bluuebunny/crossref_metadata_2025 huggingface dataset:
Cubic and quadratic distortion products in vibrations of the mouse cochlear apex
Authors: Dewey James B.
Published: November 2022

When the ear is stimulated by two tones presented at frequencies f1 and f2, nonlinearity in the cochlea's vibratory response leads to the generation of distortion products (DPs), with the cubic 2f1–f2 DP commonly viewed as the most prominent. While the quadratic f2–f1 DP is also evident in numerous physiological and perceptual studies, its presence in the cochlea's mechanical response has been less well documented. Here, examination of vibratory DPs within the mouse cochlea confirmed that f2–f1 was a significant and sometimes dominant component, whether DPs were measured near their generation site, or after having propagated from more basal locations.
Non-affine motion and selection of slip coefficient in constitutive modeling of polymeric solutions using a mixed derivative
Authors: Nieto Simavilla D. , Español P. , Ellero M.
Published: November 2022

Constitutive models for the dynamics of polymer solutions traditionally rely on closure relations for the extra stress or related microstructural variables (e.g., conformation tensor) linking them to flow history. In this work, we study the eigendynamics of the conformation tensor within the GENERIC framework in mesoscopic computer simulations of polymer solutions to separate the effects of nonaffine motion from other sources of non-Newtonian behavior. We observe that nonaffine motion or slip increases with both the polymer concentration and the polymer chain length. Our analysis allows to uniquely calibrate a mixed derivative of the Gordon–Schowalter type in macroscopic models based on a micro-macromapping of the dynamics of the polymeric system. The presented approach paves the way for better polymer constitutive modeling in multiscale simulations of polymer solutions, where different sources of non-Newtonian behavior are modelled independently.
Effect of Match Schedule Density on Self-Reported Wellness and Sleep in Referees During the Rugby World Cup
Authors: Elsworthy Nathan , Lastella Michele , Scanlan Aaron T. , Blair Matthew R.
Published: November 2022

Purpose: To examine the effect of match schedule on self-reported wellness and sleep in rugby union referees during the 2019 Rugby World Cup. Methods: Following an observational design, 18 international-level male referees participating in the 2019 Rugby World Cup completed a daily questionnaire to quantify wellness status (sleep quality, mood, stress, fatigue, muscle soreness, and total wellness) and sleep characteristics (bedtime, wake-up time, and time in bed) from the previous night across the tournament. Linear mixed models and effect sizes (Hedges gav) assessed differences in wellness and sleep characteristics between prematch and postmatch days surrounding single-game and 2-game congested match schedules (prematch1, postmatch1, prematch2, and postmatch2 days). Results: During regular schedules, all self-reported wellness variables except stress were reduced (gav = 0.33–1.05, mean difference −0.32 to −1.21 arbitrary units [AU]) and referees went to bed later (1.08, 1:07 h:min) and spent less time in bed (−0.78, 00:55 h:min) postmatch compared with prematch days. During congested schedules, only wellness variables differed across days, with total wellness reduced on postmatch1 (−0.88, −3.56 AU) and postmatch2 (−0.67, −2.70 AU) days, as well as mood (−1.01, −0.56 AU) and fatigue (−0.90, −1.11 AU) reduced on postmatch1 days compared with prematch days. Conclusion: Referees were susceptible to acute reductions in wellness on days following matches regardless of schedule. However, only single-game regular match schedules negatively impacted the sleep characteristics of referees. Targeted strategies to maximize wellness status and sleep opportunities in referees considering the match schedule faced should be explored during future Rugby World Cup competitions.
Oxidative Reactions Catalyzed by Hydrogen Peroxide Produced by Streptococcus pneumoniae and Other Streptococci Cause the Release and Degradation of Heme from Hemoglobin
Authors: Alibayov Babek , Scasny Anna , Khan Faidad , Creel Aidan , Smith Perriann , Vidal Ana G. Jop , Fitisemanu Fa’alataitaua M. , Padilla-Benavides Teresita , Weiser Jeffrey N. , Vidal Jorge E.
Published: November 2022

Streptococcus pneumoniae(Spn) strains cause pneumonia that kills millions every year worldwide. Spn produces Ply, a hemolysin that lyses erythrocytes releasing hemoglobin, and also produces the pro-oxidant hydrogen peroxide (Spn-H2O2) during growth.
Microbial and Immune Regulation of the Gut-Lung Axis during Viral-Bacterial Coinfection
Authors: Lane Sidney , Hilliam Yasmin , Bomberger Jennifer M.
Published: November 2022

Viral-bacterial coinfections of the respiratory tract have long been associated with worsened disease outcomes. Clinical and basic research studies demonstrate that these infections are driven via complex interactions between the infecting pathogens, microbiome, and host immune response, although how these interactions contribute to disease progression is still not fully understood. Research over the last decade shows that the gut has a significant role in mediating respiratory outcomes, in a phenomenon known as the “gut-lung axis.” Emerging literature demonstrates that acute respiratory viruses can modulate the gut-lung axis, suggesting that dysregulation of gut-lung cross talk may be a contributing factor during respiratory coinfection. This review will summarize the current literature regarding modulation of the gut-lung axis during acute respiratory infection, with a focus on the role of the microbiome, secondary infections, and the host immune response.
Performance Characteristics of Six Immunoglobulin M Enzyme-Linked Immunosorbent Assays Used for Laboratory Confirmation of Measles
Authors: Sowers Sun B. , Anthony Kiana , Mercader Sara , Colley Heather , Crooke Stephen N. , Rota Paul A. , Latner Donald R. , Hickman Carole J.
Published: November 2022

Laboratory confirmation of infection is an essential component of measles surveillance. Detection of measles-specific IgM in serum by enzyme-linked immunosorbent assay (ELISA) is the most common method used to confirm measles infection.
Clinical Performance and Trends during the First Two Months of Monkeypox Virus PCR Testing at Two United States Reference Labs
Authors: Lieberman Nicole A. P. , Mathias Patrick C. , Bradley Benjamin T. , Greninger Alexander L.
Published: November 2022

Recently, a sustained human-to-human outbreak of monkeypox virus (MPXV), a member of the
Orthopoxvirus
genus, which includes the etiologic agent of smallpox, has been documented in multiple nonendemic countries, including the United States. Prior to June 2022, testing in the United States was limited to public health labs and the Centers for Disease Control and Prevention.
Primer Design for Reverse Transcription-Quantitative PCR Simulation: an Online Lab Exercise Using a SARS-CoV-2 Model
Authors: Mwakalundwa Gwantwa , Bush Tripp Susan , Dvorak Cheryl , Foster-Hartnett Dawn
Published: November 2022

Since the start of the 2019 coronavirus disease (COVID-19) pandemic, many microbiology lab activities have been conducted online. We produced a simple PCR primer design and virtual PCR activity for introductory students to use as part of an online laboratory course or as an independent activity in a traditional laboratory setting.
Extension of
O
-Linked Mannosylation in the Golgi Apparatus Is Critical for Cell Wall Integrity Signaling and Interaction with Host Cells in Cryptococcus neoformans Pathogenesis
Authors: Thak Eun Jung , Son Ye Ji , Lee Dong-Jik , Kim Hyunah , Kim Jung Ho , Lee Su-Bin , Jang Yu-Byeong , Bahn Yong-Sun , Nichols Connie B. , Alspaugh J. Andrew , Kang Hyun Ah
Published: November 2022

Cryptococcus neoformans
assembles two types of
O
-linked glycans on its surface proteins, the more abundant major
O
-glycans that do not contain xylose residues and minor
O
-glycans containing xylose. Here, we demonstrate the role of the Cap6 α1,3-mannosyltransferase in the synthesis of minor
O
-glycans.
Mycobacteriophage Tarkin: a Cluster E Phage
Authors: Cleary Katherine E. , Fakhri Anna M. , Dionne Ethan N. , Warner Marcie , DeGiorgis Joseph A. , Cornely Kathleen
Published: November 2022

Mycobacteriophage Tarkin is a newly isolated phage that infects
Mycobacterium smegmatis
mc
2
155. Tarkin was discovered in Providence, RI, and has a 75,998-bp genome sequence. Tarkin is predicted to have 142 protein coding genes and 2 tRNA genes. Based on gene content similarity, Tarkin is grouped with mycobacteriophages in cluster E.
The Zinc Finger Transcription Factor Fts2 Represses the Yeast-to-Filament Transition in the Dimorphic Yeast Yarrowia lipolytica
Authors: Chen Jia-Wen , Mao Yi-Sheng , Yan Lv-Qiao , Gao Xiang-Dong
Published: November 2022

The repressors of filamentation are important negative regulators of the yeast-to-filament transition. However, except in
Candida albicans
, very few repressors of filamentation are known in dimorphic fungi.
Metagenomic Next-Generation Sequencing for the Diagnosis of Neonatal Infectious Diseases
Authors: Chen Lu , Zhao Yujuan , Wei Jiakai , Huang Wendi , Ma Ying , Yang Xuefeng , Liu Yang , Wang Jing , Xia Han , Lou Zheng
Published: November 2022

To the best of our knowledge, this is the first report on evaluating the performance of mNGS using cfDNA and RNA from body fluid and blood samples for diagnosing neonatal infections. mNGS of RNA and cfDNA can achieve the unbiased detection and identification of trace pathogens from different kinds of neonatal body fluid and blood samples with a high total coincidence rate (226/331; 68.3%) against final clinical diagnoses by sample. The best timing for mNGS detection in neonatal infections ranged from 1 to 3 days, rather than 0 days, after the start of continuous antimicrobial therapy.
Tracing the First Days of the SARS-CoV-2 Pandemic in Greece and the Role of the First Imported Group of Travelers
Authors: Bousali Maria , Pogka Vasiliki , Vatsellas Giannis , Loupis Theodoros , Athanasiadis Emmanouil I. , Zoi Katerina , Thanos Dimitris , Paraskevis Dimitrios , Mentis Andreas , Karamitros Timokratis
Published: November 2022

The strain that dominated in Greece during the first pandemic wave was primarily imported from a group of returning travelers in February 2020, while molecular and clinical data suggest that the origin of the transmission was Egypt. The observed molecular transmission clusters reflect the transmission dynamics of this particular strain bearing the D614G mutation while highlighting the necessity of their use as a surveillance tool for the prioritization of nonpharmaceutical interventions and combating present and future outbreaks.
Quantifying Trade-Offs in the Choice of Ribosomal Barcoding Markers for Fungal Amplicon Sequencing: a Case Study on the Grapevine Trunk Mycobiome
Authors: Monod Vinciane , Hofstetter Valérie , Zufferey Vivian , Viret Olivier , Gindro Katia , Croll Daniel
Published: November 2022

Surveying fungal communities is key to our understanding of ecological functions of diverse habitats. Fungal communities can inform about the resilience of agricultural ecosystems, risks to human health, and impacts of pathogens.
SARS-CoV-2 Anti-Spike IgG Antibody and ACE2 Receptor Binding Inhibition Levels among Breakthrough Stage Veteran Patients
Authors: Chensue Stephen W. , Siler Andrew F. , Kim Paul S. , Dimcheff Derek E. , Daghfal David J. , Prostko John , Frias Edwin , Linder Kathleen A. , Schildhouse Richard J.
Published: November 2022

Currently, clinicians have no guidance for the serologic assessment of SARS-Cov-2 postvaccination status regarding protection and risk of infection. Vaccination and boosters are administered blindly without evaluation of need or outcome at the individual level.
Transcriptome and Gut Microbiota Profiling Analysis of ANIT-Induced Cholestasis and the Effects of Da-Huang-Xiao-Shi Decoction Intervention
Authors: Wang Wang , Jiang Shujun , Xu Chengcheng , Tang Lili , Liang Yan , Zhao Yang , Zhu Guoxue
Published: November 2022

Cholestasis is a serious manifestation of liver diseases resulting in liver injury, fibrosis, and liver failure with limited therapies. To date, only ursodeoxycholic acid (UDCA) has been approved by the U.S.
Long-Term Protection Elicited by an Inactivated Vaccine Supplemented with a Water-Based Adjuvant against Infectious Hematopoietic Necrosis Virus in Rainbow Trout (Oncorhynchus mykiss)
Authors: Lin Yujie , Ren Guangming , Zhao Jingzhuang , Shao Yizhi , He Baoquan , Tang Xin , Sha Ou , Zhao Wenwen , Liu Qi , Xu Liming , Lu Tongyan
Published: November 2022

Infectious hematopoietic necrosis virus (IHNV) is one of the most serious pathogens threatening the global salmon and trout industry. However, there is currently only one commercialized infectious hematopoietic necrosis (IHN) vaccine, and it is inadequate for solving the global IHN problem.
Plurihormonal pituitary adenoma cosecreting ACTH and GH: a rare cause of Cushing’s disease
Authors: Amir Jumana , Guiot Marie Christine , Garfield Natasha
Published: November 2022

Plurihormonal pituitary adenomas are rare forms of pituitary adenomas that express more than one hormone. The most common association is with growth hormone (GH) and prolactin. Cosecretion of GH and adrenocorticotrophic hormone (ACTH) is rare with only 25 reported cases in literature. Most presented with features of GH excess, and only four presented with Cushing’s disease. We report a case of a woman in her 30s with recurrent plurihormonal pituitary macroadenoma cosecreting GH and ACTH, diagnosed during workup for polycystic ovarian syndrome, and both times presenting uniquely with Cushing’s disease. Biochemical testing showed GH excess and hypercortisolism. She underwent transsphenoidal surgery twice and immunohistochemistry showed positive staining for GH and ACTH on both occasions. We aim to raise more awareness of this rare type of pituitary adenoma, shed light on the importance of recognising rare presentations and highlight the necessity of rigorous follow-up given morbidity and potentially higher mortality risk.
Measurement of clinical delay intervals among younger adults with colorectal cancer using health administrative data: a population-based analysis
Authors: Castelo Matthew , Paszat Lawrence , Hansen Bettina E , Scheer Adena S , Faught Neil , Nguyen Lena , Baxter Nancy N
Published: November 2022

Background

Clinical delays may be important contributors to outcomes among younger adults (<50 years) with colorectal cancer (CRC). We aimed to describe delay intervals for younger adults with CRC using health administrative data to understand drivers of delay in this population.

Methods

This was a population-based study of adults <50 diagnosed with CRC in Ontario, Canada from 2003 to 2018. Using administrative code-based algorithms (including billing codes), we identified four time points along the pathway to treatment—first presentation with a CRC-related symptom, first investigation, diagnosis date and treatment start. Intervals between these time points were calculated. Multivariable quantile regression was performed to explore associations between patient and disease factors with the median length of each interval.

Results

6853 patients aged 15–49 were diagnosed with CRC and met the inclusion criteria. Males comprised 52% of the cohort, the median age was 45 years (IQR 40–47), and 25% had stage IV disease. The median time from presentation to treatment start (overall interval) was 109 days (IQR 55–218). Time between presentation and first investigation was short (median 5 days), as was time between diagnosis and treatment start (median 23 days). The greatest component of delay occurred between first investigation and diagnosis (median 78 days). Women, patients with distal tumours, and patients with earlier stage disease had significantly longer overall intervals.

Conclusions

Some younger CRC patients experience prolonged times from presentation to treatment, and time between first investigation to diagnosis was an important contributor. Access to endoscopy may be a target for intervention.
Examining the evidence on complementary and alternative therapies to treat peripartum depression in pregnant or postpartum women: study protocol for an umbrella review of systematic reviews and meta-analyses
Authors: Dubreucq Julien , Kamperman Astrid M , Al-Maach Nadia , Bramer Wichor M , Pacheco Francisca , Ganho-Avila Ana , Lambregtse-van den Berg Mijke
Published: November 2022

Introduction

Complementary and alternative therapies (CATs) refer to a diverse range of approaches that can be used as add-on or an alternative to conventional therapies. While a number of individual studies and systematic reviews (SRs) or meta-analyses (MAs) have investigated the effectiveness of specific types of CATs to treat depressive symptoms at specific moments of the perinatal period, an overarching synthesis of the literature is currently lacking. We will conduct an umbrella review of SRs and MAs to assess to which extent CATs are associated with depressive symptoms reduction during pregnancy or after childbirth.

Methods and analysis

We will search a broad set of electronic databases (MEDLINE via Ovid, Embase.com, CINAHL via EBSCOhost, PsycINFO via Ovid, AMED and Google Scholar). We will include SRs with or without MAs meeting the following criteria: (1) the review should focus mostly on individual studies reporting a randomised controlled design; (2) diagnosis should be made during pregnancy or during the post partum using a clinical interview according to DSM or ICD criteria; (3) the reviewed intervention should start during pregnancy or in the first postpartum year and meet the criteria for being considered as CAT. The main outcome will be depressive symptoms reduction during pregnancy or after childbirth. Secondary outcomes will include the remission of depression according to DSM criteria and intervention acceptability. Overlap between reviews will be described, quantified and discussed. We will rate the quality of the included SRs or MAs using the AMSTAR-2 tool. MAs will be performed by using the data from the individual RCT studies included in the SRs or MAs. Sensitivity analyses restricted to studies with a low-moderate risk of bias will be realised. Publication bias will be examined visually by using a funnel plot, and formally using the Egger’s test and test of excess significance.

Ethics and dissemination

We intend to publish the results of the umbrella review in an international peer-reviewed journal. Oral presentations in congresses and internal diffusion through the Rise up-PPD European COST Action network are also planned.

PROSPERO registration number

CRD42021229260.
Comorbidity of mental ill-health in tuberculosis patients under treatment in a rural province of South Africa: a cross-sectional survey
Authors: Thungana Yanga , Wilkinson Robert , Zingela Zukiswa
Published: November 2022

Objectives

Tuberculosis (TB) remains prevalent despite the availability of effective anti-TB medications, and accumulating evidence suggests a high rate of mental disorders in people with TB. This is because TB and psychiatric disorders share several risk factors, such as poverty, homelessness and substance use disorder. Moreover, psychiatric comorbidities in patients with TB are associated with poor treatment outcomes. This study explored the psychiatric comorbidity and clinical correlates in individuals receiving TB treatment.

Design

A cross-sectional survey over 10 months.

Setting

Two primary care clinics at King Sabata Dalindyebo district, Mthatha, Eastern Cape, South Africa.

Participant

Patients receiving TB treatment in the two clinics.

Intervention

The Mini-International Neuropsychiatric Interview was used to screen for psychiatric disorders.

Primary and secondary outcome measures

Rates of mental disorders in patients with TB over a 10-month period. Variation in rates by sex, employment status and HIV comorbidity.

Results

In a sample of 197 participants, most patients were men (62%) and screened positive for a mental disorder (82%) with anxiety (48%), depression (38%) and substance use disorders (43%) being the most common psychiatric conditions. On average, individuals had 4 (SD 2) mental disorders. Females had higher rates of depression (p=0.005) and non-adherence to TB treatment (p=0.003), and alcohol use disorder was more common in males (p<0.001) and in those non-adherent to TB treatment. Additionally, low education levels and unemployment were associated with depressive and anxiety disorders (p<0.05).

Conclusions

Mental disorders are common in patients with TB, and mental health services need to be integrated into the management of patients with TB. Factors linked to mental disorders in this cohort, such as low education, gender and unemployment, may be useful for compiling a risk profile to help identify those with TB who may require more intensive support for their mental health.
Time intervals and distances travelled for prehospital ambulance stroke care: data from the randomised-controlled ambulance-based Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)
Authors: Dixon Mark , Appleton Jason P , Scutt Polly , Woodhouse Lisa J , Haywood Lee J , Havard Diane , Williams Julia , Siriwardena Aloysius Niroshan , Bath Philip M
Published: November 2022

Objectives

Ambulances offer the first opportunity to evaluate hyperacute stroke treatments. In this study, we investigated the conduct of a hyperacute stroke study in the ambulance-based setting with a particular focus on timings and logistics of trial delivery.

Design

Multicentre prospective, single-blind, parallel group randomised controlled trial.

Setting

Eight National Health Service ambulance services in England and Wales; 54 acute stroke centres.

Participants

Paramedics enrolled 1149 patients assessed as likely to have a stroke, with Face, Arm, Speech and Time score (2 or 3), within 4 hours of symptom onset and systolic blood pressure >120 mm Hg.

Interventions

Paramedics administered randomly assigned active transdermal glyceryl trinitrate or sham.

Primary and secondary outcomes

Modified Rankin scale at day 90. This paper focuses on response time intervals, distances travelled and baseline characteristics of patients, compared between ambulance services.

Results

Paramedics enrolled 1149 patients between September 2015 and May 2018. Final diagnosis: intracerebral haemorrhage 13%, ischaemic stroke 52%, transient ischaemic attack 9% and mimic 26%. Timings (min) were (median (25–75 centile)): onset to emergency call 19 (5–64); onset to randomisation 71 (45–116); total time at scene 33 (26–46); depart scene to hospital 15 (10–23); randomisation to hospital 24 (16–34) and onset to hospital 97 (71–141). Ambulances travelled (km) 10 (4–19) from scene to hospital. Timings and distances differed between ambulance service, for example, onset to randomisation (fastest 53 min, slowest 77 min; p<0.001), distance from scene to hospital (least 4 km, most 20 km; p<0.001).

Conclusion

We completed a large prehospital stroke trial involving a simple-to-administer intervention across multiple ambulance services. The time from onset to randomisation and modest distances travelled support the applicability of future large-scale paramedic-delivered ambulance-based stroke trials in urban and rural locations.

Trial registration number

ISRCTN26986053.
Characterising performance information use in the primary healthcare systems of El Salvador, Lebanon and Malawi: multiple qualitative case study protocol
Authors: Munar Wolfgang , Wahid Syed Shabab , Makwero Martha , El-Jardali Fadi , Dullie Luckson , Yang Wen-Chien
Published: November 2022

Introduction

Governments in low-income and middle-income countries (LMICs) and official development assistance agencies use a variety of performance measurement and management approaches to improve the performance of healthcare systems. The effectiveness of such approaches is contingent on the extent to which managers and care providers use performance information. To date, major knowledge gaps exist about the contextual factors that contribute, or not, to performance information use by primary healthcare (PHC) decision-makers in LMICs. This study will address three research questions: (1) How do decision-makers use performance information, and for what purposes? (2) What are the contextual factors that influence the use or non-use of performance information? and (3) What are the proximal outcomes reported by PHC decision-makers from performance information use?

Methods and analysis

We present the protocol of a theory-driven, qualitative study with a multiple case study design to be conducted in El Salvador, Lebanon and Malawi.Data sources include semi structured in-depth interviews and document review. Interviews will be conducted with approximately 60 respondents including PHC system decision-makers and providers. We follow an interdisciplinary theoretical framework that draws on health policy and systems research, public administration, organisational science and health service research. Data will be analysed using thematic analysis to explore how respondents use performance information or not, and for what purposes as well as barriers and facilitators of use.

Ethics and dissemination

The ethical boards of the participating universities approved the protocol presented here. Study results will be disseminated through peer-reviewed journals and global health conferences.
Incidence and risk factors of diabetes mellitus in the Chinese population: a dynamic cohort study
Authors: Xue Long , Wang Huiying , He YunZhen , Sui Mengyun , Li Hongzheng , Mei Lin , Ying Xiaohua
Published: November 2022

Objective

Diabetes mellitus is a common condition often associated with an ageing population. However, only few longitudinal studies in China have investigated the incidence of diabetes and identified its risk factors. Therefore, this study aimed to investigate the incidence and risk factors of diabetes in Chinese people aged ≥45 years using the harmonised China Health and Retirement Longitudinal Study (CHARLS) data.

Design

A dynamic cohort study.

Setting

The harmonised CHARLS 2011–2018.

Participants

19 988 adults aged ≥45 years.

Primary outcome measure

Incident diabetes from 2011 to 2018.

Results

The harmonised CHARLS is a representative longitudinal survey of people aged ≥45 years. Using data extracted from the harmonised CHARLS, we calculated the incidence of diabetes and used a competing risk model to determine risk factors of diabetes. In 2011–2013, 2013–2015, 2015–2018, the crude incidence of diabetes among middle-aged and older people in China was 1403.21 (1227.09 to 1604.19), 1673.22 (1485.73 to 1883.92) and 3919.83 (3646.01 to 4213.30) per 100 000 person‐years, respectively, with a significant increasing trend. There were no geographical variations in the incidence of diabetes. Age, obesity and alcohol consumption were associated with an increased risk of incident diabetes.

Conclusion

The incidence of diabetes increased annually, without any geographical differences. Age, obesity and alcohol consumption were found to be risk factors for incident diabetes.
Prevalence of completion of maternity continuum of care and its associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Mose Ayenew , Haile Kassahun , Timerga Abebe
Published: November 2022

Objective

The present study aimed to estimate the pooled prevalence of completion of the maternity continuum of care (CoC) and its associated factors in Ethiopia.

Study design

Systematic review and meta-analysis.

Study setting

Ethiopia.

Study participants

A total of 6245 reproductive-age women were included.

Primary outcome

The pooled prevalence of completion of the maternity CoC.

Secondary outcome

Factors associated with completion of the maternity CoC.

Methods

We systematically searched international databases such as PubMed, Scopus, African Journals Online, Google Scholar and Web of Sciences to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used for this study. Publication bias was assessed using the funnel plot and Egger’s test. Evidence of heterogeneity was checked using Cochrane Q test and I2statistics. Subgroup analysis was computed based on the study regions. Data were analysed using STATA V.14 statistical software. Weighted inverse variance random effect models were used to estimate the pooled prevalence of completion of the maternity CoC.

Results

The pooled prevalence of completion of maternity continuum care in Ethiopia was 25.82% (95% CI: 16.69% to 34.94%). Urban residence(adjusted odds ratio (AOR)=2.77, 95% CI: 1.99 to 3.86), having secondary and above educational status (AOR=3.50, 95% CI: 2.50 to 50), prepregnancy contraceptive utilisation (AOR=3.25, 95% CI: 2.02 to 5.22), women’s autonomy (AOR=3.81, 95% CI: 2.74 to 5.31), following mass media (AOR=2.51, 95% CI: 1.79 to 3.50), early initiation of antenatal care (ANC) (AOR=4.98, 95% CI: 3.28 to 7.57), planned pregnancy (AOR=2.93, 95% CI: 1.99 to 4.32), birth preparedness and complication readiness (AOR=1.80, 95% CI: 1.29 to 2.51) and distance from a health facility<30 min (AOR=3.29, 95% CI: 2.45 to 4.42) were factors associated with completion of maternity continuum care in Ethiopia.

Conclusion

The pooled prevalence of completion of maternity continuum care in Ethiopia was low. Therefore, policymakers and stakeholders should improve the completion of ANC, the rate of skilled birth attendants and postnatal follow-up. Enhancing the accessibility of health facilities, women’s awareness and empowering women’s decision-making are recommended.

PROSPERO registration number

CRD42022312692.
BREAst Cancer Personalised NuTrition (BREACPNT): dietary intervention in breast cancer survivors treated with endocrine therapy – a protocol for a randomised clinical trial
Authors: Rein Michal Sela , Dadiani Maya , Godneva Anastasia , Bakalenik-Gavry Michal , Morzaev-Sulzbach Dana , Vachnish Yaeli , Kolobkov Dmitry , Lotan-Pompan maya , Weinberger Adina , Segal Eran , Gal-Yam Einav Nili
Published: November 2022

Introduction

Breast cancer survivors treated with adjuvant endocrine therapy commonly experience weight gain, which has been associated with low adherence to therapy and worse breast cancer prognosis. We aim to assess whether a personalised postprandial glucose targeting diet will be beneficial for weight management as compared with the recommended Mediterranean diet in this patient population

Methods and analysis

The BREAst Cancer Personalised NuTrition study is a phase-2 randomised trial in hormone receptor positive patients with breast cancer, treated with adjuvant endocrine therapy. The study objective is to assess whether dietary intervention intended to improve postprandial glycaemic response to meals results in better weight and glycaemic control in this population as compared with the standard recommended Mediterranean diet. Consenting participants will be assigned in a single blinded fashion to either of two dietary arms (Mediterranean diet or an algorithm-based personalised diet). They will be asked to provide a stool sample for microbiome analysis and will undergo continuous glucose monitoring for 2 weeks, at the initiation and termination of the intervention period. Microbiome composition data will be used to tailor personal dietary recommendations. After randomisation and provision of dietary recommendations, participants will be asked to continuously log their diet and lifestyle activities on a designated smartphone application during the 6-month intervention period, during which they will be monthly monitored by a certified dietitian. Participants’ clinical records will be followed twice yearly for 5 years for treatment adherence, disease-free survival and recurrence.

Ethics and dissemination

The study has been approved by the ethics committee in the Sheba medical centre (file 5725-18-SMC, Ramat Gan, Israel) and the Weizmann Institutional Review Board (file 693-2, Rehovot, Israel). The findings of this study will be published in a peer reviewed publication.

Trial registration number

NCT04079270.
Diabetes incidence in subjects with PREDIABetes from ReUNion Island: the PREDIABRUN observational cohort study protocol
Authors: Anthony Norah , Bruneau Léa , Leruste Sebastien , Franco Jean-Marc , Domercq Alain , Kowalczyk Christine , Nobecourt Estelle , Marimoutou C
Published: November 2022

Introduction

Improved knowledge of prediabetic subjects’ profile and their risk of developing type 2 diabetes mellitus (T2DM) would enhance secondary prevention. The primary objective is to describe factors associated with incident T2DM in subjects with pre-diabetes diagnosed in primary care.

Methods and analysis

The study is based on Reunion Island, a French overseas region that experiences a particularly high disease burden of T2DM. This is an observational, non-randomised prospective cohort study conducted in primary care in which private general practitioner (GP) investigators recruit participants with pre-diabetes from their practices regardless of the initial motive for consultation. Pre-diabetes is defined by WHO criteria, that is, fasting plasma glucose between 1.10 g/L and 1.25 g/L and/or plasma glucose 2 hours after ingestion of 75 g of glucose (2-hour post load plasma glucose) between 1.40 g/L and 1.99 g/L. The design is based on an annual follow-up by the GP (according to French National Health Authority recommendations) with collection of clinical and laboratory data and specific lifestyle questionnaires answered by telephone at three time points: inclusion, and at 2-year and 5-year follow-up visits. Follow-up clinical and laboratory data are collected by the investigating GP as part of the study, and study-specific laboratory collections (serum, DNA and urine) will be obtained 2 and 5 years after inclusion. The primary outcome is transition to T2DM.

Ethics and dissemination

This protocol has been approved by the research ethics committee of Saint Etienne (CPP Saint Etienne reference number: 2019–03). Enrolment began in August 2019. Results will be disseminated in at least three papers published in peer-reviewed medical journals, one oral communication and a large-scale communication to the local population and healthcare policymakers.

Trial registration number

NCT04463160and ID-RCB 2018-A03106-49.
Race and resource allocation: an online survey of US and UK adults’ attitudes toward COVID-19 ventilator and vaccine distribution
Authors: Kappes Andreas , Zohny Hazem , Savulescu Julian , Singh Ilina , Sinnott-Armstrong Walter , Wilkinson Dominic
Published: November 2022

Objective

This study aimed to assess US/UK adults’ attitudes towards COVID-19 ventilator and vaccine allocation.

Design

Online survey including US and UK adults, sampled to be representative for sex, age, race, household income and employment. A total of 2580 participated (women=1289, age range=18 to 85 years, Black American=114, BAME=138).

Interventions

Participants were asked to allocate ventilators or vaccines in scenarios involving individuals or groups with different medical risk and additional risk factors.

Results

Participant race did not impact vaccine or ventilator allocation decisions in the USA, but did impact ventilator allocation attitudes in the UK (F(4,602)=6.95, p<0.001). When a racial minority or white patient had identical chances of survival, 14.8% allocated a ventilator to the minority patient (UK BAME participants: 24.4%) and 68.9% chose to toss a coin. When the racial minority patient had a 10% lower chance of survival, 12.4% participants allocated them the ventilator (UK BAME participants: 22.1%). For patients with identical risk of severe COVID-19, 43.6% allocated a vaccine to a minority patient, 7.2% chose a white patient and 49.2% chose a coin toss. When the racial minority patient had a 10% lower risk of severe COVID-19, 23.7% participants allocated the vaccine to the minority patient. Similar results were seen for obesity or male sex as additional risk factors. In both countries, responses on the Modern Racism Scale were strongly associated with attitudes toward race-based ventilator and vaccine allocations (p<0.0001).

Conclusions

Although living in countries with high racial inequality during a pandemic, most US and UK adults in our survey allocated ventilators and vaccines preferentially to those with the highest chance of survival or highest chance of severe illness. Race of recipient led to vaccine prioritisation in cases where risk of illness was similar.
Targeting the reduction of inflammatory risk associated with cardiovascular disease by treating periodontitis either alone or in combination with a systemic anti-inflammatory agent: protocol for a pilot, parallel group, randomised controlled trial
Authors: King Shalinie , Church Lauren , Garde Siddharth , Chow Clara K , Akhter Rahena , Eberhard Joerg
Published: November 2022

Introduction

Cardiovascular disease (CVD) is associated with systemic inflammation. Colchicine, an anti-inflammatory drug, reduces the incidence of CVD events. Periodontitis, a chronic localised inflammatory disease of the tissues supporting the teeth, triggers systemic inflammation and contributes to inflammatory risk. Treatment for periodontitis reduces markers of inflammation, however, there is no evidence on whether an anti-inflammatory medication in combination with periodontal treatment can reduce the inflammatory risk. The aim of this trial is to investigate the effect of periodontal treatment either alone or in combination with an anti-inflammatory agent on inflammation in patients with periodontitis and CVD at 8 weeks.

Methods and analysis

60 participants with moderate-to-severe periodontitis, coronary artery disease and an increased inflammatory risk (>2 mg/L high sensitivity C reactive protein (hsCRP) levels) will be recruited from a tertiary referral hospital in Australia in a parallel design, single blind, randomised controlled trial. Baseline hsCRP levels, lipid profile and periodontal assessment will be completed for each participant before they are randomised in a 1:1:1:1 ratio to one of 4 arms as follows: (group A) periodontal treatment and colchicine; (group B) periodontal treatment only; (group C) colchicine only or (group D) control/delayed periodontal treatment. Periodontal treatment will be provided over three treatment visits, 0.5 mg of colchicine will be provided as a daily tablet. Participants will be followed up at 8 weeks to measure primary and secondary outcomes and complete a follow-up questionnaire. The primary outcome is the difference in hsCRP levels, the secondary outcomes are differences in lipid levels and periodontal parameters and the feasibility measures of recruitment conversion rate, completion rate and the safety and tolerability of the trial.

Ethics and dissemination

The study has been approved by the Western Sydney Local Health District Human Ethics Committee (protocol number 2019/ETH00200). Results will be published in peer-reviewed journals and presented at conferences.

Trial registration number

ACTRN12619001573145.
Effectiveness of community-based multidisciplinary integrated care for older people: a protocol for a systematic review
Authors: Hayes Christina , Manning Molly , Condon Brian , Griffin Anne Christina , FitzGerald Christine , Shanahan Elaine , O'Connor Margaret , Glynn Liam , Robinson Katie , Galvin Rose
Published: November 2022

Introduction

The increasing number of older adults with multiple complex care needs has placed increased pressure on healthcare systems internationally to reorientate healthcare delivery. For many older adults, their first point of contact with the health service is with their general practitioner (GP) and GP participation with integrated care models is the foundation of a population-based approach. A knowledge gap remains in relation to the effectiveness of GP participation in community-based integrated health and social care approaches for older adults. This systematic review aims to examine the effectiveness of multidisciplinary-integrated care for community-dwelling older adults with GP participation.

Methods and analysis

This systematic review will include randomised controlled trials (RCTs), quasi and cluster RCTs focusing on integrated care interventions for community-dwelling older adults by multidisciplinary teams including health and social care professionals and GPs. The databases PUBMED, EMBASE, CINAHL, Central Register of Controlled Trials in the Cochrane Library and MEDLINE will be searched. The primary outcome measure will be functional status. Secondary outcomes will include: primary healthcare utilisation, secondary healthcare utilisation, participant satisfaction with care, health-related quality of life, nursing home admission and mortality. The methodological quality of the studies will be assessed using the Cochrane Risk of Bias Tool V.2. The elements of care integration will be mapped in the individual studies using the Rainbow Model of Integrated Care taxonomy. A meta-analysis will be completed, depending on the uniformity of the data. Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the certainty of evidence.

Ethics and dissemination

Formal ethical approval is not required as all data included are anonymous secondary data. Scientific outputs will be presented at relevant conferences and in collaboration with our public and patient involvement stakeholder panel of older adults at the Ageing Research Centre at the University of Limerick.

PROSPERO registration number

CRD42022309744.
Persistent symptoms after SARS-CoV-2 infection in children: a cross-sectional population-based serological study
Authors: Dumont Roxane , Nehme Mayssam , Lorthe Elsa , De Mestral Carlos , Richard Viviane , Baysson Helene , Pennacchio Francesco , Lamour Julien , Semaani Claire , Zaballa María-Eugenia , Pullen Nick , Perrin Anne , L'Huillier Arnaud G , Posfay-Barbe Klara Maria , Guessous Idris , Stringhini Silvia
Published: November 2022

Objectives

To estimate the prevalence of children and adolescents reporting persistent symptoms after SARS-CoV-2 infection.

Design

A random sample of children and adolescents participated with their family members to a serological survey including a blood drawing for detecting antibodies targeting the SARS-CoV-2 nucleocapsid (N) protein and a questionnaire on COVID-19-related symptoms experienced since the beginning of the pandemic.

Setting

The study took place in the canton of Geneva, Switzerland, between June and July 2021.

Participant

660 children aged between 2 and 17 years old.

Primary and secondary outcome

The primary outcome was the persistence of symptoms beyond 4 weeks comparing seropositive and seronegative participants. The type of declared symptoms were also studied as well as associated risk factors.

Results

Among seropositive children, the sex-adjusted and age-adjusted prevalence of symptoms lasting longer than 2 weeks was 18.3%, compared with 11.1% among seronegatives (adjusted prevalence difference (ΔaPrev)=7.2%, 95% CI: 1.5% to 13.0%). Among adolescents aged 12–17 years, we estimated the prevalence of experiencing symptoms lasting over 4 weeks to be 4.4% (ΔaPrev,95% CI: −3.8% to 13.6%), whereas no seropositive child aged 2–11 reported symptoms of this duration. The most frequently declared symptoms were fatigue, headache and loss of smell.

Conclusions

We estimated the prevalence of experiencing persistent symptoms lasting over 4 weeks to be around 4% among adolescents, which represents a large absolute number, and should raise awareness and concern. We did not observe meaningful differences of persistent symptoms between seropositive and seronegative younger children, suggesting that they may be less affected than their older counterparts.
Economic evaluation of encorafenib with cetuximab in patients with BRAF V600E-mutant metastatic colorectal cancer in France: a cost-effectiveness analysis using data from the BEACON CRC randomised controlled trial
Authors: Trouiller Jean-Baptiste , Macabeo Bérengère , Poll Andrew , Howard Dan , Buckland Andy , Sivignon Marine , Clay Emilie , Malka David , Samalin Emmanuelle , Toumi Mondher , Laramée Philippe
Published: November 2022

Objective

The BEACON CRC randomised controlled trial (NCT02928224) in BRAF-mutant metastatic colorectal cancer (mCRC) patients showed improved overall survival for the combination treatment of encorafenib (BRAF inhibitor) with cetuximab (EGFR inhibitor) compared with cetuximab with chemotherapy (FOLFIRI (folinic acid, fluorouracil and irinotecan) or irinotecan). We aimed to evaluate the cost-effectiveness of encorafenib with cetuximab in adult patients with BRAF-mutant mCRC after prior systemic therapy, from the perspective of the French healthcare system.

Design

A partitioned survival analysis model was developed to assess the cost-effectiveness of encorafenib with cetuximab using data from BEACON CRC (encorafenib with cetuximab and cetuximab with FOLFIRI or irinotecan). For two further comparator treatments (FOLFIRI alone and bevacizumab with FOLFIRI), a systemic literature review identified appropriate clinical trial data for indirect comparison. Piecewise modelling extrapolation was used to fulfil a lifetime horizon in the model. A discount rate of 2.5% was used. Treatment-emergent adverse events ≥grade 3 with an incidence of ≥2% were included, as well as relative dose intensity and utility values.

Outcome measures

The effectiveness outcomes of the model were expressed in terms of incremental life years gained and incremental quality-adjusted life years (QALY) gained. The cost-effectiveness of encorafenib with cetuximab was assessed using the incremental cost-effectiveness ratio (ICER). Results were presented probabilistically to account for parametric uncertainty. Deterministic and scenario analyses were conducted.

Results

The ICER for encorafenib with cetuximab versus cetuximab with FOLFIRI or irinotecan, FOLFIRI alone and bevacizumab with FOLFIRI was €69 823/QALY, €70 421/QALY and €72 336/QALY, respectively. Encorafenib with cetuximab was considered cost-effective compared with the three comparators at a willingness to pay threshold of €90 000/QALY, with probabilities of being cost-effective of 89.8%, 98.2% and 86.4%, respectively.

Conclusions

This analysis showed encorafenib with cetuximab to be a cost-effective treatment in mCRC patients with a BRAF V600E mutation.