bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Cut‐Points for Low Muscle Strength and Lean Mass in Mobility‐Limited Older Adults
Authors: Grosicki Gregory J. , Travison Thomas G. , Zhu Hao , Magaziner Jay , Binder Ellen F. , Pahor Marco , Correa‐de‐Araujo Rosaly , Cawthon Peggy M. , Bhasin Shalender , Orwig Denise , Greenspan Susan , Manini Todd , Massaro Joe , Santanasto Adam , Patel Sheena , Fielding Roger A.
Published: July 2020

BACKGROUND

The Sarcopenia Definitions and Outcomes Consortium (SDOC) is a collaborative initiative seeking to develop and evaluate cut‐points for low muscle strength and lean mass that predict an increased risk for slowness (usual walking speed <.8 m/s) among older adults.

OBJECTIVES

The goal of the present study was to provide clinicians and researchers with an understanding of the diagnostic implications of using SDOC variables and cut‐points in mobility‐limited older adults. Using data from older individuals with specific conditions that render them at increased risk for mobility limitation, we evaluated the performance characteristics (ie, sensitivity and specificity) of five putative sarcopenia parameters and then compared these values with previously recommended diagnostic criteria for sarcopenia.

DESIGN

Retrospective analysis of six randomized controlled trials enriched in persons at risk for mobility limitation.

SETTING

National and international geriatric clinical research centers.

PARTICIPANTS

A total of 925 mobility‐limited older adults (≥55 years of age; 58% women) were included in the analysis.

MEASUREMENTS

The prevalence of low muscle strength and lean mass were assessed using five candidate metrics discriminative of slowness. Analyses of sensitivity and specificity were used to compare muscle weakness criteria with published diagnostics for sarcopenia.

RESULTS

Odds ratios (ORs) supported maximal grip strength (Grip max <35.5 and 20.0 in men and women, respectively) as the most discriminative of slowness in both men and women (OR = 3.66 and 3.53, respectively). More men (58%) than women (30%) fell below sex‐specific maximal grip cut‐points. When applying previously recommended sarcopenia component definitions in our population, we found that fewer individuals met those criteria (range = 6%‐32%).

CONCLUSION

A greater number of individuals fall below SDOC Grip max cut‐points compared with previous recommendations. Clinicians and researchers working with older adults may consider these thresholds as an inclusive means to identify candidates for low‐risk lifestyle promyogenic and function‐promoting therapies. J Am Geriatr Soc 68:1445‐1453, 2020.
The Diverse Implementation of Geriatrics‐Orthopedics Comanagement Programs in the United States
Authors: Rogers Stephanie E. , Ko Jocelyn S. , McNicoll Lynn , Mendelson Daniel Ari
Published: July 2020

BACKGROUND

Many health systems are establishing geriatrics‐orthopedics (Geri‐Ortho) comanagement programs; however, there is paucity of published information on existing programs' variations in clinical operations, structure, and reported implementation challenges and perceived successes.

OBJECTIVE

Our objective was to obtain detailed information about the variety of existing Geri‐Ortho comanagement programs in the United States.

DESIGN/PARTICPANTS

We conducted a cross‐sectional survey of 44 existing Geri‐Ortho comanagement programs, with 23 (52%) of programs responding.

MEASUREMENT

Quantitative questions were used to assess operational, staffing, and financial structures; and qualitative questions were used to identify reported challenges and perceived successes of implementation.

RESULTS

Programs self‐identified as urban (n = 23), academic (n = 20), or nonprofit (n = 22) and as having a level I trauma center (n = 17). Most programs (n = 18) were funded fully by the institution. Fourteen programs used geriatricians, and nine used medicine/hospitalists as the supporting clinical service, whereas approximately half (n = 11) used these services in a true comanagement model. Six universal themes were identified as necessary for program implementation. The most commonly described successes perceived by all respondents were improvements in clinical outcomes and better interdisciplinary relationships. Reported challenges included difficulty in interdisciplinary geriatrics education, difficulty in adherence to protocols, and lack of funding for staffing.

CONCLUSIONS

There are diverse types of Geri‐Ortho comanagement programs in the United States, although universal elements exist. Many had similar challenges in implementation, and further studies are needed to determine which implementation elements are critical to clinical and financial outcomes. J Am Geriatr Soc 68:1714‐1719, 2020.
Factors Predicting Participation in the Prospective Genomic Sequencing Study, Total Cancer Care (TCC), in Kentucky
Authors: Riggs McKayla J. , Huang Bin , Chen Quan , Bocklage Therese , Schuh Marissa R. , Poi Ming , Villano John L. , Cavnar Michael J. , Arnold Susanne M. , Miller Rachel W. , Ueland Frederick R. , Kolesar Jill M.
Published: July 2020

Purpose

Large‐scale genomic sequencing studies are driving oncology drug development. However, rural populations, like those residing in Appalachian Kentucky, are underrepresented in these efforts. In this study, we determined the frequency of participation, reasons for nonparticipation, and factors predicting the decision to participate in the Total Cancer Care (TCC) prospective genomic cohort study.

Methods

A total of 1,188 patients were invited to enroll in the TCC prospective cohort from December 2018 to May 2019. Declining patients were queried for their rationale for nonparticipation and their patient data were obtained from the Kentucky Cancer Registry (KCR). Logistic regression was used to assess the association between characteristics and study participation. The association of study participation with survival was modeled with Cox proportional‐hazards regression.

Results

90.9% (1,081) patients consented to participate. In multivariate analysis, factors significantly associated with participation were age, gender, treatment status, and race. Though overall more women participated in the study, men were more likely to participate than women when invited (OR 1.57). Younger, Caucasian individuals who had received chemotherapy, but not surgery, were also more likely to participate. Patients in the Kentucky Appalachian cohort were primarily rural, had less educational attainment, and lower socioeconomic status. Kentucky Appalachian patients were no less likely to enroll in TCC than non‐Appalachian patients. Consented individuals had higher overall survival compared to those who declined.

Conclusion

Though minorities, those with low socioeconomic status, and rural populations are underrepresented in genomic studies, they were no less likely to participate when given the opportunity, and participation was associated with better clinical outcomes.
Association of job stress, CLOCK gene polymorphism and their interaction with poor sleep quality
Authors: Li Yuling , Cao Zeyuan , Wu Shuang , Wang Chao , He Shuchang , Dong Yan , Zhang Xiangyang
Published: July 2020

Job stress and the Circadian Locomotor Output Cycles Kaput (CLOCK) gene could affect circadian rhythm and sleep quality. The main aim of our present study was to investigate the association of job stress, CLOCK gene polymorphism and their interaction with sleep quality in a non‐clinical Chinese Han population, which has not been reported to date. Using a cross‐sectional design, 450 subjects were recruited in Beijing. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and job stress was measured with the Work Stress Scale. CLOCK gene rs11932595 polymorphism was genotyped in 297 blood samples. Correlation analysis showed a close but different association of high job stress with the PSQI and its components. Analysis of variance showed significant main effects of the CLOCK gene rs11932595 polymorphism. G‐allele carriers had a higher score in the PSQI, sleep duration, sleep latency and sleep disturbances. Further interaction analyses showed an ordinal interaction on sleep duration, and a disordinal interaction on daytime dysfunction. Specifically, G‐allele carriers had poorer sleep duration than AA homozygotes when in high job stress, while the two subgroups displayed similar sleep duration when in low job stress, conforming to the diathesis–stress model. In comparison to G‐allele carriers, AA homozygotes experienced less daytime dysfunction when in low job stress whereas more daytime dysfunction when in high job stress, fitting with the differential susceptibility model. As genetic links have been revealed, our investigation might be conducive for elucidating aetiological factors for sleep quality and targets for implementing interventions to attain good sleep quality.
Bovine viral diarrhea virus: An updated American College of Veterinary Internal Medicine consensus statement with focus on virus biology, hosts, immunosuppression, and vaccination
Authors: Walz Paul H. , Chamorro Manuel F. , M. Falkenberg Shollie , Passler Thomas , van der Meer Frank , R. Woolums Amelia
Published: July 2020

Control of bovine viral diarrhea virus (BVDV) in cattle populations across most of the world has remained elusive in spite of advances in knowledge about this viral pathogen. A central feature of virus perseverance in cattle herds is the unique mechanism of persistent infection. Managing BVDV infection in herds involves controlling persistently infected carrier animals using a multidimensional approach of vaccination, biosecurity, and identification of BVDV reservoirs. A decade has passed since the original American College of Veterinary Internal Medicine consensus statement on BVDV. While much has remained the same with respect to clinical signs of disease, pathogenesis of infection including persistent infection, and diagnosis, scientific articles published since 2010 have led to a greater understanding of difficulties associated with control of BVDV. This consensus statement update on BVDV presents greater focus on topics currently relevant to the biology and control of this viral pathogen of cattle, including changes in virus subpopulations, infection in heterologous hosts, immunosuppression, and vaccination.
Identifying gaps across the cascade of care for the prevention of HBV mother‐to‐child transmission in Burkina Faso: Findings from the real world
Authors: Guingané Alice N. , Bougouma Alain , Sombié Roger , King Rachel , Nagot Nicolas , Meda Nicolas , Van de Perre Philippe , Tuaillon Edouard
Published: July 2020

Background

Prevention of mother‐to‐child transmission (PMTCT) is a challenge for controlling the hepatitis B epidemic. In Sub‐Saharan countries, pilot interventions including the screening of pregnant women for HBsAg, implementation of anti‐HBV therapy and infant immunization within 24 hours of life are initiated and need to be evaluated. This pilot study aimed to describe the cascade of care for hepatitis B PMTCT in a real life situation, and to identify sociodemographic factors associated with adequate management of pregnant women and infants.

Method

The study was conducted from October 1st, 2014 to February 28th, 2016 in the antenatal clinics (ANCV) of Baskuy district which comprises nine first‐level public health centres. Univariate and multivariate logistic regression analysis were used to identify sociodemographic factors associated with the likelihood of retention in the cohort, HBV DNA testing, birth dose delivery and HBsAg testing of the children at 6 months of age; P ˂ .05 was selected as cut off for significance.

Results

In this prospective cohort study, of 5200 pregnant women consulting for the antenatal visit, 2261 (43.5%) were proposed pre‐test counselling and HBsAg screening and 2220 (98.2%) have agreed to screening. Among 1580 (71.2%) women that came back for the post‐counselling interview, 75 were positive for HBsAg (4.8%), 73 (97.3% of the women provided HBsAg result) consented to medical consultation with hepatogastroenterologists and 53 (72.6%); performed the HBV DNA testing. Forty‐seven out of 60 (78.3%; 65.8‐87.9) children born alive were immunized for HBV within 24 hours of life. Retention in care was associated with the level of education of the infant’s father, secondary school or higher was associated with a better retention in care of the women (OR: 6.6; P = .03).

Conclusion

Our study shows large gaps in HBV PMTCT. Resources for hepatitis B screening, care and prevention including universal access to the vaccine birth dose should be allocated to reduce infection in HBV exposed infants born in Burkina Faso.
Intergenerational breastfeeding practices among parents and children: 1993 Pelotas (Brazil) birth cohort
Authors: Vaz Juliana dos Santos , dos Santos Leonardo Pozza , Gatica‐Dominguez Giovanna , Bierhals Isabel Oliveira , Gomes Ana Paula , Gonçalves Helen , Kac Gilberto , Menezes Ana Baptista , Assunção Maria Cecilia Formoso
Published: July 2020

The objective of this study was to investigate intergenerational breastfeeding practices according to parental sex and age at delivery in the 1993 Pelotas (Brazil) birth cohort study. This is a prospective birth cohort study, and at the 22‐year follow‐up, a substudy with all children of the cohort members who had become parents was conducted (93Cohort‐II). First generation breastfeeding data were collected at 3 months and 4‐year‐old follow‐ups. In the 93Cohort‐II, parents answered a questionnaire about their children's breastfeeding practices. Adjusted Tobit and Poisson regression models with robust variance were applied to estimate the association between predominant parental breastfeeding duration and exclusive breastfeeding duration of the children at 3 and 6 months. Out of 3,810 cohort participants, 955 (25%) had delivered at least one live‐born infant, and 1,222 children were assessed. Fifty‐four percent of parents were ≤19 years old. Direct effects of predominant parental breastfeeding duration on exclusive breastfeeding duration of their children were only observed when data were stratified by parental age: children born to parents aged ≥20 years old and who were predominantly breastfed for at least 3 months presented higher exclusive breastfeeding duration and higher prevalence of being exclusively breastfed for at least 3 months. When analyses were stratified by mothers and fathers, the result remained significant only among mothers. Longer predominant breastfeeding duration in the first generation was associated with longer exclusive breastfeeding duration in the second generation, but only among older mothers. Education and social support surrounding breastfeeding should be intensified among fathers and younger parents to create a positive environment supportive of breastfeeding.
Relationship between individual metabolic rate and patch departure behaviour: evidence from aquatic gastropods
Authors: Cozzoli Francesco , Shokri Milad , Ligetta Giovanna , Ciotti Mario , Gjoni Vojsava , Marrocco Vanessa , Vignes Fabio , Basset Alberto
Published: July 2020

Individual energy requirements are tightly related to individual resource use and by extension of space‐use patterns and other traits at higher levels of the ecological hierarchy. However, there is still little experimental evidence linking individual energetics and space‐use behaviour. Individual energy requirements scale mainly with body size and temperature, but these do not explain all individual variation. Therefore, studies focused on inter individual variation in resource and space use behaviour can be used to frame foraging dynamics in an energy perspective. We empirically tested the hypothesis of a relationship between individual energetics and patch departure behaviour using as model organisms four small species (body mass ranging from 0.4 to 14 mg AFDW) of aquatic gastropods strongly differing in adult size: Galba truncatula, Bithynia tentaculata, Theodoxus fluviatilis and Ecrobia ventrosa (in descending order of size). Motility tests were performed in controlled microcosm conditions. The tests were designed to classify the specimens as either low motility (not inclined to abandon the patch) or high motility (likely to abandon the patch). The tests entailed measuring the propensity of the individuals to abandon a limited resource patch (2 g DW of conditioned Phragmites australis leaves) within a given amount of time (24 h) when foraging with conspecifics under conditions where competition for food is expected to increase over time due to resource depletion. The individual standard metabolic rate of the tested specimens was measured via open flow respirometry and compared across motility classes at intra‐ and interspecific level. At both levels, we observed that individuals with higher standard metabolic rates were more inclined to abandon the patch. This finding establishes a link between foraging theory and competitive coexistence mechanisms.
Role of the rice blast resistance gene Pi‐cd in rice (Oryza sativa) breeding programmes
Authors: Fujino Kenji , Obara Mari , Kiuchi Hitoshi , Shinada Hiroshi , Nishimura Tsutomu , Maekawa Toshihiko , Hirayama Yuji
Published: July 2020

A series of DNA markers for various agronomic traits may accelerate the success of marker‐assisted selection in practical plant breeding programmes. Here, we developed DNA markers for the blast resistance gene Pi‐cd. In this study, we examined the effects of the Pi‐cd locus on not only blast resistance but also agronomic traits in agriculture. We developed three pyramiding lines (PLs) coupling Pi‐cd with three blast resistance genes, pi21, Pi35 and Pi39. The effect of Pi‐cd on blast resistance was dependent on the coupled resistance genes. Then, we evaluated the effects of Pi‐cd on 13 agronomic traits. Amylose content and 1,000‐grain weight showed significant differences between the PLs and current commercial varieties, which had no negative effects on agronomic trait values. Furthermore, we investigated the distribution of genotype for the Pi‐cd locus among varieties of upland rice. The KT genotype specific to rice blast resistance may be predominant in the varieties. The results suggested that Pi‐cd has the potential to be useful for improving blast resistance in rice breeding programmes.
Regional oxygen saturation and acute kidney injury in premature infants
Authors: Dorum Bayram Ali , Ozkan Hilal , Cetinkaya Merih , Koksal Nilgun
Published: July 2020

Background

Decreased renal blood flow plays a vital role in the etiology of acute kidney injury (AKI). In this study, we aim to investigate the role of renal regional oxygen saturation (rSO2) reductions in predicting AKI in the first 24 h of life.

Methods

One hundred premature babies with a gestational age of ≤32 weeks were included. Renal and cerebral rSO2s were monitored for 24 h by near‐infrared spectroscopy. Infants were followed up for the first 7 days for the diagnosis of AKI.

Results

Infants' median gestational age was 29 (23–32) weeks, and their birthweight was 1,192 ± 355 g. It was found that the renal rSO2 values were lower in the first 24 h of life in patients who developed AKI, and this decrease was statistically significant in the first 6 h of life.

Conclusions

The low renal rSO2 values in the early hours of life in premature babies may have a role in predicting AKI.
Death from an Adult‐onset Still’s disease triggered by visceral leishmaniasis
Authors: Wang Donghong , Huang Qiong , Wang Yong , Guo Junxian , Pu Zhongshu
Published: July 2020

A 24‐year‐old patient presented with a 4‐month‐long high‐spiking fever, characteristic rash, sore throat and arthralgias. Bone marrow biopsy examination demonstrated visceral leishmaniasis with the presence of typical Leishman‐Donovan bodies. During the treatment for visceral leishmaniasis with the sodium stibogluconate, he died suddenly. According to the symptoms, we infer that the patient catch the adult‐onset Still's disease due to the visceral leishmaniasis.
Childhood abuse history and attention bias in adults
Authors: Letkiewicz Allison M. , Silton Rebecca L. , Mimnaugh Katherine J. , Miller Gregory A. , Heller Wendy , Fisher Joscelyn , Sass Sarah M.
Published: July 2020

Attention biases toward unpleasant information are evident among children and adults with a history of abuse and have been identified as a potential pathway through which abused children develop psychopathology. Identifying whether a history of childhood abuse affects the time course of attention biases in adults is critical, as this may provide intervention targets. The present study examined the time course of attention bias during an emotion‐word Stroop task using event‐related potentials (ERPs) in a sample of adults with a range of child abuse histories using a categorical approach (comparing adults with or without a history of moderate‐to‐severe childhood abuse) and a dimensional approach (analyzing the range from no abuse to severe abuse in a continuous manner). Although behavioral performance did not vary as a function of abuse history, adults with a history of moderate‐to‐severe childhood abuse showed ERP evidence of early reduced processing of emotional stimuli (smaller N200) and later reduced processing of emotional and nonemotional stimuli (smaller P300), followed by later increased processing of unpleasant stimuli (larger slow wave [SW]). Results suggest that early disengagement from emotional stimuli may help individuals with moderate‐to‐severe abuse histories to achieve normal behavioral performance on the emotion‐word Stroop task. Additionally, regardless of analytic approach, adults with elevated levels of childhood abuse exhibited prolonged engagement (larger SW) specifically with unpleasant stimuli. Present results demonstrate attention bias patterns in adults with a history of childhood abuse and clarify the time course of attention bias. Results are discussed in the context of potential treatment implications.
A Simple Toxicokinetic Model Exhibiting Complex Dynamics and Nonlinear Exposure Response
Authors: Park Robert M.
Published: July 2020

Uncertainty in model predictions of exposure response at low exposures is a problem for risk assessment. A particular interest is the internal concentration of an agent in biological systems as a function of external exposure concentrations. Physiologically based pharmacokinetic (PBPK) models permit estimation of internal exposure concentrations in target tissues but most assume that model parameters are either fixed or instantaneously dose‐dependent. Taking into account response times for biological regulatory mechanisms introduces new dynamic behaviors that have implications for low‐dose exposure response in chronic exposure. A simple one‐compartment simulation model is described in which internal concentrations summed over time exhibit significant nonlinearity and nonmonotonicity in relation to external concentrations due to delayed up‐ or downregulation of a metabolic pathway. These behaviors could be the mechanistic basis for homeostasis and for some apparent hormetic effects.
Analysis and spatial distribution of schistosomiasis mansoni in a historically endemic area of northeastern Brazil
Authors: Gomes de Amorim Santos Israel , Santos Ramos Rosália Elen , Soares Gomes Dharliton , Pereira Bezerra Letícia , Oliveira Silva Laryssa , Martins Cirilo Tatyane , Carlos Alves Luiz , André Brayner Fábio
Published: July 2020

Objective

To perform a descriptive analysis of the activities of the Schistosomiasis Control Program, as well as the spatial distribution of the condition in the state of Alagoas, Brazil, for the period from 2007 to 2016.

Methods

Descriptive ecological study. Data from positive human cases and operational data were collected in the Information System of the Schistosomiasis Control Program, and data for spatial analysis were collected on the website of the Brazilian Institute of Geography and Statistics. An analysis of spatial autocorrelation (Moran statistics) was performed, where a spatial pattern was established, which showed the Q1 and Q2 patterns to be the most important, and Q3 and Q4 representing transition areas.

Results

In the years under study, at least 85% (n = 60/70) of the municipalities carried out the activities recommended by the PCE (Schistosomiasis Control Program). Alagoas presented an average positivity rate of 7.1%, which is very high compared to the prevalence of 3.3% at the last national schistosomiasis survey conducted between 2010 and 2015. Moran's statistics showed 22/70 municipalities forming a Q1 cluster, of high/high pattern, and 32/70 municipalities forming a Q2 cluster, of low/low pattern, with the others in a transition area. Moran Map data, however, showed only 7/70 municipalities in the endemic area with a spatial autocorrelation, with these municipalities having the Mundau River as a common element.

Conclusion

Schistosomiasis mansoni is of great importance for public health in Alagoas and that the use of spatial analysis can identify priority areas for preventive and control measures against schistosomiasis mansoni.
Maternity iron, anaemia and blood management in South Australia: a practice‐based evidence for clinical practice improvement
Authors: Flores Cindy J. , Yong Angelina , Knights Eleanor , Grech Jodie , Saxon Ben , Markus Corey , Sinha Romi , Osborn Kym
Published: July 2020

Background

Anaemia at delivery is a strong modifiable risk factor for transfusion in women with a postpartum haemorrhage (PPH). A Maternity Patient Blood Management (PBM) Practice Based Evidence Clinical Practice Improvement (CPI) was conducted to optimize antenatal haemoglobin and iron stores prior to delivery.

Methods

Australian maternity PBM CPI resources (featuring algorithms on diagnosing iron deficiency with both haemoglobin and ferritin screening, as well as information on oral iron therapy for maternity patients) were introduced at a major tertiary hospital from November 2016 to March 2017. To assess the effectiveness of these resources on haemoglobin and iron stores, an interrupted time series (ITS) analysis was conducted for 11,263 deliveries from January 2016 to June 2018. The evaluation timeframe was divided into baseline (pre‐CPI), pilot (during CPI) and post‐pilot (post‐CPI).

Results

In 1550 patients with haemoglobin and ferritin in the first trimester, non‐anaemic iron deficiency was detected in 416 women (26·8%) and iron deficiency anaemia (IDA) in 239 women (15·41%) throughout the whole study period. The number of women with IDA increases as pregnancy progresses but applying PBM CPI shows a reduction of IDA rate in all trimesters and reduction in anaemia at delivery in the post‐pilot period from baseline. More anaemic episodes were observed in the postpartum period compared to the first trimester. ITS analysis for the whole study period showed a clinically significant increase in the monthly average predelivery haemoglobin of 0·9 g/l (P = 0·16). This corresponded with a reduction in the monthly rate of anaemic patients by 18% (P = 0·12). There was a significant decrease in the rates of anaemia at delivery and decrease in red cell transfusion in anaemic women, even though the number of women with PPH was stable. The factors associated with red cell transfusion are anaemia at delivery (P < 0·001) and the incidence of PPH (P < 0·001).

Conclusions

The maternity PBM CPI resources had a clinically relevant but not statistically significant effect in optimizing antenatal haemoglobin and decreasing the risk of predelivery anaemia. This study demonstrates how a CPI can modify one risk factor for blood loss, which is the anaemia at delivery, and subsequent transfusion in the perinatal period.
PREMS and PROMS data within the acute health care context: a scoping review protocol
Authors: Kynoch Kate , Ramis Mary-Anne , Khalil Hanan
Published: July 2020

Objective:

The objective of this scoping review is to investigate use of patient reported experience measures and patient reported outcome measures within the acute health care context.

Introduction:

Data from patient reported outcome measures and patient reported experience measures provide important information for health professionals and organizations in order to improve patient-centered care. These two measures have potential to narrow the gap between the clinician's and patient's views and help tailor treatment plans to meet the patient's preferences and needs.

Inclusion criteria:

This scoping review will consider studies that include patients of any age and any condition who have obtained care from any acute health care facility. The concepts of this review are: the types of research studies that have been done using patient reported experience measures and patient reported outcome measures data in acute hospital settings, the geographical contexts of these two measures’ studies, the barriers and facilitators that have been identified in studies that use data from the measures, the characteristics of patient reported experience measures and patient reported outcome measures data and the ways in which these types of data have been applied to clinical practice in acute care settings. This review will consider studies that are set in any acute health care setting including inpatient and outpatient areas, emergency departments, and critical care units.

Methods:

This scoping review, utilizing JBI methods, will include an extensive search of the databases for published and unpublished literature. The review will consider any type of quantitative, qualitative, or mixed methods research evidence as well as systematic reviews to understand how hospitals use patient reported experience measures and patient reported outcome measures data in health care. Each included study will be assessed by two independent reviewers and data will be extracted from included papers using a standardized data extraction tool.
Influence of Novel Torch Type on Mechanical and Microstructural Characteristics of Cold Metal Transfer Brazed Joints
Authors: Singh Jaivindra , Arora Kanwer Singh , Shajan Nikhil , Shome Mahadev , Shukla Dinesh Kumar
Published: July 2020

The present study aimed to braze interstitial free (IF) steel by using novel Braze+ and conventional Robacta torches with the aid of CuAl8 filler wire for a range of heat input 72–250 J/mm. Results showed that focused/denser arc and smaller arc action range, i.e., lower heat loss in the case of Braze+ torch resulted in better wettability, thicker intermetallic layer at the interface of deposited bead-steel, and higher dispersive phase fraction in the bead compared to Robacta torch which ultimately contributed to the evolution of mechanical properties of brazed joints. Furthermore, wettability, thickness of intermetallic layer and fraction of dispersive phases increased with the heat input due to increased deposition rate per unit time, availability of reacting atoms near the interface, and melting of base metal, respectively. Hardness variation of the brazed joints revealed that base metal was prone to failure due to comparatively higher hardness as well as improved resistance to failure of HAZ (due to the formation of acicular ferrite) and deposited bead (due to dispersion hardening). In addition, Fe, Al, and Cu were the main constituents of intermetallic layer and dispersive phases in the bead. IMC layer was harder in the case of Braze+ torch due to comparatively higher Fe content. Two modes of failure namely interface (brittle features) and base metal (ductile features) were observed during shear-tensile testing.
An Alternate Approach to SHPB Tests to Compute Johnson-Cook Material Model Constants for 97 WHA at High Strain Rates and Elevated Temperatures Using Machining Tests
Authors: Sagar Chithajalu Kiran , Priyadarshini Amrita , Gupta Amit Kumar , Kumar Tarun , Saxena Shreya
Published: July 2020

With advances in computational techniques, numerical methods such as finite element method (FEM) are gaining much of the popularity for analysis as these substitute the expensive trial and error experimental techniques to a great extent. Consequently, selection of suitable material models and determination of precise material model constants are one of the prime concerns in FEM. This paper presents a methodology to determine the Johnson-Cook constitutive equation constants (JC constants) of 97 W Tungsten heavy alloys (WHAs) under high strain rate conditions using machining tests in conjunction with Oxley’s predictive model and particle swarm optimization (PSO) algorithm. Currently, availability of the high strain rate data for 97 WHA are limited and consequently, JC constants for the same are not readily available. The overall methodology includes determination of three sets of JC constants, namely, M1 and M2 from the Split-Hopkinson pressure bar (SHPB) test data available in literature by using conventional optimization technique and artificial bee colony (ABC) algorithm, respectively. However, M3 is determined from machining tests using inverse identification method. To validate the identified JC constants, machining outputs (cutting forces, temperature, and shear strain) are predicted using finite element (FE) model by considering M1, M2, and M3 as input under different cutting conditions and then validated with corresponding experimental values. The predicted outputs obtained using JC constants M3 closely matched with that of the experimental ones with error percentage well within 10%.
Reactivation of Epstein-Barr Virus by HIF-1α Requires p53
Authors: Kraus Richard J. , Cordes Blue-leaf A. , Sathiamoorthi Saraniya , Patel Parita , Yuan Xueying , Iempridee Tawin , Yu Xianming , Lee Denis L. , Lambert Paul F. , Mertz Janet E.
Published: July 2020

EBV, a human herpesvirus, is latently present in most nasopharyngeal carcinomas, Burkitt lymphomas, and some gastric cancers. To develop a lytic-induction therapy for treating patients with EBV-associated cancers, we need a way to efficiently reactivate EBV into lytic replication. EBV’s
BZLF1
gene product, Zta, usually controls this reactivation switch. We previously showed that HIF-1α binds the
BZLF1
gene promoter, inducing Zta synthesis, and HIF-1α-stabilizing drugs can induce EBV reactivation. In this study, we determined which EBV-positive cell lines are reactivated by classes of HIF-1α-stabilizing drugs. We found, unexpectedly, that HIF-1α-stabilizing drugs only induce reactivation when they also induce accumulation of phosphorylated, wild-type p53. Fortunately, p53 phosphorylation can also be provided by drugs such as nutlin-3, leading to synergistic reactivation of EBV. These findings indicate that some HIF-1α-stabilizing drugs may be helpful as part of a lytic-induction therapy for treating patients with EBV-positive malignancies that contain wild-type p53.
Globally Abundant “
Candidatus
Udaeobacter” Benefits from Release of Antibiotics in Soil and Potentially Performs Trace Gas Scavenging
Authors: Willms Inka M. , Rudolph Anina Y. , Göschel Isabell , Bolz Simon H. , Schneider Dominik , Penone Caterina , Poehlein Anja , Schöning Ingo , Nacke Heiko
Published: July 2020

Soil bacteria have been investigated for more than a century, but one of the most dominant terrestrial groups on Earth, “
Candidatus
Udaeobacter,” remains elusive and largely unexplored. Its natural habitat is considered a major reservoir of antibiotics, which directly or indirectly impact phylogenetically diverse microorganisms. Here, we found that “
Ca.
Udaeobacter” representatives exhibit multidrug resistance and not only evade harmful effects of antimicrobials but even benefit from antibiotic pressure in soil. Therefore, “
Ca.
Udaeobacter” evidently affects the composition of soil resistomes worldwide and might represent a winner of rising environmental pollution with antimicrobials. In addition, our study indicates that “
Ca.
Udaeobacter” representatives utilize H
2
and thereby contribute to global hydrogen cycling. The here-reported findings provide insights into elementary lifestyle features of “
Ca.
Udaeobacter,” potentially contributing to its successful global dissemination.
A Core Genome Multilocus Sequence Typing Scheme for Streptococcus mutans
Authors: Liu Shanshan , Li Xiaoliang , Guo Zhenfei , Liu Hongsheng , Sun Yu , Liu Yudong , Wang Qinglong , Liao Shengkai , Zhang Kai
Published: July 2020

Streptococcus mutans
is regarded as a major pathogen responsible for the onset of dental caries.
S. mutans
can transmit among people, especially within families. In this study, we established a new epidemiological approach to
S. mutans
classification. This approach can effectively differentiate among closely related isolates and offers superior reliability relative to that of the traditional MLST molecular typing method. As such, it has the potential to better support effective public health strategies centered around this bacterium that are aimed at preventing and treating dental caries.
Gastric metastases from primary breast cancers: rare causes of common gastrointestinal disorders
Authors: Yuen Tiffany , Liu Eddie , Kohansal Ali
Published: July 2020

We report two cases of gastric metastases from primary breast cancers. In case 1, a 31-year-old woman with right-sided ductal breast carcinoma presented with nausea, vomiting and frank haematemesis, 8 months after mastectomy and adjuvant chemotherapy. An esophagogastroduodenoscopy (EGD) revealed multiple ulcerated gastric lesions secondary to metastatic adenocarcinoma from primary breast tumour. In case 2, an 84-year-old woman with a history of left lobular carcinoma presented with early satiety, 17 years after initial mastectomy and adjuvant endocrine therapy. An EGD revealed unspecific gastric mucosa with thickened and erythematous folds and biopsies revealed adenocarcinoma from primary breast carcinoma. Our cases demonstrate how gastric metastases have variable, non-specific clinical and endoscopic presentations. Symptoms may include nausea, vomiting, early satiety and gastrointestinal (GI) bleeding. Endoscopic appearance may range from thickened gastric folds to ulcerating lesions. Our cases demonstrate that gastric metastases should be considered in patients with breast cancer history presenting with GI symptoms.
Resuscitative hysterotomy for maternal collapse in a triplet pregnancy
Authors: Tambawala Zenab Yusuf , Cherawala Masuma , Maqbool Sadia , Hamza Lama Khalid
Published: July 2020

We encountered a 47-year-old woman, at 35 weeks of gestation, carrying triplets, who attended the hospital with severe pre-eclampsia and at admission had eclamptic fit followed by cardiac arrest. Cardiopulmonary resuscitation was started when she did not respond to initial measures; resuscitative hysterotomy was started on the site of collapse immediately, within 4 min postarrest, to deliver the triplets within 5 min postmaternal cardiac arrest. Timely decision of resuscitative hysterotomy done primarily to restore maternal cardiac output due to a grossly gravid uterus saved the mother and the triplets. With increasing maternal age and use of in vitro fertilisation resulting in multiple pregnancies, maternal comorbidities are more likely. These could result in maternal collapse in which case timely resorting to resuscitative hysterotomy can make survival of mother and feti more likely.
Toward a complete estimate of physical and psychosocial morbidity from prolonged obstructed labour: a modelling study based on clinician survey
Authors: Roa Lina , Caddell Luke , Ganyaglo Gabriel , Tripathi Vandana , Huda Nazmul , Romanzi Lauri , Alkire Blake C
Published: July 2020

Introduction

Prolonged obstructed labour often results from lack of access to timely obstetrical care and affects millions of women. Current burden of disease estimates do not include all the physical and psychosocial sequelae from prolonged obstructed labour. This study aimed to estimate the prevalence of the full spectrum of maternal and newborn comorbidities, and create a more comprehensive burden of disease model.

Methods

This is a cross-sectional survey of clinicians and epidemiological modelling of the burden of disease. A survey to estimate prevalence of prolonged obstructed labour comorbidities was developed for prevalence estimates of 27 comorbidities across seven categories associated with prolonged obstructed labour. The survey was electronically distributed to clinicians caring for women who have suffered from prolonged obstructed labour in Asia and Africa. Prevalence estimates of the sequelae were used to calculate years lost to disability for reproductive age women (15 to 49 years) in 54 low- and middle-income countries that report any prevalence of obstetric fistula.

Results

Prevalence estimates were obtained from 132 participants. The median prevalence of reported sequelae within each category were: fistula (6.67% to 23.98%), pelvic floor (6.53% to 8.60%), genitourinary (5.74% to 9.57%), musculoskeletal (6.04% to 11.28%), infectious/inflammatory (5.33% to 9.62%), psychological (7.25% to 24.10%), neonatal (13.63% to 66.41%) and social (38.54% to 59.88%). The expanded methodology calculated a burden of morbidity associated with prolonged obstructed labour among women of reproductive age (15 to 49 years old) in 2017 that is 38% more than the previous estimates.

Conclusions

This analysis provides estimates on the prevalence of physical and psychosocial consequences of prolonged obstructed labour. Our study suggests that the burden of disease resulting from prolonged obstructed labour is currently underestimated. Notably, women who suffer from prolonged obstructed labour have a high prevalence of psychosocial sequelae but these are often not included in burden of disease estimates. In addition to preventative and public health measures, high quality surgical and anaesthesia care are urgently needed to prevent prolonged obstructed labour and its sequelae.
Control of three gastrointestinal illness outbreaks in a British Role 1 facility in Afghanistan: a primary care perspective
Authors: Makin Seth , Hudson L , Robinson R , Riley M R , Murphy D
Published: July 2020

Introduction

In 2019, Camp Qargha (QAA), a British-led multinational military camp in Kabul, had three of the largest outbreaks of gastrointestinal illness (GI) experienced by the British Military since 2003. This paper discusses the incidence, the response of the British-led Role 1 (R1) medical treatment facility, identifies potential causative and exacerbating factors, and explains the control measures initiated.

Method

GI in QAA results in local and UK military-wide data collection including in the form of local GI questionnaires, FMed85 forms and EpiNATO returns. The data from these was used to identify trends during and after outbreaks and produce environmental health (EH) and local outbreak reports.

Results

Overall, among the outbreaks 56% of stool samples tested positive for norovirus. In each outbreak incidence peaked within the first 3 days, and hardened multiperson rooms were worst affected. 206 patient presentations occurred during the three outbreaks, 706 working days were lost in isolation, with QAA shut down while in quarantine for 27 days.

Discussion

Significant strain was placed on QAA and the R1. Causative factors may include close interaction with the local national (LN) population, a high population density and accommodation being limited by specific national infrastructure protocols in an operational environment.

Conclusion

Early recognition of GI, positive standard operating procedures and good hygiene habits are essential to prevent the spread of GI such as norovirus. An early awareness of LN population illness patterns will allow the R1 and command to be better prepared for outbreaks in the future.
Protocol for a phase IV, open-label feasibility study investigating non-invasive markers of hepatic fibrosis in people living with HIV-1 and non-alcoholic fatty liver disease randomised to receiving optimised background therapy (OBT) plus maraviroc or OBT alone
Authors: Bradshaw Daniel , Gilleece Yvonne , Verma Sumita , Abramowicz Iga , Bremner Stephen , Perry Nicky
Published: July 2020

Introduction

At least 30% of people living with HIV (PLWH) infection have non-alcoholic fatty liver disease (NAFLD), which has now become a leading cause of hepatic fibrosis and cirrhosis. Management is based largely on lifestyle modifications, which are difficult to achieve, and therapeutic options are urgently needed. Maraviroc (MVC), through antagonism of CCR5 receptors, may reduce hepatic fibrosis progression and could be an effective treatment for NAFLD. However, dosing is usually two times per day, unlike most currently recommended antiretroviral therapies. This study will investigate the feasibility and acceptability of addition of MVC to combination antiretroviral therapy in PLWH and NAFLD as a treatment for NAFLD.

Methods and analysis

This is a phase IV, randomised, open-label, non-invasive feasibility study. Sixty individuals with well-controlled HIV-1 and NAFLD will be recruited from UK HIV clinics and randomised 1:1 to receive either optimised background therapy (OBT) plus MVC or OBT alone. Follow-up will be every 24 weeks for 96 weeks. The primary outcome measures will include recruitment and retention rates, adverse events and adherence. Secondary outcomes will include changes in markers of hepatic fibrosis, including the Enhanced Liver Fibrosis score, median liver stiffness measurement and controlled attenuation parameter scores on Fibroscan, and quality of life assessments. Analyses will be performed according to intention-to-treat principles. For secondary outcomes, estimated differences and 95% CIs between the groups using a t-method will be presented for continuous variables and as exact 95% binomial CIs for categorical variables.

Ethics and dissemination

Ethical approval was obtained through the London Dulwich UK Research Ethics Committee (reference 17/LO/2093). Results will be disseminated both through community groups and peer-reviewed scientific literature.

Trial registration numberSRCTN31461655. EudraCT number 2017-004141-24; Pre-results.
Uptake and patient and provider communication modality preferences of virtual visits in primary care: a retrospective cohort study in Canada
Authors: Stamenova Vess , Agarwal Payal , Kelley Leah , Fujioka Jamie , Nguyen Megan , Phung Michelle , Wong Ivy , Onabajo Nike , Bhatia R Sacha , Bhattacharyya Onil
Published: July 2020

Objectives

To evaluate the uptake of a platform for virtual visits in primary care, examine patient and physician preferences for virtual communication methods and report on characteristics of visits and patients experience of care.

Design

A retrospective cohort study.

Setting

Primary care practices within five regions in Ontario, Canada after 18 months of access to virtual care services.

Participants

326 primary care providers and 14 291 registered patients.

Interventions

Providers used a platform that allowed them to connect with their patients through synchronous (audio/video) and/or asynchronous (secure messaging) communication.

Main outcome measures

User-level data from the platforms including patient demographics, practice characteristics, communication modality used, visit characteristics and patients’ satisfaction.

Results

Among the participants, 44% of registered patients and 60% of registered providers used the platform at least once. Among patient users, 51% completed at least one virtual visit. The majority of virtual visits (94%) involved secure messaging. The most common patient requests were for medication prescriptions (24%) and follow-up from previous appointment (22%). The most common provider request was to follow-up on test results (59%). Providers indicated that 81% of virtual visits required no follow-up for that issue and 99% of patients reported that they would use virtual care services again.

Conclusions

While there are a growing number of primary care video visit services, our study found that both patients and providers in rostered practices prefer secure messaging over video. Despite fears that virtual visits would be overused by patients, when patients connected with their own primary care provider, many virtual visits appeared to replace in-person visits, and patients did not overwhelm physicians with requests. This approach may improve access and continuity in primary care.