bluuebunny/crossref_metadata_2025 huggingface dataset:
Proof of Concept for the FLEX Intervention: Feasibility of Home Based Coaching to Improve Physical Activity Outcomes and Viral Load Suppression among African American Youth Living with HIV
Authors: Budhwani Henna , Bulls Maurice , Naar Sylvie
Published: January 2021

FLEX is a Motivational Interviewing, home-based coaching program that concurrently targets HIV-related and physical activity goals among African American youth living with HIV in the United States. To create and pilot test FLEX, we leveraged a 2-step exploratory sequential mixed methods design informed by the ORBIT model with initial qualitative work followed by pre-post analysis of quantitative outcomes, concluding with qualitative exit surveys. Data were evaluated pre- and 3-months post-intervention. Recruitment was 90%. Participants reported high program satisfaction and program adherence (76% completion rate). Preliminary findings indicate reductions in participants’ viral loads and improvements across 4 measures of physical activity.
Schools With Test-Based Promotion: Effects on Instructional Time Allocation and Student Learning in Grade 3
Authors: Hong Yihua , Hong Guanglei
Published: January 2021

This study is focused on the threat of retention associated with test-based promotion in Grade 3. Through analyzing the Early Childhood Longitudinal Study Kindergarten Class of 1998–1999 data, we found that schools having such a policy apparently increased math instructional time but not reading instructional time in Grade 3. On average, the policy did not produce significant differences in third graders’ reading and math learning. However, there seemed to be a notable increase in the proportion of students who achieved an at or above-average proficiency level in Grade 3 math. In both reading and math, the test-based promotion seemingly benefited students at the average or lower than average ability levels. In contrast, there was no evidence that the policy had an impact on students at the two ends of the ability distribution. We discussed the implication of the findings for the current design and implementation of test-based promotion in early grades.
The Poverty of Policy: Examining Care Leaving Policy in Ethiopia
Authors: Takele Anduamlak Molla , Kotecho Messay Gebremariam , Mendes Philip
Published: January 2021

International research consistently shows that young care leavers’ journey from care to emerging adulthood is characterised by adversities such as unemployment, poor academic performance, homelessness, involvement in criminal activities, mental illness and early parenthood. As research evidence points out, such negative outcomes are closely linked with the existence of multiple placements, lack of mentoring, limited connections with significant others, the absence of early preparation to leave care, and a dearth of or inadequate policy frameworks that entitle care leavers to use aftercare support schemes. In order to support care leavers’ transition from care to emerging adulthood, Global North countries have implemented an independent care leaving policy framework that serves as a scaffolding for challenges that would arise from care leavers’ exploration of the adult world upon leaving care. However, such experience in formulation of policy to empower care leavers to be an independent adult is not well developed in countries in Global South due to the infant nature of research on care leaving and a preference for addressing the issues of care leavers in the existing child policy frameworks rather than formulating a special policy that deals with care leaving. The status of Ethiopia in this regard is not different. Existing policy frameworks concerning children have failed to address the needs of Ethiopian care leavers despite the existence of over five million orphan and vulnerable children in the country most of whom are placed in institutional childcare centres. This article presents the case for an independent care leaving policy in Ethiopia to address the multifaceted needs of children in care and improve the care leaving service in the country. Thus, the study will shed light on the state of care leaving policy in the world and lessons for Ethiopia to support Ethiopia’s attempt to serve the most vulnerable children in care by developing its own care leaving policy.
Work-Life Conflict During the COVID-19 Pandemic
Authors: Schieman Scott , Badawy Philip J. , A. Milkie Melissa , Bierman Alex
Published: January 2021

The coronavirus disease 2019 pandemic upended work, family, and social life. These massive changes may have created shifts in exposure to work-life conflict. Using a national survey that followed Canadian workers from September 2019 into April and June 2020, the authors find that work-life conflict decreased among those with no children at home. In contrast, for those with children at home, the patterns depended on age of youngest child. Among individuals with children younger than 6 or between 6 and 12, no decreases in work-life conflict were observed. In contrast, those with teenagers did not differ from the child-free. Although these patterns did not significantly differ by gender, they were amplified among individuals with high work-home integration. These findings suggest an overall pattern of reduced work-life conflict during the pandemic—but also that these shifts were circumscribed by age of youngest child at home and the degree of work-home integration.
COVID-19 and Dental and Dental Hygiene Students’ Career Plans
Authors: García D.T. , Akinkugbe A.A. , Mosavel M. , Smith C.S. , Brickhouse T.H.
Published: January 2021

Objective:

The aims of this study were to investigate whether dental and dental hygiene students’ career plans postgraduation were affected by the coronavirus disease 2019 (COVID-19) pandemic and to examine wellness and readiness for clinical practice among students who reported a change in career plans.

Methods:

An anonymous online REDCap survey was developed and emailed to 436 dental and dental hygiene students at a US dental school. The survey consisted of 81 questions that covered demographics, career plans postgraduation, and readiness and wellness measures. An open-ended question assessing how students’ career plans have changed during the pandemic was also included.

Results:

A total of 252 students completed the survey, of whom 11.5% reported that their plans for future dental practice have changed since the COVID-19 outbreak. Students who reported a change to their career plans had significantly higher mean perceived stress (20.1 vs. 16.3; P = 0.003) and anxiety (9.2 vs. 6.2; P = 0.004) scores and lower mean resilience (18.9 vs. 20.9; P = 0.01) scores than those who reported no change to their career plans. Concerns were raised regarding the limited employment opportunities, long-term stability of the dental profession, and the interruptions to clinical education and licensure examinations consequent to the pandemic.

Conclusions:

A comprehensive effort inclusive of adeptly designed clinical and curriculum experiences paired with wellness interventions and support tailored to students is needed. These measures need to support trainees across varying years in training and resilience levels to be effective for dental and dental hygiene students as they approach their future career intentions in the dental profession. Additional longitudinal research is needed to assess if change in career intentions during the COVID-19 pandemic corresponds with actual change postpandemic and affects the dental profession.

Knowledge Transfer Statement:

This study explores the potential short-term change in career intentions of dental hygiene and dental students during the COVID-19 pandemic. Findings can inform workforce planning as well as interventions developed and implemented by academic dental institutions to support student wellness during unexpected and prolonged emergency situations.
West Nile Virus Chorioretinitis in the Presence of Negative Cerebrospinal Fluid Polymerase Chain Reaction Results
Authors: Moussa Kareem , Jeng-Miller Karen W. , Kim Leo A. , Eliott Dean
Published: January 2021

Purpose:

This work aims to evaluate the utility of nucleic acid amplification testing (NAAT) and serology in confirming West Nile Virus (WNV) infection in patients with suspected WNV chorioretinitis.

Methods:

A retrospective cross-sectional study was conducted of a cluster of patients who presented to the Retina Service of Massachusetts Eye and Ear between September and October 2018.

Results:

Three patients were identified with classic WNV chorioretinitis lesions with negative cerebrospinal fluid NAAT and positive serum serology findings. The diagnosis of WNV chorioretinitis was made based on the appearance of the fundus lesions and the presence of characteristic findings on fluorescein angiography as previously described in the literature.

Conclusions:

This report highlights 3 unique cases of WNV chorioretinitis in which NAAT of cerebrospinal fluid failed to identify WNV as the inciting agent. These cases stress the importance of serum serologic testing in diagnosing WNV infection.
Interdisciplinary Entrepreneurship Education: Exploring 10-Year Trends in Student Enrollment, Interest and Motivation
Authors: Yi Soohyun , Duval-Couetil Nathalie
Published: January 2021

Interdisciplinary entrepreneurship programs are becoming the norm rather than the exception at universities across the world. This paper examines trends in student enrollment, interests, motivations, career goals, and perceived competency over the past decade at a large public university offering an entrepreneurship credential to undergraduate students in all majors. Several trends were identified via pre- and post-program surveys ( n = 5,271 and n = 1,323) administered to participants. Engineering, technology, science, and international student enrollment grew; the motivations and interests of non-business students evolved slightly over time; and gender differences, but not disciplinary ones, were detected in relation to program outcomes and perceived effectiveness. Implications of this work for entrepreneurship education include showing how monitoring enrollment trends can inform program development and serve as a foundation for new research questions.
Long-Term Stability of the Electronic Sensor Component of a Digital Pill System in Real-World Storage Settings
Authors: Chai Peter R. , Goodman Georgia , Bustamante Majo J. , Mohamed Yassir , Castillo-Mancilla Jose , Boyer Edward W. , Mayer Kenneth H. , Rosen Rochelle K. , Baumgartner Susan L. , Buffkin Eric , O’Cleirigh Conall
Published: January 2021

Background: Digital pill systems comprise an ingestible sensor integrated into a gelatin capsule that overencapsulates medication allowing real-time measures of medication ingestion. These systems may improve the manner in which medication adherence can be assessed and supported. Objective: In this investigation, we tested the durability of the ingestible sensor as part of a clinical trial to measure the feasibility and acceptability of the system to measure adherence to once daily tenofovir disoproxil fumarate/emtricitabine (NCT03842436). Methods: Digital pills not dispensed during the study were stored in a pharmacy. Seventeen sensors were selected from digital pills stored for at least 12 months and activated in a simulated gastric environment. A radiofrequency spectrum analyzer and the reader device used in the clinical trial to capture ingestion events were used to measure activation of emitters. A passing evaluation was defined as an energized emitter within 30 minutes of immersion, ability to broadcast a signal for 10 minutes, and successful acquisition by the reader. Results: All ingestible sensors passed the stability test. Mean activation time in simulated gastric fluid was 3.33 minutes (SD = 1.47); emitters remained active for a mean of 47.72 minutes (SD = 1.78). These parameters matched guidelines defined in the ID-Cap system requirements for use in patients. Conclusions: Ingestible sensor components of the ID-Cap system were therefore stable after long-term storage.
A subset of CyberShake ground-motion time series for response-history analysis
Authors: Baker Jack W , Rezaeian Sanaz , Goulet Christine A , Luco Nicolas , Teng Ganyu
Published: January 2021

This manuscript describes a subset of CyberShake numerically simulated ground motions that were selected and vetted for use in engineering response-history analyses. Ground motions were selected that have seismological properties and response spectra representative of conditions in the Los Angeles area, based on disaggregation of seismic hazard. Ground motions were selected from millions of available time series and were reviewed to confirm their suitability for response-history analysis. The processes used to select the time series, the characteristics of the resulting data, and the provided documentation are described in this article. The resulting data and documentation are available electronically.
Plagiarism in Project Studies
Authors: Geraldi Joana
Published: January 2021

Plagiarism is condemned yet remains a frequently occurring form of academic misconduct. This editorial informs project scholars about plagiarism and Project Management Journal’s ( PMJ®) approach to it. We define plagiarism as the theft of words, ideas, and representations, and explain three principles to judge plagiarism based on our expectations on research integrity: honesty, originality, and authorship. Accordingly, plagiarism detection services (PDS) assist but do not limit our judgment. We hope to lay the foundation for a comprehensive understanding of plagiarism in project studies, and thus help (early career) scholars understand the different facets of plagiarism and thereby avoid it.
Effectiveness, safety, and factors associated with the clinical success of endoscopic biliary drainage for patients with hepatocellular carcinoma: a retrospective multicenter study
Authors: Matsumi Akihiro , Kato Hironari , Ueki Toru , Ishida Etsuji , Takatani Masahiro , Fujii Masakuni , Wato Masaki , Toyokawa Tatsuya , Harada Ryo , Tsugeno Hirofumi , Matsubara Minoru , Matsushita Hiroshi , Okada Hiroyuki
Published: January 2021

Background

Only a few reports have assessed the effectiveness of endoscopic biliary drainage (EBD) in hepatocellular carcinoma (HCC) patients with obstructive jaundice and liver dysfunction.

Methods

This was a retrospective study based on the clinical databases from the Okayama University Hospital and 10 affiliated hospitals. All patients received EBD for jaundice or liver dysfunction. The indication for EBD was aggravation of jaundice or liver dysfunction with intrahepatic bile duct (IHBD) dilation. The technical and clinical success rate, complications, factors associated with clinical failure, and survival duration were evaluated.

Results

A total of 107 patients were enrolled in this study. Technical success was achieved in 105 of 107 patients (98.1%). Clinical success was achieved in 85 of 105 patients (81%). Complications related to endoscopic retrograde cholangiography (ERC) occurred in 3 (2.8%) patients. Child–Pugh class C (odds ratio 3.90, 95% confidence interval [CI] 1.47–10.4, p = 0.0046) was the only factor associated with clinical failure, irrespective of successful drainage. The median survival duration was significantly longer in patients with clinical success than in those without clinical success (5.0 months vs. 0.93 months; hazard ratio [HR] 3.2, 95% CI 1.87–5.37). HCC Stage I/II/III (HR 0.57, CI 0.34–0.95, p = 0.032), absence of portal thrombosis (HR 0.52, CI 0.32–0.85, p = 0.0099), and clinical success (HR 0.39, CI 0.21–0.70, p = 0.0018) were significant factors associated with a long survival.

Conclusions

EBD for obstructive jaundice and liver dysfunction in patients with HCC can be performed safely with a high technical success rate. Clinical success can improve the survival duration, even in patients expected to have a poor prognosis.

Trial registration

Retrospectively registered.
Comparison of survival in elderly patients treated with uretero-cutaneostomy or ileal conduit after radical cystectomy
Authors: Huang Shang , Chen Hanzhong , Li Teng , Pu Xiaoyong , Liu Jiumin , Bi Xuecheng
Published: January 2021

Background

In bladder cancer patients with age ≥ 80 years old, there have been controversies in performing uretero-cutaneostomy or ileal conduit as urinary diversion after radical cystectomy. Limited study evaluated overall survival (OS) and cancer-specific survival (CSS) between the two urinary diversions in elderly patients. This study is to compare OS and CSS between uretero-cutaneostomy and ileal conduit after radical cystectomy in bladder cancer patients with age ≥ 80 years old.

Patients and methods

Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Bladder cancer patients diagnosed between 2004 and 2016 with age ≥ 80 years old who underwent radical cystectomy with either UC or IC were selected. After propensity score matching, Cox regression and Kaplan-Meier analysis were used to analyze the survival. We calculated statistical power for survival.

Results

Of 1394 patients who met the inclusion criteria, 1093 underwent ileal conduit and 301 underwent uretero-cutaneostomy. After propensity score matching, 285 patients were included in each group. Multivariable Cox analysis showed urinary diversion was not a risk factor of OS and CSS (HR 1.044, [95% CI 0.867–1.257] and 1.012 [0.748–1.368], respectively). Both OS and CSS were not significantly different, with median survival of ileal conduit and uretero-cutaneostomy were 19 [16–24] months and 19 [15–26] months respectively. Additionally, We found OS had the following risk factors: tumor stage (distant vs regional vs localized, 5.332 [3.610–7.875] vs 1.730 [1.375–2.176] vs 1), node density (>0.2 vs ≤0.2 vs none, 1.410 [1.047–1.898] vs 0.941 [0.658–1.344] vs 1) and age (1.067 [1.032–1.103] for each year). While CSS had the following risk factors: tumor stage (distant vs regional vs localized, 4.035 [2.046–7.959] vs 2.476 [1.651–3.713] vs 1), node density (>0.2 vs ≤0.2 vs none, 2.501 [1.645–3.804] vs 1.062 [0.590–1.914] vs 1) and tumor size (greater than 3 cm vs less than 3 cm, 1.596 [1.057–2.412] vs 1). Our analysis obtained 0.707 power for overall survival.

Conclusion

Urinary diversion by uretero-cutaneostomy or by ileal conduit was not associated with overall and cancer-specific survival. It is reasonable to consider uretero-cutaneostomy as a regular procedure of urinary diversion in elderly bladder cancer patients after radical cystectomy to avoid associate complications.
Co-infection of COVID-19 and influenza A in a hemodialysis patient: a case report
Authors: Jing Ran , Vunnam Rama Rao , Schnaubelt Elizabeth , Vokoun Chad , Cushman-Vokoun Allison , Goldner David , Vunnam Srinivas Rao
Published: January 2021

Background

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus that was first discovered in December 2019 in Wuhan, China. With the growing numbers of community spread cases worldwide, the World Health Organization (WHO) declared the COVID-19 outbreak as a pandemic on March 11, 2020. Like influenza viruses, SARS-CoV-2 is thought to be mainly transmitted by droplets and direct contact, and COVID-19 has a similar disease presentation to influenza. Here we present a case of influenza A and COVID-19 co-infection in a 60-year-old man with end-stage renal disease (ESRD) on hemodialysis.

Case presentation

A 60-year-old man with ESRD on hemodialysis presented for worsening cough, shortness of breath, and diarrhea. The patient first developed a mild fever (37.8 °C) during hemodialysis 3 days prior to presentation and has been experiencing worsening flu-like symptoms, including fever of up to 38.6 °C, non-productive cough, generalized abdominal pain, nausea, vomiting, and liquid green diarrhea. He lives alone at home with no known sick contacts and denies any recent travel or visits to healthcare facilities other than the local dialysis center. Rapid flu test was positive for influenza A. Procalcitonin was elevated at 5.21 ng/mL with a normal white blood cell (WBC) count. Computed tomography (CT) chest demonstrated multifocal areas of consolidation and extensive mediastinal and hilar adenopathy concerning for pneumonia. He was admitted to the biocontainment unit of Nebraska Medicine for concerns of possible COVID-19 and was started on oseltamivir for influenza and vancomycin/cefepime for the probable bacterial cause of his pneumonia and diarrhea. Gastrointestinal (GI) pathogen panel and Clostridioides difficile toxin assay were negative. On the second day of admission, initial nasopharyngeal swab came back positive for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction (RT-PCR). The patient received supportive care and resumed bedside hemodialysis in strict isolation, and eventually fully recovered from COVID-19.

Conclusions

We presented a case of co-infection of influenza and SARS-CoV-2 in a hemodialysis patient. The possibility of SARS-CoV-2 co-infection should not be overlooked even when other viruses including influenza can explain the clinical symptoms, especially in high-risk patients.
Socio-demographic associations of HIV among women attending antenatal care in selected rural primary care facilities in South Africa’s Eastern Cape province
Authors: Mabunda Sikhumbuzo A. , Sigovana Khuthala , Chitha Wezile , Apalata Teke , Nomatshila Sibusiso
Published: January 2021

Background

To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalence of HIV among women attending antenatal care and further determine spousal support during antenatal care attendance in rural areas in Eastern Cape province, South Africa.

Methods

A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p≤0.05 for statistical significance.

Results

A total of 343 participants were included in the final analysis. The antenatal HIV prevalence was 38.2% (95%CI: 33.2–43.9). For 75% of the women, the HIV diagnosis was made 141 days before the date of the interview (median=77 days, interquartile range=42–141 days). Participants between the age of 30 to 39 years were 50% more likely to be HIV positive compared to those who were between the age of 20 to 29, these differences were statistically significant (PR=1.5; p-value=0.001). Furthermore, self-employed women were 30% less likely to be HIV positive when compared to unemployed participants, this was also statistically significant (PR=0.7; p-value< 0.0001).

Conclusion

Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high in this population, coupled with no spousal attendance in antenatal care. It is important to move beyond awareness about the HIV status to actionable strategies of reducing the HIV incident cases. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.
Prediction of risk factors of bronchial mucus plugs in children with Mycoplasma pneumoniae pneumonia
Authors: Zhang Jiahui , Wang Ting , Li Rongrong , Ji Wei , Yan Yongdong , Sun Zhichao , Tan Jiahong , Wu Jinfeng , Huang Li , Chen Zhengrong
Published: January 2021

Background

Recently, many cases of pneumonia in children with Mycoplasma pneumoniae infection have been shown to have varying degrees of intrabronchial mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of patients with Mycoplasma infection are analyzed in this study. The risk factors for M. pneumoniae pneumonia (MPP) mucus plug formation in children are explored, and a risk factor scoring system is established.

Methods

MPP patients treated with bronchoscopy were retrospectively enrolled in the study from February 2015 to December 2019. The children were divided into a mucus plug group and a control group according to the presence or absence of mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of the two groups of children were compared. Univariate and multivariate logistic regression models were used to identify the risk factors for MPP mucus plug formation. The receiver operating characteristic (ROC) curve was drawn to evaluate the regression model and establish the MPP mucous plug risk factor scoring system.

Results

A univariate analysis showed that the children in the mucous group were older and had a longer fever duration, longer hospital stay, higher fever peak, more cases of wheezing symptoms and allergies, and azithromycin or corticosteroids were administered later. In addition, neutrophil, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), sputum MP-DNA copy number, and total immunoglobulin A (IgA) levels were higher, while prealbumin (PA) levels were lower. The ROC curve analysis showed that children with MPP had PA ≤144.5 mg/L, had used corticosteroids during the course of the illness of ≥4.5 days, CRP ≥12.27 mg/L, an LDH ≥ 462.65 U/L, and there was a possibility of intra-airway mucus formation. The independent risk factors were scored according to their odds ratio (OR) value. Among the 255 children with MPP, the high-risk group had 44 (83.02%) mucus plugs out of 53; the middle-risk group had 35 (34.3%) mucus plugs out of 102; and the low-risk group had 11 (11%) mucus plugs out of 100.

Conclusions

PA levels, timing of corticosteroid use (use in the first few days), CRP levels, and LDH levels were independent risk factors for MPP mucus plug formation. This provides a basis for the early identification of MPP in children combined with mucus plug formation.
Implementation of a referral and expert advice call Center for Maternal and Newborn Care in the resource constrained health system context of the Greater Accra region of Ghana
Authors: Oduro-Mensah Ebenezer , Agyepong Irene Akua , Frimpong Edith , Zweekhorst Marjolein , Vanotoo Linda Amarkai
Published: January 2021

Background

Referral and clinical decision-making support are important for reducing delays in reaching and receiving appropriate and quality care. This paper presents analysis of the use of a pilot referral and decision making support call center for mothers and newborns in the Greater Accra region of Ghana, and challenges encountered in implementing such an intervention.

Methods

We analyzed longitudinal time series data from routine records of the call center over the first 33 months of its operation in Excel.

Results

During the first seventeen months of operation, the Information Communication Technology (ICT) platform was provided by the private telecommunication network MTN. The focus of the referral system was on maternal and newborn care. In this first phase, a total of 372 calls were handled by the center. 93% of the calls were requests for referral assistance (87% obstetric and 6% neonatal). The most frequent clinical reasons for maternal referral were prolonged labor (25%), hypertensive diseases in pregnancy (17%) and post-partum hemorrhage (7%). Birth asphyxia (58%) was the most common reason for neonatal referral. Inadequate bed space in referral facilities resulted in only 81% of referrals securing beds. The national ambulance service was able to handle only 61% of the requests for assistance with transportation because of its resource challenges. Resources could only be mobilized for the recurrent cost of running the center for 12 h (8.00 pm – 8.00 am) daily. During the second phase of the intervention we switched the use of the ICT platform to a free government platform operated by the National Security. In the next sixteen-month period when the focus was expanded to include all clinical cases, 390 calls were received with 51% being for medical emergency referrals and 30% for obstetrics and gynaecology emergencies. Request for bed space was honoured in 69% of cases.

Conclusions

The call center is a potentially useful and viable M-Health intervention to support referral and clinical decision making in the LMIC context of this study. However, health systems challenges such inadequacy of human resources, unavailability of referral beds, poor health infrastructure, lack of recurrent financing and emergency transportation need to be addressed for optimal functioning.
Patterns of hypnotic prescribing for residual insomnia and recurrence of major depressive disorder: a retrospective cohort study using a Japanese health insurance claims database
Authors: Yamato Kentaro , Inada Ken , Enomoto Minori , Marumoto Tatsuro , Takeshima Masahiro , Mishima Kazuo
Published: January 2021

Background

Major depressive disorder (MDD) is highly prevalent in Japan and frequently accompanied by insomnia that may persist even with MDD remission. Hypnotics are used for the pharmacological treatment of insomnia, but their influence on MDD recurrence or residual insomnia following MDD remission is unclear. This retrospective, longitudinal, cohort study utilized a large Japanese health insurance claims database to investigate patterns of hypnotic prescriptions among patients with MDD, and the influence of hypnotic prescription pattern on MDD recurrence.

Methods

Eligible patients (20–56 years) were those registered in the Japan Medical Data Center database between 1 January 2005 and 31 December 2018, and prescribed antidepressant and hypnotic therapy after being diagnosed with MDD. Patients who had ceased antidepressant therapy for > 180 days were followed for 1 year to evaluate depression recurrence, as assessed using Kaplan-Meier estimates. Logistic regression modelling was used to analyze the effect of hypnotic prescription pattern on MDD recurrence.

Results

Of the 179,174 patients diagnosed with MDD who initiated antidepressant treatment between 1 January 2006 and 30 June 2017, complete prescription information was available for 2946 eligible patients who had been prescribed hypnotics. More patients were prescribed hypnotic monotherapy (70.8%) than combination therapy (29.2%). The most prescribed therapies were benzodiazepine monotherapy (26.2%), non-benzodiazepine monotherapy (28.9%), and combination therapy with two drugs (21.1%). Among patients prescribed multiple hypnotics, concomitant prescriptions for anxiolytics, antipsychotics, mood stabilizers and sedative antidepressants were more common. The 1-year recurrence rate for MDD was approximately 20%, irrespective of hypnotic mono- versus combination therapy or class of hypnotic therapy. Being a spouse (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.03–2.02) or other family member (OR, 1.46, 95% CI, 0.99–2.16) of the insured individual, or being prescribed a sedative antidepressant (OR, 1.50, 95% CI, 1.24–1.82) conferred higher odds of MDD recurrence within 1 year of completing antidepressant therapy.

Conclusions

Benzodiazepines are the most prescribed hypnotic among Japanese patients with MDD, though combination hypnotic therapy is routinely prescribed. Hypnotic prescription pattern does not appear to influence real-world MDD recurrence, though hypnotics should be appropriately prescribed given class differences in efficacy and safety.
Effects of a new thyrotropic drug isolated from Potentilla alba on the male reproductive system of rats and offspring development
Authors: Krepkova Lubov V. , Bortnikova Valentina V. , Babenko Aleksandra N. , Mizina Praskovya G. , Mkhitarov Vladimir A. , Job Kathleen M. , Sherwin Catherine M. , Enioutina Elena Y.
Published: January 2021

Background

The dysfunction of the thyroid gland is a common medical condition. Nowadays, patients frequently use medicinal herbs as complementary or alternative options to conventional drug treatments. These patients may benefit from treatment of thyroid dysfunctions withPotentilla albaL. preparations. While it has been reported thatPotentilla albapreparations have low toxicity, nothing is known about their ability to affect reproductive functions in patients of childbearing age.

Methods

Male Wistar rats were orally treated with a thyrotrophic botanical drug, standardizedPotentilla albaDry Extract (PADE), at doses 8 and 40 times higher than the median therapeutic dose recommended for the clinical trials, for 60 consecutive days. Male Wistar rats receiving water (H2O) were used as controls. After completing treatment, half of the PADE-treated and control males were used to determine PADE gonadotoxicity, and the remaining half of PADE-treated and control males were mated with intact females. Two female rats were housed with one male for two estrus cycles. PADE effects on fertility and fetal/offspring development were evaluated.

Results

Herein, we report that oral treatment of male Wistar rats with PADE before mating with intact females instigated marked effects on male reproductive organs. Treatment significantly decreased the motility of the sperm and increased the number of pathological forms of spermatozoa. Additionally, a dose-dependent effect on Leydig cells was observed. However, these PADE effects did not significantly affect male fertility nor fetal and offspring development when PADE-treated males were mated with intact females.

Conclusions

PADE treatment of male rates negatively affected sperm and testicular Leydig cell morphology. However, these changes did not affect male fertility and offspring development. It is currently not known whether PADE treatment may affect human male fertility and offspring development. Therefore, these results from an animal study need to be confirmed in humans. Results from this animal study can be used to model the exposure-response relationship and adverse outcomes in humans.
Protective effect of 6-paradol in acetic acid-induced ulcerative colitis in rats
Authors: Rafeeq Misbahuddin , Murad Hussam Aly Sayed , Abdallah Hossam Mohammed , El-Halawany Ali M.
Published: January 2021

Background

Ulcerative colitis is a gut inflammatory disorder due to altered immune response to gut microbiome, with interplay of environmental and genetic factors. TNF-α activates inflammatory response through a cascade of immune responses, augmenting pro-inflammatory mediators and proteases, activating chemotaxis, and infiltration of inflammatory cells, leading to ulceration and haemorrhage through cytotoxic reactive oxygen species. 6-Paradol, a dietary component in several plants belonging to the Zingiberaceae family, has shown anti-inflammatory and antioxidant activities. Current study evaluates the effect of 6-paradol in amelioration of ulcerative colitis in rats for the first time.

Methods

6-Paradol (95% purity) was obtained from seeds ofAframomum melegueta.Rats were divided randomly into six groups (n = 8). Group one was administered normal saline; group two was treated with the vehicle only; group three, sulfasalazine 500 mg/kg; and groups four, five, and six, were given 6-paradol (50, 100, 200, respectively) mg/kg orally through gastric gavage for 7 days. Colitis was induced on 4th day by intrarectal administration of 2 ml acetic acid (3%), approximately 3 cm from anal verge. On 8th day, rats were sacrificed, and distal one-third of the colon extending proximally up to 4 cm from anal orifice was taken for biochemical and gross examination. Two centimetres of injured mucosal portion was taken for histopathological investigations. SPSS (ver.26) was used for statistical analysis.

Results

Colonic and serum glutathione (GSH) levels decreased, while colonic and serum malondialdehyde (MDA), colonic myeloperoxidase (MPO) activity, serum interleukin-6 (IL-6), serum tumour necrosis factor-α (TNF-α) levels, and colon weight to length ratio were increased significantly in the colitis untreated group compared to normal control. Treatment with 6-paradol considerably improved all these parameters, especially at a dose of 200 mg/kg (p < 0.001), revealing non-significant differences with sulfasalazine 500 mg/kg and normal control (p = 0.998). Sulfasalazine and 6-paradol in a dose dependent manner also markedly reversed mucosal oedema, atrophy and inflammation, cryptic damage, haemorrhage, and ulceration. There were non-significant differences between low and medium doses and between medium and high doses of 6-paradol for IL-6 and serum MDA levels.

Conclusion

6-Paradol demonstrated protection against acetic acid-induced ulcerative colitis, probably by anti-inflammatory and antioxidant actions.
Validation and psychometric evaluation of the Dutch person-centred care of older people with cognitive impairment in acute care (POPAC) scale
Authors: Keuning-Plantinga Annette , Finnema Evelyn J. , Krijnen Wim , Edvardsson David , Roodbol Petrie F.
Published: January 2021

Background

Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes.

Methods

After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency.

Results

The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057–0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69–0.77) indicated the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item.

Conclusions

Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.
A multi-stakeholder approach to the co-production of the research agenda for medicines optimisation
Authors: Fellenor John , Britten Nicky , Courtenay Molly , Payne Rupert A. , Valderas Jose , Denholm Rachel , Duncan Polly , McCahon Deborah , Tatnell Lynn , Fitzgerald Richard , Warmoth Krystal , Gillespie David , Turner Katrina , Watson Margaret
Published: January 2021

Background

Up to 50% of medicines are not used as intended, resulting in poor health and economic outcomes. Medicines optimisation is ‘a person-centred approach to safe and effective medicines use, to ensure people obtain the best possible outcomes from their medicines’. The purpose of this exercise was to co-produce a prioritised research agenda for medicines optimisation using a multi-stakeholder (patient, researcher, public and health professionals) approach.

Methods

A three-stage, multiple method process was used including: generation of preliminary research questions (Stage 1) using a modified Nominal Group Technique; electronic consultation and ranking with a wider multi-stakeholder group (Stage 2); a face-to-face, one-day consensus meeting involving representatives from all stakeholder groups (Stage 3).

Results

In total, 92 research questions were identified during Stages 1 and 2 and ranked in order of priority during stage 3. Questions were categorised into four areas: ‘Patient Concerns’ [e.g. is there a shared decision (with patients) about using each medicine?], ‘Polypharmacy’ [e.g. how to design health services to cope with the challenge of multiple medicines use?], ‘Non-Medical Prescribing’ [e.g. how can the contribution of non-medical prescribers be optimised in primary care?], and ‘Deprescribing’ [e.g. what support is needed by prescribers to deprescribe?]. A significant number of the 92 questions were generated by Patient and Public Involvement representatives, which demonstrates the importance of including this stakeholder group when identifying research priorities.

Conclusions

A wide range of research questions was generated reflecting concerns which affect patients, practitioners, the health service, as well the ethical and philosophical aspects of the prescribing and deprescribing of medicines. These questions should be used to set future research agendas and funding commissions.
Policy disparities in fighting COVID-19 among Japan, Italy, Singapore and China
Authors: Wang Xiaohan , Shi Leiyu , Zhang Yuyao , Chen Haiqian , Sun Gang
Published: January 2021

Objective

In order to provide experiences for international epidemic control, this study systematically summarized the Coronavirus disease 2019 (COVID-19) prevention and control policies in Japan, Italy, China and Singapore, and also analyzed the possible inequalities that exist in these response approaches to improve global infectious disease control.

Methods

We summarized the epidemic prevention and control policies in Japan, Italy, China, and Singapore, and analyzed the policy effects of these four countries by using the data published by Johns Hopkins Coronavirus Resource Center.

Results

As of May 27, 2020, the growing trend of new cases in Japan, Italy, China and Singapore has stabilized. However, the cumulative number of confirmed cases (231139) and case-fatality rate (14.3%) in Italy far exceeded those in the other three countries, and the effect of epidemic control was inferior. Singapore began to experience a domestic resurgence after April 5, with a cumulative number of confirmed cases reaching 32,876, but the case-fatality rate remained extremely low (0.1%). The growth of cumulative confirmed cases in China (84547) was almost stagnant, and the case-fatality rate was low (5.5%). The growth of cumulative confirmed cases in Japan (16661) increased slowly, and the case-fatality rate (4.8%) was slightly lower than that in China.

Conclusion

This study divided the epidemic prevention and control policies of the four countries into two categories: the blocking measures adopted by China and Singapore, and the mitigation measures adopted by Japan and Italy. According to the Epidemic control results of these four countries, we can conclude that the blocking measures were generally effective. As the core strategy of blocking measures, admitting mild patients into hospital and cases tracing helped curb the spread of the outbreak in Singapore and China. Countries should choose appropriate response strategies on the premise of considering their own situation, increase investment in health resources to ensure global health equity, and eventually control the spread of infectious diseases in the world effectively.
Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis, GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study
Authors: Hu Linli , Xie Rui , Wang Mengying , Sun Yingpu
Published: January 2021

Background

Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetric and neonatal outcomes of this group of patients are unknown. The aim of this study was to explore the effects of late moderate-to-critical OHSS on obstetric and neonatal outcomes.

Methods

This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion criteria, including 7,064 eligible patients diagnosed with clinical pregnancy. Ultimately, 6,356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, matching nine maternal baseline covariates and the number of multiple gestations; 385 patients with late moderate-to-critical OHSS were compared with a matched control group of 1,540 patients. The primary outcomes were the live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications.

Results

The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and matched control groups. The incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the number of neonates admitted to the NICU were significantly higher in the OHSS group than in the matched control group.

Conclusions

Pregnant women undergoing IVF with fresh ET whose course is complicated by late moderate-to-critical OHSS appear to experience shortened gestation and increased obstetrical and neonatal complications compared with matched controls whose course is not complicated by OHSS. However, the live birth rate, average neonatal weight, and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), and low neonatal birth weight (LBW) did not differ significantly between the two groups.