bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of tension variability for sleep quality in headache patients: A Holter monitoring study
Authors: Çiçekli Esen , Emre Ender
Published: August 2022

Background:

Hypertension is one of the common causes of headaches. Disruption in the circadian rhythm of blood pressure (BP) also leads to some chronic diseases. Sleep disturbances have a relationship with neurologic and cardiac diseases. Our aim was to compare the sleep quality of patients with headaches showing dipper and nondipper BP patterns.

Methods:

This retrospective study included 57 patients who applied to a neurology clinic due to headaches and were referred to the cardiology department for Holter monitoring. Chronic diseases, drugs used, smoking and exercise habits, and physical examination findings were recorded. The 24-hour Holter monitoring results were classified as dipper and nondipper. The Pittsburgh Sleep Quality Index scores were determined for each patient. The Pittsburgh Sleep Quality Index scores of patients with dipper and nondipper patterns were compared.

Results:

The sleep quality of patients with dipper Holter patterns was better than that of patients with nondipper patterns (P < .001), and patients without chronic diseases had significantly better sleep quality compared with those with chronic diseases (P = .029). In the presence of chronic disease, the number of patients with a nondipper Holter pattern was higher (P = .024). There were no significant differences in Holter results or sleep quality between smokers and nonsmokers (P > .05).

Conclusion:

Diagnoses of sleep disorders and BP abnormalities in the outpatient clinic are valuable in increasing the quality of life of patients and in preventing chronic diseases, especially cardiac diseases that may develop in the future.
Association between TGF-β gene polymorphism and myopia: A systematic review and meta-analysis
Authors: Zhu Xiaoyu , Xu Bowei , Dai Lingxue , Wang Zuoyuan , Feng Li , Zhao Jiangyue
Published: August 2022

Introduction:

The present study was conducted to determine the association of transforming growth factor-beta (TGF-β) gene polymorphism and myopia.

Method:

Four hundred twelve articles were identified, of which 11 articles with 5213 participants in 4 countries were included in the final analysis. Review Manager software (RevMan, version 5.4) was used for data analysis.

Result:

Odds ratio (OR) value of TGF-β1 rs1800469 is 1.33 (95% confidence interval [CI] = 1.15–1.54) in the allelic model; in the dominant model is 1.76 (95% CI = 1.16–2.67); in homozygous model is 5.98 (95% CI = 4.31–8.06). OR value of TGF-β1 rs4803455 is 0.62 (95% CI = 0.43–0.88) in recessive model. TGF-β2 is not associated with myopia. Relevant study on TGF-β3 is scarce.

Conclusion:

Our systematic review and meta-analysis found that TGF-β1 rs4803455 and rs1800469 were correlated with myopia.
Effect of Emergency Severity Index Annual Competency Assessment on Mistriage
Authors: Hoffman Stefanie , Voss Jo A. , Hendrickx Lori , Gibson Nicole
Published: August 2022

Background:

There is limited evidence identifying best practices to promote competency of accurate assignment of the Emergency Severity Index (ESI) acuity level to patients who present to the emergency department (ED) triage.

Local Problem:

Triage-trained nurses do not receive competency training in an ESI triage tool.

Methods:

A retrospective chart review of 150 patients was completed to evaluate mistriage rates before and after triage-trained nurses completed an ESI competency assessment.

Results:

The retrospective chart review showed no statistically significant difference in mistriage from pre- to postintervention (P = .8535).

Conclusions:

Implementation of an ESI annual competency assessment aligns well with an emerging theme in the literature that ED nurses should be provided with ongoing education that reinforces knowledge and implementation of ESI triaging.
Readmission Predictors in Patients With Type II Diabetes
Authors: Timple Veronica Santos , Kawar Lina Najib
Published: August 2022

Background:

In patients with type II diabetes, hospital readmissions occur frequently and contribute significantly to morbidity. Limited research has predicted the factors that contribute to preventable readmission.

Purpose:

This study identified the predictors of 30-day hospital readmission in patients with type II diabetes.

Methods:

This single-site 400 patients study examined effects of comorbidities, race, endocrinology consultation, diabetes self-management education, and diabetes medications on 30-day hospital readmissions.

Results:

Patients with more comorbidities, who were Hispanics, and those who received an endocrinology consultation were more likely to be readmitted. Patients who received diabetes self-management education or were prescribed both oral and insulin medications were less likely to be readmitted.

Conclusion:

Findings identified the factors related to 30-day readmission in patients with diabetes, emphasizing the need for diabetes self-management education. Understanding why patients are readmitted within 30 days of initial admission will empower nurses to create targeted plans to improve nursing care quality and prevent readmission.
Risk Factors for Failure of Closed Forearm Fracture Reduction in the Pediatric Emergency Department
Authors: Cohen Neta , Gigi Roy , Haberman Shira , Capua Tali , Rimon Ayelet
Published: August 2022

Objectives

This study aimed to explore risk factors for failure of forearm fracture closed reduction in the pediatric emergency department (ED) and to suggest indications for initial surgery.

Methods

This retrospective cohort study included all patients aged 0 to 18 years who presented to our pediatric ED with an extraarticular forearm fracture treated with closed reduction between May 2017 and April 2021. We explored risk factors for procedural failure, defined as a need for surgical intervention within 6 weeks of the closed reduction attempt.

Results

Of 375 patients (median age 8.1 years, 294 [78.2%] boys), 44 (11.7%) patients sustained a reduction failure, of whom 42 (95.5%) had both radius and ulna fractures. Of the 259 patients with fractures of both bones, the following parameters were independent predictors for reduction failure: refracture (adjusted odds ratio [aOR] 17.6,P< 0.001), open fracture (aOR 10.1,P= 0.007), midshaft fracture (aOR 2.6,P= 0.004), radial translation rate 37% and higher in either plane (aOR 5.1,P= 0.004), and age of 10 years and older (aOR 2.9,P= 0.01).

Conclusions

Most pediatric forearm fractures can be successfully managed by closed reduction in the ED. Two-bone fractures had the strongest association with reduction failure. Refracture, open fracture, midshaft location, initial radius bone translation of 37% and higher (and not initial angulation), and patient age of 10 years and older are independent risk factors for reduction failure in two-bone fractures. We propose a risk score for reduction failure that can serve as a decision-making tool.
Impact of a Faster Computed Tomography Scanner on Sedation for Pediatric Head Computed Tomography Scans in 2 Large Emergency Departments—A Retrospective Study
Authors: Burger Rebecca Kriss , Figueroa Janet , Parikh Ashishkumar K. , Riedesel Erica L.
Published: August 2022

Objectives

Children in the emergency department (ED) often require sedation for head computed tomography (CT) to ensure adequate image quality. Image acquisition time for a head CT using a conventional single-source CT scanner is approximately 12 seconds; however, after installation in November 2017 of 2 new dual-source dual-energy CT scanners, that time decreased to 1 to 3 seconds. We hypothesized that fewer patients would require sedation using the faster CT scanners.

Methods

We conducted a retrospective chart review of patients aged 0 to 18 years undergoing head CT at 2 pediatric EDs within 1 hospital system, 2 years before and 2 years after installation of the faster CT scanner. Patients undergoing multiple CTs or other procedures were excluded. Demographic information, diagnosis, disposition, sedatives (chloral hydrate, dexmedetomidine, etomidate, fentanyl, ketamine, midazolam, methohexital, pentobarbital, and propofol) administered before imaging, and ED length of stay were analyzed.

Results

A total of 15,175 patient encounters met inclusion criteria, 7412 before and 7763 after installation of the new CT. The median age was 7 years and 44% were female. Before the new CT scanner was installed 8% required sedation, compared with 7% after (effect size, 0.0341). Midazolam was the most commonly administered sedative. Fewer patients required deep sedation using the faster CT scanner.

Conclusions

After installation of a dual-source dual-energy CT scanner, fewer patients required sedation to complete head CT in the pediatric ED. Faster image acquisition time decreased the need for deep sedation.
Brain-specific genes contribute to chronic but not to acute back pain
Authors: Bortsov Andrey V. , Parisien Marc , Khoury Samar , Martinsen Amy E. , Lie Marie Udnesseter , Heuch Ingrid , Hveem Kristian , Zwart John-Anker , Winsvold Bendik S. , Diatchenko Luda
Published: August 2022

Introduction:

Back pain is the leading cause of disability worldwide. Although most back pain cases are acute, 20% of acute pain patients experience chronic back pain symptoms. It is unclear whether acute pain and chronic pain have similar or distinct underlying genetic mechanisms.

Objectives:

To characterize the molecular and cellular pathways contributing to acute and chronic pain states.

Methods:

Cross-sectional observational genome-wide association study.

Results:

A total of 375,158 individuals from the UK Biobank cohort were included in the discovery of genome-wide association study. Of those, 70,633 (19%) and 32,209 (9%) individuals met the definition of chronic and acute back pain, respectively. A total of 355 single nucleotide polymorphism grouped into 13 loci reached the genome-wide significance threshold (5x10-8) for chronic back pain, but none for acute. Of these, 7 loci were replicated in the Nord-Trøndelag Health Study (HUNT) cohort (19,760 chronic low back pain cases and 28,674 pain-free controls). Single nucleotide polymorphism heritability was 4.6% (P=1.4x10-78) for chronic back pain and 0.81% (P=1.4x10-8) for acute back pain. Similar differences in heritability estimates between acute and chronic back pain were found in the HUNT cohort: 3.4% (P=0.0011) and 0.6% (P=0.851), respectively. Pathway analyses, tissue-specific heritability enrichment analyses, and epigenetic characterization suggest a substantial genetic contribution to chronic but not acute back pain from the loci predominantly expressed in the central nervous system.

Conclusion:

Chronic back pain is substantially more heritable than acute back pain. This heritability is mostly attributed to genes expressed in the brain.
Evaluation of Quantitative Aspects of Craniofacial Deformities in Transfusion Dependent Beta-Thalassemia Major Patients: A Cephalometric Study
Authors: Gupta Deepak Kumar , Singh Satinder Pal , Utreja Ashok , Verma Sanjeev
Published: August 2022

Purpose:

To evaluate the quantitative (cephalometric) aspects of the craniofacial deformities in transfusion-dependent beta-thalassemia (TDT) patients.

Materials and Methods:

Sixty-five TDT patients receiving a regular blood transfusion in the Department of Pediatrics of age group 5 to 8 years (younger) and 15 years and above (older) were compared with control groups of similar age using cephalograms (lateral and posterior-anterior view).

Results and Observation:

The prevalence of skeletal class II tendency is higher in thalassemic patients that do not improve with age. The thalassemic patients were found to show large angle ANB i.e. Angle between points point a, nasion and point B (ANB), large flexure angle, small angle SNB i.e. Angle between points sella, nasion and point B (SNB), and normal angle SNA i.e. Angle between points sella, nasion and point A (SNA) angles suggestive of retrognathic mandible. The thalassemic patients were observed to have smaller transverse widths and thickened calvarium on the posterior-anterior view.

Conclusion:

The skeletal class II malocclusion appears to be a manifestation of generalized growth retardation/delayed puberty in thalassemic patients leading to diminished mandibular growth, rather than maxillary prognathism due to marrow hyperplasia.
A Novel Technique for Spreader Flap by Folding the Dorsal Hump in Patients Undergoing Primary Rhinoplasty
Authors: AlAwadh Ibrahim H. , Bogari Ahmad , Assiri Hassan , Alabduljabbar Ziyad , AlNassar Raad , Hudise Jibril , AlArfaj Ahmed
Published: August 2022

Objectives:

We describe our novel modified spreader flap, which involves keeping the large cartilaginous septal T hump attached to the upper lateral cartilages to increase the thickness and length of the flap. Our objectives were to assess hump reduction and recurrence, nasal axis deviation, dorsal width, internal nasal valve grade, and Rhinoplasty Outcome Evaluation (ROE) score preoperatively and one year postoperatively.

Materials and Methods:

In a prospective study that included 21 patients who met the criteria, patients were followed up for 1 year after surgery, with an assessment of the dorsal projection, tip projection, axis deviation, dorsal width, and internal nasal valve grade. In addition, the modified Cottle maneuver and Rhinoplasty Outcome Evaluation score were also performed and obtained, respectively.

Results:

Our novel technique was performed in 20 patients (95.2%). In 1 additional patient, we added a regular auto-spreader flap on the contralateral side. One year postoperatively, the axis was found in the midline in all patients (100%). Assessment of internal valve collapse showed that collapse was reduced to grade 0 in 13 patients (61.9%) and grade 1 in 8 patients (38.1%). There were no hump recurrences or visible irregularities. The results showed a statistically significant difference between the pre- and postoperative values in dorsal projection, dorsal width, and rhinoplasty outcome evaluation score.

Conclusions:

This novel technique shows promising statistically significant results in reducing dorsal hump projection and width, correcting axis deviation, and improving internal nasal valve and rhinoplasty outcome evaluation score, while being less cartilage and time-consuming.
Nasal Sinus Mucoceles Manifesting Ocular Symptoms
Authors: Peng Xiao-lin , Yue Zhen-zhong , Zhang Yong-lan , Sun Pei-yong
Published: August 2022

Introduction:

To describe the ocular symptoms in a series of patients with nasal sinus mucoceles of different locations.

Methods:

The authors analyzed the diagnosis and treatment of patients with sinus mucoceles and ocular symptoms who presented to the hospital from February 2010 to April 2020. A total of 61 patients were included in the study. The locations of the mucoceles were the frontal sinus (8 patients), ethmoid sinus (25 patients), and sphenoid sinus (28 patients). The authors selected 1 typical mucocele case from each of the sinuses, including the frontal, ethmoid, and sphenoid sinuses, and analyzed the history, diagnosis, and treatment of mucoceles in each location.

Results:

The main clinical manifestations were ophthalmic symptoms, such as exophthalmos or displacement, eye pain, blindness or decreased vision, blepharoptosis, and diplopia; no obvious nasal symptoms were noted. Most patients with these symptoms went to an ophthalmologist first. All lesions in this study were found through imaging examinations. Most symptoms improved after surgical interventions. Only 2 of the 61 patients had no improvement in vision because of the long period of vision loss.

Conclusions:

Although sinus mucoceles are located in the sinuses, ocular symptoms are more prevalent than nasal symptoms. The earlier the imaging examinations are performed; the sooner lesions are detected, and the patients can be treated.
Errors in Surgery
Authors: Marsh Katherine M. , Turrentine Florence E. , Schenk Worthington G. , Hanks John B. , Schirmer Bruce D. , Davis John P. , McMurry Timothy L. , Ratcliffe Sarah J. , Zaydfudim Victor M. , Jones R.S.
Published: August 2022

Objective:

While errors can harm patients they remain poorly studied. This study characterized errors in the care of surgical patients and examined the association of errors with morbidity and mortality.

Background:

Errors have been reported to cause <10% or >60% of adverse events. Such discordant results underscore the need for further exploration of the relationship between error and adverse events.

Methods:

Patients with operations performed at a single institution and abstracted into the American College of Surgeons National Surgical Quality Improvement Program from January 1, 2018, to December 31, 2018 were examined. This matched case control study comprised cases who experienced a postoperative morbidity or mortality. Controls included patients without morbidity or mortality, matched 2:1 using age (±10 years), sex, and Current Procedural Terminology (CPT) group. Two faculty surgeons independently reviewed records for each case and control patient to identify diagnostic, technical, judgment, medication, system, or omission errors. A conditional multivariable logistic regression model examined the association between error and morbidity.

Results:

Of 1899 patients, 170 were defined as cases who experienced a morbidity or mortality. The majority of cases (n=93; 55%) had at least 1 error; of the 329 matched control patients, 112 had at least 1 error (34%). Technical errors occurred most often among both cases (40%) and controls (23%). Logistic regression demonstrated a strong independent relationship between error and morbidity (odds ratio=2.67, 95% confidence interval: 1.64–4.35, P<0.001).

Conclusion:

Errors in surgical care were associated with postoperative morbidity. Reducing errors requires measurement of errors.
The Relationship Between Trichotillomania and Serum Brain-Derived Neurotrophic Factor Levels in Children and Adolescents: A Case-Control Study
Authors: Akaltun İsmail
Published: August 2022

Objective

Trichotillomania (TTM) is a clinical psychiatric manifestation involving significant hair loss in association with recurrent hair-pulling behavior, the etiology of which is still unknown. Insufficiency or disorder in the synthesis of brain-derived neurotrophic factor (BDNF) is reported to be potentially associated with neurological, neurodegenerative, and psychiatric diseases in humans and animals. This study examines the relationship between serum BDNF levels and TTM.

Methods

Ninety-four children and adolescents, 47 patients with TTM and a 47-member control group, were included in the study. Participants were administered the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (6–18 Years) Present and Lifetime Version, and the members of the case group completed the Clinical Global Impression scale. Serum BDNF levels were determined from blood specimens collected from the study and control groups, and the results were subjected to statistical analysis.

Results

Serum BDNF levels were 11.06 ± 1.9 ng/mL in the TTM group and 13.78 ± 2.2 ng/mL in the control group. Serum BDNF was significantly lower in the case group than in the control group. Moderate negative correlation was also determined between Clinical Global Impression scores and serum BDNF levels in the case group.

Conclusions

Low serum BDNF was associated with TTM and the severity thereof. Furthermore, more extensive studies are needed to elucidate this association.
Hepatitis C virus infection reduces the lifespan of chimpanzees used in biomedical research
Authors: Hirata Satoshi , Havercamp Kristin , Yamanashi Yumi , Udono Toshifumi
Published: August 2022

Chimpanzees were used in hepatitis research for over three decades with the aim to identify and develop treatments for the virus, a leading cause of chronic liver disease in humans. We used a dataset of 120 chimpanzees housed at a single institution in Japan, 22 of whom became chronically infected with hepatitis C virus (HCV), to examine whether HCV infection results in a reduced lifespan as reported in humans. Survival analysis showed that HCV carriers experienced a higher mortality risk compared with non-carriers. Although no chimpanzee died from hepatic disease, carriers showed higher gamma-glutamyl transpeptidase (γGTP) levels compared with non-carriers suggesting that HCV infection negatively affected their liver condition. These results provide evidence that special attention is necessary to monitor the long-term condition of ex-biomedical primates.
Vernon Martin Ingram. 19 May 1924—17 August 2006
Authors: Kilmartin J. V. , Crowther R. A.
Published: August 2022

Vernon Ingram was a protein chemist who made important contributions to the development of protein crystallography and to the understanding of the role of mutations in the pathology of human haemoglobin diseases. Born in Germany, he moved to England, where he graduated and undertook his first research in London. After a post-doctoral time in the United States, he obtained a job in Cambridge at the Medical Research Council Unit for the Study of Molecular Structure of Biological Systems. He produced the first heavy atom derivatives of haemoglobin, which demonstrated that isomorphous replacement was a practical approach to solving protein structures by X-ray crystallography. While in Cambridge he characterized the single amino acid change that was responsible for the pathological behaviour of sickle cell haemoglobin. After six years in Cambridge, he moved to Massachusetts Institute of Technology, where he spent the rest of his career. There he continued to work on haemoglobin and later, among other projects, he studied the abnormal aggregation of proteins that occurs in many neurodegenerative diseases. Early in his career, within a couple of years, he had made two seminal contributions to the nascent field of molecular biology, and he is rightly regarded as one of the fathers of molecular medicine.
Ion channel model reduction using manifold boundaries
Authors: Whittaker Dominic G. , Wang Jiahui , Shuttleworth Joseph G. , Venkateshappa Ravichandra , Kemp Jacob M. , Claydon Thomas W. , Mirams Gary R.
Published: August 2022

Mathematical models of voltage-gated ion channels are used in basic research, industrial and clinical settings. These models range in complexity, but typically contain numerous variables representing the proportion of channels in a given state, and parameters describing the voltage-dependent rates of transition between states. An open problem is selecting the appropriate degree of complexity and structure for an ion channel model given data availability. Here, we simplify a model of the cardiac human Ether-à-go-go related gene (hERG) potassium ion channel, which carries cardiac
I
Kr
, using the manifold boundary approximation method (MBAM). The MBAM approximates high-dimensional model-output manifolds by reduced models describing their boundaries, resulting in models with fewer parameters (and often variables). We produced a series of models of reducing complexity starting from an established five-state hERG model with 15 parameters. Models with up to three fewer states and eight fewer parameters were shown to retain much of the predictive capability of the full model and were validated using experimental hERG1a data collected in HEK293 cells at 37°C. The method provides a way to simplify complex models of ion channels that improves parameter identifiability and will aid in future model development.
Emigration or return? International mobility and Theodore von Kármán's Chinese students and associates
Authors: Zhihui Zhang
Published: August 2022

This paper traces the experiences of about a dozen Chinese students/scientists who studied with the aerodynamicist Theodore von Kármán at the California Institute of Technology in the 1930s and 1940s. This special group provides an early instance of a situation that has attracted significant scholarly attention since the 1960s—educational migration of highly talented individuals and the difficult choices those individuals faced when they decided to stay abroad or to return home. This study deepens the scholarship on ‘study abroad motivation’ for international students and the push–pull factors related to returning to their homeland or staying abroad. Kármán tried to support his students' decisions whatever they were, without putting pressure on their decision to stay or to return. The thinking of the students was inevitably affected by changes in Sino–US relations and changes in US policy. All struggled to meet their obligation to homeland, family expectations and senses of personal honour against the advanced academic environment they had enjoyed. The stability of America's peaceful society and improved material standards of living compared with China made this a difficult decision. Different people balanced these competing demands differently. The key was how they decided to take advantage—or not—of the new circumstances.
Recovery and genetic characterization of black queen cell virus
Authors: Yang Sa , Deng Yanchun , Zhang Li , Wang Xinling , Deng Shuai , Dai Pingli , Hou Chunsheng
Published: August 2022

Black queen cell virus (BQCV) is a severe threat to the honeybee (Apis mellifera) worldwide. Although several BQCV strains have been reported in China, the molecular basis for BQCV pathogenicity has not been well understood. Thus, a reverse genetic system of BQCV is required for studying viral replication and its pathogenic mechanism. Here, the complete genome sequence of BQCV was obtained from honeybees using reverse transcription PCR (RT-PCR), namely a BQCV China-GS1 strain (KY741959). Then, a phylogenetic tree was built to analyse the genetic relationships among BQCV strains from different regions. Our results showed that the BQCV China-GS1 contained two ORFs, consistent with the known reference strains, except for the BQCV China-JL1 strain (KP119603). Furthermore, the infectious clone of BQCV was constructed based on BQCV China-GS1 using a low copy vector pACYC177 and gene recombination. Due to the lack of culture cells for bee viruses, we infected the healthy bees with infectious clone of BQCV, and the rescued BQCV resulted in the recovery of recombinant virus, which induced higher mortality than those of the control group. Immune response after inoculated with BQCV further confirmed that the infectious clone of BQCV caused the cellular and humoral immune response of honeybee (A. mellifera). In conclusion, the full nucleotide sequence of BQCV China-GS1 strain was determined, and the infectious clone of BQCV was constructed in this study. These data will improve the understanding of pathogenesis and the host immune responses to viral infection.
The acceptability of testing contacts of confirmed COVID-19 cases using serial, self-administered lateral flow devices as an alternative to self-isolation
Authors: Love Nicola K. , Ready Derren R. , Turner Charlie , Yardley Lucy , Rubin G. James , Hopkins Susan , Oliver Isabel
Published: August 2022

Introduction. Evidence suggests that although people modify their behaviours, full adherence to self-isolation guidance in England may be suboptimal, which may have a detrimental impact on COVID-19 transmission rates.

Hypothesis. Testing asymptomatic contacts of confirmed COVID-19 cases for the presence of SARS-CoV-2 could reduce onward transmission by improving case ascertainment and lessen the impact of self-isolation on un-infected individuals.

Aim. This study investigated the feasibility and acceptability of implementing a ‘test to enable approach’ as part of England’s tracing strategy.

Methodology. Contacts of confirmed COVID-19 cases were offered serial testing as an alternative to self-isolation using daily self-performed lateral flow device (LFD) tests for the first 7 days post-exposure. Asymptomatic participants with a negative LFD result were given 24 h of freedom from self-isolation between each test. A self-collected confirmatory PCR test was performed on testing positive or at the end of the LFD testing period.

Results. Of 1760 contacts, 882 consented to daily testing, of whom 812 individuals were within 48 h of exposure and were sent LFD testing packs. Of those who declined to participate, 39.1% stated they had already accessed PCR testing. Of the 812 who were sent LFD packs, 570 (70.2%) reported one or more LFD results; 102 (17.9%) tested positive. Concordance between reported LFD result and a supplied LFD image was 97.1%. In total, 82.8% of PCR-positive samples and 99.6% of PCR-negative samples were correctly detected by LFD. The proportion of secondary cases from contacts of those who participated in the study and tested positive (6.3%; 95% CI: 3.4–11.1%) was comparable to a comparator group who self-isolated (7.6%; 95% CI: 7.3–7.8%).

Conclusion. This study shows a high acceptability, compliance and positivity rates when using self-administered LFDs among contacts of confirmed COVID-19 cases. Offering routine testing as a structured part of the contact tracing process is likely to be an effective method of case ascertainment.
Anakinra in hospitalized COVID-19 patients guided by baseline soluble urokinase plasminogen receptor plasma levels: a real world, retrospective cohort study
Authors: Segala Francesco Vladimiro , Rando Emanuele , Salvati Federica , Negri Marcantonio , Catania Francesca , Sanmartin Flavia , Murri Rita , Giamarellos-Bourboulis Evangelos J. , Fantoni Massimo
Published: August 2022

Background

In patients with COVID-19 and baseline soluble urokinase plasminogen receptor plasma (suPAR) levels ≥ 6ng/mL, early administration of anakinra, a recombinant interleukin-1 receptor antagonist, may prevent disease progression and death. In case of suPAR testing unavailability, the Severe COvid Prediction Estimate (SCOPE) score may be used as an alternative in guiding treatment decisions.

Methods

We conducted a monocenter, retrospective cohort study, including patients with SARS-CoV2 infection and respiratory failure. Patients treated with anakinra (anakinra group, AG) were compared to two control groups of patients who did not receive anakinra, respectively with ≥ 6 ng/mL (CG1) and < 6 ng/mL (CG2) baseline suPAR levels. Controls were paired by age, sex, date of admission and vaccination status. Primary endpoint of the study was disease progression at day 14 from admission, as defined by patient distribution on a simplified version of the 11-point World Health Organization Clinical Progression Scale (WHO-CPS).

Results

Between July, 2021 and January, 2022, 153 patients were included, among which 56 were treated with off-label anakinra, 49 retrospectively fulfilled prescriptive criteria for anakinra and were assigned to CG1, and 48 presented with suPAR levels < 6ng/mL and were assigned to CG2. At day 14, when comparing to CG1, patients who received anakinra had significantly reduced odds of progressing towards worse clinical outcome both in ordinal regression analysis (OR 0.25, 95% CI 0.11-0.54, p<0.001) and in multivariable analysis (OR 0.19, 95% CI 0.03-0.82, p=0.037), and these results were confirmed even when controlling for age, sex, BMI and vaccinal status. Sensitivities of baseline suPAR and SCOPE score in predicting progression towards severe disease or death at day 14 were similar (83% vs 100%, p=0.59).

Conclusion

This real-word, retrospective cohort study confirmed the safety and the efficacy of suPAR-guided, early use of anakinra in hospitalized COVID-19 patients with respiratory failure.
Assessing the Relationship Between Zero-Dose Communities and Access to Selected Primary Healthcare Services for Children and Pregnant Women in Emergency Settings
Authors: Suprenant MP , Nyankesha E , Moreno-Garcia R , Buj V , Yakubu A , Shafique F , Zaman MH
Published: August 2022

In this study the authors examine the relationship between “zero-dose” communities and access to other healthcare services. This was done by first ensuring the first dose of the Diphtheria Tetanus and Pertussis vaccine was a better measure of zero-dose communities than the measles-containing vaccine. Once the best variable was selected, it was used to examine the association with access to primary healthcare services for children and pregnant women residing in the Democratic Republic of Congo, Afghanistan, and Bangladesh, each of which are currently experiencing emergencies of various contexts and degrees. These services were divided into: a) unscheduled healthcare services such as birth assistance as well as seeking care and treatment for diarrheal diseases and cough/fever episodes and b) other scheduled health services such as antenatal care visits and vitamin A supplementation. Using the most recent Demographic Health Survey data from each country (2014: Democratic Republic of Congo, 2015: Afghanistan, 2018: Bangladesh), data was analyzed via Chi Squared analysis or Fischer’s Exact Test. If results were significant, a univariate linear regression analysis was performed to examine if the noted association was linear. While the linear relationship observed between children who had received the first dose of the Diphtheria Tetanus and Pertussis vaccine (the reverse to zero-dose communities) and coverage of other vaccines was expected, the results of the regression analysis depicted an unexpected split in behavior between scheduled (and birth assistance) and unscheduled illness treatment services. For scheduled and birth assistance health services, a linear relationship was generally observed. Meanwhile, for unscheduled services associated with infectious disease treatments, a linear relationship was generally not observed. While in our study it does not appear that first dose of the Diphtheria Tetanus and Pertussis vaccine, the best proxy of zero-dose communities, can be used to predict (at least in a direct linear manner) access to some primary (particularly infectious treatments) healthcare services in emergency/humanitarian settings, it can serve as an indirect measure of health services not associated with the treatment of childhood infections such as antenatal care, skilled birth assistance, and to a lesser degree even vitamin A supplementation.
Metabolomic and gut microbiome profiles across the spectrum of community-based COVID and non-COVID disease: A COVID-19 Biobank study
Authors: Österdahl Marc F. , Whiston Ronan , Sudre Carole H. , Asnicar Francesco , Cheetham Nathan J. , Miguez Aitor Blanco , Bowyer Vicky , Antonelli Michela , Snell Olivia , dos Santos Canas Liane , Hu Christina , Wolf Jonathan , Menni Cristina , Malim Michael , Hart Deborah , Spector Tim , Berry Sarah , Segata Nicola , Doores Katie , Ourselin Sebastien , Duncan Emma L , Steves Claire J
Published: August 2022

Whilst many with SARS-CoV-2 infection have mild disease, managed in the community, individuals with cardiovascular risk factors experienced often more severe acute disease, requiring hospitalisation. Increasing concern has also developed over long symptom duration in many individuals, including the majority who managed acutely in the community. Risk factors for long symptom duration, including biological variables, are still poorly defined.

We examine post-illness metabolomic and gut-microbiome profiles, in community-dwelling participants with SARS-CoV-2, ranging from asymptomatic illness to Post-COVID Syndrome, and participants with prolonged non-COVID-19 illnesses. We also assess a pre-established metabolomic biomarker score for its association with illness duration.

We found an atherogenic-dyslipidaemic metabolic profile, and greater biomarker scores, associated with longer illness, both in individuals with and without SARS-CoV-2 infection. We found no association between illness duration and gut microbiome in convalescence.

Findings highlight the potential role of cardiometabolic dysfunction to the experience of long illness duration, including after COVID-19.
Understanding the impact of COVID-19 risk perceptions on mitigation behaviors: A mixed methods approach using survey instruments and serious games
Authors: Merrill Scott C. , Nowak Sarah A. , Shrum Trisha R. , Hanley John P. , Clark Eric M. , Fredrickson Luke , Liu Tung-Lin , Beattie Robert M. , O’Keefe Aislinn , Zia Asim , Koliba Christopher J.
Published: August 2022

COVID-19 risk mitigation behavior, including social distancing and mask wearing, was a principal factor influencing the spread of COVID-19. Yet this behavior, and its association with COVID-19 perceptions and beliefs, is poorly understood. Here we used a mixed methods approach combining serious game data with survey instruments to describe relationships between perceptions and behavior. Using a series of survey questions, participants were described along a spectrum denoting their perception of their susceptibility to COVID-19 associated with a list of activities. Afterwards, participants engaged with a serious game to examine behavioral responses to scenarios involving shopping at a grocery store and going to a park during simulated pandemic conditions. Messages describing the simulated infection risk were shown to drive many behavioral decisions. Another significant correlate, derived from survey results, was the participant’s perception of susceptibility associated with various activities for acquiring the COVID-19 infection. Individuals that perceived every day activities, such as grocery shopping, as unlikely to lead to a COVID-19 infection spent more time near others in the game-simulated grocery store environment compared to those that consider such activities as risky. Additionally, we found that participant behavior became increasingly risky as time progresses if they were lucky enough not to experience an infection. This reflects behavior observed in the United States and more broadly, possibly explains how people update their perception of the risk of activities. Overall, results show a link between perception and action with regards to COVID-19 and support the use of targeted risk messaging to influence behavior. Moreover, the link between reported real-world perceptions and game behavior suggest that serious games can be used as valuable tools to test policies, risk messaging and communication, with the goal of nudging individuals with varied and nuanced perceptions and belief sets towards behaviors that will reduce the impact of COVID-19.
Pharmacological and psychological treatment have common and specific effects on brain activity in obsessive-compulsive disorder
Authors: van der Straten AL , Bruin WB , van de Mortel LA , ten Doesschate F , Merkx MJM , de Koning PP , Vulink NCC , Figee M , van den Heuvel OA , Denys D , van Wingen GA
Published: August 2022

Background

Initial treatment for obsessive-compulsive disorder (OCD) consists of pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs) and/or psychological treatment with cognitive-behavioral therapy (CBT). The assumption is that both treatments have different neural working mechanisms, but empirical evidence is lacking. We investigated whether these treatments induce similar or different functional neural changes in OCD.

Methods

We conducted a longitudinal non-randomised controlled trial in which thirty-four OCD patients were treated with sixteen weeks of CBT or SSRIs. Functional magnetic resonance imaging was performed before and after treatment during emotional processing (emotional face matching and symptom provocation tasks) and response inhibition (stop signal task). Twenty matched healthy controls were scanned twice with a similar time interval. The study was registered at the Netherlands Trial Registry (NTR6575), https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6575.

Results

Both CBT and SSRIs were successful in reducing OCD symptoms. Compared to healthy controls, treatment led to a reduction of insula activity in OCD patients during symptom provocation. The comparison between treatment groups revealed wide-spread divergent brain changes in the cerebellum, posterior insula, caudate nucleus, hippocampus, occipital and prefrontal cortex during all tasks, explained by relative increases of activity following CBT compared to relative decreases of activity following SSRIs.

Conclusions

Pharmacological and psychological treatment primarily lead to opposite changes in brain function, with a common reduction of insula activity during symptom provocation. These findings provide insight in common and specific neural mechanisms underlying treatment response, suggesting that CBT and SSRIs support recovery from OCD along partly distinct pathways.
Effects of behavioral restrictions on COVID-19 spread
Authors: Sasaki Kenji , Ikeda Yoichi , Nakano Takashi
Published: August 2022

Several measures including behavioral restrictions for individuals have been taken to control the spread of COVID-19 all over the world. The aim of these measures is to prevent infected persons from contacting with susceptible persons. Since the behavioral restrictions for all citizens, such as the city-wide lockdown, are directly linked to stagnation of economic activities, the assessment of such measures is crucial. In order to evaluate the effects of behavioral restrictions, we employ the broken-link model to compare the situation of COVID-19 in Shanghai where the lockdown was implemented from March to June 2022 with it in Taiwan where a spread of COVID-19 was known to be well controlled so far. The result shows that the small link-connection probability is achieved by substantial isolation of infected person including the lockdown measures. Although the strict measures for behavioral restrictions are effective to reduce the total infected people, the daily confirmed cases follow the curve which is evaluated by the broken-link model. This result is considered as unavoidable infections for population.
Clinical effectiveness of SARS-CoV-2 booster vaccine against Omicron infection in residents and staff of Long-Term Care Facilities: a prospective cohort study (VIVALDI)
Authors: Stirrup Oliver , Shrotri Madhumita , Adams Natalie L. , Krutikov Maria , Nacer-Laidi Hadjer , Azmi Borscha , Palmer Tom , Fuller Christopher , Irwin-Singer Aidan , Baynton Verity , Tut Gokhan , Moss Paul , Hayward Andrew , Copas Andrew , Shallcross Laura
Published: August 2022

Background

Successive SARS-CoV-2 variants have caused severe disease in long-term care facility (LTCF) residents. Primary vaccination provides strong short-term protection, but data are limited on duration of protection following booster vaccines, particularly against the Omicron variant. We investigated effectiveness of booster vaccination against infections, hospitalisations and deaths among LTCF residents and staff in England.

Methods

We included residents and staff of LTCFs within the VIVALDI study (ISRCTN 14447421) who underwent routine, asymptomatic testing (December 12 2021-March 31 2022). Cox regression was used to estimate relative hazards of SARS-CoV-2 infection, and associated hospitalisation and death at 0-13, 14-48, 49-83 and 84 days after dose 3 of SARS-CoV-2 vaccination compared to 2 doses (after 84+ days), stratified by previous SARS-CoV-2 infection and adjusting for age, sex, LTCF capacity and local SARS-CoV-2 incidence.

Results

14175 residents and 19973 staff were included. In residents without prior SARS-CoV-2 infection, infection risk was reduced 0-83 days after first booster, but no protection was apparent after 84 days. Additional protection following booster vaccination waned, but was still present at 84+ days for COVID-associated hospitalisation (aHR: 0.47, 0.24-0.89) and death (aHR: 0.37, 0.21-0.62). Most residents (64.4%) had received primary course of AstraZeneca, but this did not impact on pre- or post-booster risks. Staff showed a similar pattern of waning booster effectiveness against infection, with few hospitalisations and no deaths.

Conclusions

Booster vaccination provides sustained protection against severe outcomes following infection with the Omicron variant, but no protection against infection from 3 months onwards. Ongoing surveillance for SARS-CoV-2 in LTCFs is crucial.

The COVID-19 pandemic has severely impacted residents in long-term care facilities (LTCFs). Booster vaccination provides sustained moderate protection against severe outcomes, but no protection against infection was apparent from around 3 months onwards. Ongoing surveillance in LTCFs is crucial.
The Relationship Between Work Pressure, Cognitive Evaluation and Burnout of Young Doctors
Authors: Zhang Rui-ting
Published: August 2022

Objective

At present, there are relatively few studies on the burnout of young doctors in China. This study can enrich the relationship between work pressure, cognitive evaluation(benign and stress)and burnout among young doctors, and help to understand the current situation of burnout among young doctors.

Methods

A questionnaire survey was conducted among 116 young doctors from different departments to collect data on career motivation, work stress, cognitive evaluation and burnout.

Result

(1)The work pressure of young doctors has a predictive effect on burnout.(2)The primary evaluation of young doctors has an independent effect on burnout.(3)The 116 young doctors surveyed in this article are all at a high level of burnout.

Conclusion

(1)The work pressure of young doctors has a predictive effect on job burnout. Effective intervention on pay-reward can further reduce the sense of burnout of young doctors and reduce occupational stress.(2)The primary evaluation of young doctors has an independent impact on burnout, and positive cognitive evaluation is beneficial to reduce the level of burnout.
Is the self-reporting of mental health problems sensitive to public stigma towards mental illness? A comparison of time trends across English regions (2009-19)
Authors: Gagné Thierry , Henderson Claire , McMunn Anne
Published: August 2022

Purpose

The prevalence of mental health problems has rapidly increased over time. The extent to which this captures changes in self-reporting due to decreasing stigma is unclear. We explore this by comparing time trends in mental health and stigma-related indicators across English regions.

Methods

We produced annual estimates of self-reported mental disorders (SRMDs) across waves of the Health Survey for England (2009-18, n = 78,226) and three stigma-related indicators (knowledge, attitudes, and intended behaviour) across waves of the Attitudes Towards Mental Illness survey (2009-19, n = 17,287). Differences in trends were tested across nine Government Office Regions using linear models, adjusting for age, sex, ethnicity, marital status, and social class.

Results

In 2009, SRMDs did not vary by region (p = .916) whereas stigma-related indicators did (p < .001), with London having the highest level of stigma and the North East having lowest level of stigma. Between 2009 and 2018-19, SRMDs increased and stigma-related indicators improved at different rates across regions (SRMDs p = .024; stigma-related indicators p < .001). London reported the lowest increase in SRMDs (+0.3 percentage point per year) yet among the largest improvements in attitudes and intended behaviour across regions.

Conclusions

Improvements in attitudes towards mental illness did not mirror changes in self-reported mental health problems across English regions over the past decade. The findings do not support the argument that changes in public stigma, at least when defined at this regional scale, have been driving the increase in self-reported mental health indicators in recent years.