bluuebunny/crossref_metadata_2025 huggingface dataset:
Label-free monitoring of immuno-specific interactions of adsorbed multilayer of proteins
Authors: Peranantham Pazhanisami , Gopi Kadalore Ramalingam , Jeyachandran Yekkoni Lakshmanan
Published: February 2021

Protein–protein interactions in adsorbed multilayer of an immuno-specific system of proteins that include staphylococcal protein A (SpA), bovine serum albumin (BSA), anti-chicken immunoglobulin Y (ac-IgG), chicken serum IgG (cs-IgG), and rabbit serum IgG (rs-IgG) on polystyrene (PS) were studied using attenuated total reflection–Fourier transform infrared spectroscopy. A systematic analysis allowed a direct qualitative and quantitative determination of protein interactions at each step of specific and nonspecific binding conditions at the molecular level. The study also provided information about (1) the adsorption behavior of the proteins, (2) the role of SpA in enabling correct orientation of the adsorbed IgG and maintaining the stability of the adsorbed SpA/ac-IgG system on the PS surface, (3) the function of BSA as both blocking reagent and promoter of specific and selective binding, and (4) the bioactivity conserved accommodation of SpA molecules on the PS surface. Furthermore, the unique characteristics of cs-IgG such as passive toward SpA adsorption and exposure of the multivalence state at nonspecific binding conditions was revealed spectroscopically. The present investigation provides a platform for further extension of the adopted methodology to a more complex system of immuno-detection for highly sensitive and rapid diagnostics.
Attenuation of the Köhler Effect in Racially Dissimilar Partnered Exercise Reversed Using Team Identity Strategy
Authors: Moss Tayo , Samendinger Stephen , Kerr Norbert L. , Cesario Joseph , Smith Alan L. , Johnson Deborah J. , Feltz Deborah L.
Published: February 2021

The authors describe two research experiments exploring the influence of race on the Köhler motivation gain effect with exercise tasks. Experiment 1 tested whether partner racial dissimilarity affects individual performance. Experiment 2 created a team identity recategorization intervention to potentially counter the influence on performance observed in Experiment 1. White male participants were partnered with either a Black or Asian partner (Experiment 1) or with a Black partner utilizing team names and shirt colors as a team identity recategorization strategy (Experiment 2). Racially dissimilar dyads completed two sets of abdominal plank exercises with a Köhler conjunctive task paradigm (stronger partner; team performance outcome dependent upon the weaker-ability participant’s performance). The results of Experiment 1 suggest attenuation of the previously successful group motivation gain effect in the racially dissimilar condition. The simple recategorization strategy utilized in Experiment 2 appeared to reverse motivation losses under conjunctive-task conditions in racially dissimilar exercise dyads.
Rose-Colored Glasses: Competing Media Perceptions of the Pete Rose Betting Scandal
Authors: Greenham Craig
Published: February 2021

In a 2004 autobiography, legendary player Pete Rose confessed to gambling on baseball games, even those that included his Cincinnati Reds. The passage of time has clarified much about the betting scandal that plagued Major League Baseball (MLB) in 1989. Over the course of the six-month saga, Rose’s denials and his adversarial relationship with the Commissioner’s Office shrouded MLB’s investigation in controversy. This study explores the press coverage of the scandal in 1989 and determines that the Cincinnati press was more sympathetic to, and supportive of Rose than out-of-market coverage, represented in this investigation by The New York Times. These findings are consistent with previous research that indicates that local media favors hometown institutions during times of crisis. This study expands that theory by demonstrating that favoritism extends to individual players whose connection to the city is significant, and furthers our understanding of the media’s role in shaping the narratives of scandal.
Vasculature-driven stem cell population coordinates tissue scaling in dynamic organs
Authors: Ichijo Ryo , Kabata Mio , Kidoya Hiroyasu , Muramatsu Fumitaka , Ishibashi Riki , Abe Kota , Tsutsui Ko , Kubo Hirokazu , Iizuka Yui , Kitano Satsuki , Miyachi Hitoshi , Kubota Yoshiaki , Fujiwara Hironobu , Sada Aiko , Yamamoto Takuya , Toyoshima Fumiko
Published: February 2021

Blood vessels induce epidermal proliferating clusters in the vicinity of activating stem cells to populate expanding skin.
Paroxetine-mediated GRK2 inhibition is a disease-modifying treatment for osteoarthritis
Authors: Carlson Elijah L. , Karuppagounder Vengadeshprabhu , Pinamont William J. , Yoshioka Natalie K. , Ahmad Adeel , Schott Eric M. , Le Bleu Heather K. , Zuscik Michael J. , Elbarbary Reyad A. , Kamal Fadia
Published: February 2021

G protein–coupled receptor kinase 2 is increased in OA, and inhibition by the antidepressant paroxetine prevents disease progression.
Targeted immunotherapy for HER2-low breast cancer with 17p loss
Authors: Li Yujing , Sun Yifan , Kulke Michael , Hechler Torsten , Van der Jeught Kevin , Dong Tianhan , He Bin , Miller Kathy D. , Radovich Milan , Schneider Bryan P. , Pahl Andreas , Zhang Xinna , Lu Xiongbin
Published: February 2021

Trastuzumab conjugated to α-amanitin kills HER2-low breast cancer cells with loss of chromosome 17p and enhances checkpoint blockade therapy.
Cell type–specific microRNA therapies for myocardial infarction
Authors: Liu Bohao , Wang Bryan , Zhang Xiaokan , Lock Roberta , Nash Trevor , Vunjak-Novakovic Gordana
Published: February 2021

microRNA-based therapies for myocardial infarction have opportunities and limitations on the basis of the target cell type and molecular pathways.
Engineering adeno-associated viral vectors to evade innate immune and inflammatory responses
Authors: Chan Ying Kai , Wang Sean K. , Chu Colin J. , Copland David A. , Letizia Alexander J. , Costa Verdera Helena , Chiang Jessica J. , Sethi Meher , Wang May K. , Neidermyer William J. , Chan Yingleong , Lim Elaine T. , Graveline Amanda R. , Sanchez Melinda , Boyd Ryan F. , Vihtelic Thomas S. , Inciong Rolando Gian Carlo O. , Slain Jared M. , Alphonse Priscilla J. , Xue Yunlu , Robinson-McCarthy Lindsey R. , Tam Jenny M. , Jabbar Maha H. , Sahu Bhubanananda , Adeniran Janelle F. , Muhuri Manish , Tai Phillip W. L. , Xie Jun , Krause Tyler B. , Vernet Andyna , Pezone Matthew , Xiao Ru , Liu Tina , Wang Wei , Kaplan Henry J. , Gao Guangping , Dick Andrew D. , Mingozzi Federico , McCall Maureen A. , Cepko Constance L. , Church George M.
Published: February 2021

Incorporating TLR9-inhibitory sequences in the AAV vector genome inhibits immunogenicity and enhances transgene expression in multiple animal models.
Percutaneous liquid ablation agent for tumor treatment and drug delivery
Authors: Albadawi Hassan , Zhang Zefu , Altun Izzet , Hu Jingjie , Jamal Leila , Ibsen Kelly N. , Tanner Eden E. L. , Mitragotri Samir , Oklu Rahmi
Published: February 2021

An ionic liquid formulation ablates tumors, uniformly distributes drugs in the ablation zone, and has synergistic effects with chemotherapy.
Redundancy in Aromatic
O
-Demethylation and Ring-Opening Reactions in
Novosphingobium aromaticivorans
and Their Impact in the Metabolism of Plant-Derived Phenolics
Authors: Perez Jose M. , Kontur Wayne S. , Gehl Carson , Gille Derek M. , Ma Yanjun , Niles Alyssa V. , Umana German , Donohue Timothy J. , Noguera Daniel R.
Published: February 2021

For lignocellulosic biorefineries to effectively contribute to reduction of fossil fuel use, they need to become efficient at producing chemicals from all major components of plant biomass. Making products from lignin will require engineering microorganisms to funnel multiple phenolic compounds to the chemicals of interest, and
N. aromaticivorans
is a promising chassis for this technology.
Complete Genome Sequence of Sphingomonas paucimobilis Strain Kira, Isolated from Human Neuroblastoma SH-SY5Y Cell Cultures Supplemented with Retinoic Acid
Authors: Nishimura Kohei , Ikarashi Mirai , Yasuda Yuji , Sato Mayu , Cano Guerrero Marta , Galipon Josephine , Arakawa Kazuharu
Published: February 2021

Because of its small size, Gram-negative
Sphingomonas paucimobilis
can pose a risk of nosocomial infection. We report the complete circular genome sequence of
S. paucimobilis
strain Kira, which was isolated from retinoic acid-supplemented SH-SY5Y human cell cultures, to be 3,917,410 bp (G+C content, 65.7%; 3,672 protein-coding sequences), with two plasmids (79,575 bp and 44,333 bp).
Clinical and Molecular Epidemiology of an Emerging Panton-Valentine Leukocidin-Positive ST5 Methicillin-Resistant Staphylococcus aureus Clone in Northern Australia
Authors: McGuinness Sarah L. , Holt Deborah C. , Harris Tegan M. , Wright Connor , Baird Rob , Giffard Phillip M. , Bowen Asha C. , Tong Steven Y. C.
Published: February 2021

Staphylococcus aureus
is an important human pathogen that causes a wide range of clinical infections. In the past 2 decades, an epidemic of community-associated skin and soft tissue infections has been driven by
S. aureus
strains with specific virulence factors and resistance to beta-lactam antibiotics.
Transcription Profiles Associated with Inducible Adhesion in Candida parapsilosis
Authors: Bliss Joseph M. , Tollefson George A. , Cuevas Abigail , Longley Sarah J. , Neale Matthew N. , Uzun Alper , Shaw Sunil K.
Published: February 2021

Invasive
Candida
infections are frequent complications of the immunocompromised and are associated with substantive morbidity and mortality. Although
C. albicans
is the best-studied species, emerging infections by non-
albicans Candida
species have led to increased efforts to understand aspects of their pathogenesis that are unique from
C. albicans
.
C. parapsilosis
is a frequent cause of invasive infections, particularly among premature infants.
Modelling the determinants of health and cancers as perceived by children: using imagery as a mediator of expression and narration
Authors: Gay Chloé , Deyra Maeliane , Berland Pauline , Gerbaud Laurent , Pizon Frank
Published: February 2021

Objectives

To model and analyse conceptions of determinants of health and cancer that are expressed and perceived by school children aged 6–11 based on a multiphase qualitative protocol.

Methodology

This is a multicentric, qualitative study of human and social sciences conducted among school children aged 6–11 years old. Two different tools were used, e.Photoexpression and Photonarration, in four French schools. This innovative and exploratory method addresses global health during the first phase (e.Photoexpression) and the theme of cancer during the second phase (Photonarration). The children express themselves through photography and narration.

Results

1498 qualitative productions were made by 381 children aged 6–11 years old. The analysis of these productions of expression and narration through images allowed modelling of determinants of health and cancer as perceived by children through 7 fields and 28 categories. The conceptions of determinants of health and child cancer refer to rationalities that are centred on individual determinants (76%), minimise environmental determinants (20%) and conceal the parameters of access to healthcare and social services (3%).

Discussion

These findings provide new data to the international literature on children’s perceptions of determinants of health and cancer. These research findings, which can be applied to interventions and current practices, will enable prevention workers to act more effectively, closer to children’s perceptions and needs.
SARS-CoV-2 genome and antibodies in breastmilk: a systematic review and meta-analysis
Authors: Zhu Faith , Zozaya Carlos , Zhou Qi , De Castro Charmaine , Shah Prakesh S
Published: February 2021

Objective

To systematically review and meta-analyse the rate of SARS-CoV-2 genome identification and the presence of SARS-CoV-2 antibodies in breastmilk of mothers with COVID-19.

Design

A systematic review of studies published between January 2019 and October 2020 without study design or language restrictions.

Setting

Data sourced from Ovid Embase Classic+Embase, PubMed, Web of Science, Scopus, relevant bibliographies and the John Hopkins University COVID-19 database.

Patients

Mothers with confirmed COVID-19 and breastmilk tested for SARS-CoV-2 by RT-PCR or for anti-SARS-CoV-2 antibodies.

Main outcome measures

Presence of SARS-CoV-2 genome and antibodies in breastmilk.

Results

We included 50 articles. Twelve out of 183 women from 48 studies were positive for SARS-CoV-2 genome in their breastmilk (pooled proportion 5% (95% CI 2% to 15%; I2=48%)). Six infants (50%) of these 12 mothers tested positive for SARS-CoV-2, with one requiring respiratory support. Sixty-one out of 89 women from 10 studies had anti-SARS-CoV-2 antibody in their breastmilk (pooled proportion 83% (95% CI 32% to 98%; I2=88%)). The predominant antibody detected was IgA.

Conclusions

SARS-CoV-2 genome presence in breastmilk is uncommon and is associated with mild symptoms in infants. Anti-SARS-CoV-2 antibodies may be a more common finding. Considering the low proportion of SARS-CoV-2 genome detected in breastmilk and its lower virulence, mothers with COVID-19 should be supported to breastfeed.
Delayed-onset unilateral Vogt-Koyanagi-Harada syndrome: a multimodal imaging appraisal
Authors: Verma Saurabh , Thakur Himani , Azad Shorya Vardhan , Kumar Vinod
Published: February 2021

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.
Unique case of glandular odontogenic cyst showing mucoepidermoid carcinoma-like islands in cystic wall
Authors: Kaur Harpreet , Mishra Deepika , Yadav Rahul
Published: February 2021

Glandular odontogenic cyst (GOC) is a very rare jaw cyst accounting for 0.2% of all odontogenic cysts. It presents usually in adults with a slight male predominance. It shows radiological, histopathological and even immunohistochemical overlap with low grade intraosseous mucoepidermoid carcinoma (MEC) but their distinction is crucial. A 57-year-old woman with bilocular radiolucency in the anterior mandible crossing the midline is described here. Microscopy features were consistent with glandular odontogenic cyst but multiple MEC-like islands were seen in the capsule, creating a diagnostic head trip with low grade intraosseous MEC. However, the absence of cellular atypia and epidermoid and intermediate cells led to a final diagnosis of GOC, with close follow-up of the patient recommended. This rare finding shows the relation between GOC and MEC or the origin of MEC from GOC.
Rare cause of acute abdomen–cocaine-induced small intestinal perforation with coexisting lower gastrointestinal bleed: an unusual presentation
Authors: Deivasigamani Sriram , Irrinki Santhosh , Shah Jimil , Sakaray Yashwant
Published: February 2021

Cocaine, an alkaloid, is an addictive drug and its abuse as a recreational drug is on the increasing side with its associated complications. Gastrointestinal complications, after cocaine abuse, are less known and need to be addressed since the abuse is on the rise and the existing evidence is scarce. We report a case of a 22-year-old male patient who presented with abdominal pain following a cocaine injection. On examination, signs of peritonitis were noted and laparotomy revealed a 2×1 cm perforation in the distal ileum. The unhealthy intestinal segment was resected and taken out as a double-barrel ileostomy. The patient had an episode of severe lower gastrointestinal bleeding on postoperative day 6. CT and colonoscopy revealed signs of ischaemic bowel and tissue biopsy showed oedematous, inflamed and haemorrhagic bowel mucosa. The patient was managed conservatively and is doing well under follow-up in a de-addiction centre.
Gastric perforation secondary to Rapunzel syndrome
Authors: Jackman Jamaall , Nana Gael R , Catton James , Christakis Ioannis
Published: February 2021

Rapunzel syndrome is rare and describes a trichobezoar that extends through the pylorus into the jejunum, ileum or even the colon. Due to the large intraluminal size and weight they can attain, acute presentations of obstruction or perforation may occur. We report a case of a 17-year-old girl who presented to the emergency department following a syncopal episode. On examination, a left upper quadrant mass was appreciated with no signs of peritonism. Contrast-enhanced CT demonstrated a giant trichobezoar with resulting gastric perforation and intra-abdominal free fluid. Laparotomy and gastrotomy were performed and the patient had an uneventful recovery with psychiatric review prior to discharge. Though uncommon, bezoars should be included in our differential diagnosis as they can present in various ways owing to their size and weight. This case illustrates the risk of gastric perforation with large gastric bezoars.
Clinician prescription of lipid-lowering drugs and achievement of treatment goals in patients with newly diagnosed type 2 diabetes mellitus
Authors: García-Ulloa Ana Cristina , Lechuga-Fonseca Claudia , Del Razo-Olvera Fabiola Mabel , Aguilar-Salinas Carlos Alberto , Galaviz Karla Ivette , Narayan K M Venkat , Hernández-Jiménez Sergio
Published: February 2021

Introduction

Lipid control is essential in type 2 diabetes mellitus (T2DM). The aim of this study is to investigate factors associated with lipid therapy adherence and achievement of goals in real-life setting among patients with recently diagnosed T2DM.

Research design and methods

This is a longitudinal analysis in a center of comprehensive care for patients with diabetes. We include patients with T2DM, <5 years of diagnosis, without disabling complications (eg, amputation, myocardial infarct, stroke, proliferative retinopathy, glomerular filtration rate <60 mL/min/m2) and completed 2-year follow-up. The comprehensive diabetes care model includes 9 interventions in 4 initial visits and annual evaluations. Endocrinologists follow the clinic’s guideline and adapt therapy to reach risk-based treatment goal. The main outcome measures were the proportion of patients meeting low-density lipoprotein cholesterol (c-LDL) (<100 mg/dL) and triglycerides (<150 mg/dL) and proportion of patients taking statin, fibrate or combination at baseline, 3 months and annual evaluations.

Results

We included 288 consecutive patients (54±9 years, 53.8% women), time since T2DM diagnosis 1 (0–5) year. Baseline, 10.8% patients were receiving statin therapy (46.5% moderate-intensity therapy and 4.6% high-intensity therapy), 8.3% fibrates and 4.2% combined treatment. The proportion of patients with combined treatment increased to 41.6% at 3 months, decreased to 20.8% at 1 year and increased to 38.9% at 2 years of evaluation. Patients receiving treatment met LDL and triglycerides goals at 3 months (17% vs 59.7%, relative ratio (RR)=0.89, 95% CI 0.71 to 1.12), at 1 year (17% vs 26.7%, RR=0.62, 95% CI 0.41 to 0.95) and at 2 years (17% vs 29.9%, RR=0.63, 95% CI 0.43 to 0.93). Main reasons for medication suspension: patient considered treatment was not important (37.5%) and other physician suspended treatment (31.3%).

Conclusion

88.2% of patients with T2DM required lipid-lowering drugs. Education for patients and physicians is critical to achieve and maintain diabetes goals.

Trial registration number

NCT02836808.
Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: a systematic review and meta-analysis
Authors: Lee Justin , Negm Ahmed , Peters Ryan , Wong Eric K C , Holbrook Anne
Published: February 2021

Objectives

Prevention of falls and fall-related injuries is a priority due to the substantial health and financial burden of falls on patients and healthcare systems. Deprescribing medications known as ‘fall-risk increasing drugs’ (FRIDs) is a common strategy to prevent falls. We conducted a systematic review to determine its efficacy for the prevention of falls and fall-related complications.

Design

Systematic review and meta-analysis.

Data sources

MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and grey literature from inception to 1 August 2020.

Eligibility criteria for selecting studies

Randomised controlled trials of FRID withdrawal compared with usual care evaluating the rate of falls, incidence of falls, fall-related injuries, fall-related fractures, fall-related hospitalisations or adverse effects related to the intervention in adults aged ≥65 years.

Data extraction and synthesis

Two reviewers independently performed citation screening, data abstraction, risk of bias assessment and certainty of evidence grading. Random-effects models were used for meta-analyses.

Results

Five trials involving 1305 participants met eligibility criteria. Deprescribing FRIDs did not change the rate of falls (rate ratio (RaR) 0.98, 95% CI 0.63 to 1.51), the incidence of falls (risk difference 0.01, 95% CI −0.06 to 0.09; relative risk 1.04, 95% CI 0.86 to 1.26) or rate of fall-related injuries (RaR 0.89, 95% CI 0.57 to 1.39) over a follow-up period of 6–12 months. No trials evaluated the impact of deprescribing FRIDs on fall-related fractures or hospitalisations.

Conclusion

There is a paucity of robust high-quality evidence to support or refute that a FRID deprescribing strategy alone is effective at preventing falls or fall-related injury in older adults. Although there may be other reasons to deprescribe FRIDs, our systematic review found that it may result in little to no difference in the rate or risk of falls as a sole falls reduction strategy.

PROSPERO registration number

CRD42016040203.
Losing ground at the wrong time: trends in self-reported influenza vaccination uptake in Switzerland, Swiss Health Survey 2007–2017
Authors: Zürcher Kathrin , Zwahlen Marcel , Berlin Claudia , Egger Matthias , Fenner Lukas
Published: February 2021

Objectives

We studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged ≥65 years.

Design

Three cross-sectional surveys.

Participants

Individuals who participated in the Swiss Health Surveys 2007, 2012 and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses.

Results

We included 51 582 individuals in this analysis. The median age was 49 years (IQR 25–64), and 27 518 were women (53.3%). The proportion of reporting a history of influenza vaccination overall was 31.9% (95% CI 31.4 to 32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged ≥65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). In logistic regression, self-reported vaccination coverage decreased in the 65–75 years old (adjusted OR (aOR) 0.56, 95% CI 0.48 to 0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77 to 1.03 between 2012 and 2017). Uptake was positively associated with the ≥65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession and having any underlying chronic disease.

Conclusion

Influenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the influenza season 2020/2021 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media.
Feasibility of 3-month melatonin supplementation for brain oxidative stress and sleep in mild cognitive impairment: protocol for a randomised, placebo-controlled study
Authors: Menczel Schrire Zoe , Phillips Craig L , Duffy Shantel L , Marshall Nathaniel S , Mowszowski Loren , La Monica Haley M , Gordon Christopher J , Chapman Julia L , Saini Bandana , Lewis Simon J G , Naismith Sharon L , Grunstein Ronald R , Hoyos Camilla M
Published: February 2021

Introduction

Melatonin has multiple proposed therapeutic benefits including antioxidant properties, synchronisation of the circadian system and lowering of blood pressure. In this protocol, we outline a randomised controlled trial to assess the feasibility, acceptability and tolerability of higher dose (25 mg) melatonin to target brain oxidative stress and sleep disturbance in older adults with mild cognitive impairment (MCI).

Methods and analysis

The study design is a randomised double-blind, placebo-controlled, parallel group trial. Forty individuals with MCI will be recruited from the Healthy Brain Ageing Clinic, University of Sydney and from the community, and randomised to receive either 25 mg oral melatonin or placebo nightly for 12 weeks. The primary outcomes are feasibility of recruitment, acceptability of intervention and adherence to trial medication at 12 weeks. Secondary outcomes will include the effect of melatonin on brain oxidative stress as measured by magnetic resonance spectroscopy, blood pressure, blood biomarkers, mood, cognition and sleep. Outcomes will be collected at 6 and 12 weeks. The results of this feasibility trial will inform a future conclusive randomised controlled trial to specifically test the efficacy of melatonin on modifiable risk factors of dementia, as well as cognition and brain function. This will be the first trial to investigate the effect of melatonin in the population with MCI in this way, with the future aim of using this approach to reduce progression to dementia.

Ethics and dissemination

This protocol has been approved by the Sydney Local Health District Ethics Committee (X18-0077). This randomised controlled trial will be conducted in compliance with the protocol published in the registry, the International Conference for Harmonisation on Good Clinical Practice and all other applicable regulatory requirements. The findings of the trial will be disseminated via conferences, publications and media, as applicable. Participants will be informed of results of the study at the conclusion of the trial. Eligible authors will include investigators who are involved in the conception and design of the study, the conduct of the trial, the analysis of the results, and reporting and presentation of study findings.

Trial registration number

Australian and New Zealand Clinical Trials Registry (ANZCTRN 12619000876190).

Protocol version

V.8 15 October 2020.
Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys
Authors: Wamamili Ben , Lawler Sheleigh , Wallace-Bell Mark , Gartner Coral , Sellars David , Grace Randolph C , Courtney Ryan , Coope Pat
Published: February 2021

Objectives

Examine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics.

Design

Cross-sectional studies.

Setting

The University of Queensland (UQ), Australia and eight New Zealand (NZ) universities.

Participants

Students at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women).

Methods

Χ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international).

Results

Smoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%.

Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes.

Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use.

Conclusions

Results suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping.
What are the barriers to the completion of a home-based rehabilitation programme for patients awaiting surgery for lung cancer: a prospective observational study
Authors: Catho Heloise , Guigard Sebastien , Toffart Anne-Claire , Frey Gil , Chollier Thibaut , Brichon Pierre-Yves , Roux Jean-François , Sakhri Linda , Bertrand Dominique , Aguirre Charles , Gorain Sandy , Wuyam Bernard , Arbib François , Borel Jean Christian
Published: February 2021

Objectives

Home-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge.

Design

A prospective observational study.

Intervention

All patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week).

Outcomes

The H-RP was defined as ‘completed’ if the four components were performed before surgery.

Results

Out of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%–75%; 60–74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex.

Conclusion

Facing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP.

Trial registration number

NCT03530059.
Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis
Authors: Kong Qihang , Ming Wai-kit , Mi Xue-Song
Published: February 2021

Objective

To determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).

Design

Systematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.

Data sources

The PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.

Eligibility criteria when selecting studies

We included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.

Data extraction and synthesis

Data extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).

Results

Thirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.

Conclusions

This meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.

PROSPERO registration number

CRD42020160673.
Insufficient iodine nutrition status and the risk of pre-eclampsia: a systemic review and meta-analysis
Authors: Businge Charles Bitamazire , Usenbo Anthony , Longo-Mbenza Benjamin , Kengne AP
Published: February 2021

Background

Although subclinical hypothyroidism in pregnancy is one of the established risk factors for pre-eclampsia, the link between iodine deficiency, the main cause of hypothyroidism, and pre-eclampsia remains uncertain. We conducted a systematic review to determine the iodine nutrition status of pregnant women with and without pre-eclampsia and the risk of pre-eclampsia due to iodine deficiency.

Methods

MEDLINE, EMBASE, Google Scholar, Scopus and Africa-Wide Information were searched up to 30th June 2020. Random-effect model meta-analysis was used to pool mean difference in urinary iodine concentration (UIC) between pre-eclamptic and normotensive controls and pool ORs and incidence rates of pre-eclampsia among women with UIC <150 µg/L.

Results

Five eligible studies were included in the meta-analysis. There was a significant difference in the pooled mean UIC of 254 pre-eclamptic women and 210 normotensive controls enrolled in three eligible case–control studies (mean UIC 164.4 µg/L (95% CI 45.1 to 283.6, p<0.01, I2 >50)). The overall proportions of pre-eclampsia among women with UIC <150 µg/L and UIC >150 µg/L in two cross-sectional studies were 203/214 and 67/247, respectively, with a pooled OR of 0.01 (95% CI 0 to 4.23, p=0.14, I2 >50) for pre-eclampsia among women with UIC >150 µg/L. The overall incidence of pre-eclampsia among women with UIC <150 µg/L and UIC >150 µg/L in two cohort studies was 6/1411 and 3/2478, respectively, with a pooled risk ratio of 2.85 (95% CI 0.42 to 20.05, p=0.09, I2 <25).

Conclusion

Although pre-eclamptic women seem to have lower UIC than normotensive pregnant women, the available data are insufficient to provide a conclusive answer on association of iodine deficiency with pre-eclampsia risk.

PROSPERO registration number

CRD42018099427.
Cost-effectiveness analysis of percutaneous coronary intervention for single-vessel coronary artery disease: an economic evaluation of the ORBITA trial
Authors: McCreanor Victoria , Nowbar Alexandra , Rajkumar Christopher , Barnett Adrian G , Francis Darrel , Graves Nicholas , Boden William E , Weintraub William S , Al-Lamee Rasha , Parsonage William A
Published: February 2021

Objective

To evaluate the cost-effectiveness of percutaneous coronary intervention (PCI) compared with placebo in patients with single-vessel coronary artery disease and angina despite anti-anginal therapy.

Design

A cost-effectiveness analysis comparing PCI with placebo. A Markov model was used to measure incremental cost-effectiveness, in cost per quality-adjusted life-years (QALYs) gained, over 12 months. Health utility weights were estimated using responses to the EuroQol 5-level questionnaire, from the Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina trial and UK preference weights. Costs of procedures and follow-up consultations were derived from Healthcare Resource Group reference costs and drug costs from the National Health Service (NHS) drug tariff. Probabilistic sensitivity analysis was undertaken to test the robustness of results to parameter uncertainty. Scenario analyses were performed to test the effect on results of reduced pharmaceutical costs in patients undergoing PCI, and the effect of patients crossing over from placebo to PCI due to refractory angina within 12 months.

Setting

Five UK NHS hospitals.

Participants

200 adult patients with stable angina and angiographically severe single-vessel coronary artery disease on anti-anginal therapy.

Interventions

At recruitment, patients received 6 weeks of optimisation of medical therapy for angina after which they were randomised to PCI or a placebo procedure.

Outcome measures

Incremental cost-effectiveness ratio (ICER) expressed as cost (in £) per QALY gained for PCI compared with placebo.

Results

The estimated ICER is £90 218/QALY gained when using PCI compared with placebo in patients receiving medical treatment for angina due to single-vessel coronary artery disease. Results were robust under sensitivity analyses.

Conclusions

The ICER for PCI compared with placebo, in patients with single-vessel coronary artery disease and angina on anti-anginal medication, exceeds the threshold of £30 000 used by the National Institute of Health and Care Excellence when undertaking health technology assessment for the NHS context.

Trial registration: The ORBITA study is registered with ClinicalTrials.gov, number NCT02062593.
Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: cross-sectional study
Authors: Manrique-Arija Sara , Mena-Vazquez Natalia , Ureña Inmaculada , Rioja José , Valdivielso Pedro , Ginel-Mendoza Leovigildo , Abad-Sánchez Salomé , Jiménez-Núñez Francisco G , Oliver-Martos Begoña , Fernandez-Nebro Antonio
Published: February 2021

Objectives

To describe the prevalence of insulin resistance (IR) in patients with established rheumatoid arthritis (RA) and to analyse the contribution of cumulative inflammatory burden and other factors to its development.

Design

Observational cross-sectional study.

Participants

Patients with RA and controls matched for age, sex and Body Mass Index. We excluded patients with diabetes.

Settings

Patients from an RA inception cohort at Hospital Regional Universitario de Málaga, Spain, were recruited between September 2016 and May 2018.

Primary and secondary outcome measures

IR was evaluated using the homeostasis model assessment for IR and beta-cell function and the quantitative insulin sensitivity check index. Other variables included the cumulative 28-Joint Disease Activity Score (DAS28) with C reactive protein (CRP) body composition and cytokines. Two logistic regression models were constructed to identify factors associated with IR in patients with RA.

Results

Eighty-nine patients with RA and 80 controls were included. The prevalence of IR was similar in both cases and controls. Inflammatory activity was controlled appropriately in patients during follow-up (mean DAS28 3.1 (0.8)). The presence of IR in patients with RA was associated with obesity (OR 6.01, 95% CI 1.9 to 8.7), higher cumulative DAS28-CRP values during follow-up (OR 2.8, 95% CI 1.3 to 6.0), and higher interleukin-1β levels (OR 1.6, 95% CI 1.1 to 2.4). The second model showed that the risk of IR increased by 10% for each kilogram of excess body fat.

Conclusion

In patients with well-controlled, established RA, IR is associated mainly with poorer control of inflammation from diagnosis and with obesity, specifically total fat mass.
Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
Authors: Bish Melanie Rae , Faulks Fiona , Amir Lisa Helen , Huxley Rachel R , McIntyre Harold David , James Rachel , Mnatzaganian George
Published: February 2021

Objectives

Using routinely collected hospital data, this study explored secular trends over time in breast feeding initiation in a large Australian sample. The association between obesity and not breast feeding was investigated utilising a generalised estimating equations logistic regression that adjusted for sociodemographics, antenatal, intrapartum and postpartum conditions, mode of delivery and infant’s-related covariates.

Design

Population-based retrospective panel.

Setting

A regional hospital that serves 26% of Victoria’s 6.5 million population in Australia.

Participants

All women experiencing live births between 2010 and 2017 were included. Women with missing body mass index (BMI) were excluded.

Results

A total of 7491 women contributed to 10 234 live births. At baseline, 57.2% of the women were overweight or obese, with obesity increasing over 8 years by 12.8%, p=0.001. Although, breast feeding increased over time, observed in all socioeconomic status (SES) and BMI categories, the lowest proportions were consistently found among the obese and morbidly obese (78.9% vs 87.1% in non-obese mothers, p<0.001). In the multivariable analysis, risk of not breast feeding was associated with higher BMI, teenage motherhood, smoking, belonging to the lowest SES class, gravidity >4 and undergoing an assisted vaginal or caesarean delivery. Compared with women with a normal weight, the obese and morbidly obese were 66% (OR 1.66, 95% CI 1.40 to 1.96, p<0.001) to 2.6 times (OR 2.61, 95% CI 2.07 to 3.29, p<0.001) less likely to breast feed, respectively. The detected dose–response effect between higher BMI and lower breast feeding was not explained by any of the study covariates.

Conclusion

This study provides evidence of increasing breast feeding proportions in regional Victoria over the past decade. However, these proportions were lowest among the obese and morbidly obese and those coming from the most disadvantaged backgrounds suggesting the need for targeted interventions to support breast feeding among these groups. The psychosocial and physiological associations between obesity and breast feeding should further be investigated.
Cohort profile: the COVID-19 Coping Study, a longitudinal mixed-methods study of middle-aged and older adults’ mental health and well-being during the COVID-19 pandemic in the USA
Authors: Kobayashi Lindsay C , O’Shea Brendan Q , Kler Jasdeep S , Nishimura Raphael , Palavicino-Maggio Caroline B , Eastman Marisa R , Vinson Yamani Rikia , Finlay Jessica M
Published: February 2021

Purpose

The COVID-19 pandemic, beginning in early 2020, has resulted in massive social, economic, political and public health upheaval around the world. We established a national longitudinal cohort study, the COVID-19 Coping Study, to investigate the effects of pandemic-related stressors and changes in life circumstances on mental health and well-being among middle-aged and older adults in the USA.

Participants

From 2 April to 31 May 2020, 6938 adults aged ≥55 years were recruited from all 50 US states, the District of Columbia and Puerto Rico using online, multi-frame non-probability-based sampling.

Findings to date

Mean age of the baseline sample was 67.3 years (SD: 7.9 years) and 64% were women. Two in three adults reported leaving home only for essential purposes in the past week (population-weighted proportion: 69%; 95% CI: 68% to 71%). Nearly one in five workers aged 55–64 years was placed on a leave of absence or furloughed since the start of the pandemic (17%; 95% CI: 14% to 20%), compared with one in three workers aged ≥75 years (31%; 95% CI: 21% to 44%). Nearly one-third of adults screened positive for each of depression (32%; 95% CI: 30% to 34%), anxiety (29%; 28% to 31%) and loneliness (29%; 95% CI: 27% to 31%), with decreasing prevalence of each with increasing age.

Future plans

Monthly and annual follow-ups of the COVID-19 Coping Study cohort will assess longitudinal changes to mental health, cognitive health and well-being in relation to social, behavioural, economic and other COVID-19-related changes to life circumstances. Quantitative and in-depth qualitative interview data will be collected through online questionnaires and telephone interviews. Cohort data will be archived for public use.
‘Lines in the sand’: an Australian qualitative study of patient group practices to promote independence from pharmaceutical industry funders
Authors: Parker Lisa , Grundy Quinn , Fabbri Alice , Mintzes Barbara , Bero Lisa
Published: February 2021

Objectives

To study how patient groups that accept pharmaceutical industry money perceive and manage the risk of undue influence from their sponsors.

Design

Empirical ethics approach using a qualitative interview study.

Setting

The Australian patient group sector.

Participants

27 participants from 23 patient groups, purposively recruited for diversity of group characteristics (degree of pharmaceutical industry funding, health focus, location) and participant role (staff, board members).

Analysis

Interview data were transcribed and read repeatedly to identify concepts and patterns in the data. These were grouped into conceptual categories that described and explained the findings. We used an inductive analytical approach to identify important themes and concepts in the data.

Results

Participants in this study described how the patient group sector receives pressure from pharmaceutical company funders to act in ways that prioritise company interests. Groups worked to try and protect their credibility and ability to act in ways of their own choosing using practical rules or ‘lines in the sand’ about industry funding activities. They were grouped around the dominant topics of: sponsor exclusivity, brand marketing, agenda setting, advocacy and content of group activities. Lines in the sand were largely experience-driven and ethically informed; they varied between groups. There was also variable transparency among groups about financial interactions with pharmaceutical companies.

Conclusions

It is important to know about patient group practices around pharmaceutical industry funders as this allows public scrutiny about the adequacy of such practices. Inadequate strategies may mean that funders can influence patient groups activities in ways that do not necessarily prioritise the interests of members. We found that groups differed in their approach, with little independent external guidance to inform responses to commonly encountered types of influence. Inadequate transparency limits the ability of the public to make informed assessments about the risk of bias over the activities of groups that accept industry funding.