bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of earthquake casualties and comparison of accuracy of five injury triage methods: evidence from a retrospective study
Authors: Peng Yang , Hu Hai
Published: October 2021

Objective

The use of an injury triage method among earthquake injury patients can facilitate the reasonable allocation of resources, but the various existing injury triage methods need further confirmation. This study aims to assess the accuracy of several injury triage methods, namely, the Simple Triage and Rapid Treatment (START) technique; CareFlight Injury Triage (CareFlight); Rapid Emergency Medicine Score (REMS); Triage Revised Trauma Score (T-RTS) and Triage Early Warning Score (TEWS), based on their effects on earthquake injury patients.

Design

Data in the Huaxi Earthquake Casualty Database were analysed retrospectively.

Setting

This study was conducted in China.

Participants

Data on 29 523 earthquake casualties were separately evaluated using the START technique, CareFlight, REMS, T-RTS and TEWS, with these being the five types of injury triage studied.

Primary outcome measure

The receiver operating characteristic (ROC) curves for the five injury triages were calculated based on hospital deaths, injury severity scores greater than 15 points, and whether casualties stayed in the intensive care unit.

Results

The ROC curve areas of the START technique, CareFlight, REMS, T-RTS and TEWS were 0.750, 0.737, 0.835, 0.736 and 0.797, respectively. Among the five injury triages, the most accurate in predicting hospital deaths was REMS, with an average area under the curve (AUC) of 0.835, with this due to the inclusion of more evaluation indicators.

Conclusion

All methods had an effect on the triage of earthquake mass casualties. Among them, the REMS injury triage method had the largest AUC of the five triage methods. Except for REMS, no obvious difference was found in the effect of the other four injury triage methods.
Women’s acceptability of and experience with primary human papillomavirus testing for cervix screening: HPV FOCAL trial cross-sectional online survey results
Authors: Smith Laurie W , Racey C Sarai , Gondara Lovedeep , Krajden Mel , Lee Marette , Martin Ruth Elwood , Stuart Gavin , Peacock Stuart , Coldman Andrew J , Franco Eduardo L , van Niekerk Dirk , Ogilvie Gina S
Published: October 2021

Objective

To study participant’s acceptability of and attitudes towards human papillomavirus (HPV) testing compared with cytology for cervical cancer screening and what impact having an HPV positive result may have in future acceptability of screening.

Design

Cross-sectional online survey of clinical trial participants.

Setting

Primary care, population-based Cervix Screening Program, British Columbia, Canada.

Participants

A total of 5532 participants from the HPV FOCAL trial, in which women received HPV and cytology testing at study exit, were included in the analysis. Median age was 54 years. The median time of survey completion was 3 years after trial exit.

Outcome measures

Acceptability of HPV testing for primary cervical cancer screening (primary); attitudes and patient perceptions towards HPV testing and receipt of HPV positive screen results (secondary).

Results

Most respondents (63%) were accepting of HPV testing, with the majority (69%) accepting screening to begin at age 30 years with HPV testing. Only half of participants (54%) were accepting of an extended screening interval of 4–5 years. In multivariable logistic regression, women who received an HPV positive screen test result during the trial (OR=1.41 95% CI 1.11 to 1.80) or were older (OR=1.01, 95% CI 1.00 to 1.02) were more likely to report HPV testing as acceptable.

Conclusions

In this evaluation of acceptability and attitudes regarding HPV testing for cervix screening, most are accepting of HPV testing for screening; however, findings indicate heterogeneity in concerns and experiences surrounding HPV testing and receipt of HPV positive results. These findings provide insights for the development of education, information and communication strategies during implementation of HPV-based cervical cancer screening.

Trial registration numbers

ISRCTN79347302andNCT00461760.
Sharps injuries and splash exposures among healthcare workers in Arab countries: protocol of a systematic review and meta-analysis
Authors: Karkaz Ibtisam , Elbarazi Iffat , Östlundh Linda , Paulo Marília Silva , Sheek-Hussein, Mohamud , Al-Rifai Rami H , Ádám Balázs
Published: October 2021

Introduction

Sharps injuries, including needlestick injuries and splash exposures, constitute serious occupational health problems for healthcare workers, carrying the risk of bloodborne infections. However, data on such occupational incidents and their risk factors in healthcare settings are scarce and not systematically summarised in the Arab countries.

The aim of this study is to conduct a systematic review and meta-analysis to review published literature about sharps injuries and splash exposures of healthcare workers in Arab countries, with the objectives to determine the incidence and/or prevalence of these events, their identified risk factors and the applied preventive and postexposure prophylactic measures.

Methods and analysis

The protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. A comprehensive presearch developed in January to March 2021 in the database PubMed will be followed by a systematic search of six, core medical and health science databases: PubMed, EMBASE, Scopus, CINAHL, Web of Science and Africa-Wide Information in May 2021. The search will be performed without any filters or restrictions for publication years. Covidence systematic review tool will be used for document management, blinded screening and study selection. Two reviewers will independently screen the records, extract data and conduct risk of bias assessment. Results will be synthesised narratively in summary tables, and, if findings allow, meta-analysis will be conducted on the incidence and/or prevalence of sharps injuries and splash exposures, and on the effect size of risk factors.

Ethics and dissemination

The systematic review methodology does not require ethics approval due to the nature of the study design based only on published studies. The results of the systematic review will be published in a peer-reviewed journal, disseminated to stakeholders and made publicly available.

PROSPERO registration number

CRD42021242416.
Cigarette prices in eight sub-Saharan African countries in 2018: a cross-sectional analysis
Authors: Chang Kiara , Mayne Emily , Laverty Anthony A , Agaku Israel , Filippidis Filippos T
Published: October 2021

Objective

While the trend in smoking prevalence is decreasing worldwide, the number of male tobacco smokers is growing in Africa. This study compares the cigarette market in eight sub-Saharan African countries. This includes examining cigarette prices, pricing differentials, pack sizes and affordability at national and subnational levels.

Design and setting

A cross-sectional data analysis using data from the Data on Alcohol and Tobacco in Africa (DATA) Project. The DATA Project was centrally coordinated by project supervisors following a standardised protocol. University students were recruited to conduct data collection and a total of 22 347 retail cigarette price data points collected between June and August 2018 were analysed (including Botswana, Ethiopia, Lesotho, Namibia, Nigeria, South Africa, Zambia and Zimbabwe). Prices were converted to US$ and standardised to the price of a 20-cigarette pack.

Results

This research found large price differentials within provinces/states, with the gap between medium and minimum prices per 20-cigarette pack exceeding 50% of the medium price in 18 out of 24 provinces/states. Single cigarettes were widely available, especially in Lesotho and Ethiopia. Results of multivariable regression suggest prices (per 20-cigarette pack) were lower for cigarettes sold in packs than single sticks (−US$0.27, 95% CI: −US$0.39 to −US$0.23) and lower in less populated areas (−US$0.28 in rural compared with urban settings, 95% CI: −US$0.41 to −US$0.15). Availability of cheaper single cigarettes (lower per unit price than packed cigarettes) were identified for Lesotho and South Africa.

Conclusions

These findings identify a varied picture in cigarette pricing in studied countries and suggest measures to tackle pricing differentials and availability of single sticks are warranted. These measures should counteract the potential health consequences of the increasing penetration of tobacco industry in these sub-Saharan African countries.
Perinatal factors and hospitalisations for severe childhood infections: a population-based cohort study in Sweden
Authors: Videholm Samuel , Kostenniemi Urban , Lind Torbjörn , Silfverdal Sven-Arne
Published: October 2021

Objective

To examine the association between perinatal factors and hospitalisations for sepsis and bacterial meningitis in early childhood (from 28 days to 2 years of age).

Design

A population‐based cohort study. The Swedish Medical Birth Register was combined with the National Inpatient Register, the Cause of Death Register, the Total Population Register and the Longitudinal integration database for health insurance and labour market studies. Associations between perinatal factors and hospitalisations were examined using negative binomial regression models.

Setting

Sweden.

Participants

1 406 547 children born in Sweden between 1997 and 2013.

Main outcome measures

Hospital admissions for sepsis and bacterial meningitis recorded between 28 days and 2 years of life.

Results

Gestational age was inversely associated with severe infections, that is, extreme prematurity was strongly associated with an increased risk of sepsis, adjusted incidence rate ratio (aIRR) 10.37 (95% CI 6.78 to 15.86) and meningitis aIRR 6.22 (95% CI 2.28 to 16.94). The presence of congenital malformation was associated with sepsis aIRR 3.89 (95% CI 3.17 to 4.77) and meningitis aIRR 1.69 (95% CI 1.09 to 2.62). Moreover, children born small or large for gestational age were more likely to be hospitalised for sepsis and children exposed to maternal smoking were more likely to be hospitalised for meningitis.

Conclusions

Prematurity and several other perinatal factors were associated with an increased risk of severe infections in young children. Therefore, clinical guidelines for risk assessment of infections in young children should consider perinatal factors.
Patients’ and psychiatrists’ perspectives on clozapine treatment—a scoping review protocol
Authors: Jakobsen Michelle Iris , Storebø Ole Jakob , Austin Stephen Fitzgerald , Nielsen Jimmi , Simonsen Erik
Published: October 2021

Introduction

The atypical antipsychotic clozapine has shown superior efficacy compared with other antipsychotics and is the gold standard for treating otherwise treatment resistant schizophrenia. However, multiple studies have found that clozapine is underutilised in most parts of the world. A few reviews of literature addressing barriers to clozapine prescribing have been conducted. While there is some variation in the literature included in these reviews, a common feature of the studies included is that they primarily focus on clinical staff’s attitudes and perceived barriers for prescribing. Studies of patient perspectives are only sparsely included. A preliminary literature search revealed though, that additional literature on the subject exists, including literature on patient perspectives. It is therefore difficult to conclude if the formerly synthesised literature is representative of current evidence or if the topic has been adequately investigated to inform clinical practice. A scoping review is warranted in order to map and synthesise primary literature on patients’ and psychiatrists’ perspectives on clozapine treatment, and to identify gaps for future research.

Methods and analysis

The electronic databases Cochrane Library, CINAHL, Web of Science, Psychinfo, MEDLINE and EMBASE will be searched for relevant publications, supplied with searches of Google scholar, The Networked Digital Library of Theses and Dissertations and OpenGrey. Citation tracking of selected studies will furthermore be undertaken. Two researchers will independently screen and extract data. Data will be collated to provide a descriptive summary of the literature, along with a qualitative content analysis of key findings. Identified gaps in research will be accompanied by recommendations for future investigations.

Ethics and dissemination

Findings will be disseminated through a peer-reviewed journal and conference presentations. The scoping review does not require ethics approval.
Establishment of a consensus definition for mesenchymal stromal cells (MSC) and reporting guidelines for clinical trials of MSC therapy: a modified Delphi study protocol
Authors: Renesme Laurent , Cobey Kelly D , Le Maxime , Lalu Manoj M , Thebaud Bernard
Published: October 2021

Introduction

Despite being more than two decades of research, mesenchymal stromal cell (MSC) treatments are still struggling to cross the translational gap. Two key issues that likely contribute to these failures are (1) the lack of clear definition for MSC and (2) poor quality of reporting in MSC clinical studies. To address these issues, we propose a modified Delphi study to establish a consensus definition for MSC and reporting guidelines for clinical trials of MSC therapy.

Methods and analysis

We will conduct a three-round international modified Delphi survey. Findings from a recent scoping review examining how MSCs are defined and reported in preclinical and clinical studies were used to draft the initial survey for round 1 of our Delphi. Participants will include a ‘core group’ of individuals as well as researchers whose work was captured in our scoping review. The core group will include stakeholders from different research fields including developmental biology, translational science, research methods, regulatory practices, scholarly journal editing and industry. The first two survey rounds will be online, and the final round will take place in person. Each participant will be asked to rate their agreement on potential MSC definition characteristics and reporting items using a Likert scale. After each round, we will analyse the data to determine which items have reached consensus for inclusion/exclusion, and then develop a revised questionnaire for any new items, or items that did not reach consensus.

Ethics and dissemination

This study received ethical approval from the Ottawa Health Research Network Research Ethics Board. To support the dissemination of our findings, we will use an evidence-based ‘integrated knowledge translation’ approach to engage knowledge users from the inception of the research. This will allow us to develop a tailored end-of-project knowledge translation plan to support and ensure dissemination and implementation of the Delphi results.
Dutch multicentre, prospective follow-up, cohort study comparing the neurological and neuropsychological sequelae of hospitalised non-ICU- and ICU-treated COVID-19 survivors: a study protocol
Authors: Klinkhammer Simona , Horn Janneke , Visser-Meily Johanna M A , Verwijk Esmée , Duits Annelien , Slooter Arjen J C , van Heugten Caroline M
Published: October 2021

Introduction

Owing to the novelty of COVID-19, there are still large knowledge gaps concerning its effect on the brain and the resulting impact on peoples’ lives. This large-scale prospective follow-up study investigates COVID-19-associated brain damage, neuropsychological dysfunction and long-term impact on the well-being of patients and their close ones. It is hypothesised that structural brain damage and cognitive dysfunction primarily occur in severely ill patients, as compared with moderately ill patients. Cognitive complaints, emotional distress and impact on well-being are hypothesised to be less dependent on illness severity.

Methods and analysis

For this multicentre study, 200 patients with COVID-19 (100 intensive care unit (ICU) patients and 100 non-ICU patients) formerly hospitalised in one of the six recruiting hospitals during the first European infection wave (ie, March to June 2020) and their close ones will be recruited. At minimally 6 months posthospital discharge, patients will perform a set of neuropsychological tests and are subjected to a 3T MRI scan. Patients and close ones will fill out a set of questionnaires, also at minimally 6 months posthospital discharge and again another 6 months thereafter. Data related to COVID-19 hospitalisation will be extracted from the patients’ medical records. MRI abnormalities will ultimately be related to neuropsychological test performance and questionnaire outcomes.

Ethics and dissemination

Ethics approval was granted by the medical research ethics committee of Maastricht University Medical Centre and Maastricht University (NL75102.068.20). The project is sponsored by The Brain Foundation Netherlands. Findings will be presented at national and international conferences, as well as published in peer-reviewed scientific journals.

Trial registration number

NCT04745611.
Emergency department presentations of alcohol and other substance misuse: first cross-sectional national study in Qatar
Authors: Alabdulla Majid , Reagu Shuja , Elhassan Nahid M , Shinith Dhanya , Shiekh Saba T , Abbas Maha O , Chandrappa Nirvana Swamy Kudlur
Published: October 2021

Objectives

This study attempts the first in a series of investigations into the misuse of alcohol and substances in Qatar. This study explores the emergency presentations of alcohol and substance abuse to all the state funded emergency departments (EDs) in the country which serve around 90% of the population over a 22-month period. Due to legal penalties for alcohol and substance use, and lack of subsidised community-based facilities, ED presentations are a good starting point to explore this burden.

Design and participants

A retrospective population-based, cross-sectional study, analysing electronic patient records of all state funded EDs spanning a period of 22 months, from 1 January 2019 to 31 October 2020 was carried out. The study included all eligible individuals aged 18 or over. Primary reason/diagnosis for presentation containing any of the alcohol or substance use key words were included in the study using composite data capture forms by trained clinicians.

Results

An overwhelming majority (95.5%) of the total 1495 cases presenting to the EDs with substance abuse were using alcohol. Only 2.1% of the cases were females. Those of Asian (non-Arab) constituted 70% of this group. Qatari citizens presented with highest proportion of substance abuse other than alcohol (23%). Overall, 2.26% of all presentations to the EDs were related to alcohol and substance abuse and this amounted to 3 ED visits per 10 000 of population per year. 56.6% of the cases presented over the weekend. Less than 1% were referred to psychiatry and no other meaningful rehabilitative interventions were offered to others.

Conclusion

As Qatar moves towards establishing community-based rehabilitative resources for alcohol and substances abuse, the findings from this study will help in shaping these developments. These can include ED-based routine screening for alcohol abuse and referral to rehabilitation services without fear of legal penalties.
Effectiveness of customised safety intervention programmes to increase the safety culture of hospital staff
Authors: Wong Shiu Yee , Fu Allan Chak Lun , Han Jia , Lin Jianhua , Lau Mun Cheung
Published: October 2021

The aim of this study was to investigate the effectiveness of customised safety interventions in improving the safety cultures of both clinical and non-clinical hospital staff. This was assessed using the Safety Attitude Questionnaire-Chinese at baseline, 2 years and 4 years after the implementation of safety interventions with a high response rate ranging from 80.5% to 87.2% and excellent internal consistency (Cronbach’s alpha=0.93). The baseline survey revealed a relatively low positive attitude response in the Safety Climate (SC) domain. Both SC and Working Conditions (WC) domains were shown to have increased positive attitude responses in the second survey, while only the Management Perception domain had gained 3.8% in the last survey. In addition, safety dimensions related to collaboration with doctors and service delays due to communication breakdown were significantly improved after customised intervention was applied. Safety dimensions related to safety training, reporting and safety awareness had a high positive response in the initial survey; however, the effect was difficult to sustain subsequently. Multilevel analysis further illustrated that non-clinical staff were shown to have a more positive attitude than clinical staff, while female staff had a higher positive attitude percentage in job satisfaction than male staff. The results showed some improvements in various safety domains and dimensions, but also revealed inconsistent changes in subsequent surveys. The change in positive safety culture over the years and its sustainability need to be further explored. It is suggested that hospital management should continuously monitor and evaluate their strategies while delivering multifaceted interventions to be more specifically focused and to motivate staff to be enthusiastic in sustaining patient safety culture.
Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19
Authors: Gorny Monika , Blackstock Sarah , Bhaskaran Arun , Layther Imogen , Qoba Mimoza , Vassar Carly , Ellis Jacob , Begent Joanna , Forrester John , Goldin Jon , Hallet Zoe , Read Tina , Hodges Sally , Groszmann Michael , Hudson Lee Duncan
Published: October 2021

Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new ‘hubs’ were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children’s hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings.
Public knowledge and attitudes concerning palliative care
Authors: Zimmermann Camilla , Wong Joanne L. , Swami Nadia , Pope Ashley , Cheng YiQin , Mathews Jean , Howell Doris , Sullivan Richard , Rodin Gary , Hannon Breffni , Moineddin Rahim , Le Lisa W.
Published: October 2021

Objective

WHO recommends early integration of palliative care alongside usual care to improve quality of life, although misunderstanding of palliative care may impede this. We compared the public’s perceived and actual knowledge of palliative care, and examined the relationship of this knowledge to attitudes concerning palliative care.

Methods

We analysed data from a survey of a representative sample of the Canadian public, accessed through a survey panel in May–June 2019. We compared high perceived knowledge (‘know what palliative care is and could explain it’) with actual knowledge of the WHO definition (knew ≥5/8 components, including that palliative care can be provided early in the illness and together with life-prolonging treatments), and examined their associations with attitudes to palliative care.

Results

Of 1518 adult participants residing in Canada, 45% had high perceived knowledge, of whom 46% had high actual knowledge. Participants with high (vs low) perceived knowledge were more likely to associate palliative care with end-of-life care (adjusted OR 2.15 (95% CI 1.66 to 2.79), p<0.0001) and less likely to believe it offered hope (0.62 (95% CI 0.47 to 0.81), p=0.0004). Conversely, participants with high (vs low) actual knowledge were less likely to find palliative care fearful (0.67 (95% CI 0.52 to 0.86), p=0.002) or depressing (0.72 (95% CI 0.56 to 0.93), p=0.01) and more likely to believe it offered hope (1.88 (95% CI 1.46 to 2.43), p<0.0001).

Conclusions

Stigma regarding palliative care may be perpetuated by those who falsely believe they understand its meaning. Public health education is needed to increase knowledge about palliative care, promote its early integration and counter false assumptions.
Geospatial analysis of salmonellosis and its association with socioeconomic status in Texas
Authors: Gourishankar Anand
Published: October 2021

Objective

The study’s objective was to find the association between salmonellosis and socioeconomic status (SES) in hot spot areas and statewide counties.

Design

A retrospective cohort study.

Setting

The data were recorded regarding salmonellosis in 2017 from the Texas surveillance database. It included assessment of hot spot analysis and SES association with salmonellosis at the county level.

Participants

Patients with salmonellosis of all age groups in Texas.

Results

There were a total of 5113 salmonellosis from 254 counties with an unadjusted crude rate of 18 per 100 000 person-years. Seven SES risk factors in the hot spot counties were as follows: low values of the severe housing problem, unemployment, African American and high values of social association rate, fast food/full-service restaurant use, Hispanic and Hispanic senior low access-to-store (p<0.05). A 12% difference existed between local health departments in hot (25%) and cold spot (37%) counties (χ2 (1, n=108)=0.5, p=0.81).

Statewide independent risk factors were severe housing problem (incidence rate ratio (IRR)=1.1; 95% CI: 1.05 to 1.14), social association rate (IRR=0.89; 95% CI: 0.87 to 0.92), college education (IRR=1.05; 95% CI: 1.04 to 1.07) and non-Hispanic senior local access-to-store (IRR=1.98; 95% CI: 1.26 to 3.11). The severe housing problem predicted zero occurrences of infection in a county (OR=0.51; 95% CI: 0.28 to 0.95).

Conclusions

Disparity exists in salmonellosis and SES. Attention to unmet needs will decrease salmonellosis. Severe housing problem is a notable risk.
Evaluation of an innovative new method for quantitation of plasma cells on CD138 immunohistochemistry
Authors: Gantana Ethan , Mashigo Nomusa , Abdullah Ibtisam , Musekwa Ernest , Lohlun Robert , Nell Erica-Mari , Chetty Carissa , Ntobongwana Monalisa , Chapanduka Zivanai
Published: October 2021

Aim

To compare the frequently used CD138 immunohistochemistry-based method of plasma cell quantitation, to a proposed new method, using interobserver and intraobserver concordance parameters.

Methods

Archival CD138 immunohistochemically stained slides made from paraffin-embedded bone marrow biopsies of 33 patients with a confirmed diagnosis of multiple myeloma were used. Light microscopic examination was performed using low magnification lenses (10×) for both the overview estimation method (method A) and the new method (method B), and high magnification lenses (50×), for method B only. For method B, reviewers selected three areas with low, intermediate and high plasma cell densities using 10× lenses. Using a well-defined technique, the 50× lens was then used to count plasma cells as a percentage of all nucleated cells. After blinded relabelling of all the slides, the nine reviewers repeated the plasma cell quantitation using both methods. The plasma cell counts were obtained, and the review times were recorded.

Results

Overall intraobserver concordance was comparable for method A (concordance correlation coefficient (CCC)=0.840) and method B (CCC=0.733). Interobserver concordance for method A (intraclass correlation coefficient (ICC)=0.793 and 0.713) and method B (ICC=0.657 and 0.658) indicated high similarity between reviewers. Method A showed poor interobserver concordance (ICC=0.105) at low plasma cell densities.

Conclusions

The new method is comparable to the frequently used overview estimation method in terms of intraobserver and interobserver concordance, and cost. The new method has superior interobserver concordance at low plasma cell densities. The new method appears more amenable to digital scanning and analysis.
Prescription of anxiolytics, sedatives, hypnotics and antidepressants in outpatient, universal care during the COVID-19 pandemic in Portugal: a nationwide, interrupted time-series approach
Authors: Estrela Marta , Silva Tânia Magalhães , Gomes Eva Rebelo , Piñeiro Maria , Figueiras Adolfo , Roque Fátima , Herdeiro Maria Teresa
Published: October 2021

Background

The COVID-19 pandemic has had a significant impact on the population’s mental health. However, its impact on the consumption of anxiolytics, sedatives, hypnotics and antidepressants remains to be evaluated. Hence, this article aims to assess the prescription trends of these drugs in Portugal, from January 2018 to March 2021, while critically examining whether the COVID-19 pandemic had an impact on these prescription trends or not.

Methods

A nationwide interrupted time-series analysis of the prescription data of anxiolytics, sedatives, hypnotics and antidepressants in outpatient setting of the public health sector was conducted. The data encompassed the defined daily dose per month, age range and sex and were analysed following a segmented regression approach.

Results

The pandemic preceded an immediate reduction in the prescription of anxiolytics, sedatives and hypnotics for children and adolescents. However, an increasing trend throughout the pandemic has been noted in the prescription of these drugs, especially among adults aged 65 years or above. A drop in antidepressant prescription was observed as an immediate effect of the pandemic among male and female adolescents and elderly women. From March 2020 to March 2021, a decreasing prescription trend has been noted among men.

Conclusions

When analysing specific genders and age ranges, differences can be noted, in terms of both immediate impact and prescribing trends throughout 1 year of the COVID-19 pandemic. The impact of the pandemic on mental health and its association with the consumption trends of psychoactive drugs, and with the access to mental health treatments, should be further assessed.
Adverse employment histories and allostatic load: associations over the working life
Authors: Wahrendorf Morten , Chandola Tarani , Goldberg Marcel , Zins Marie , Hoven Hanno , Siegrist Johannes
Published: October 2021

Background

Most studies on the health impact of occupational stress use single-point measures of stress at work. This study analyses the associations of properties of entire employment trajectories over an extended time period with a composite score of allostatic load (AL).

Methods

Data come from the French CONSTANCES cohort, with information on adverse employment histories between ages 25 and 45 and a composite score of AL (based on 10 biomarkers, range 0–10) among people aged 45 or older (47 680 women and 45 035 men). Data were collected by questionnaires (including retrospective employment histories) or by health examinations (including blood-based biomarkers). We distinguish six career characteristics: number of temporary jobs, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion.

Results

For both men and women, results of negative binomial regressions indicate that adverse employment histories are related to higher levels of AL, particularly histories that are characterised by a continued disadvantaged occupational position, repeated periods of unemployment or years out of work. Findings are adjusted for partnership, age and education, and respondents with a health-related career interruption or early retirement are excluded.

Conclusions

Our study highlights physiological responses as a mechanism through which chronic stress during working life is linked to poor health and calls for intervention efforts among more disadvantaged groups at early stages of labour market participation.
Developing a company-specific job exposure matrix for the Asbest Chrysotile Cohort Study
Authors: Feletto Eleonora , Kovalevskiy Evgeny V , Schonfeld Sara J , Moissonnier Monika , Olsson Ann , Kashanskiy Sergey V , Ostroumova Evgenia , Bukhtiyarov Igor V , Schüz Joachim , Kromhout Hans
Published: October 2021

Objectives

Exposure assessment for retrospective industrial cohorts are often hampered by limited availability of historical measurements. This study describes the development of company-specific job-exposure matrices (JEMs) based on measurements collected over five decades for a cohort study of 35 837 workers (Asbest Chrysotile Cohort Study) in the Russian Federation to estimate their cumulative exposure to chrysotile containing dust and fibres.

Methods

Almost 100 000 recorded stationary dust measurements were available from 1951-2001 (factories) and 1964–2001 (mine). Linear mixed models were used to extrapolate for years where measurements were not available or missing. Fibre concentrations were estimated using conversion factors based on side-by-side comparisons. Dust and fibre JEMs were developed and exposures were allocated by linking them to individual workers’ detailed occupational histories.

Results

The cohort covered a total of 515 355 employment-years from 1930 to 2010. Of these individuals, 15% worked in jobs not considered professionally exposed to chrysotile. The median cumulative dust exposure was 26 mg/m3years for the entire cohort and 37.2 mg/m3years for those professionally exposed. Median cumulative fibre exposure was 16.4 fibre/cm3years for the entire cohort and 23.4 fibre/cm3years for those professionally exposed. Cumulative exposure was highly dependent on birth cohort and gender. Of those professionally exposed, women had higher cumulative exposures than men as they were more often employed in factories with higher exposure concentrations rather than in the mine.

Conclusions

Unique company-specific JEMs were derived using a rich measurement database that overlapped with most employment-years of cohort members and will enable estimation of quantitative exposure–response.
Self-reported psychological distress and self-perceived health in residents living near pesticide-treated agricultural land: a cross-sectional study in The Netherlands
Authors: Simoes Mariana , Huss Anke , Janssen Nicole , Vermeulen Roel
Published: October 2021

Objectives

There is rising concern regarding possible health effects from exposure to pesticides in residents living near agricultural land. Some studies indicated increased risks of reporting symptoms of anxiety and depression among agricultural workers but less is known about the mental and perceived health of rural residents. We aimed to study possible associations between self-reported psychological distress (SPD) and self-perceived health (SPH) in residents near pesticide-treated agricultural land.

Methods

Using the Public Health Monitor national survey from 2012, we selected 216 932 participants who lived in rural and semi-urban areas of the Netherlands and changed addresses at most once in the period 2009–2012. Psychological distress (PD) was assessed via the Kessler Psychological Distress scale (K10) and participants were asked to assess their own health. We estimated the area of specific crop groups cultivated within buffers of 50 m, 100 m, 250 m and 500 m around each individual’s residence for the period 2009–2012. Association between these exposure proxies and the outcomes was investigated using logistic regression, adjusting for individual, lifestyle and area-level confounders.

Results

Overall, results showed statistically non-significant OR across all buffer sizes for both SPD and SPH, except for the association between SPH and ‘all crops’ (total area of all considered crop groups) with OR (95% CI) ranging from 0.77 (0.63 to 0.93) in 50 m to 1.00 (1.00 to 1.00) in 500 m. We observed that most ORs were below unity for SPH.

Conclusions

This study provides no evidence that residential proximity to pesticide treated-crops is associated with PD or poorer perceived health.
Implementation of programming for survivors of violence-related trauma at a level 1 trauma center
Authors: Simske Natasha M , Rivera Trenton , Ren Bryan O , Benedick Alex , Simpson Megen , Kalina Mark , Hendrickson Sarah B , Vallier Heather A
Published: October 2021

Background

Prior investigation of violence intervention programs has been limited. This study will describe resources offered by Victims of Crime Advocacy and Recovery Program (VOCARP), their utilization, and effect on recidivism.

Methods

VOCARP was established in 2017 at our center, and all patients who engaged with programming (n=1019) were prospectively recorded. Patients are offered services in the emergency department, on inpatient floors and at outpatient clinic visits. Two control groups (patients sustaining violent injuries without VOCARP use (n=212) and patients with non-violent trauma (n=201)) were similarly aggregated.

Results

During 22 months, 96% of patients accepted education materials, 31% received financial compensation, 27% requested referrals, and 22% had crisis interventions. All other resources were used by <20% of patients. Patients who used VOCARP resources were substantially different from those who declined services; they were less often male (56% vs. 71%), more often single (79% vs. 51%), had greater unemployment (63% vs. 51%) and were less frequently shot (gunshot wound: 26% vs. 37%), all p<0.05. Overall recidivism rate was 9.4%, with no difference between groups. Use of mental health services was linked to lower recidivism rates (4.4% vs. 11.7%, p=0.016). While sexual assault survivors who used VOCARP resources had lower associated recidivism (2.4% vs. 12%, p=0.14), this was not statistically significant.

Discussion

This represents the largest violence intervention cohort reported to date to our knowledge. Despite substantial engagement, efficacy in terms of lower recidivism appears limited to specific subgroups or resource utilization.

Level of evidence

Level II. Therapeutic.
Stellar models with like-Tolman IV complexity factor
Authors: Andrade J. , Contreras E.
Published: October 2021

In this work, we construct stellar models based on the complexity factor as a supplementary condition which allows to close the system of differential equations arising from the Gravitational Decoupling. The assumed complexity is a generalization of the one obtained from the well known Tolman IV solution. We use Tolman IV, Wyman IIa, Durgapal IV and Heintzmann IIa as seeds solutions. Reported compactness parameters of SMC X-1 and Cen X-3 are used to study the physical acceptability of the models. Some aspects related to the density ratio are also discussed.
Elucidating cosmological model dependence with $$H_0$$
Authors: Ó Colgáin Eoin , Sheikh-Jabbari M. M.
Published: October 2021

We observe that the errors on the Hubble constant $$H_0$$

H
0

, a universal parameter in any FLRW cosmology, can be larger in specific cosmological models than Gaussian processes (GP) data reconstruction. We comment on the prior mean function and trace the smaller GP errors to stronger correlations, which we show precludes all well studied dynamical dark energy models. We also briefly illustrate cosmographic expansions as another model independent cosmological reconstruction. Our analysis suggests that “cosmological model independence”, especially in the statement of Hubble tension, has become a misnomer.
Financing Strategy and Carbon Emission Abatement in a Supply Chain considering Retailers’ Competition
Authors: Yu Man , Li Tuo , Shi Zhanwen
Published: October 2021

This paper investigates the issues of financing channels (bank credit financing, trade credit financing, and dual-channel financing) and carbon emission abatement in a supply chain consisting of one capital-constrained manufacturer and two capital-constrained retailers. Compared with bank credit, we find that every member can make more profit under trade credit when only one financing channel is available. When both bank credit and trade credit are available, the retailers’ financing strategy highly depends on the interest rates charged by the creditors. In addition, we also examine the impact of financing channels on emission abatement. It shows that the manufacturer reduces more carbon emissions under trade credit. Interestingly, the emission abatement has nothing to do with trade credit interest rate when retailers only adopt trade credit, whereas it is closely related to trade credit interest rate under dual-channel financing.
Complementary Transcriptomic and Proteomic Analysis in the Substantia Nigra of Parkinson’s Disease
Authors: Dong Bao-hua , Niu Zhao-qing , Zhang Jing-tao , Zhou Yi-jing , Meng Fan-mei , Dong Ai-qin
Published: October 2021

Parkinson’s disease (PD) is a disease that involves brain damage and is associated with neuroinflammation, mitochondrial damage, and cell aging. However, the pathogenic mechanism of PD is still unknown. Sequencing data and proteomic data can describe the fluctuation of molecular abundance in diseases at the mRNA level and protein level, respectively. In order to explore new targets in the pathogenesis of PD, the study analyzed molecular changes from the database by combining transcriptomic and proteomic analysis. Differentially expressed genes and differentially abundant proteins were summarized and analyzed. Enrichment and cluster analysis emphasized the importance of neurotransmitter release, mitochondrial damage, and vesicle transport. The molecular network revealed a subnetwork of 9 molecules related to SCNA and TH and revealed hub gene with differential expression at both mRNA and protein levels. It found that ACHE and CADPS could be used as new targets in PD, emphasizing that impaired nerve signal transmission and vesicle transport affect the pathogenesis of PD. Our research emphasized that the joint analysis and verification of transcriptomics and proteomics were devoted to understanding the comprehensive views and mechanism of pathogenesis in PD.
Clinical Value of Serum Thrombospondin-2 Combined with CA19-9 in Early Diagnosis of Gastric Cancer
Authors: Li Lanzhi , Dong Jie , Fu Lei , Xia Xinhua , Pan Feng , Ning Yuan
Published: October 2021

Gastric cancer (GC) is a kind of common cancer worldwide. Too late in diagnosis results in poor prognosis of patients with GC. Thrombospondin-2 (THBS2) is a type of secreted protein that has been found to be a diagnostic biomarker in a variety of cancers. Our study aimed to uncover the clinical value of THBS2 in early detection for patients with gastric cancer. THBS2 was upregulated in gastric cancer tissue compared with normal tissue via analyzing data obtained from The Cancer Genome Atlas (TCGA) database. Additionally, the enzyme-linked immunosorbent assay revealed that the level of serum THBS2 and carcinoembryonic antigen, CA19-9, was higher dramatically in patients with early gastric cancer (EGC) than that in healthy control (HC) in addition to patients with benign gastric tumor (BGT), which suggested that THBS2 indeed associated with GC. Receiver operator characteristic (ROC) curve assay was conducted to demonstrate that serum THBS2 was similar to CA19-9 to distinguish patients with early gastric cancer from healthy control and patients with benign gastric tumor and that THBS2 combined with CA19-9 improved the detective performance of THBS2 for early gastric cancer. Furthermore, we applied the gene set enrichment analysis assay to analyze signaling pathways related to THBS2. We found that THBS2 positively controlled MAPK and WNT signaling pathways, which indicated that THBS2 might exert its functions via the pathway mentioned above. Thus, our study expounded that serum THBS2 could serve as a vital early diagnostic marker for patients with gastric cancer.
A Machine Learning-Based Big EEG Data Artifact Detection and Wavelet-Based Removal: An Empirical Approach
Authors: Stalin Shalini , Roy Vandana , Shukla Prashant Kumar , Zaguia Atef , Khan Mohammad Monirujjaman , Shukla Piyush Kumar , Jain Anurag
Published: October 2021

The electroencephalogram (EEG) signals are a big data which are frequently corrupted by motion artifacts. As human neural diseases, diagnosis and analysis need a robust neurological signal. Consequently, the EEG artifacts’ eradication is a vital step. In this research paper, the primary motion artifact is detected from a single-channel EEG signal using support vector machine (SVM) and preceded with further artifacts’ suppression. The signal features’ abstraction and further detection are done through ensemble empirical mode decomposition (EEMD) algorithm. Moreover, canonical correlation analysis (CCA) filtering approach is applied for motion artifact removal. Finally, leftover motion artifacts’ unpredictability is removed by applying wavelet transform (WT) algorithm. Finally, results are optimized by using Harris hawks optimization (HHO) algorithm. The results of the assessment confirm that the algorithm recommended is superior to the algorithms currently in use.
Effect of Sodium Alginate in Combination with Zataria multiflora Boiss. on Phenolic Compounds, Antioxidant Activity, and Browning Enzymes of Fresh In-Hull Pistachio (Pistacia vera L.)
Authors: Hashemi Maryam , Shakerardekani Ahmad , Mirzaalian Dastjerdi Abdolmajid , Mirdehghan SeyedHossein
Published: October 2021

The color of fresh pistachio is used as a postharvest quality indicator. The present study was performed to investigate the chemical properties of fresh pistachios coated with different sodium alginate concentrations (1 and 1.5%), various amounts of Shirazi thyme essential oil (0.3 and 0.5%), and their combination during storage (2 ± 1°C and 85 ± 5% RH). Over the storage duration, chemical parameters were measured on days 13, 26, and 39. The results showed that although the application of sodium alginate in combination with thyme essential oil decreased polyphenol oxidase activity in comparison with other treatments, the highest total phenolics and phenylalanine ammonia lyase activity were found in pistachios coated with alginate (1%) + thyme essential oil (0.3% and 0.5%). In general, it was proven that treatments containing 1% alginate + 0.3% essential oil had the ability to maintain the quality of fresh pistachio fruit approximately over 39 days of storage.