bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the vaccination status of liver transplant patients: Effectiveness of personally addressing patients and written recommendations to family physicians after 3 years
Authors: Dehnen Dorothea , Herwig Anna , Herzer Kerstin , Weltermann Birgitta
Published: July 2019

Background

After documenting insufficient vaccinations in 444 liver transplant (LT) patients, we investigated the effects of a combined strategy (addressing both patients and primary care physicians) on immunization prevalences after a 3‐year follow‐up.

Methods

The primary care physicians of all adult LT patients from a university center received a written recommendation addressing immunization needs. Patients were asked for their vaccination documents by phone. Changes in immunization rates for vaccine‐preventable diseases after the intervention were calculated based on patients’ immunization documents from 2014‐2016.

Results

The study cohort consisted of 401 patients. Prevalence rates for all vaccinations improved during the intervention period compared to the baseline study: tetanus from 88.3% to 92.8%, diphtheria from 80.0% to 89.0%, hepatitis A from 50.1% to 60.8%, hepatitis B from 66.3% to 77.1%, and pneumococci from 62.8% to 76.3%. The influenza vaccination rate improved, but remained at a low level before (2010:13%, 2011:11.5%, 2012:19%) and during the intervention (2014:27.4%, 2015:24.4%, 2016:23.2%). Despite these vaccinations, the prevalence rates of the quality indicators standard vaccinations completed (2013:17.2%; 2016:21.2%), indicated vaccinations completed (2013:2.7%, 2016:4.5%), and all vaccinations completed (2013:1%; 2016 1.5%) improved only slightly.

Conclusions

Our results demonstrated that intensified communication by written information to the primary care physician and phone calls to the patients improved the number of vaccinations. Nonetheless, a potential for further improvement persists, especially with regard to annual influenza vaccinations.
Evaluation of suture reinforcement for stapled intestinal anastomoses: 77 dogs (2008‐2018)
Authors: Sumner Scarlett M. , Regier Penny J. , Case J. Brad , Ellison Gary W.
Published: July 2019

Objective

To determine the influence of oversewing a transverse staple line in functional end‐to‐end stapled intestinal anastomoses (FEESA) in dogs.

Study design

Retrospective observational study.

Sample population

Seventy‐seven client‐owned dogs that underwent 78 FEESA reinforced (n = 30) or not reinforced (n = 48) with suture at the transverse staple line.

Methods

The medical records database was searched and reviewed for dogs that had undergone a FEESA between January 2008 and September 2018. Data were collected regarding signalment, body weight, clinical presentation, indication for surgery, serum albumin, presence of septic peritonitis, previous surgeries, surgical techniques (ie, oversew, crotch suture, omental wrap, omental patch, serosal patch), histopathology results, and postoperative outcome.

Results

The only differences identified between groups consisted of higher preoperative albumin (2.89 ± 0.56 vs 2.34 ± 0.62 g/dL; P = .006) and lower postoperative dehiscence rate (0/30 vs 7/48; P = .028) in dogs with an oversewn FEESA. Oversewing the FEESA was identified as the significant factor in a model with oversewing and preoperative albumin fit to the outcome of dehiscence (oversew P = .010, albumin P = .761). The location of the dehiscence was specified in four of seven dogs, all along the transverse staple line. Patterns used for oversew were unspecified (n = 11), simple continuous (8), Cushing (4), simple interrupted (2), cruciate (1), interrupted horizontal mattress (1), and Lembert (1).

Conclusion

Oversewing the transverse staple line in FEESA was associated with a reduced occurrence of postoperative dehiscence.

Clinical significance

Our results provide evidence to support additional investigation of suture reinforcement (oversewing) at the transverse staple line of FEESA to reduce postoperative dehiscence.
Effects of selective cutting and timing of herbicide application on growth and development of Cirsium arvense in spring barley
Authors: Tavaziva V J , Lundkvist A , Verwijst T
Published: July 2019

Recently, a new implement for controlling weeds in cereals (CombCut) has been developed. It cuts weeds in growing cereals without damaging them by using the physical differences (in height, stem thickness, straw stiffness and branching pattern) between crops and weeds. To evaluate and compare the effects of selective cutting with different timings of herbicide application on Cirsium arvense in spring barley, a randomised block experiment was conducted in Sweden in 2015–2017, in a field with a naturally occurring C. arvense population. Treatments consisted of control (C), herbicide application at 4–5‐leaf stage of C. arvense (H1), herbicide application at 8–10‐leaf stage (H2) and selective cutting at 10‐leaf stage (S). The treatments were performed in 2015 and repeated in 2016 in the same plots, and a final evaluation was performed in 2017. Compared to the control, S, H1 and H2 were equally efficient in reducing above‐ground biomass production of C. arvense and increasing spring barley grain yield per unit area. The number of C. arvense shoots per area was, however, higher in S compared to H1 and H2. No differences in control effects on shoot number were observed between H1 and H2. Our study indicates that (i) selective cutting (S) reduces C. arvense equally efficient as herbicide application and (ii) early herbicide spraying is as efficient as spraying later in the season.
Burgess-like subconvexity for
Authors: Wu Han
Published: July 2019

We generalize our previous method on the subconvexity problem for

$\text{GL}_{2}\times \text{GL}_{1}$

with cuspidal representations to Eisenstein series, and deduce a Burgess-like subconvex bound for Hecke characters, that is, the bound

$|L(1/2,\unicode[STIX]{x1D712})|\ll _{\mathbf{F},\unicode[STIX]{x1D716}}\mathbf{C}(\unicode[STIX]{x1D712})^{1/4-(1-2\unicode[STIX]{x1D703})/16+\unicode[STIX]{x1D716}}$

for varying Hecke characters

$\unicode[STIX]{x1D712}$

over a number field

$\mathbf{F}$

with analytic conductor

$\mathbf{C}(\unicode[STIX]{x1D712})$

. As a main tool, we apply the extended theory of regularized integrals due to Zagier developed in a previous paper to obtain the relevant triple product formulas of Eisenstein series.
Sheaves of categories with local actions of Hochschild cochains
Authors: Beraldo Dario
Published: July 2019

The notion of Hochschild cochains induces an assignment from
$\mathsf{Aff}$
, affine DG schemes, to monoidal DG categories. We show that this assignment extends, under appropriate finiteness conditions, to a functor
$\mathbb{H}:\mathsf{Aff}\rightarrow \mathsf{Alg}^{\text{bimod}}(\mathsf{DGCat})$
, where the latter denotes the category of monoidal DG categories and bimodules. Any functor
$\mathbb{A}:\mathsf{Aff}\rightarrow \mathsf{Alg}^{\text{bimod}}(\mathsf{DGCat})$
gives rise, by taking modules, to a theory of sheaves of categories
$\mathsf{ShvCat}^{\mathbb{A}}$
. In this paper, we study
$\mathsf{ShvCat}^{\mathbb{H}}$
. Loosely speaking, this theory categorifies the theory of
$\mathfrak{D}$
-modules, in the same way as Gaitsgory’s original
$\mathsf{ShvCat}$
categorifies the theory of quasi-coherent sheaves. We develop the functoriality of
$\mathsf{ShvCat}^{\mathbb{H}}$
, its descent properties and the notion of
$\mathbb{H}$
-affineness. We then prove the
$\mathbb{H}$
-affineness of algebraic stacks: for
${\mathcal{Y}}$
a stack satisfying some mild conditions, the
$\infty$
-category
$\mathsf{ShvCat}^{\mathbb{H}}({\mathcal{Y}})$
is equivalent to the
$\infty$
-category of modules for
$\mathbb{H}({\mathcal{Y}})$
, the monoidal DG category of higher differential operators. The main consequence, for
${\mathcal{Y}}$
quasi-smooth, is the following: if
${\mathcal{C}}$
is a DG category acted on by
$\mathbb{H}({\mathcal{Y}})$
, then
${\mathcal{C}}$
admits a theory of singular support in
$\operatorname{Sing}({\mathcal{Y}})$
, where
$\operatorname{Sing}({\mathcal{Y}})$
is the space of singularities of
${\mathcal{Y}}$
. As an application to the geometric Langlands programme, we indicate how derived Satake yields an action of
$\mathbb{H}(\operatorname{LS}_{{\check{G}}})$
on
$\mathfrak{D}(\operatorname{Bun}_{G})$
, thereby equipping objects of
$\mathfrak{D}(\operatorname{Bun}_{G})$
with singular support in
$\operatorname{Sing}(\operatorname{LS}_{{\check{G}}})$
.
CRISPR patent fight revived
Authors: Cohen Jon
Published: July 2019

U.S. patent office issues new interference declaration
Integrating stress responses and immunity
Authors: Pierre Philippe
Published: July 2019

Stress is required to assemble immune signaling complexes during infection
Anidulafungin Susceptibility Testing of Candida glabrata Isolates from Blood Cultures by the MALDI Biotyper Antibiotic (Antifungal) Susceptibility Test Rapid Assay
Authors: Vatanshenassan Mansoureh , Arastehfar Amir , Boekhout Teun , Berman Judith , Lass-Flörl Cornelia , Sparbier Katrin , Kostrzewa Markus
Published: July 2019

Echinocandins are the recommended first-line antifungals for treatment of invasive candidiasis. The increasing number of
Candida glabrata
strains resistant against echinocandins is an emerging health care concern. The rapid detection of resistant
C. glabrata
isolates is an urgent requirement for clinical laboratories.
NU-6027 Inhibits Growth of Mycobacterium tuberculosis by Targeting Protein Kinase D and Protein Kinase G
Authors: Kidwai Saqib , Bouzeyen Rania , Chakraborti Sohini , Khare Neha , Das Sumana , Priya Gosain Tannu , Behura Assirbad , Meena Chhuttan Lal , Dhiman Rohan , Essafi Makram , Bajaj Avinash , Saini Deepak Kumar , Srinivasan Narayanaswamy , Mahajan Dinesh , Singh Ramandeep
Published: July 2019

Tuberculosis (TB) is a global health concern, and this situation has further worsened due to the emergence of drug-resistant strains and the failure of BCG vaccine to impart protection. There is an imperative need to develop highly sensitive, specific diagnostic tools, novel therapeutics, and vaccines for the eradication of TB. In the present study, a chemical screen of a pharmacologically active compound library was performed to identify antimycobacterial compounds.
Rapid Accumulation of Motility-Activating Mutations in Resting Liquid Culture of Escherichia coli
Authors: Parker Darren J. , Demetci Pınar , Li Gene-Wei
Published: July 2019

The ability to tune gene expression in times of need outside preordained regulatory networks is an essential evolutionary process that allows organisms to survive and compete. Here, we show that upon overnight incubation in liquid medium without shaking, populations of largely nonmotile
Escherichia coli
bacteria can rapidly accumulate mutants that have constitutive motility. This effect contributes to widespread secondary mutations in the single-gene knockout library, the Keio collection. As a result, 49/71 (69%) of the Keio strains tested exhibited various degrees of motility, whereas their parental strain is poorly motile. These observations highlight the plasticity of gene expression even in the absence of preexisting regulatory programs and should raise awareness of procedures for handling laboratory strains of
E. coli
.
Same-Day Tools, Including Xpert Ultra and IRISA-TB, for Rapid Diagnosis of Pleural Tuberculosis: a Prospective Observational Study
Authors: Meldau Richard , Randall Philippa , Pooran Anil , Limberis Jason , Makambwa Edson , Dhansay Muhammed , Esmail Aliasgar , Dheda Keertan
Published: July 2019

The diagnosis of pleural tuberculosis (TB) is problematic. The comparative performance of newer same-day tools for pleural TB, including Xpert MTB/RIF Ultra (ULTRA), has hitherto not been comprehensively studied. Adenosine deaminase (ADA), IRISA-TB (interferon gamma ultrasensitive rapid immunosuspension assay), Xpert MTB/RIF, and ULTRA performance outcomes were evaluated in pleural fluid samples from 149 patients with suspected pleural TB.
Newcastle Disease Virus V Protein Degrades Mitochondrial Antiviral Signaling Protein To Inhibit Host Type I Interferon Production via E3 Ubiquitin Ligase RNF5
Authors: Sun Yingjie , Zheng Hang , Yu Shengqing , Ding Yunlei , Wu Wei , Mao Xuming , Liao Ying , Meng Chunchun , Ur Rehman Zaib , Tan Lei , Song Cuiping , Qiu Xusheng , Wu Fengyun , Ding Chan
Published: July 2019

Host anti-RNA virus innate immunity relies mainly on the recognition by retinoic acid-inducible gene I and melanoma differentiation-associated protein 5 and subsequently initiates downstream signaling through interaction with MAVS. On the other hand, viruses have developed various strategies to counteract MAVS-mediated signaling. The mechanism for paramyxoviruses regulating MAVS to benefit their infection remains unknown. In this article, we demonstrate that the V proteins of NDV and several other paramyxoviruses target MAVS for ubiquitin-mediated degradation through E3 ubiquitin ligase RING-finger protein 5 (RNF5). MAVS degradation leads to the inhibition of the downstream IFN-β pathway and therefore benefits virus proliferation. Our study reveals a novel mechanism of NDV evading host innate immunity and provides insight into the therapeutic strategies for the control of paramyxovirus infection.
A Single Amino Acid Substitution at Residue 218 of Hemagglutinin Improves the Growth of Influenza A(H7N9) Candidate Vaccine Viruses
Authors: Li Xing , Gao Yamei , Ye Zhiping
Published: July 2019

The circulating avian influenza A(H7N9) has caused recurrent epidemic waves with high mortality in China since 2013, in which the alarming fifth wave crossing 2016 and 2017 was highlighted by a large number of human infections and the emergence of highly pathogenic avian influenza (HPAI) A(H7N9) strains in human cases. We generated low-pathogenic reassortant CVVs derived from the emerging A(H7N9) with improved virus replication and protein yield in both MDCK cells and eggs by introducing a single substitution, G218E, into HA, which was associated with reducing HA receptor binding and subsequently balancing HA-NA functions. The
in vitro
and
in vivo
experiments demonstrated comparable antigenicity of the G218E CVVs with that of their wild-type (WT) counterparts, and both the WT and the G218E CVVs fully protected ferrets from parental HPAI virus challenge. With high yield traits and the anticipated antigenicity, the G218E CVVs should benefit preparedness against the threat of an A(H7N9) influenza pandemic.
Acute psychosis in glycogen storage disease: a rare but severe complication
Authors: Dunne Thomas Frederick , Geberhiwot Tarekegn , Jones Rowena
Published: July 2019

Glycogen storage disease type 1 (GSD-1) is a group of inherited metabolic disorders characterised by the inability to use intracellular glucose stores. It is associated with a high risk of hypoglycaemia, as well as long-term complications including growth retardation, hepatocellular adenomas, renal disease, hypertriglyceridaemia and hyperuricaemia. Treatment involves slow absorption carbohydrates, for example, cornstarch. We present a case of acute psychosis in a patient with GSD-1a. This was initially attributed to his opiate use. Later in his management an MRI scan of his head was performed which revealed regions of brain atrophy following significant hypoglycaemic insult, thus identifying an organic cause of his psychosis. This case presents a rare complication of glycogen storage disease: organic psychosis attributable to cortical atrophy from profound hypoglycaemic insult. It emphasises the importance of investigating organic causes of psychiatric symptoms.
Respiratory failure secondary to congenital pulmonary arterial thrombus with lung dysplasia
Authors: Odackal Namrita J , McCulloch Michael A , Hainstock Michael R , Vergales Brooke D
Published: July 2019

Respiratory failure requiring extracorporeal membranous oxygenation in the newborn is commonly seen secondary to severe pathology such as congenital diaphragmatic hernia, meconium aspiration syndrome, pulmonary hypertension and pulmonary hypoplasia. However, atypical causes of respiratory failure, such as pulmonary arterial thrombi, are often refractory to traditional management and require careful multidisciplinary evaluation. We report a case of respiratory failure secondary to congenital pulmonary arterial thrombosis of unknown aetiology in an otherwise healthy neonate. We discuss the abnormal anatomy and pathophysiology that presented in our patient secondary to this condition and discuss our diagnostic process, management and outcomes. Additionally, we review the literature for reported cases and discuss current hypotheses on the development of congenital pulmonary arterial thrombi. Given the rare occurrence of this event, we hope to contribute to the understanding of future similar cases and emphasise the importance of keeping pulmonary arterial thrombi in the clinical differential.
Child Health CheckPoint: cohort summary and methodology of a physical health and biospecimen module for the Longitudinal Study of Australian Children
Authors: Clifford Susan A , Davies Sarah , Wake Melissa
Published: July 2019

Objectives

‘Growing Up in Australia: The Longitudinal Study of Australian Children’ (LSAC) is Australia's only nationally representative children’s longitudinal study, focusing on social, economic, physical and cultural impacts on health, learning, social and cognitive development. LSAC's first decade collected wide-ranging repeated psychosocial and administrative data; here, we describe the Child Health CheckPoint, LSAC’s dedicated biophysical module.

Design, setting and participants

LSAC recruited a cross-sequential sample of 5107 infants aged 0–1 year and a sample of 4983 children aged 4–5 years in 2004, since completing seven biennial visits. CheckPoint was a cross-sectional wave that travelled Australia in 2015–2016 to reach LSAC’s younger cohort at ages 11–12 years between LSAC waves 6 and 7. Parent–child pairs participated in comprehensive assessments at 15 Assessment Centres nationwide or, if unable to attend, a shorter home visit.

Measures

CheckPoint’s intergenerational, multidimensional measures were prioritised to show meaningful variation within normal ranges and capture non-communicable disease (NCD) phenotype precursors. These included anthropometry, physical activity, fitness, time use, vision, hearing, and cardiovascular, respiratory and bone health. Biospecimens included blood, saliva, buccal swabs (also from second parent), urine, hair and toenails. The epidemiology and parent–child concordance of many measures are described in separate papers.

Results

1874 (54% of eligible) parent–child pairs and 1051 second parents participated. Participants' geographical distribution mirrored the broader Australian population; however, mean socioeconomic position and parental education were higher and fewer reported non-English-speaking or Indigenous backgrounds. Application of survey weights partially mitigates that the achieved sample is less population representative than previous waves of LSAC due to non-random attrition. Completeness was uniformly high for phenotypic data (>92% of eligible), biospecimens (74%–97%) and consent (genetic analyses 98%, accessing neonatal blood spots 97%, sharing 96%).

Conclusions

CheckPoint enriches LSAC to study how NCDs develop at the molecular and phenotypic levels before overt disease emerges, and clarify the underlying dimensionality of health in childhood and mid-adulthood.
Telomere length: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Authors: Nguyen Minh Thien , Lycett Kate , Vryer Regan , Burgner David P , Ranganathan Sarath , Grobler Anneke C , Wake Melissa , Saffery Richard
Published: July 2019

Objectives

To (1) describe the epidemiology of child and adult telomere length, and (2) investigate parent–child telomere length concordance.

Design

Population-based cross-sectional study within the Longitudinal Study of Australian Children.

Setting

Assessment centres in seven major Australian cities and eight selected regional towns; February 2015 to March 2016.

Participants

Of 1874 participating families, telomere data were available for analysis for 1206 children and 1343 parents, of whom 1143 were parent–child pairs. There were 589 boys and 617 girls; 175 fathers and 1168 mothers.

Outcome measures

Relative telomere length (T/S ratio), calculated by comparing telomeric DNA (T) level with the single copy (S) beta-globin gene in venous blood-derived genomic DNA by quantitative real-time PCR.

Results

Mean T/S ratio for all children, boys and girls was 1.09 (SD 0.56), 1.05 (SD 0.53) and 1.13 (SD 0.59), respectively. Mean T/S ratio for all parents, fathers and mothers was 0.81 (SD 0.37), 0.82 (SD 0.36) and 0.81 (SD 0.38), respectively. Parent–child T/S ratio concordance was moderate (correlation 0.24). In adjusted regression models, one unit higher parent T/S ratio was associated with 0.36 (estimated linear regression coefficient (β); 95% CI 0.28 to 0.45) higher child T/S ratio. Concordance was higher in the youngest parent-age tertile (β 0.49; 95% CI 0.34 to 0.64) compared with the middle (β 0.35; 95% CI 0.21 to 0.48) and oldest tertile (β 0.26; 95% CI 0.11 to 0.41; p-trend 0.04). Father–child concordance was 0.34 (95% CI 0.18 to 0.48), while mother–child was 0.22 (95% CI 0.17 to 0.28).

Conclusions

We provide telomere length population values for children aged 11–12 years and their mid-life parents. Relative telomere length was shorter in adults than children, as expected. There was modest evidence of parent–child concordance, which diminished with increasing parent age.
Physical activity and sedentary activity: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Authors: Fraysse François , Grobler Anneke C , Muller Josh , Wake Melissa , Olds Timothy
Published: July 2019

Objectives

To describe the epidemiology and parent–child concordance of objectively measured physical activity in a population-based sample of Australian parent–child dyads.

Design

Cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children.

Setting

Assessment centres in seven Australian cities and eight regional towns or home visits; February 2015–March 2016.

Participants

Of all CheckPoint families (n=1874), 1261 children (50% girls) and 1358 parent (88% mothers) provided objectively measured activity data, comprising 1077 parent–child dyads.

Outcome measures

Activity behaviour was assessed by GENEActiv accelerometer. Duration of moderate-to-vigorous physical activity (MVPA) and vigorous physical activity and sedentary behaviour (SB) were derived usingCobracustom software, along with MVPA/SB fragmentation and mean daily activity. Pearson’s correlation coefficients and linear regression estimated parent–child concordance. Survey weights and methods accounted for the complex sample design and clustering.

Results

Although parents had average lower accelerometry counts than children (mean [SD] 209 [46] vs 284 [71] g.min), 93% of parents met MVPA daily duration guidelines on published cutpoints (mean [SD] 125 [63] min/day MVPA), compared with only 15% of children (mean 32 [27] min). Parents showed less daily SB duration (parents: 540 [101], children: 681 [69] minutes) and less fragmented accumulation of MVPA (parents: α=1.85, children: α=2.00). Parent–child correlation coefficients were 0.16 (95% CI 0.11 to 0.22) for MVPA duration, 0.10 (95% CI 0.04 to 0.16) for MVPA fragmentation, 0.16 (95% CI 0.11 to 0.22) for SB duration and 0.18 (95% CI 0.12 to 0.23) for SB fragmentation.

Conclusions

Standardised cutpoints are needed for objective activity measures to inform activity guidelines across the lifecourse. This may reflect large amounts of time in non-shared environments (school and work).
Lung function: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Authors: Welsh Liam , Kathriachchige Gayan , Raheem Tahmeed , Grobler Anneke C , Wake Melissa , Ranganathan Sarath
Published: July 2019

Objectives

To describe the epidemiology of lung function in Australian children aged 11–12 years and their parents, and explore the degree of intergenerational concordance.

Design

Cross-sectional study (the Child Health CheckPoint) nested in the Longitudinal Study of Australian Children (LSAC).

Setting

Assessment centres in seven Australian cities and eight regional towns, February 2015 to March 2016. Families unable to attend a clinic appointment were offered a home visit during the same period.

Participants

1874 families (53% of all eligible) participated in the study. Lung function data were available for 1759 children aged 11–12 years and 1774 parents (1668 biological pairs).

Outcome measures

Participants completed spirometry with measures including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid expiratory flow (MEF), converted to z-scores using Global Lung Initiative equations. Parent–child concordance was assessed using Pearson’s correlation coefficients and multivariable linear regression models. Survey weights and methods accounted for LSAC’s complex sampling, stratification and clustering within postcodes.

Results

All lung function measures followed approximately normal distributions. Mean (SD) for FEV1, FVC and MEF z-scores in children were 0.33 (1.07), 0.83 (1.14) and −0.48 (1.09), respectively. Mean (SD) in parents were 0.28 (1.10), 0.85 (1.15) and −0.45 (1.10), respectively. Parent FEV1, FVC and MEF were associated with child lung function with significant positive correlation coefficients (0.22, 95% CI 0.17 to 0.26; 0.24, 95% CI 0.20 to 0.29; and 0.24, 95% CI 0.20 to 0.29, respectively).

Conclusions

Mean lung volumes were larger but with smaller airway size than international standards for both parents and children in this population sample. Modest associations between parent and child lung function highlight the potential for better identification of ‘at risk’ populations. Therefore, these findings may aid the development of health policy that aims to prevent the onset or limit the progression of lung disease.
Body composition: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Authors: Clifford Susan A , Gillespie Alanna N , Olds Timothy , Grobler Anneke C , Wake Melissa
Published: July 2019

Objectives

Overweight and obesity remain at historically high levels, cluster within families and are established risk factors for multiple diseases. We describe the epidemiology and cross-generational concordance of body composition among Australian children aged 11–12 years and their parents.

Design

The population-based cross-sectional Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children (LSAC).

Setting

Assessment centres in seven major Australian cities and eight regional cities, or home visits; February 2015–March 2016.

Participants

Of all participating CheckPoint families (n=1874), body composition data were available for 1872 children (49% girls) and 1852 parents (mean age 43.7 years; 88% mothers), including 1830 biological parent-child pairs.

Measures

Height, weight, body mass index (BMI), waist circumference and waist-to-height ratio for all participants; body fat and fat-free mass by four-limb bioimpedence analysis (BIA) at assessment centres, or body fat percentage by two-limb BIA at home visits.Analysis:parent-child concordance was assessed using (i) Pearson’s correlation coefficients, and (ii) partial correlation coefficients adjusted for age, sex and socioeconomic disadvantage. Survey weights and methods accounted for LSAC’s complex sample design.

Results

20.7% of children were overweight and 6.2% obese, as were 33.5% and 31.6% of parents. Boys and girls showed similar distributions for all body composition measures but, despite similar BMI and waist-to-height ratio, mothers had higher proportions of total and truncal fat than fathers. Parent-child partial correlations were greatest for height (0.37, 95% CI 0.33 to 0.42). Other anthropometric and fat/lean measures showed strikingly similar partial correlations, ranging from 0.25 (95% CI 0.20 to 0.29) for waist circumference to 0.30 (95% CI 0.25 to 0.34) for fat-free percentage. Whole-sample and sex-specific percentile values are provided for all measures.

Conclusions

Excess adiposity remains prevalent in Australian children and parents. Moderate cross-generational concordance across all measures of leanness and adiposity is already evident by late childhood.
(Un)Spoken realities of living with axial spondyloarthritis: a qualitative study focused on couple experiences
Authors: Raybone Kerry , Family Hannah , Sengupta Raj , Jordan Abbie
Published: July 2019

Objective

Axial spondyloarthritis is a long-term rheumatic condition. The symptoms, including pain, can impact on the daily life routines and psychological well-being of individuals that are diagnosed with axial spondyloarthritis (axSpA). Partners are often a main source of support for individuals who manage a long-term condition and they can also be affected by the illness experience, often themselves reporting elevated levels of emotional distress. Few qualitative studies have explored the impact of axSpA on partner relationships. This study addresses the social context of axSpA by investigating the experiences for both individuals with axSpA and their partners.

Design

Semistructured individual telephone interviews analysed using thematic analysis at a dyadic partner level.

Setting

Participants were recruited from the social media pages of a UK-based axSpA-specific charity.

Participants

Nine heterosexual partner dyads (23–65 years), who were currently cohabiting, comprising nine individuals diagnosed with axSpA (n=6 females) and nine partners (n=3 females).

Results

Three themes ‘Perceived relational closeness’, ‘Playing third wheel to axSpA’ and ‘Tensions surrounding a carer-type role’ were identified. The findings illustrate how living with axSpA can influence closeness between partners and dominate daily decisions, particularly surrounding leisure activities. Partners commonly adopted a carer-type role, despite many individuals with axSpA expressing desire for a greater sense of autonomy.

Conclusions

This study provides an important insight into the lived experiences of both individuals with axSpA and their partners. Findings highlight the social context of managing a long-term condition and suggest the need for including partners within consultations, and the need for support provision for partners.
Updating EuroSCORE by including emotional, behavioural, social and functional factors to the risk assessment of patients undergoing cardiac surgery: a study protocol
Authors: Cromhout Pernille Fevejle , Berg Selina Kikkenborg , Moons Philip , Damgaard Sune , Nashef Samer , Thygesen Lau Caspar
Published: July 2019

Introduction

Conventional risk assessment in cardiac surgery focus on medical and physiological factors and have been developed to predict mortality. Other relevant risk factors associated with increased risk of poor outcomes are not included. Adding non-medical variables as potential prognostic factors to risk assessments direct attention away from specific diagnoses towards a more holistic view of the patients and their predicament. The aim of this paper is to describe the method and analysis plan for the development and validation of a prognostic screening tool as a supplement to the European System for Cardiac Operative Risk Evaluation (EuroSCORE) to predict mortality, readmissions and prolonged length of admission in patients within 90 days after cardiac surgery, as individual outcomes.

Methods and analysis

The development of a prognostic screening tool with inclusion of emotional, behavioural, social and functional factors complementing risk assessment by EuroSCORE will adopt the methods recommended by the PROGnosis RESearch Strategy Group and report using the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis statement. In the development stage, we will use data derived from three datasets comprising 1143, 3347 and 982 patients for a prospective cohort study of patients undergoing cardiac surgery, respectively. We will construct logistic regression models to predict mortality, prolonged length of admission and 90-day readmissions. In the validation stage, we will use data from a separate sample of 333 patients planned to undergo cardiac surgery to assess the performance of the developed prognostic model. We will produce validation plots showing the overall performance, area under the curve statistic for discrimination and the calibration slope and intercept.

Ethics and dissemination

The study will follow the requirements from the Ethical Committee System ensuring voluntary participation in accordance with the Helsinki declarations. Data will be filed in accordance with the requirements of the Danish Data Protection Agency.
Comparison of surgical strategies in patients with spontaneous intracerebral haemorrhage: a protocol for a network meta-analysis
Authors: Yu Zhiyuan , Zheng Jun , Ma Lu , Guo Rui , You Chao , Li Hao
Published: July 2019

Introduction

Spontaneous intracerebral haemorrhage (sICH) is a severe stroke subtype. The effective therapies for patients with sICH are still unclear, and the role of surgical treatment in sICH management is still controversial. Although some large trials did not show that surgery could benefit patients with sICH, some other studies suggested that some specific surgical strategies can have potential benefits to these patients. For a better understanding of the surgical treatment in patients with sICH, it is necessary to conduct a network meta-analysis to compare the effects of medical treatment and different surgical methods comprehensively.

Methods and analysis

This protocol has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Related studies until August 2018 will be searched in the following databases: PubMed, Embase, Scopus, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang. Randomised controlled trials and non-randomised prospective studies comparing at least two different interventions in patients with sICH will be included. Quality assessment will be conducted using Cochrane Collaboration’s tool or Newcastle-Ottawa Scale based on their study designs. The primary outcome will be functional outcome and the secondary outcome will be mortality. Pairwise and network meta-analysis will be conducted using STATA V.14 (StataCorp, College Station, Texas, USA). Mean ranks and the surface under the cumulative ranking curve will be used to evaluate every intervention. Statistical inconsistency assessment, subgroup analysis, sensitivity analysis and publication bias assessment will be performed.

Ethics and dissemination

Ethics approval is not necessary because this study will be based on publications. The results of this study will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42018112239
Trajectories of sickness absence among salaried workers: evidence from the WORKss cohort in Catalonia (Spain), 2012-2014
Authors: Ubalde-Lopez Monica , Hernando-Rodriguez Julio C , Benavides Fernando G , Serra Laura
Published: July 2019

Objectives

Sickness absence (SA) is a widely studied integrated measure of health status. To better understand how SA behaves over time (SA trajectory) a longitudinal and individual-centred approach will allow identifying groups of individuals who share common characteristics. The aim of this study was to identify and describe SA trajectories and to assess employment conditions and diagnosis groups as determinants.

Setting

Working-life and sickness absence administrative records from a representative sample of affiliated with the Spanish Social Security system.

Participants

38 420 workers affiliated with the Spanish Social Security system, born 1949 to 1969 or 1970 to 1990, resident in Catalonia who had SA between 2012 and 2014 (75 212 episodes).

Results

We identified three different SA trajectories in both birth cohorts for men and women: low-stable (86.2% to 90.8% of individuals), decreasing (4.4% to 5.9% of individuals) and increasing (4.1% to 8.7% of individuals) accumulated days of SA. The main characteristic of SA trajectories was the medical diagnosis group. The increasing SA trajectory had a higher proportion of workers with SA due to mental disorders compared with the other trajectories. The association analysis showed diagnosis group strongly related with all SA trajectories, particularly SA due to mental disorders showed the strongest association with the increasing trajectory among young men (adjusted OR (aOR): 42.40, 95% CI 17.03 to 105.57). Low salary levels exhibited a strong relationship with decreased accumulation of SA days over time for old women (aOR: 2.08, 95% CI 1.36 to 3.18) and men (aOR: 2.75, 95% CI 1.77 to 4.27). Unskilled manual occupations were associated with increasing trajectories among young women (aOR: 1.36, 95% CI 1.01 to 1.84). No significant differences were observed for other employment conditions across trajectories.

Conclusions

Workers with mental disorders are more likely to have increased days of SA, whereas low salary levels at later ages are related to a decrease in SA days over time. Special attention to preventing the course of mental disorders at young and middle age is warranted.
Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa
Authors: Amugsi Dickson Abanimi , Dimbuene Zacharie Tsala , Kyobutungi Catherine
Published: July 2019

Objective

To investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.

Design

Secondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).

Settings

Ghana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).

Subjects

Women aged 15–49 years (n=64698).

Results

Compared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.

Conclusions

Our analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.
Impact of Universal Credit in North East England: a qualitative study of claimants and support staff
Authors: Cheetham Mandy , Moffatt Suzanne , Addison Michelle , Wiseman Alice
Published: July 2019

Objectives

To understand the impact of the roll-out of Universal Credit (UC) from the perspectives of claimants and staff supporting them in North East England.

Design

Qualitative study comprising interviews and focus groups.

Setting

Gateshead and Newcastle, two localities in North East England characterised by high levels of socioeconomic deprivation, where the roll-out of UC started in 2017 as a new way to deliver welfare benefits for the UK working age population.

Participants

33 UC claimants with complex needs, disabilities and health conditions and 37 staff from local government, housing, voluntary and community sector organisations.

Results

Participants’ accounts of the UC claims process and the consequences of managing on UC are reported; UC negatively impacts on material wellbeing, physical and mental health, social and family lives. UC claimants described the digital claims process as complicated, disorientating, impersonal, hostile and demeaning. Claimants reported being pushed into debt, rent arrears, housing insecurity, fuel and food poverty through UC. System failures, indifference and delays in receipt of UC entitlements exacerbated the difficulties of managing on a low income. The threat of punitive sanctions for failing to meet the enhanced conditionality requirements under UC added to claimant’s vulnerabilities and distress. Staff reported concerns for claimants and additional pressures on health services, local government and voluntary and community sector organisations as a result of UC.

Conclusions

The findings add considerable detail to emerging evidence of the deleterious effects of UC on vulnerable claimants’ health and wellbeing. Our evidence suggests that UC is undermining vulnerable claimants’ mental health, increasing the risk of poverty, hardship, destitution and suicidality. Major, evidence-informed revisions are required to improve the design and implementation of UC to prevent further adverse effects before large numbers of people move on to UC, as planned by the UK government.
One-year longitudinal study of psychological distress and self-assessed health in survivors of out-of-hospital cardiac arrest
Authors: Viktorisson Adam , Sunnerhagen Katharina S , Johansson Dongni , Herlitz Johan , Axelsson Åsa
Published: July 2019

Objectives

Few studies have investigated the psychological and health-related outcome after out-of-hospital cardiac arrest (OHCA) over time. This longitudinal study aims to evaluate psychological distress in terms of anxiety and depression, self-assessed health and predictors of these outcomes in survivors of OHCA, 3 and 12 months after resuscitation.

Methods

Recruitment took place from 2008 to 2011 and survivors of OHCA were identified through the national Swedish Cardiopulmonary Resuscitation Registry. Inclusion criteria were age ≥18 years, survival ≥12 months and a Cerebral Performance Category score ≤2. Questionnaires containing the Hospital Anxiety and Depression Scale and European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) were administered at 3 and 12 months after the OHCA. Participants were also asked to report treatment-requiring comorbidities.

Results

Of 298 survivors, 85 (29%) were eligible for this study and 74 (25%) responded. Clinically relevant anxiety was reported by 22 survivors at 3 months and by 17 at 12 months, while clinical depression was reported by 10 at 3 months and 4 at 12 months. The mean EQ-5D-3L index value increased from 0.82 (±0.26) to 0.88 (±0.15) over time. There were significantly less symptoms of psychological distress (p=0.01) and better self-assessed health (p=0.003) at 12 months. Treatment-requiring comorbidity predicted anxiety (OR 4.07, p=0.04), while being female and young age predicted poor health (OR 6.33, p=0.04; OR 0.91, p=0.002) at 3 months. At 12 months, being female was linked to anxiety (OR 9.23, p=0.01) and depression (OR 14.78, p=0.002), while young age predicted poor health (OR 0.93, p=0.003).

Conclusion

The level of psychological distress and self-assessed health improves among survivors of OHCA between 3 and 12 months after resuscitation. Higher levels of psychological distress can be expected among female survivors and those with comorbidity, while survivors of young age and who are female are at greater risk of poor health.
Trends in inequality in life expectancy at birth between 2004 and 2017 and projections for 2030 in Korea: multiyear cross-sectional differences by income from national health insurance data
Authors: Khang Young-Ho , Bahk Jinwook , Lim Dohee , Kang Hee-Yeon , Lim Hwa-Kyung , Kim Yeon-Yong , Park Jong Heon
Published: July 2019

Objectives

The current status, time trends and future projections of a national health equity target are crucial elements of national health equity surveillance. This study examined time trends in inequality by income in life expectancy (LE) at birth between 2004 and 2017 and made future projections for the year 2030 in Korea.

Design

Using individually linked mortality data, time trends in inequality by income in LE at birth were examined. The LE projection was made with the Lee-Carter model.

Setting

Total Korean population and death data derived from the National Health Information Database of the National Health Insurance Service.

Participants

A total of 685 773 157 subjects and 3 486 893 deaths between 2004 and 2017 were analysed.

Primary and secondary outcome measures

Annual LE and the magnitude of inequality by income in LE between 2004 and 2030.

Results

Inequality by income in LE among the total Korean population increased during the past 14 years, and this inequality is projected to become even greater in the future. In 2030, the magnitude of inequality by income in LE is projected to increase by 0.25 years in comparison to the magnitude in 2017. The increase in LE inequality was projected to be more prominent among women, with a projected 1.08 year increase in LE inequality between 2017 and 2030.

Conclusion

Aggressive policies should be developed to close the increasing LE gap in Korea. LE inequalities by income should be considered as a measurable target for health equity in the process of establishing the National Health Plan 2030 in Korea.
Population health bio-phenotypes in 11–12 year old children and their midlife parents: Growing Up in Australia’s Child Health CheckPoint
Authors: Wake Melissa , Clifford Susan A
Published: July 2019

In an ambitious undertaking, Growing Up in Australia’s Child Health CheckPoint streamlined and implemented wide-ranging population phenotypes and biosamples relevant to non-communicable diseases in nearly 1900 parent–child dyads throughout Australia at child aged 11–12 years. This BMJ Open Special Issue describes the methodology, epidemiology and parent–child concordance of 14 of these phenotypes, spanning cardiovascular, respiratory, bone, kidney, hearing and language, body composition, metabolic profiles, telomere length, sleep, physical activity, snack choice and health-related quality of life. The Special Issue also includes a cohort summary and study methodology paper.