barriers to its implementation and creation of solutions to overcome barriers warrants attention.
The ERF‐VII transcription factor SmERF73 coordinately regulates tanshinone biosynthesis in response to stress elicitors in Salvia miltiorrhiza
Authors: Zheng Han , Jing Li , Jiang Xihong , Pu Chunjuan , Zhao Shuangshuang , Yang Jian , Guo Juan , Cui Guanghong , Tang Jinfu , Ma Ying , Yu Muyao , Zhou Xiuteng , Chen Meilan , Lai Changjiangsheng , Huang Luqi , Shen Ye
Published: May 2021

Here, we investigate the role of SmERF73, a group VII ETHYLENE RESPONSE FACTOR stress response transcription factor, in the regulation of post‐modification of the skeleton precursors of diterpene tanshinones in Salvia miltiorrhiza.

Most genes found to be involved in tanshinone biosynthesis are located on chromosome 6, and five of these genes comprise a large gene cluster in S. miltiorrhiza. We found that SmERF73 overexpression in S. miltiorrhiza coordinately up‐regulated the transcription of seven tanshinone biosynthetic genes, four of which were located in the tanshinone gene cluster, consequently increasing tanshinone accumulation, while SmERF73 silencing reduced corresponding gene transcription and tanshinone accumulation.

SmERF73 recognizes GCC‐box promoter elements of four tanshinone‐associated genes (DXR1, CPS1, KSL1 and CYP76AH3) and activates their expression. Moreover, SmERF73 and its targets were up‐regulated by stress elicitors; SmERF73 appears to be at least partly mediated by the jasmonic acid (JA) signaling pathway via interaction with SmJAZ3.

SmERF73 coordinately regulates tanshinone biosynthetic gene expression, suggesting a potential link between tanshinone production and plant stress responses.
Short‐term health outcomes following whole blood donation: A nationwide, retrospective cohort study
Authors: Toss Fredrik , Zhao Jingcheng , Sjölander Arvid , Edgren Gustaf
Published: May 2021

Background

Blood donation is associated with a number of adverse events. Most of these are both uncommon and nonsevere, leading to mild discomfort for the donor at worst. However, adverse events occurring outside of the donation facility have largely not been studied. In this study, we aim to further the understanding by performing the first large‐scale analysis of short‐term risks following whole blood donation.

Methods

We set up a nationwide cohort of donors who donated whole blood between 1987 and 2018. Analyses were conducted using conditional logistic regression in a self‐comparison design, where each donor was compared only to themselves, considering the 30‐day risk of 16 outcomes following whole blood donation. Outcomes included cardiac/vascular diseases such as myocardial infarction, unspecified conditions such as fainting, accidents or external causes of injury, and death.

Results

A total of 963,311 donors were included; of whom, 19,670 experienced at least one of the outcomes within 30 days of a blood donation. For fainting and hypotonia, we observed transient 2‐ to 5‐fold risk increases on the day of donation and the subsequent 2–3 days. Importantly, the risk increase for the most pronounced effect corresponded to less than one additional events of fainting per 200,000 blood donations. Risks of all other outcomes were either unaffected or lower than expected right after blood donation.

Discussion

To conclude, we found no evidence of new or unexpected short‐term health effects after blood donation and confirmed that risks of hypotension‐related events requiring hospital care are present but small.
Super enhancement of rheological properties of amorphous PLA through generation of a fiberlike oriented crystal network
Authors: Nofar Mohammadreza , Mohammadi Mojtaba , Carreau Pierre J.
Published: May 2021

Blends containing 85 wt. % of an amorphous polylactide with 15 wt. % of three different semicrystalline PLA (cPLA) grades with different crystallizabilty were separately blended via a twin-screw extruder below the melting temperature of the cPLAs. The extrudates were either directly pelletized or pelletized after being drawn at a draw ratio of 10. The small amplitude oscillatory shear behavior of the samples revealed that while the rheological properties of the undrawn samples were enhanced, those of the drawn samples were much more dramatically increased. In undrawn samples, the enhancements were due to the presence of unmelted crystal clusters, which could form a solid network structure in the blend. The much more pronounced increases in drawn samples, however, were due to the transformation of the crystal clusters into the fiberlike oriented crystal network, which formed a stronger solid network. This reinforcing behavior in both undrawn and drawn samples was even more pronounced when cPLA with a higher degree of crystallinity and a higher melting temperature was used. In drawn samples, the stress growth experiments confirmed the formation of such oriented crystal structure during which the primary overshoot caused by the crystal network structure could be formed again after molecular relaxation. This was while, in undrawn samples, stress overshoots were barely visible.
Shipping rule cleans the air but dirties the water
Authors: Stokstad Erik
Published: May 2021

Growing use of ship exhaust scrubbers has increased marine discharge of compounds.
Sequence diversity analyses of an improved rhesus macaque genome enhance its biomedical utility
Authors: Warren Wesley C. , Harris R. Alan , Haukness Marina , Fiddes Ian T. , Murali Shwetha C. , Fernandes Jason , Dishuck Philip C. , Storer Jessica M. , Raveendran Muthuswamy , Hillier LaDeana W. , Porubsky David , Mao Yafei , Gordon David , Vollger Mitchell R. , Lewis Alexandra P. , Munson Katherine M. , DeVogelaere Elizabeth , Armstrong Joel , Diekhans Mark , Walker Jerilyn A. , Tomlinson Chad , Graves-Lindsay Tina A. , Kremitzki Milinn , Salama Sofie R. , Audano Peter A. , Escalona Merly , Maurer Nicholas W. , Antonacci Francesca , Mercuri Ludovica , Maggiolini Flavia A. M. , Catacchio Claudia Rita , Underwood Jason G. , O’Connor David H. , Sanders Ashley D. , Korbel Jan O. , Ferguson Betsy , Kubisch H. Michael , Picker Louis , Kalin Ned H. , Rosene Douglas , Levine Jon , Abbott David H. , Gray Stanton B. , Sanchez Mar M. , Kovacs-Balint Zsofia A. , Kemnitz Joseph W. , Thomasy Sara M. , Roberts Jeffrey A. , Kinnally Erin L. , Capitanio John P. , Skene J. H. Pate , Platt Michael , Cole Shelley A. , Green Richard E. , Ventura Mario , Wiseman Roger W. , Paten Benedict , Batzer Mark A. , Rogers Jeffrey , Eichler Evan E.
Published: May 2021

A high-quality rhesus macaque genome

Genome technology has improved substantially since the first full organismal genomes were generated. Applying new technology, Warren
et al.
refined the genome of the rhesus macaque, a model nonhuman primate. Long-read technology and other recent advances in sequencing technology were applied to generate a genome with far fewer gaps and helped to refine the locations and numbers of repetitive elements. Furthermore, the authors performed resequencing among populations to identify the genetic variability of the rhesus macaque. Thus, a previously incomplete and inaccurate set of sequence information is now fully resolved, improving gene mapping for biomedical and comparative genetic studies.

Science
, this issue p.
eabc6617
Promoting a culture of climate care
Psychological Roots of the Climate Crisis
Sally Weintrobe
Bloomsbury Academic, 2021. 344 pp.
Authors: Coen Deborah R.
Published: May 2021

Neoliberalism has led to a society impervious to climate reality, argues a psychologist
The footprint of evolution in seed dispersal interactions
Authors: Bello Carolina , Barreto Elisa
Published: May 2021

The evolutionary stability of fruit-eating birds is linked to their role in dispersing seeds
Israel's COVID-19 endgame
Authors: Balicer Ran D. , Ohana Reut
Published: May 2021

As several countries now confront COVID-19 surges, Israel may be crossing over to other side of the pandemic. Whereas 5.5 million new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were reported globally last week, Israel reported only 398 (compared with >50,000 in January). Already, 54% of Israel's 9.2 million citizens have been fully vaccinated, considerably more than in most other countries. In the coming months, as restrictions continue to ease, the country should be optimistic, yet cautious, as risks of resurgence persist. Israel thus may well be an early case study for favorable outcomes of a mass-vaccination campaign.
Oculomotor synkinesis: an uncommon sequela of paediatric cavernous sinus thrombosis
Authors: Lalwani Sakshi , Kekunnaya Ramesh , Sheth Jenil
Published: May 2021

We report an unusual case of acquired oculomotor synkinesis as a sequela of cavernous sinus thrombosis in a child. A 4-year-old male child presented to our emergency services with sudden onset periorbital swelling with complete ptosis of the left upper eyelid. This was preceded by a febrile episode and a furuncle at the tip of the nose. Computerised axial tomography of the orbit revealed orbital cellulitis in the left eye. The child was started on systemic antibiotics followed by a short course of systemic steroids. MRI of the brain with contrast revealed left cavernous sinus and superior ophthalmic vein thrombosis. Following administration of systemic anticoagulants and antibiotics, the ocular motility and ptosis improved remarkably. However, 6 months post-treatment, the child developed signs of aberrant regeneration of the third cranial nerve (oculomotor synkinesis).
Recurrent spontaneous small bowel perforations with a rare pathology: non-familial visceral myopathy
Authors: Shi Meiyi , Choi Young Mee , Kiselak Elizabeth
Published: May 2021

Visceral myopathy is a rare, often misdiagnosed disease characterised by abnormalities in the gastrointestinal smooth muscle layer. Its clinical presentation includes pseudo-obstruction, intestinal dysmotility and spontaneous perforation. We report an atypical case of a 51-year-old man with a history of recurrent small bowel perforations who presented with an acute abdomen. A laparotomy was performed with identification of a distal jejunal perforation. A small bowel resection with end-to-end anastomosis was done. Minimal adhesions were seen intraoperatively despite the patient’s multiple prior surgeries. Pathology showed histiocytic inflammation and patchy loss of the muscle layer reflective of visceral myopathy. Genetic testing revealed a variant of uncertain significance in the myosin light chain kinase gene. It is difficult to make a conclusive diagnosis given the patient’s clinical presentation closely mimicking other gastrointestinal disorders. However, it is crucial to consider visceral myopathy in patients with recurrent spontaneous intestinal perforations as a differential diagnosis.
Comprehensive management of major aphthous ulcer
Authors: Warrier Aravind , Sruthi Maguluru , Anbarasi K
Published: May 2021

Recurrent aphthous ulcers are the most prevalent oral mucosal disease, but the subset major aphthous ulcer is a less frequent type. These ulcers are refractory, may persist for several weeks to months, and interfere with the normal state of health. The aetiology is multifactorial and so is the treatment. We present a case of an adolescent male patient reported with multiple oral ulcers. He developed three ulcers simultaneously and suffered for 10 months despite using topical medications prescribed by different dental practitioners. We executed a multidisciplinary treatment approach that resulted in a long-term disease-free state. The treatment methods followed in our case could be a successful model to implement by medical practitioners and oral physicians when the situation demands.
Challenges in electromyographic endotracheal tube (EMG ETT) placement via awake fibreoptic intubation during emergency thyroidectomy
Authors: Mohammad Iskandar Fathir Fath , Nik Lah Nik Amin Sahid , Ismail Abdul Jabbar , Yeap Tat Boon
Published: May 2021

Recurrent laryngeal nerve (RLN) injury is one of the main complications of total thyroidectomy. If the injury is bilateral, total airway obstruction, aphonia and hoarseness of voice could be precipitated. Hence, it is wise for the operating surgeon to be guided by neural monitoring during thyroidectomy. We present a valuable experience handling a middle-aged man with a huge papillary thyroid carcinoma . He needed an urgent thyroidectomy due to obstructive symptoms. We highlight our intraoperative dexterity in handling his surgery in the context of continuous monitoring of RLN using electromyography.
Long-term follow-up of a child with Wolcott-Rallison syndrome
Authors: Shah Nikhil , Karguppikar Madhura Bharat , Khadilkar Vaman , Khadilkar Anuradha
Published: May 2021

Wolcott-Rallison syndrome (WRS), the most common cause of permanent neonatal diabetes mellitus (DM) in consanguineous families, has a poor prognosis, with a mean survival of 5.8 years. Majority of children with WRS succumb to the disease in the first decade of life. We present the long-term follow-up of an 8-year-2-month-old girl with genetically proven WRS who was born to a non-consanguineous parentage. She is on basal bolus regimen of insulin therapy for DM. In addition, she was noted to have features of skeletal dysplasia at 3 years and 3 months of age, which has led to her short stature. Surprisingly, she has had no episodes of hepatitis or liver dysfunction so far, which is frequently seen in children with WRS. To the best of our knowledge, she is the oldest surviving patient with WRS reported in India and South Asia.
Sinus bradycardia with haemodynamic compromise following lithium intoxication
Authors: Snipes Garrett Michael , Hafeez Adam , Marek George , Winchester David E
Published: May 2021

Lithium is a well-established treatment for mood disorders and considered first-line pharmacological therapy for bipolar disorder as per the American Psychiatric Association guidelines. However, lithium is associated with significant toxicity. Cardiotoxicity including sinus node dysfunction is a rare but clinically significant presentation of lithium intoxication. This case report describes an adult male presenting with unstable sinus bradycardia in the setting of acute kidney injury and elevated serum lithium levels. The patient required temporary management with inotropic support and transcutaneous pacing. The patient’s heart rate and hypotension improved in parallel with resolution of his acute kidney injury and elevated serum lithium level after treatment with intravenous fluids. Given the prevalence of bradycardia in both the outpatient and inpatient settings, a high index of suspicion is necessary for the prevention and identification of this clinical entity to guide appropriate management.
Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study
Authors: Romero-Brufau Santiago , Chopra Ayush , Ryu Alex J , Gel Esma , Raskar Ramesh , Kremers Walter , Anderson Karen S , Subramanian Jayakumar , Krishnamurthy Balaji , Singh Abhishek , Pasupathy Kalyan , Dong Yue , O’Horo John C , Wilson Walter R , Mitchell Oscar , Kingsley Thomas C
Published: May 2021

Objective

To estimate population health outcomes with delayed second dose versus standard schedule of SARS-CoV-2 mRNA vaccination.

Design

Simulation agent based modeling study.

Setting

Simulated population based on real world US county.

Participants

The simulation included 100 000 agents, with a representative distribution of demographics and occupations. Networks of contacts were established to simulate potentially infectious interactions though occupation, household, and random interactions.

Interventions

Simulation of standard covid-19 vaccination versus delayed second dose vaccination prioritizing the first dose. The simulation runs were replicated 10 times. Sensitivity analyses included first dose vaccine efficacy of 50%, 60%, 70%, 80%, and 90% after day 12 post-vaccination; vaccination rate of 0.1%, 0.3%, and 1% of population per day; assuming the vaccine prevents only symptoms but not asymptomatic spread (that is, non-sterilizing vaccine); and an alternative vaccination strategy that implements delayed second dose for people under 65 years of age, but not until all those above this age have been vaccinated.

Main outcome measures

Cumulative covid-19 mortality, cumulative SARS-CoV-2 infections, and cumulative hospital admissions due to covid-19 over 180 days.

Results

Over all simulation replications, the median cumulative mortality per 100 000 for standard dosing versus delayed second dose was 226
v
179, 233
v
207, and 235
v
236 for 90%, 80%, and 70% first dose efficacy, respectively. The delayed second dose strategy was optimal for vaccine efficacies at or above 80% and vaccination rates at or below 0.3% of the population per day, under both sterilizing and non-sterilizing vaccine assumptions, resulting in absolute cumulative mortality reductions between 26 and 47 per 100 000. The delayed second dose strategy for people under 65 performed consistently well under all vaccination rates tested.

Conclusions

A delayed second dose vaccination strategy, at least for people aged under 65, could result in reduced cumulative mortality under certain conditions.
Prospective observational study of prevalence, assessment and treatment of pancreatic exocrine insufficiency in patients with inoperable pancreatic malignancy (PANcreatic cancer Dietary Assessment (PanDA): a study protocol
Authors: Carnie Lindsay E , Lamarca Angela , Vaughan Kate , Kapacee Zainul Abedin , McCallum Lynne , Backen Alison , Barriuso Jorge , McNamara Mairéad G , Hubner Richard A , Abraham Marc , Valle Juan W
Published: May 2021

Introduction

Pancreatic exocrine insufficiency (PEI) in patients with pancreatic malignancy is well documented in the literature and is known to negatively impact on overall survival and quality of life. A lack of consensus opinion remains on the optimal diagnostic test that can be adapted for use in a clinical setting for this cohort of patients. This study aims to better understand the prevalence of PEI and the most suitable diagnostic techniques in patients with advanced pancreatic malignancy.

Methods and analysis

This prospective observational study will be carried out in patients with pancreatic malignancy (including adenocarcinoma and neuroendocrine neoplasms). Consecutive patients with inoperable pancreatic malignancy referred for consideration of first-line chemotherapy will be considered for eligibility. The study comprises three cohorts: demographic cohort (primary objective to prospectively investigate the prevalence of PEI in patients with inoperable pancreatic malignancy); sample size 50, diagnostic cohort (primary objective to design and evaluate an optimal diagnostic panel to detect PEI in patients with inoperable pancreatic malignancy); sample size 25 and follow-up cohort (primary objective to prospectively evaluate the proposed PEI diagnostic panel in a cohort of patients with inoperable pancreatic malignancy); sample size 50. The following is a summary of the protocol and methodology.

Ethics and dissemination

Full ethical approval has been granted by the North West Greater Manchester East Research and Ethics Committee, reference: 17/NW/0597. This manuscript reflects the latest protocol V.8 approved 21 April 2020. Findings will be disseminated by presentation at national/international conferences, publication in peer-review journals and distribution via patient advocate groups.

Trial registration number

194255,NCT0361643.
Snoring frequency and risk of type 2 diabetes mellitus: a prospective cohort study
Authors: Dai Ningbin , Shi Qianwen , Hua Yujie , Guo Yu , Bian Zheng , Li Liming , Chen Zhengming , Wu Ming , Lu Yan
Published: May 2021

Objective

To evaluate the association between snoring frequency and type 2 diabetes mellitus (T2DM) according to age and gender in Chinese population.

Design

A cohort study was performed in Suzhou site of the China Kadoorie Biobank. Residents who didn’t suffer from T2DM at baseline survey (2004–2008) and in half a year after baseline were enrolled in this study and followed cause-specific morbidity until 31 December 2013. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. Cox regression models were used to estimate HRs and 95% CIs for the snoring and T2DM association.

Setting

Wuzhong district, Suzhou, China.

Participants

A total of 49 453 participants (men: 41.8%; mean age: 51.14±10.28 years) were enrolled in this study.

Outcome measures

T2DM cases were defined as International Classification of Diseases 10th Revision code of E11 and were identified through disease registries and health insurance databases.

Results

During a media of 7.18 years follow-up, 1120 T2DM cases were identified. Higher T2DM incidence was observed in participants with frequent and occasional snoring compared with those without (4.80 and 2.87 vs 2.39 per 1000 person-years). The multivariable-adjusted model found snoring was independently associated with T2DM (HR 1.28, 95% CI 1.20 to 1.38), both in men (HR 1.25, 95% CI 1.10 to 1.41) and women (HR 1.28, 95% CI 1.17 to 1.39). Moreover, a significant multiplicative interaction effect between snoring and age was detected on T2DM risk (p=0.015).

Conclusions

Snoring was independently associated with an increased risk of T2DM in Chinese population, both in men and women. Meanwhile, there was an interaction effect between snoring and age on T2DM risk.
Office work and stretch training (OST) study: effects on the prevalence of musculoskeletal diseases and gender differences: a non-randomised control study
Authors: Holzgreve Fabian , Fraeulin Laura , Haenel Jasmin , Schmidt Helmut , Bader Andreas , Frei Markus , Groneberg David A , Ohlendorf Daniela , van Mark Anke
Published: May 2021

Objectives

For the prevention of musculoskeletal diseases (MSDs), stretch training can be a measure of the workplace health promotion (WHP) for office workers. This can lead to an increase in mobility and, ultimately, reduce or prevent MSD. The aim of the study was to examine a standardised and individualised stretch training on a device, specifically ‘five Business’, for the prevalence of MSD.

Design

This study is a non-randomised control study.

Setting

WHP programme with clerical employees of a German car manufacturer.

Participants

252 (110 women; 142 men) subjects (median age of 44 (X∼21 years) finished the study successfully. Inclusion criteria included a full-time employment in the office workplace and subjective health.

Intervention

The intervention group completed 22–24 training units of 10 min each on the ‘five-Business’ device two times a week for 12 weeks.

Primary and secondary outcome measures

Data were collected in the form of a pre–post study Nordic Questionnaire.

Results

After the intervention, significantly fewer subjects reported pain in the area of the neck (−17.79), shoulder (−11.28%), upper back (−14.7%), lower back (−12.78%) and feet (−8.51%). The gender analysis revealed that women are, in general, more often affected by musculoskeletal complaints than men, especially in the neck (+29.5%) and feet (+15.03%). Both sexes had significant reductions of MSD in the most commonly affected regions. Thus, 27.12% less women reported having neck pain, while 13.14% less men reported having low back pain.

Conclusions

The results suggest that a stretching programme performed for 3 months can reduce musculoskeletal complaints in the most commonly affected areas in office workers. Both men and women benefited from the stretch training to a similar extent, suggesting that this would be a promising measure for therapy and prevention as part of WHP.
Allogeneic human umbilical cord-derived mesenchymal stem/stromal cells for chronic obstructive pulmonary disease (COPD): study protocol for a matched case–control, phase I/II trial
Authors: Hoang Duc M , Nguyen Kien T , Nguyen Anh H , Nguyen Bach N , Nguyen Liem Thanh
Published: May 2021

Introduction

The global prevalence of chronic obstructive pulmonary disease (COPD) is increasing, and it has become a major public health burden worldwide, including in Vietnam. A large body of preclinical and clinical studies supports the safety of mesenchymal stem/stromal cells (MSCs) in the treatment of lung injury, including COPD. The aim of this trial is to investigate the safety and potential therapeutic efficacy of allogeneic administration of umbilical cord-derived MSCs (UC-MSCs) as a supplementary intervention in combination with standard COPD medication treatments in patients with moderate-to-severe COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 and Vietnam Ministry of Health’s guidelines.

Methods and analysis

This matched case–control phase I/II trial is conducted at Vinmec Times City International Hospital, Hanoi, Vietnam between June 2020 and December 2021. In this study, 40 patients will be enrolled and assigned into two age-matched, gender-matched and COPD condition-matched groups, including a UC-MSC group and a control group. Both groups will receive standard COPD medication treatment based on the GOLD 2019 guidelines and the Vietnam Ministry of Health protocol. The UC-MSC group will receive two doses of thawed UC-MSC product with an intervention interval of 3 months. The primary outcome measures will include the incidence of prespecified administration-associated adverse events and serious adverse events. The efficacy will be evaluated based on the absolute changes in the number of admissions, arterial blood gas analysis, lung function and lung fibrosis via CT scan and chest X-ray. The clinical evaluation will be conducted at baseline and 3, 6 and 12 months postintervention.

Ethics and dissemination

Ethical approval was secured from the Ethical Committee of Vinmec International Hospital (number:166/2019/QĐ-VMEC) and Vietnam Ministry of Health (number:2002/QĐ-BYT). The results will be reported to trial collaborators, publication in peer-reviewed academic journals.

Trial registration number

NCT04433104.
Rating of four different foods in women with hyperemesis gravidarum: a randomised controlled trial
Authors: Tan Gi Ni , Tan Peng Chiong , Hong Jesrine Gek Shan , Kartik Balaraman , Omar Siti Zawiah
Published: May 2021

Objective

To evaluate four foods in women with hyperemesis gravidarum (HG) on their agreeability and tolerability.

Design

Prospective, randomised, within-subject cross-over trial.

Setting

Single-centre, tertiary, university hospital in Malaysia.

Participants

72 women within 24-hour of first admission for HG who were 18 years or above, with confirmed clinical pregnancy of less than 16 weeks’ gestation were recruited and analysed. Women unable to consume food due to extreme symptoms, known taste or swallowing disorder were excluded.

Interventions

Each participant chewed and swallowed a small piece of apple, watermelon, cream cracker and white bread in random order and was observed for 10 min after each tasting followed by a 2 min washout for mouth rinsing and data collection.

Outcome measures

Primary outcome was food agreeability scored after 10 min using an 11-point 0–10 Visual Numerical Rating Scale (VNRS). Nausea was scored at baseline (prior to tasting) and 2 and 10 min using an 11-point VNRS. Intolerant responses of gagging, heaving and vomiting were recorded.

Results

On agreeability scoring, apple (mean±SD 7.2±2.4) ranked highest followed by watermelon (7.0±2.7) and crackers (6.5±2.6), with white bread ranked lowest (6.0±2.7); Kruskal-Wallis H test, p=0.019. Apple had the lowest mean nausea score and mean rank score, while white bread had the highest at both 2 and 10 min; the Kruskal-Wallis H test showed a significant difference only at 10 min (p=0.019) but not at 2 min (p=0.29) in the ranking analyses. The intolerant (gagged, heaved or vomited) response rates within the 10 min study period were apple 3/72 (4%), watermelon 7/72 (10%), crackers 8/72 (11%) and white bread 12/72 (17%): χ2test for trend p=0.02.

Conclusion

Sweet apple had the highest agreeability score, the lowest nausea severity and intolerance–emesis response rate when tasted by women with HG. White bread consistently performed worst.
Scoping review of mental health in prisons through the COVID-19 pandemic
Authors: Johnson Luke , Gutridge Kerry , Parkes Julie , Roy Anjana , Plugge Emma
Published: May 2021

Objective

To examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.

Design

Scoping review.

Data sources

PubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.

Eligibility criteria for selection of studies

All papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.

Results

Of 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.

Conclusions

It is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.
Postoperative occlusion degree after flow-diverter placement with adjunctive coiling: analysis of complications
Authors: Kang Huibin , Luo Bin , Liu Jianmin , Zhang Hongqi , Li Tianxiao , Song Donglei , Zhao Yuanli , Guan Sheng , Maimaitili Aisha , Wang Yunyan , Feng Wenfeng , Wang Yang , Wan Jieqing , Mao Guohua , Shi Huaizhang , Zhang Ying , Yang Xinjian
Published: May 2021

Background

Although coiling with a flow diverter may provide immediate dome protection, no studies have evaluated the effect on complications of postoperative occlusion degree immediately postoperatively. The purpose of this study was to determine whether postoperative occlusion degree immediately after flow-diverter placement with adjunctive coiling was associated with complications.

Methods

All patients’ data were collected from the post-market multi-center cohort study of embolization of intracranial aneurysms with a pipeline embolization device (PED) in China (PLUS) registry. We divided patients into those treated with a PED alone (PED-only (PO) group), those treated with a PED with coils and incomplete occlusion (PED + coils + incomplete occlusion (PCIO) group), and those treated with a PED with coils and complete occlusion (PED + coils + complete occlusion (PCCO) group).

Results

We evaluated 1171 consecutive patients with 1322 aneurysms treated with a PED: 685 aneurysms were treated with PO, 444 with PCIO, and 193 with PCCO. The PCCO group had a higher rate of aneurysm occlusion at the last follow-up than the PCIO and PO groups (P<0.0001). Multivariate analysis of the predictors of ischemic stroke and modified Rankin Scale score (mRS) deterioration showed that PCCO was an independent predictor of ischemic stroke (HR, 2.03; 95% CI, 1.12 to 3.67; P=0.019) and mRS deterioration (HR, 2.59; 95% CI, 1.57 to 4.26; P<0.0001).

Conclusions

Although postoperative complete occlusion with a PED and adjunctive coiling can increase the rate of aneurysm occlusion, this approach may also increase the risk of ischemic stroke and lead to poor postoperative functional outcomes.
The impact of post-prandial delay periods on ad libitum consumption of a laboratory breakfast meal
Authors: Palmer Blake , Irwin Chris , McCartney Danielle , Cox Gregory R. , Desbrow Ben
Published: May 2021

This study examined the impact of varying the holding time following an ad libitum laboratory breakfast on acute dietary behaviour and subsequent intake. Twenty-four participants (20 females (age: 23.4 ± 6.3 years; body mass index: 23.9 ± 3.9 kg·m–2, mean ± SD)) completed 3 trials following a quasi-randomised, crossover design. Each trial (7-day separation) incorporated a defined post-prandial delay (DPD) period of either zero (no delay), 1 or 3 hours following a buffet breakfast consumed over 30 minutes. Dietary intake outcomes included energy, macronutrient and core food group intakes. On completion of the DPD period, participants left the laboratory and recorded all food/beverages consumed for the remainder of the day. One-way repeated-measures ANOVA assessed all outcomes, with post hoc analysis conducted on significant main effects. Energy and carbohydrate intakes were significantly lower on no delay vs. 1-hour (p = 0.014) and 3-hour (p = 0.06) DPD trials (energy intake: 1853 ± 814 kJ vs. 2250 ± 1345 kJ vs. 1948 ± 1289 kJ; carbohydrates: 68 ± 34 g vs. 77 ± 44 vs. 69 ± 43 g; respectively). DPD periods did not influence the time to consume next meal or energy, macronutrient and core food group intakes for the remainder of the day. Delaying participants from leaving a laboratory alters dietary intake at an ad libitum test meal. The post-meal holding period is an important methodological consideration when planning laboratory studies to assess appetite.

Novelty: Delaying participants from leaving a laboratory alters dietary intake at ad libitum breakfast meals. The length of the delay period did not affect dietary intake at ad libitum breakfast meals.
Measurements of electron impact K-shell ionization cross sections of Cr21+ ions
Authors: Vogel David , Beiersdorfer Peter , Wong Keith , Zasadzinski Ron , Gu Ming Feng
Published: May 2021

We present relative cross section measurements of the inner-shell ionization of highly charged chromium ions by high-energy (7–30 keV) electrons. The measurements use a technique based on high-resolution X-ray spectroscopy, which correlates ionization events with Kα decay X-rays. Moreover, the measurements show that inner-shell ionization only affects the strength of the heliumlike 1s2s 3S1 → 1s2 1S0 forbidden line. The cross sections inferred for Li-like Cr21+ agree well with distorted wave calculations.