bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with risk sexual behaviours of HIV/STDs infection among university students in Henan, China: a cross-sectional study
Authors: Du Xiaoan , Zhang Ling , Luo Hong , Rong Wenlong , Meng Xianxin , Yu Hang , Tan Xiaodong
Published: August 2021

Background

This study aimed to identify factors associated with risk sexual behaviours and target high-risk groups at risk of HIV/STDs infection among university students.

Methods

The cross-sectional study was conducted from 1 November to 31 December 2020 in one university, located in Henan Province. A total of 1602 individuals who reported having ever had sex were analyzed as the subjects of this study. Descriptive analysis and multivariable logistic regression analysis were applied for this study to assess factors associated with risk sexual behaviours among university students.

Results

University students who reported having ever had sex accounted for about 9%, with an average age of 19.37 ± 1.03. Of them, having multiple sexual partners and inconsistent condom use during the last 6 months were 37.3% and 35%, respectively. Over 50% of participants had their sexual debut before the age of 18. Bisexual students (AOR = 0.27; 95% CI 0.16, 0.44) and those who lived on over 3000 Yuan per month (AOR = 0.50; 95% CI 0.28, 0.91) were consistently less likely to engage in condom use during the last 6 months. University students who were from high-grade (AOR = 1.56; 95% CI 1.12, 2.18 for sophomore; AOR = 1.84; 95% CI 1.28, 2.65 for junior; AOR = 2.07; 95% CI 1.38, 3.11 for senior), who lived on over 3,000 Yuan per month (AOR = 4.19; 95% CI 2.17, 8.11) or who reported being homosexual (AOR = 3.92; 95% CI 2.17, 7.06) and bisexual (AOR = 33.22; 95% CI 13.11, 84.15) were more likely to have multiple sexual relationships. University students who had sexual debut before the age of 18 were more likely to engage in risk sexual behaviours.

Conclusions

The prevalence of sexual activity among Chinese university students is generally low, but risk sexual behaviours are of considerable concern. University students with higher living expenses, who are not heterosexual and who are younger at first sexual intercourse tend to engage in risk sexual behaviours. The scale-up of intervention is the need to prevent the expansion of the HIV epidemic among young students.
Hsa_circ_0004674 promotes osteosarcoma doxorubicin resistance by regulating the miR-342-3p/FBN1 axis
Authors: Bai Yumei , Li Yanghua , Bai Juan , Zhang Yumei
Published: August 2021

Background

The occurrence of chemoresistance is a common problem in tumor treatment. Circular RNA (circRNA) has been confirmed to be related to tumor chemoresistance. However, the role and the underlying molecular mechanism of hsa_circ_0004674 in the chemoresistance of osteosarcoma (OS) are still unclear.

Methods

The expression of hsa_circ_0004674, miR-342-3p, and fibrillin-1 (FBN1) was determined by qRT-PCR. Cell counting kit 8 assay was used to evaluate the doxorubicin (DXR) resistance of cells. The proliferation and apoptosis of cells were measured using colony formation assay and flow cytometry. Western blot analysis was utilized to examine the protein levels of resistance markers, Wnt/β-catenin pathway markers and FBN1. The interaction between miR-342-3p and hsa_circ_0004674 or FBN1 was confirmed by dual-luciferase reporter assay and RNA pull-down assay. Moreover, animal experiments were performed to assess the effect of hsa_circ_0004674 silencing on the DXR sensitive of OS in vivo.

Results

The upregulated hsa_circ_0004674 was found in DXR-resistant OS tissues and cells. Knockdown of hsa_circ_0004674 could inhibit the DXR resistance of OS cells in vitro and promote the DXR sensitive of OS tumors in vivo. In addition, we discovered that hsa_circ_0004674 could sponge miR-342-3p, and miR-342-3p could target FBN1. MiR-342-3p inhibitor could reverse the inhibition effect of hsa_circ_0004674 knockdown on the DXR resistance of OS cells. Similarly, the suppressive effect of miR-342-3p on the DXR resistance of OS cells also could be reversed by FBN1 overexpression. Furthermore, we revealed that hsa_circ_0004674 silencing inhibited the activity of Wnt/β-catenin pathway by the miR-342-3p/FBN1 axis.

Conclusion

Hsa_circ_0004674 facilitated the DXR resistance of OS through Wnt/β-catenin pathway via regulating the miR-342-3p/FBN1 axis, suggesting that hsa_circ_0004674 was a promising target for the chemoresistance of OS.
Megaendoprostheses in the management of malignant tumors of the lower extremities—risk factors for revision surgery
Authors: von Salis-Soglio Moritz , Ghanem Mohamed , Lycke Christian , Roth Andreas , Osterhoff Georg
Published: August 2021

Background

Improved oncological and surgical measures now enable curative treatment of malignant lower extremity tumors in majority of cases. Complication rates associated with surgical resection of lower extremity tumors and replacement with megaendoprostheses are high. The aim of this study was to identify risk factors that predispose to revision surgery following the use of megaimplants in curative treatment of malignant tumors of the lower extremities.

Methods

this retrospective study included patients aged ≥ 18 years who underwent implantation of a megaendoprosthesis for tumors or metastatic lesions of the lower extremities between January 2010 and December 2020. Baseline characteristics and information on adjuvant treatment, hospitalization time, comorbidities, mobility, complications, and revision surgery were considered. Primary outcomes were revision surgery and reasons for revision. Secondary outcomes were in-hospital complications and the duration of hospitalization.

Results

Fifty-four patients (48% female, age 63 years, SD 15) were available for final analysis. Surgeries were performed at hip level in 37 patients (68.5%) and at knee level in 17 patients (31.5%). Revision for wound-related causes was performed in 12 cases (22.2%), with microbiological proof of infection in 8 cases (14.8%). Revision for hip joint instability was carried out in 4 cases (7.4%) and for disconnection between components of the megaimplant in 2 cases (3.7%). Those patients requiring a wound-related revision had undergone a longer primary surgical intervention than those who required an implant-related revision (276 vs 134 min, p = .002). Wound drains after the primary implantation remained longer in situ in patients who later required revision surgery for wound-related complications (5 vs 3 days, p = .020). An ASA > 3 was associated with an increased likelihood for in-hospital complications in general (p = .041), and in-hospital death in particular (p = .012).

Conclusions

The management of malignant tumors of the lower extremities with megaendoprostheses is associated with a high rate of wound-related complications. Swift surgical performance and early postoperative removal of wound drains minimize the risk of complications in general and the necessity of revision surgery in particular. Patients with more comorbidities were more likely to suffer in-hospital complications.
Anti-malarial drug: the emerging role of artemisinin and its derivatives in liver disease treatment
Authors: Xiong Ye , Huang Jianrong
Published: August 2021

Artemisinin and its derivatives belong to a family of drugs approved for the treatment of malaria with known clinical safety and efficacy. In addition to its anti-malarial effect, artemisinin displays anti-viral, anti-inflammatory, and anti-cancer effects in vivo and in vitro. Recently, much attention has been paid to the therapeutic role of artemisinin in liver diseases. Several studies suggest that artemisinin and its derivatives can protect the liver through different mechanisms, such as those pertaining to inflammation, proliferation, invasion, metastasis, and induction of apoptosis and autophagy. In this review, we provide a comprehensive discussion of the underlying molecular mechanisms and signaling pathways of artemisinin and its derivatives in treating liver diseases. Further pharmacological research will aid in determining whether artemisinin and its derivatives may serve as promising medicines for the treatment of liver diseases in the future.
Phase 1 study of M2698, a p70S6K/AKT dual inhibitor, in patients with advanced cancer
Authors: Tsimberidou Apostolia-Maria , Shaw Jamie V. , Juric Dejan , Verschraegen Claire , Weise Amy M. , Sarantopoulos John , Lopes Gilberto , Nemunaitis John , Mita Monica , Park Haeseong , Ellers-Lenz Barbara , Tian Hui , Xiong Wenyuan , Kaleta Remigiusz , Kurzrock Razelle
Published: August 2021

Background

The PI3K/AKT/mTOR (PAM) pathway is a key regulator of tumor therapy resistance. We investigated M2698, an oral p70S6K/AKT dual inhibitor, in patients with advanced cancer who failed standard therapies.

Methods

M2698 was administered as monotherapy (escalation, 15–380 mg daily; food effect cohort, 240–320 mg daily) and combined with trastuzumab or tamoxifen.

Results

Overall, 101 patients were treated (M2698, n = 62; M2698/trastuzumab, n = 13; M2698/tamoxifen, n = 26). Patients were predominantly aged < 65 years, were female, had performance status 1 and were heavily pretreated. There was a dose- and concentration-dependent inhibition of pS6 levels in peripheral blood mononuclear cells and tumor tissue. M2698 was well tolerated; the most common treatment-emergent adverse events were gastrointestinal, abnormal dreams and fatigue (serious, attributed to M2698: monotherapy, 8.1%; M2698/trastuzumab, 7.7%; M2698/tamoxifen, 11.5% of patients). The recommended phase 2 doses of M2698 were 240 mg QD (monotherapy), 160 mg QD (M2698/trastuzumab) and 160 mg QD/240 mg intermittent regimen (M2698/tamoxifen). In the monotherapy cohort, 27.4% of patients had stable disease at 12 weeks; no objective response was noted. The median progression-free survival (PFS) durations in patients with PAM pathway alterations with and without confounding markers (KRAS, EGFR, AKT2) were 1.4 months and 2.8 months, respectively. Two patients with breast cancer (M2698/trastuzumab, n = 1; M2698/tamoxifen, n = 1) had partial response; their PFS durations were 31 months and 2.7 months, respectively.

Conclusions

M2698 was well tolerated. Combined with trastuzumab or tamoxifen, M2698 demonstrated antitumor activity in patients with advanced breast cancer resistant to multiple standard therapies, suggesting that it could overcome treatment resistance.

Trial registration ClinicalTrials.gov, NCT01971515. Registered October 23, 2013.
Estimating the impact of Tiny Targets in reducing the incidence of Gambian sleeping sickness in the North-west Uganda focus
Authors: Bessell Paul R. , Esterhuizen Johan , Lehane Michael J. , Longbottom Joshua , Mugenyi Albert , Selby Richard , Tirados Inaki , Torr Steve J. , Waiswa Charles , Wamboga Charles , Hope Andrew
Published: August 2021

Background

Riverine species of tsetse (Glossina) transmit Trypanosoma brucei gambiense, which causes Gambian human African trypanosomiasis (gHAT), a neglected tropical disease. Uganda aims to eliminate gHAT as a public health problem through detection and treatment of human cases and vector control. The latter is being achieved through the deployment of ‘Tiny Targets’, insecticide-impregnated panels of material which attract and kill tsetse. We analysed the spatial and temporal distribution of cases of gHAT in Uganda during the period 2010–2019 to assess whether Tiny Targets have had an impact on disease incidence.

Methods

To quantify the deployment of Tiny Targets, we mapped the rivers and their associated watersheds in the intervention area. We then categorised each of these on a scale of 0–3 according to whether Tiny Targets were absent (0), present only in neighbouring watersheds (1), present in the watersheds but not all neighbours (2), or present in the watershed and all neighbours (3). We overlaid all cases that were diagnosed between 2000 and 2020 and assessed whether the probability of finding cases in a watershed changed following the deployment of targets. We also estimated the number of cases averted through tsetse control.

Results

We found that following the deployment of Tiny Targets in a watershed, there were fewer cases of HAT, with a sampled error probability of 0.007. We estimate that during the intervention period 2012–2019 we should have expected 48 cases (95% confidence intervals = 40–57) compared to the 36 cases observed. The results are robust to a range of sensitivity analyses.

Conclusions

Tiny Targets have reduced the incidence of gHAT by 25% in north-western Uganda.

Graphical abstract
Detection of the Japanese encephalitis vector mosquito Culex tritaeniorhynchus in Australia using molecular diagnostics and morphology
Authors: Lessard Bryan D. , Kurucz Nina , Rodriguez Juanita , Carter Jane , Hardy Christopher M.
Published: August 2021

Background

Culex (Culex) tritaeniorhynchus is an important vector of Japanese encephalitis virus (JEV) affecting feral pigs, native mammals and humans. The mosquito species is widely distributed throughout Southeast Asia, Africa and Europe, and thought to be absent in Australia.

Methods

In February and May, 2020 the Medical Entomology unit of the Northern Territory (NT) Top End Health Service collected Cx. tritaeniorhynchus female specimens (n = 19) from the Darwin and Katherine regions. Specimens were preliminarily identified morphologically as the Vishnui subgroup in subgenus Culex. Molecular identification was performed using cytochrome c oxidase subunit 1 (COI) barcoding, including sequence percentage identity using BLAST and tree-based identification using maximum likelihood analysis in the IQ-TREE software package. Once identified using COI, specimens were reanalysed for diagnostic morphological characters to inform a new taxonomic key to related species from the NT.

Results

Sequence percentage analysis of COI revealed that specimens from the NT shared 99.7% nucleotide identity to a haplotype of Cx. tritaeniorhynchus from Dili, Timor-Leste. The phylogenetic analysis showed that the NT specimens formed a monophyletic clade with other Cx. tritaeniorhynchus from Southeast Asia and the Middle East. We provide COI barcodes for most NT species from the Vishnui subgroup to aid future identifications, including the first genetic sequences for Culex (Culex) crinicauda and the undescribed species Culex (Culex) sp. No. 32 of Marks. Useful diagnostic morphological characters were identified and are presented in a taxonomic key to adult females to separate Cx. tritaeniorhynchus from other members of the Vishnui subgroup from the NT.

Conclusions

We report the detection of Cx. tritaeniorhynchus in Australia from the Darwin and Katherine regions of the NT. The vector is likely to be already established in northern Australia, given the wide geographical spread throughout the Top End of the NT. The establishment of Cx. tritaeniorhynchus in Australia is a concern to health officials as the species is an important vector of JEV and is now the sixth species from the subgenus Culex capable of vectoring JEV in Australia. We suggest that the species must now be continuously monitored during routine mosquito surveillance programmes to determine its current geographical spread and prevent the potential transmission of exotic JEV throughout Australia.

Graphical abstract
Evaluation of a mosquito home system for controlling Aedes aegypti
Authors: Mohd Ngesom Ahmad Mohiddin , Ahmad Razi Anis , Azizan Nur Syahirah , Wasi Ahmad Nazni , Md Lasim Asmalia , Liang Yanfeng , Greenhalgh David , Min Jasmine Chia Siew , Sahani Mazrura , Hod Rozita , Othman Hidayatulfathi
Published: August 2021

Background

Dengue is a significant public health issue that is caused by Aedes spp. mosquitoes. The current vector control methods are unable to effectively reduce Aedes populations and thus fail to decrease dengue transmission. Hence, there is an urgent need for new tools and strategies to reduce dengue transmission in a wide range of settings. In this study, the Mosquito Home System (MHS) and Mosquito Home Aqua (MHAQ) formulations were assessed as commercial autodissemination traps in laboratory and small-scale field trials.

Method

Multiple series of laboratory and small-scale field trials were performed to assess the efficacy of MHS and MHAQ exposed to Ae. aegypti. In the laboratory trials, various parameters such as fecundity, fertility, wing size, oviposition preferences, residual effects, and MHAQ transference to other containers through controlled experiments were tested. For small-scale field trials, the efficacy of the MHS and MHAQ approaches was determined to ascertain whether wild mosquitoes could transfer the MHAQ formulation from MHS stations to ovitraps.

Results

The data revealed that Ae. aegypti was highly susceptible to low concentrations of MHAQ formulations and had a residual effect of up to 3 months, with MHAQ exposure affecting fecundity, fertility, and mosquito wing size. In the oviposition studies, gravid females strongly preferred the hay infusion compared to tap water and MHAQ during egg-laying in the laboratory. Nevertheless, the use of commercial MHAQ by MHS was highly attractive in field settings compared to conventional ovitraps among local Aedes spp. mosquitoes. In addition, MHAQ horizontal transfer activities in the laboratory and small-scale field trials were demonstrated through larval bioassays. These findings demonstrated the potential of MHAQ to be transferred to new containers in each study site.

Conclusion

This study provided proof of principle for the autodissemination of MHAQ. Through further refinement, this technique and device could become an effective oviposition trap and offer an alternative preventive tool for vector control management.

Graphical abstract
Virome in adult Aedes albopictus captured during different seasons in Guangzhou City, China
Authors: He Wenqiao , Chen Yanxia , Zhang Xiru , Peng Mingji , Xu Da , He Huan , Gao Yuhan , Chen Junlin , Zhang Jiarui , Li Zhiyu , Chen Qing
Published: August 2021

Background

The mosquito Aedes albopictus is an important vector for many pathogens. Understanding the virome in Ae. albopictus is critical for assessing the risk of disease transmission, implementation of vector control measures, and health system strengthening.

Methods

In this study, viral metagenomic and PCR methods were used to reveal the virome in adult Ae. albopictus captured in different areas and during different seasons in Guangzhou, China.

Results

The viral composition of adult Ae. albopictus varied mainly between seasons. Over 50 viral families were found, which were specific to vertebrates, invertebrates, plants, fungi, bacteria, and protozoa. In rural areas, Siphoviridae (6.5%) was the most common viral family harbored by mosquitoes captured during winter and spring, while Luteoviridae (1.1%) was the most common viral family harbored by mosquitoes captured during summer and autumn. Myoviridae (7.0% and 1.3%) was the most common viral family in mosquitoes captured in urban areas during all seasons. Hepatitis B virus (HBV) was detected by PCR in a female mosquito pool. The first near full-length HBV genome from Ae. albopictus was amplified, which showed a high level of similarity with human HBV genotype B sequences. Human parechovirus (HPeV) was detected in male and female mosquito pools, and the sequences were clustered with HPeV 1 and 3 sequences.

Conclusions

Large numbers of viral species were found in adult Ae. albopictus, including viruses from vertebrates, insects, and plants. The viral composition in Ae. albopictus mainly varied between seasons. Herein, we are the first to report the detection of HPeV and HBV in mosquitoes. This study not only provides valuable information for the control and prevention of mosquito-borne diseases, but it also demonstrates the feasibility of xenosurveillance.

Graphical Abstract
Academic activism on behalf of children during the COVID-19 pandemic in Israel; beyond public health advocacy
Authors: Paltiel Ora , Hochner Hagit , Chinitz David , Clarfield A. Mark , Gileles-Hillel Alex , Lahad Amnon , Manor Orly , Nir-Paz Ran , Paltiel Ari , Stein-Zamir Chen , Yazhemsky Ekaterina , Calderon-Margalit Ronit
Published: August 2021

Among the challenges presented by the SARS-CoV2 pandemic are those related to balancing societal priorities with averting threats to population health. In this exceptional context a group of Israeli physicians and public health scholars (multidisciplinary academic group on children and coronavirus [MACC]) coalesced, examining the role of children in viral transmission and assessing the necessity and consequences of restricted in-class education. Combining critical appraisal and analytical skills with public health experience, MACC advocated for safe and monitored school re-opening, stressing the importance of education as a determinant of health, continuously weighing this stance against evolving COVID-19-risk data. MACC’s activities included offering research-based advice to government agencies including Ministries of Health, Finance, and Education. In a setting where government bodies were faced with providing practical solutions to both decreasing disease transmission and maintaining society’s vital activities, and various advisors presented decision-makers with disparate views, MACC contributed epidemiological, clinical and health policy expertise to the debate regarding school closure as a pandemic control measure, and adaptations required for safe re-opening. In this paper, we describe the evolution, activities, policy inputs and media profile of MACC, and discuss the role of academics in advocacy and activism in the midst of an unprecedented public health crisis. A general lesson learned is that academics, based on the rigor of their scientific work and their perceived objectivity, can and should be mobilized to pursue and promote policies based on shared societal values as well as empiric data, even when considerable uncertainty exists about the appropriate course of action. Mechanisms should be in place to open channels to multidisciplinary academic groups and bring their input to bear on decision-making.
Role Of the Sun and the Middle atmosphere/thermosphere/ionosphere In Climate (ROSMIC): a retrospective and prospective view
Authors: Ward William , Seppälä Annika , Yiğit Erdal , Nakamura Takuji , Stolle Claudia , Laštovička Jan , Woods Thomas N. , Tomikawa Yoshihiro , Lübken Franz-Josef , Solomon Stanley C. , Marsh Daniel R. , Funke Bernd , Pallamraju Duggirala
Published: August 2021

While knowledge of the energy inputs from the Sun (as it is the primary energy source) is important for understanding the solar-terrestrial system, of equal importance is the manner in which the terrestrial part of the system organizes itself in a quasi-equilibrium state to accommodate and re-emit this energy. The ROSMIC project (2014–2018 inclusive) was the component of SCOSTEP’s Variability of the Sun and Its Terrestrial Impact (VarSITI) program which supported research into the terrestrial component of this system. The four themes supported under ROSMIC are solar influence on climate, coupling by dynamics, trends in the mesosphere lower thermosphere, and trends and solar influence in the thermosphere. Over the course of the VarSITI program, scientific advances were made in all four themes. This included improvements in understanding (1) the transport of photochemically produced species from the thermosphere into the lower atmosphere; (2) the manner in which waves produced in the lower atmosphere propagate upward and influence the winds, dynamical variability, and transport of constituents in the mesosphere, ionosphere, and thermosphere; (3) the character of the long-term trends in the mesosphere and lower thermosphere; and (4) the trends and structural changes taking place in the thermosphere. This paper reviews the progress made in these four areas over the past 5 years and summarizes the anticipated research directions in these areas in the future. It also provides a physical context of the elements which maintain the structure of the terrestrial component of this system. The effects that changes to the atmosphere (such as those currently occurring as a result of anthropogenic influences) as well as plausible variations in solar activity may have on the solar terrestrial system need to be understood to support and guide future human activities on Earth.
Single implant-supported two-unit cantilever fixed partial dentures in the posterior region: a retrospective case series with a mean follow-up of 6.5 years
Authors: Jensen-Louwerse Charlotte , Sikma Harjan , Cune Marco S. , Guljé Felix L. , Meijer Henny J. A.
Published: August 2021

Background

The aim of this retrospective study was to evaluate the implant survival, clinical and radiographic outcomes, and patient satisfaction of single implant-supported two-unit cantilever fixed partial dentures in the posterior region.

Methods

Patients who received a single implant-supported fixed partial denture with a cantilever in the posterior region between January 2004 and February 2018 were included. Survival rate of the implants and the fixed partial dentures and data regarding the marginal bone level, presence of plaque, calculus, bleeding on probing, mucosa health, pocket probing depth, and patient satisfaction were collected during an evaluation visit. Complications were recorded from the medical records.

Results

Twenty-three patients (mean age 64 ± 13 years) with 28 implants could be included in the study. The mean follow-up period was 6.5 ± 4.8 years at the time of data collection. The survival rate of the implants and fixed partial dentures was 100%. Mean marginal bone loss for the mesial and distal side of the implants was 0.41 mm (SD 1.18 mm) and 0.63 mm (SD 0.98 mm) respectively. A high prevalence of peri-implant-mucositis (89.3%) and peri-implantitis (17.9%) was observed as well as a limited number of technical complications. Patients were quite satisfied, as reflected by a mean VAS score of 94.0 ± 7.2 points (range 0–100) and a OHIP-NL49 score of 10.8 (range 0–196).

Conclusions

Single implant-supported fixed partial dentures with a mesial or distal cantilever can be a predictable treatment option in the posterior region, with stable peri-implant bone levels, minor technical complications, and very content patients. However, the prevalence of peri-implant mucositis and peri-implantitis was high.

Trial registration

ISRCTN, ISRCTN79055740, Registered on March 14, 2021 – —Retrospectively registered.
Planning and optimising a digital intervention to protect older adults’ cognitive health
Authors: Essery Rosie , Pollet Sebastien , Smith Kirsten A. , Mowbray Fiona , Slodkowska-Barabasz Joanna , Denison-Day James , Hayter Victoria , Bradbury Katherine , Grey Elisabeth , Western Max J. , Milton Alexander , Hunter Cheryl , Ferrey Anne E. , Müller Andre Matthias , Stuart Beth , Mutrie Nanette , Griffin Simon , Kendrick Tony , Brooker Helen , Gudgin Bernard , Phillips Rosemary , Stokes Tom , Niven John , Little Paul , Yardley Lucy
Published: August 2021

Background

By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults.

Methods

During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional ‘guiding principles’ and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content.

Results

Scoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users.

Conclusions

A digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.
Knowledge guides attention to goal-relevant information in older adults
Authors: Smith Maverick E. , Loschky Lester C. , Bailey Heather R.
Published: August 2021

How does viewers’ knowledge guide their attention while they watch everyday events, how does it affect their memory, and does it change with age? Older adults have diminished episodic memory for everyday events, but intact semantic knowledge. Indeed, research suggests that older adults may rely on their semantic memory to offset impairments in episodic memory, and when relevant knowledge is lacking, older adults’ memory can suffer. Yet, the mechanism by which prior knowledge guides attentional selection when watching dynamic activity is unclear. To address this, we studied the influence of knowledge on attention and memory for everyday events in young and older adults by tracking their eyes while they watched videos. The videos depicted activities that older adults perform more frequently than young adults (balancing a checkbook, planting flowers) or activities that young adults perform more frequently than older adults (installing a printer, setting up a video game). Participants completed free recall, recognition, and order memory tests after each video. We found age-related memory deficits when older adults had little knowledge of the activities, but memory did not differ between age groups when older adults had relevant knowledge and experience with the activities. Critically, results showed that knowledge influenced where viewers fixated when watching the videos. Older adults fixated less goal-relevant information compared to young adults when watching young adult activities, but they fixated goal-relevant information similarly to young adults, when watching more older adult activities. Finally, results showed that fixating goal-relevant information predicted free recall of the everyday activities for both age groups. Thus, older adults may use relevant knowledge to more effectively infer the goals of actors, which guides their attention to goal-relevant actions, thus improving their episodic memory for everyday activities.
COVID-19 clinical and laboratory diagnosis overview
Authors: Zayed Rania A. , Omran Dalia , Zayed Abeer A.
Published: August 2021

Background

COVID-19 was identified in Wuhan, China, in December 2019, and rapidly spread worldwide, being declared global pandemic on the 11th of March 2020. Since its emergence, COVID-19 has raised global concerns associated with drastic measures that were never adopted in any previous outbreak, to contain the situation as early as possible.

Main body

The 2019 novel corona virus (2019-nCoV) or SARS-CoV-2 is the causative agent of COVID-19. 2019-nCoV genetic sequence was rapidly identified within few days since the first reported cases and RT-PCR kits became available for COVID-19 diagnosis. However, RT-PCR diagnosis carries a risk of false-negative results; therefore, additional serologic tests are needed. In this review, we summarize the clinical scenario that raises suspicion of COVID-19 and available laboratory diagnostics.

Conclusion

The most important approach in the battle against COVID-19 is rapid diagnosis of suspicious cases, timely therapeutic intervention and isolation to avoid community spread. Diagnosis depends mainly on PCR testing and serological tests. However, even in the context of negative lab test results and clinical suspicion of COVID-19 infection, clinical decision should be based on clinical suspicion.
Tilted platforms: rental housing technology and the rise of urban big data oligopolies
Authors: Boeing Geoff , Besbris Max , Wachsmuth David , Wegmann Jake
Published: August 2021

This article interprets emerging scholarship on rental housing platforms—particularly the most well-known and used short- and long-term rental housing platforms—and considers how the technological processes connecting both short-term and long-term rentals to the platform economy are transforming cities. It discusses potential policy approaches to more equitably distribute benefits and mitigate harms. We argue that information technology is not value-neutral. While rental housing platforms may empower data analysts and certain market participants, the same cannot be said for all users or society at large. First, user-generated online data frequently reproduce the systematic biases found in traditional sources of housing information. Evidence is growing that the information broadcasting potential of rental housing platforms may increase rather than mitigate sociospatial inequality. Second, technology platforms curate and shape information according to their creators’ own financial and political interests. The question of which data—and people—are hidden or marginalized on these platforms is just as important as the question of which data are available. Finally, important differences in benefits and drawbacks exist between short-term and long-term rental housing platforms, but are underexplored in the literature: this article unpacks these differences and proposes policy recommendations.

Policy and practice recommendations

As rental housing technologies upend traditional market processes in favor of platform oligopolies, policymakers must reorient these processes toward the public good.

Long-term and short-term rental platforms offer different market benefits and drawbacks, but the latter in particular requires proactive regulation to mitigate harm.

At a minimum, policymakers must require that short-term rental platforms provide the information necessary for cities to enforce current, let alone new, housing regulations.

Practitioners should be cautious inferring market conditions from rental housing platform data, due to difficult-to-measure sampling biases.
The current state of mental healthcare in Bangladesh: part 2 – setting priorities
Authors: Hasan M. Tasdik , Anwar Tasnim , Christopher Enryka , Hossain Sahadat , Hossain Md Mahbub , Koly Kamrun Nahar , Saif-Ur-Rahman K. M. , Ahmed Helal Uddin , Arman Nazish , Hossain Saima Wazed
Published: August 2021

This is the second of a two-part profile on mental healthcare in Bangladesh. It describes the state of mental health research in the country and presents a set of priorities for addressing improvements to the fundamental gaps in mental healthcare highlighted in part 1. Focus on building infrastructure for public mental health facilities, training skilled mental health professionals, adequate distribution of financial resources and addressing stigma are all priorities that will contribute to significantly improving mental healthcare in Bangladesh.
mPalliative Care Link: Examination of a Mobile Solution to Palliative Care Coordination Among Tanzanian Patients With Cancer
Authors: Ngoma Mamsau , Mushi Beatrice , Morse Robert S. , Ngoma Twalib , Mahuna Habiba , Lambden Kaley , Quinn Erin , Sagan Sarah B. , Ho Yun Xian , Lucas F. Lee , Mmari Joshua , Miesfeldt Susan
Published: August 2021

PURPOSE

Late-stage cancer patient symptom control is a national priority in Tanzania. Mobile health promises to improve the reach of a limited pool of palliative care specialists through interprofessional, community-based care coordination. This work assessed the effectiveness of a smartphone- or Web-based app, mPalliative Care Link (mPCL), to extend specialist access via shared data and communication with local health workers. Central to mPCL is the African Palliative care Outcome Scale (POS), adapted for automated mobile symptom assessment and response.

METHODS

Adult patients with incurable cancer were randomly assigned at hospital discharge to mPCL versus phone-contact POS collection. Sociodemographic, clinical, and POS data were obtained at baseline. Twice-weekly POS responses were collected and managed via mPCL or phone contact with clinician study personnel for up to 4 months, on the basis of study arm assignment. Patient end-of-study care satisfaction was assessed via phone survey.

RESULTS

Forty-nine patients per arm participated. Comparison of baseline characteristics showed an insignificant trend toward more women ( P = .07) and higher discharge morphine use ( P = .09) in the mPCL group compared with phone-contact and significant between-group differences in cancer types ( P = .003). Proportions of deaths were near equal between groups (mPCL: 27%; phone-contact: 29%). Overall symptom severity was significantly lower in the phone-contact group ( P < .0001), and symptom severity decreased over time in both groups ( P = .0001); however, between-group change in overall symptoms over time did not vary significantly ( P = .34). Care satisfaction was generally high in both groups.

CONCLUSION

Higher symptom severity scores in the mPCL arm likely reflect between-group sociodemographic and clinical differences and clinical support of phone-contact arm participants. Similar rates of care satisfaction in both groups suggest that mPCL may support symptom-focused care coordination in a more efficient and scalable manner than phone contact. A broader study of mPCL's cost efficiency and utility in Tanzania is needed.
Randomized Phase III Trial Evaluating Radiation Following Surgical Excision for Good-Risk Ductal Carcinoma In Situ: Long-Term Report From NRG Oncology/RTOG 9804
Authors: McCormick Beryl , Winter Kathryn A. , Woodward Wendy , Kuerer Henry M. , Sneige Nour , Rakovitch Eileen , Smith Barbara L. , Germain Isabelle , Hartford Alan C. , O'Rourke Mark A. , Walker Eleanor M. , Strom Eric A. , Hopkins Judith O. , Pierce Lori J. , Pu Anthony T. , Sumida Kenneth N. M. , Vesprini Danny , Moughan Jennifer , White Julia R.
Published: August 2021

PURPOSE

To our knowledge, NRG/RTOG 9804 is the only randomized trial to assess the impact of whole breast irradiation (radiation therapy [RT]) versus observation (OBS) in women with good-risk ductal carcinoma in situ (DCIS), following lumpectomy. Long-term results focusing on ipsilateral breast recurrence (IBR), the primary outcome, are presented here.

PATIENTS AND METHODS

Eligible patients underwent lumpectomy for DCIS that was mammogram detected, size ≤ 2.5 cm, final margins ≥ 3 mm, and low or intermediate nuclear grade. Consented patients were randomly assigned to RT or OBS. Tamoxifen use was optional. Cumulative incidence was used to estimate IBR, log-rank test and Gray's test to compare treatments, and Fine-Gray regression for hazard ratios (HRs).

RESULTS

A total of six hundred thirty-six women were randomly assigned from 1999 to 2006. Median age was 58 years and mean pathologic DCIS size was 0.60 cm. Intention to use tamoxifen was balanced between arms (69%); however, actual receipt of tamoxifen varied, 58% RT versus 66% OBS ( P = .05). At 13.9 years' median follow-up, the 15-year cumulative incidence of IBR was 7.1% (95% CI, 4.0 to 11.5) with RT versus 15.1% (95% CI, 10.8 to 20.2) OBS ( P = .0007; HR = 0.36; 95% CI, 0.20 to 0.66); and for invasive LR was 5.4% (95% CI, 2.7 to 9.5) RT versus 9.5% (95% CI, 6.0 to 13.9) OBS ( P = .027; HR = 0.44; 95% CI, 0.21 to 0.91). On multivariable analysis, only RT (HR = 0.34; 95% CI, 0.19 to 0.64; P = .0007) and tamoxifen use (HR = 0.45; 95% CI, 0.25 to 0.78; P = .0047) were associated with reduced IBR.

CONCLUSION

RT significantly reduced all and invasive IBR for good-risk DCIS with durable results at 15 years. These results are not an absolute indication for RT but rather should inform shared patient-physician treatment decisions about ipsilateral breast risk reduction in the long term following lumpectomy.
How to Effectively Decrease Patient Co-Payments of High-Cost Drugs Through Innovation: Lessons From the Karmanos Specialty Pharmacy
Authors: Seymour Erlene K. , Daniel Lucius , Pointer Eva , Julian Jordan , Smith Stephen T. , Schiffer Charles A.
Published: August 2021

PURPOSE:

High-cost drugs impose a financial burden on patients with cancer. Karmanos Specialty Pharmacy (KSP) developed a process to automate financial assistance (FA) applications to decrease patient drug cost. We evaluate the outcomes of this program on cost to patients and payers.

METHODS:

This is an observational, retrospective study of the KSP claims data set from January to December 2019, accessed by 13 statewide cancer centers within Michigan. Drug cost of patients, payers, FA (funds to lower patient drug cost), and types of FA were obtained. A subset analysis was performed to determine drug delivery times.

RESULTS:

In 2019, 869 prescriptions and 1,722 prescription fills were provided to 463 patients through KSP. The total cost of drug claims was approximately $10 million US dollars (USD) among Medicare patients (58%), approximately $3.4 million USD for privately insured patients (20%), and approximately $3.7 million USD for Medicaid patients (22%). Twenty-seven percent of patients (22% of all prescription fills) required additional FA with initial total co-payment claims of $335,216 USD. $280,988 USD of FA was obtained, which substantially lowered total patient costs by 81%. $250,818 USD of FA obtained was from foundation grants (327 fills), and $21,441 USD from manufacturer co-pay cards (47 fills). An additional $12,260 USD (12 fills) from a Karmanos Patient Assistance Fund was used. There was high dependence on foundation grant assistance among Medicare patients (33% of claims). In a subset analysis, the median time from prescription written to delivery to the patient was < 7 days (0-56 days).

CONCLUSION:

Twenty-seven percent of patients (22% of prescriptions fills) in 2019 required additional FA for high-cost drugs. KSP substantially reduced patient cost by implementing an efficient process using additional pharmacy assistants to obtain FA.
Prevalence of Enthesopathies in Adults With X-linked Hypophosphatemia: Analysis of Risk Factors
Authors: Herrou Julia , Picaud Axelle Salcion , Lassalle Louis , Pacot Laurence , Chaussain Catherine , Merzoug Valérie , Hervé Agathe , Gadion Margaux , Rothenbuhler Anya , Kamenický Peter , Roux Christian , Linglart Agnès , Duplan Martin Biosse , Briot Karine
Published: August 2021

Context

Enthesopathies are the determinant of a poor quality of life in adults with X-linked hypophosphatemia (XLH).

Objective

To describe the prevalence of patients with enthesopathies and to identify the risk factors of having enthesopathies.

Methods

Retrospective study in the French Reference Center for Rare Diseases of the Calcium and Phosphate Metabolism between June 2011 and December 2020. Adult XLH patients with full body X-rays performed using the EOS® low-dose radiation system and clinical data collected from medical records.

The main outcome measures were demographics, PHEX mutation, conventional treatment, and dental disease with the presence of enthesopathies.

Results

Of the 114 patients included (68% women, mean age 42.2 ± 14.3 years), PHEX mutation was found in 105 patients (94.6%), 86 (77.5%) had been treated during childhood. Enthesopathies (spine and/or pelvis) were present in 67% of the patients (n = 76). Patients with enthesopathies were significantly older (P = .001) and more frequently reported dental disease collected from medical records (P = .03). There was no correlation between the PHEX mutations and the presence of enthesopathies. Sixty-two patients had a radiographic dental examination in a reference center. Severe dental disease (number of missing teeth, number of teeth endodontically treated, alveolar bone loss, and proportion of patients with 5 abscesses or more) was significantly higher in patients with enthesopathies.

Conclusion

Adult XLH patients have a high prevalence of enthesopathies in symptomatic adults patients with XLH seen in a reference center. Age and severe dental disease were significantly associated with the presence of enthesopathies.
Migrating appendicolith: A retained appendicolith causing recurrent infection and migrating to the skin
Authors: Drew Zachary , Jain Deepak , Mariyappa Rathnamma Bhanu
Published: August 2021

A retained appendicolith is an uncommon complication that can arise from appendix rupture and can lead to recurrent abscess formation. We present a case of a retained appendicolith causing recurrent infection over a 12-month period in a paediatric patient. The appendicolith migrated to the left side of the abdomen and then through the abdominal wall into the subcutaneous tissues. The appendicolith was finally retrieved in a joint surgical and interventional radiology case using ultrasound guidance.
Metal artifact reduction using common dental materials
Authors: Hinchy Nicole V , Anderson Nina K , Mahdian Mina
Published: August 2021

Objectives

To determine the effect of different dental lab materials on cone beam computed tomography (CBCT) metal artifact at different resolutions.

Methods

A total of seven common dental lab materials were molded to a dental sextant of four extracted, restored teeth. In addition to base alone (control), each material was scanned using the Carestream 9600 CBCT unit at three resolutions – 0.3 mm, 0.15 mm, and 0.075 mm – at manufacturer established exposure parameters. A single, representative axial view of each trial was evaluated for metal artifact both quantitatively by histogram analysis and qualitatively by profile plot analysis in ImageJ.

Results

No statistically significant differences between the control and the dental materials were found; however, post-hoc tests showed significance between Blu-mousse®and polyvinyl siloxane with dental materials and control, predominantly in lower resolutions.

Conclusions

The current study provides initial evidence on the influence of dental materials have on CBCT metal artifact as described by beam hardening, photon starvation, scatter, and noise, especially at lower resolutions. Blu-Mousse®and polyvinyl siloxane reduced the perceived beam hardening and photon starvation artifact the greatest, relative to other materials, at all three resolutions and lower resolutions, respectively.