bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and safety of secukinumab in axial spondyloarthritis: a 24-month prospective, multicenter real-life study
Authors: Ramonda Roberta , Lorenzin Mariagrazia , Sole Chimenti Maria , D’Angelo Salvatore , Marchesoni Antonio , Salvarani Carlo , Lubrano Ennio , Costa Luisa , Dal Bosco Ylenia , Fracassi Elena , Ortolan Augusta , Ferraioli Mario , Carriero Antonio , Visalli Elisa , Bixio Riccardo , Desiati Francesca , Bergamini Alberto , Pedrollo Elisa , Doria Andrea , Foti Rosario , Carletto Antonio
Published: April 2022

Objectives:

To evaluate, in a multicentric Italian cohort of axial spondyloarthritis (axSpA) patients on Secukinumab (SEC) followed for 24 months: (1) the long-term effectiveness and safety of SEC; (2) the drug retention rate and low disease activity (LDA) measured as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) < 4/Ankylosing Spondylitis Disease Activity Score (ASDAS) < 2.1 and very low disease activity (VLDA) measured as BASDAI < 2/ASDAS < 1.3; (3) any differences in outcomes according to line of biological treatment (naïve/non-naïve), gender (male/female), subtype of axSpA [radiographic axSpA (r-axSpA)/non-radiographic axSpA (nr-axSpA)].

Methods:

Consecutive axSpA patients treated with SEC were evaluated prospectively. Disease characteristics, previous/ongoing treatments, comorbidities, and follow-up duration were collected. Disease activity/functional/clinimetric scores and biochemical-values were recorded at baseline (T0), 6 (T6), 12 (T12), and 24 (T24) months. Effectiveness was evaluated over-time with descriptive statistics; multivariate Cox and logistic regression models were used to evaluate predictors of drug discontinuation and LDA at T6. Infections and adverse events were recorded.

Results:

A total 249 patients (47.8% male; median age 51) were enrolled; 40.9% had HLA-B27; 53.8% had r-axSpA, and 46.2% nr-axSpA. SEC was prescribed in 28.9% naïve and in 71.1% non-naïve patients. SEC effectiveness was shown as an improvement in several outcomes, such as ASDAS [T0 = 3.5 (2.9–4.4) versus T24 = 1.9 (1.2–2.4); p = 0.02] and BASDAI [T0 = 6.5 (5.0–7.5) versus T24 = 2.8 (1.8–4.0); p = 0.03]. At T24, naïve patients showed better physical functioning and lower disease activity than non-naïve. After 24 months of treatment, 90.7% of naïve and 75.3% of non-naïve patients achieved LDA (BASDAI < 4). Treatment was discontinued in 24.5% patients, mainly due to primary/secondary loss of effectiveness, and in 6.8% due to adverse events. Retention rate at T24 was 75% in the whole population, with some difference depending on gender ( p = 0.002).

Conclusion:

In a real-life clinical setting, SEC proved to be safe and effective in axSpA, mainly in naïve-patients, with a notable drug retention rate. No differences were observed between r-axSpA and nr-axSpA.
Secularization Trends Obscure Developmental Changes in Religiosity
Authors: Bleidorn Wiebke , Lenhausen Madeline R. , Schwaba Ted , Gebauer Jochen E. , Hopwood Christopher J.
Published: April 2022

How do people’s religious beliefs and behaviors change over the course of adulthood? Previous research found rapid decreases in religiosity during young adulthood and rebounds in middle and late adulthood. However, secularization trends—if not accounted for—can bias or obscure age-graded changes in religiosity. Using longitudinal data from over 14,000 Dutch participants aged 16 to 101 years, we disentangled secularization trends from developmental changes in religiosity. Controlling for secularization, we found no evidence for age-graded declines in religiosity among young adults but lifelong increases in religiosity. These increases were most pronounced during middle to late adulthood, consistent with theories that emphasize the self-transcendent focus of this life stage. College-educated individuals were generally less religious and experienced less pronounced age-graded increases in their religious beliefs. These findings must be understood in the context of secularization trends as indicated by significant decreases in religiosity among people of all demographic groups.
Mortality, healthcare resource utilization, and cost among Medicare beneficiaries with Clostridioides difficile infection with and without sepsis
Authors: Amin Alpesh , Nelson Winnie W. , Dreyfus Jill , Wong Anny C. , Mohammadi Iman , Teigland Christie , Dahdal David N. , Feuerstadt Paul
Published: April 2022

Objective:

To describe mortality, healthcare resource utilization (HRU), and costs among Medicare beneficiaries with primary Clostridioides difficile infection (pCDI) or recurrent CDI (rCDI), with and without sepsis.

Methods:

We conducted a retrospective observational study of 100% Medicare Fee-for-Service claims from adults aged ⩾ 65 years with ⩾1 CDI episode between 1 January 2009 and 31 December 2017. Patients were continuously enrolled in Medicare Parts A/B/D 12 months before and up to 12 months after pCDI. ICD-9/10 codes defined CDI using ⩾1 inpatient claim, or ⩾1 outpatient claim plus ⩾1 claim for CDI treatment. The pCDI episode ended after 14 days without a CDI claim. rCDI episodes started within 8 weeks from the end of a previous CDI episode. ICD-9/10 codes identified all-cause sepsis over 12 month follow-up.

Results:

Of 497,489 CDI patients, 41.0% ( N = 203,888) had sepsis; 57.7% with sepsis died versus 32.4% without sepsis. Among patients with pCDI only ( N = 345,893) or ⩾1 rCDI ( N = 151,596), 39.2% and 45.1% suffered sepsis, respectively. All-cause hospitalizations were frequent for all cohorts (range: 81–99%). Among patients who died, those with sepsis versus without had more-frequent intensive care unit (ICU) use (pCDI: 29% versus 15%; rCDI: 65% versus 34%), longer hospital stays (pCDI: 12 versus 10 days; rCDI: 12 versus 9 days), and higher per-patient-per-month costs (pCDI: $34,841 versus $22,753; rCDI: $42,269 versus $25,047). In both cohorts, sepsis patients who survived had higher total costs and all-cause HRU than those without sepsis. All p < 0.001 above.

Conclusions:

Sepsis was common among Medicare beneficiaries with CDI. CDI patients with sepsis, especially after an rCDI, experienced higher mortality, HRU, and costs compared with those without sepsis.
The Shifting Morals of Moral Entrepreneurs
Authors: Flores-Yeffal Nadia Y. , Sparger Kade
Published: April 2022

By utilizing manipulative tactics, such as persuasion techniques and strategies through social media sites, moral entrepreneurs can maintain and/or increase their scope of influence. In this article, we propose another tactic utilized by moral entrepreneurs, a concept we refer to as shifting morals. The complexity of moral entrepreneurs’ life experiences provides them with an endless set of social and moral norms that they can use to tweak their own ideals to encompass other moral framing networks to gain more followers and thus increase their influence. We examine theoretical literature, while also providing examples that resulted from content analysis from media websites to illustrate our proposed concept of shifting morals. We conclude that the shifting morals tactic is another tool moral entrepreneurs use to increase their influence in society to enact social change.
A Systematic Review of the Chinese-English Translation of Public Signs
Authors: Amenador Kate Benedicta , Wang Zhiwei
Published: April 2022

To understand the current status of Chinese-English public sign translation research in China, we analyzed 137 published studies in the past 15 years and found that public sign translation research in China has developed progressively from the nascent stage in 2005 to its climax in 2014 and then began to decline to date. Public signs translation research has attracted the attention of many scholars, and fruitful results have been achieved in terms of research content, which covers the definition, features, functions, translation errors, translation principles, strategies, and the theories applied to C-E public signs translation. However, there are still many deficiencies in related research, such as the repetition of research content, the limited scope of investigation, and the lack of a clear distinction between what constitutes a feature and a translation principle of public signs. The study suggests that future research content on public sign translation should be in-depth and more diversified. Also, more public sign translation experts should be trained to improve their translation quality, and the related supervisory body should intensify their supervision. Future researchers should extend their investigations to include other public signs in thematic areas such as menus, museums, folk gardens, culture-specific items, and theory development as studies in these areas are limited. It is hoped that the research findings will offer insight into the problems and gaps in related research and help facilitate the development of relevant language policies, translation theories, and methods for the translation and study of public signs.
Improving the Transition to College for Twice-Exceptional Students with ASD: Perspectives From College Service Providers
Authors: Madaus Joseph , Cascio Alexandra , Delgado Julie , Gelbar Nicholas , Reis Sally , Tarconish Emily
Published: April 2022

Increasing numbers of academically talented students with autism spectrum disorder (ASD) are accessing higher education. This is an underserved and understudied cohort of students, as their talents can mask their autism, or their autism can mask their talents. We conducted interviews with 11 professionals who support academically talented students with ASD at 10 very competitive 4-year institutions in the United States. Findings highlighted the significant academic and personal strengths that these students bring to college, factors that can be incorporated into secondary transition planning for twice exceptional ASD students. Suggestions about important concepts that both families and secondary transition personnel should understand regarding the differences between high school and college are also provided. Implications for secondary transition planning are discussed.
Adults’ Memory for a Maltreatment-Related Childhood Experience: Interview Protocols
Authors: Goldfarb Deborah , Goodman Gail S. , Wang Yan , Fisher Ronald P. , Vidales Daisy , Gonzalves Lauren C. , Wu Yuerui , Hartman Dana , Qin Jianjian , Eisen Mitchell L.
Published: April 2022

Adults’ claims of decades-old child maltreatment raise questions about how to obtain accurate memories about childhood events. In this study, adults who experienced a documented child maltreatment medical examination when they were 3 to 16 years old (Time 1) were interviewed 2 decades later (Time 2). The adults ( N = 115) were randomly assigned to one of three interview-protocol conditions: a standard forensic interview, the cognitive interview (CI) with mental reinstatement, or the CI with mental- and physical-context reinstatement. The CI increased accuracy by dampening reports of potentially schematic but nonexperienced information. Younger age at Time 1 was associated with memories that were less complete but not more inaccurate. A greater number of Time 2 posttraumatic-stress-disorder symptoms predicted both correct and incorrect (omissions and commissions, respectively) answers to specific questions and incorrect answers to misleading questions; commission errors were associated with Time 1 physical-abuse status. Theoretical implications and clinical and legal applications are discussed.
Mentorship in Undergraduate Biomedical Education: Identifying Student Opinions and Expectations
Authors: Wright Bradley C. , Schadler Aric D. , Swanson Hollie I.
Published: April 2022

Objective

To evaluate undergraduate biomedical education student opinions and expectations on mentorship.

Methods

A survey was administered to students enrolled in the undergraduate biology, neuroscience and nursing programs at a large public research-intensive university. The survey queried demographics, previous mentorship experiences, ideal qualities of mentors, benefits/value of mentorship and future plans for seeking mentorship. Survey responses were evaluated using either t-test comparisons or one-way ANOVA.

Results

The majority of the respondents were female and were interested in pursuing professional schools (nursing and medicine). Survey results indicate high student interest in receiving mentoring, but few were active participants in a mentoring relationship. Respondents indicated either lack of knowledge or discomfort in identifying a mentor. While faculty mentors versus peer mentors were preferred, respondents indicated that mentoring by either faculty or peers would be of value. Survey results indicate that desired benefits of mentoring included guidance in future education and career decisions, networking and career advice.

Conclusion

The major conclusions are that despite high student interest in being mentored, their participation in mentoring is very low. These finding are supportive of the development of structured mentoring programs to facilitate and enhance mentoring of undergraduate STEM students and aid in their academic career progression.
Applying Kern's Six Steps to the Development of a Community-Engaged, Just-in-Time, Interdisciplinary COVID-19 Curriculum
Authors: Scala Jack J. , Braun Nathaniel J. , Shamardani Kiarash , Rashes Emma R. , Wang William , Mediratta Rishi P.
Published: April 2022

Universities and medical schools often work towards operationalizing their shared mission of facilitating community-engaged work independently. Based on their experience teaching the COVID-19 Elective course at Stanford University School of Medicine, the authors proposed a novel solution for universities and medical schools to achieve an interdisciplinary collaboration within a diverse student population by creating targeted, project-based, and community-engaged courses for addressing emergent health needs. In this article, the authors discuss their curriculum, which was created using Kern's six-step approach for curriculum development, to address emergent health needs related to the novel coronavirus pandemic. The curriculum provides an opportunity for universities and medical schools to advance community health, educate students across the medical and non-medical education continuum, and foster interdisciplinary cooperation.
One-year healthcare costs of patients with spontaneous intracerebral hemorrhage treated in the intensive care unit
Authors: Smeds Marika , Skrifvars Markus B , Reinikainen Matti , Bendel Stepani , Hoppu Sanna , Laitio Ruut , Ala-Kokko Tero , Curtze Sami , Sibolt Gerli , Martinez-Majander Nicolas , Raj Rahul
Published: April 2022

Background:

Spontaneous intracerebral hemorrhage (ICH) entails significant mortality and morbidity. Severely ill ICH patients are treated in intensive care units (ICUs), but data on 1-year healthcare costs and patient care cost-effectiveness are lacking.

Methods:

Retrospective multi-center study of 959 adult patients treated for spontaneous ICH from 2003 to 2013. The primary outcomes were 12-month mortality or permanent disability, defined as being granted a permanent disability allowance or pension by the Social Insurance Institution by 2016. Total healthcare costs were hospital, rehabilitation, and social security costs within 12 months. A multivariable linear regression of log transformed cost data, adjusting for case mix, was used to assess independent factors associated with costs.

Results:

Twelve-month mortality was 45% and 51% of the survivors were disabled at the end of follow-up. The mean 12-month total cost was €49,754, of which rehabilitation, tertiary hospital and social security costs accounted for 45%, 39%, and 16%, respectively. The highest effective cost per independent survivor (ECPIS) was noted among patients aged >70 years with brainstem ICHs, low Glasgow Coma Scale (GCS) scores, larger hematoma volumes, intraventricular hemorrhages, and ICH scores of 3. In multivariable analysis, age, GCS score, and severity of illness were associated independently with 1-year healthcare costs.

Conclusions:

Costs associated with ICHs vary between patient groups, and the ECPIS appears highest among patients older than 70 years and those with brainstem ICHs and higher ICH scores. One-third of financial resources were used for patients with favorable outcomes. Further detailed cost-analysis studies for patients with an ICH are required.
An Unusual Case of Ruptured Sinus of Valsalva Misdiagnosed as Acute Coronary Syndrome
Authors: Shetty Rajesh Mohan , Kumar Rajendra Santhosh , Hossain Motahar
Published: April 2022

Background:

Ruptured sinus of Valsalva aneurysm (RSOVA) is rare and can mimic many other diseases. It may be misdiagnosed on initial evaluation. Uncorrected almost invariably, it has a rapid downhill course. We present a case which was initially misdiagnosed as acute coronary syndrome (ACS).

Case Summary:

A 49-year-old lady presented to a local hospital with history of chest pain. She was diagnosed with ACS based on history and electrocardiogram findings and treated conservatively. She deteriorated and developed multiorgan failure. She was transferred to our center for further management. On re-evaluation, transthoracic echocardiography showed RSOVA. She was treated with transcatheter device closure. She recovered well and was discharged in stable condition.

Discussion:

This case highlights the diagnostic difficulty when patients present with features of other common diseases. Right heart failure evaluation in the setting of appropriate clinical features should prompt consideration of RSOVA as a differential diagnosis. RSOVA if managed appropriately can lead to complete recovery.
Intervening on the storage time of RBC units and its effects on adverse recipient outcomes using real-world data
Authors: Bruun-Rasmussen Peter , Kragh Andersen Per , Banasik Karina , Brunak Søren , Johansson Pär Ingemar
Published: April 2022

Randomized controlled trials (RCTs) have found no evidence that the storage time of transfused red blood cell (RBC) units affects recipient survival. However, inherent difficulties in conducting RBC transfusion RCTs have prompted critique of their design, analyses, and interpretation. Here, we address these issues by emulating hypothetical randomized trials using large real-world data to further clarify the adverse effects of storage time. We estimated the comparative effect of transfusing exclusively older vs fresher RBC units on the primary outcome of death, and the secondary composite end point of thromboembolic events, or death, using inverse probability weighting. Thresholds were defined as 1, 2, 3, and 4 weeks of storage. A large Danish blood transfusion database from the period 2008 to 2018 comprising >900 000 transfusion events defined the observational data. A total of 89 799 patients receiving >340 000 RBC transfusions during 28 days of follow-up met the eligibility criteria. Treatment with RBC units exclusively fresher than 1, 2, 3, and 4 weeks of storage was found to decrease the 28-day recipient mortality with 2.44 percentage points (pp) (0.86 pp, 4.02 pp), 1.93 pp (0.85 pp, 3.02 pp), 1.06 pp (–0.20 pp, 2.33 pp), and −0.26 pp (–1.78 pp, 1.25 pp) compared with transfusing exclusively older RBC units, respectively. The 28-day risk differences for the composite end point were similar. This study suggests that transfusing exclusively older RBC units stored for >1 or 2 weeks increases the 28-day recipient mortality and risk of thromboembolism or death compared with transfusing fresher RBC units.
Early initiation of tolvaptan is associated with early discharge in patients with heart failure regardless of age
Authors: Kiuchi Shunsuke , Hisatake Shinji , Kabuki Takayuki , Oka Takashi , Dobashi Shintaro , Murakami Yoshiki , Sano Takahide , Ikeda Takanori
Published: April 2022

Background

Elderly patients with heart failure (HF) have been observed to decrease activities of daily living (ADL) during hospitalization. Prevention of ADL decline from shortening of hospital stays is especially important in the elderly, because decreasing ADL is associated with poor prognosis. We investigated the relationship between the early initiation of tolvaptan (TLV) after hospitalization and the length of hospital stay in patients with HF aged younger than 80 years and aged 80 years and older.

Methods

We analyzed 146 patients younger than 80 years (< 80) and 101 patients aged 80 years and older (≥ 80) who were hospitalized with HF from February 2011 to June 2016 and had initiated TLV. The relationship between the time until commencement of TLV and the length of hospital stay was assessed. Additionally, a comparison made between the TLV early start group (within the median) and the delayed start group (over the median) for both groups. Multivariate analysis was also performed on factors that required hospital stays below the median.

Results

A significant correlation was observed between time to TLV initiation and the length of hospital stay (< 80: r = 0.382, P < 0.001; ≥ 80: r = 0.395, P < 0.001). The length of hospital stay in the early group was significantly longer than that in the delayed group for both groups (< 80: early 21.0 ± 13.0 days and 33.0 ± 22.7 days, respectively, P < 0.001; ≥ 80: early 21.3 ± 12.5 days and 32.9 ± 17.9 days, respectively, P < 0.001). Conversely, no statistically significant difference found in the length of hospital stay after initiation of TLV. Moreover, no increase in adverse events in the elderly observed. A multivariate analysis revealed that a predictive factor for short-term hospitalization was early administration of TLV regardless of age.

Conclusions

The early initiation of TLV after hospitalization was associated with a shorter length of hospital stay in patients with HF regardless of age.
Effects of aerobic exercise on quality of life of people with HIV-associated neurocognitive disorder on antiretroviral therapy: a randomised controlled trial
Authors: Nweke Martins , Mshunqane Nombeko , Govender Nalini , Akinpelu Aderonke O. , Ogunniyi Adesola
Published: April 2022

Background

HIV-associated neurocognitive disorder (HAND) negatively impacts quality of life (QoL) of people living with HIV who are on antiretroviral therapy (ART). Behavioural intervention adjunct to ART may improve QoL of people with HAND. We determine the effect of a 12-week aerobic exercise programme on QoL in people with HAND who were receiving ART.

Trial design

This was a parallel-group, randomised controlled trial with concealed allocation and intention-to-treat analysis.

Methods

We identified 73 participants diagnosed with HAND. Participants were sampled from an earlier study that examined the prevalence of HAND according to the Frascati criteria. Participants were randomised and allocated to an intervention of 12-weeks of aerobic exercise, comprising three 20–60 min sessions per week of moderate-intensity aerobic exercise using a cycle ergometer. The primary outcome was QoL, which was evaluated using the World Health Quality of Life Questionnaire (WHOQoL)-BREF.

Results

Participants in the exercise (n = 39) and control (n = 35) groups had similar sociodemographic characteristics (p > 0.05). Following the 12-week aerobic exercise programme, participants in the exercise group had improved physical (p < 0.001), psychological (p = 0.008) and environmental (p = 0.001) domains of the QoL (p = 0.001) and overall QoL (p = 0.001) relative to the control group. Similarly, participants in the exercise group had lower depression scores than participants in the control group. Depression scores in the exercise group were still lower 3 months post-intervention (p = 0.007). Only the improvements in physical (p = 0.02) and psychological (p = 0.007) domains of QoL were sustained at 3 months post-intervention.

Conclusions

Aerobic exercise improves the QoL of people with HAND. To ensure sustained benefits, people with HAND may need to engage in long-term physical exercise.

Trial registration The trial is registered with the PAN African Trial Registry (PACTR). Date: 01/09/2020, ID: PACTR202009483415745
Tracking of health-related physical fitness in adolescent girls: a 3-year follow-up study
Authors: Kasović Mario , Oreški Ana , Vespalec Tomaš , Jenčíková Kateřina , Štefan Lovro
Published: April 2022

Background

Evidence has shown that higher levels of physical fitness (PF) in youth have beneficial effects on adult health-related outcomes. However, the tracking of separate PF components during adolescence has been less studied. Since PF often starts to rapidly decline during adolescence, it is necessary to provide information regarding critical time-point for interventions. This study aimed to analyze the extent of tracking the components of PF through PF tests.

Methods

In this longitudinal study, we recruited 240 adolescent girls with recoded data at 2 time-points (15 y and 17 y). PF included body composition (fat mass), explosive power of lower extremities (standing broad jump), muscle endurance of the trunk (sit-ups in 60 s), flexibility (sit-and-reach test), muscle endurance of lower extremities (squats in 60 s), aerobic endurance (the 800 m run test) and speed endurance (the 400 m run test). Tracking coefficients were calculated using generalized estimating equations. Tertiles (high, moderate and low) were calculated for each fitness component.

Results

The highest tracking coefficients between the two time-points were found for explosive power of lower extremities (β = 0.98), followed by flexibility (β = 0.89), body composition (β = 0.88), speed endurance (β = 0.86), aerobic endurance (β = 0.75), muscle endurance of lower extremities (β = 0.65), and muscle endurance of the trunk (β = 0.51). Tertile ratings remained stable across the two time-points.

Conclusions

Moderate to high tracking of PF in adolescent girls suggests that interventions aiming to increase the level of PF should probably begin in early adolescence.
Development of a social distancing monitoring system in Republic of Korea: results of a modified Delphi process
Authors: Seo Suin , Han Jin-Ok , Shin Sool , Lee Heeyoung
Published: April 2022

Background

Social distancing policies work in different ways and at different levels. In addition, various forms of monitoring systems have been implemented in different countries. However, there is an almost complete lack of specific monitoring system in Republic of Korea to effectively monitor social distancing measures compliance and outcome. This study aims to develop a monitoring system for social distancing measures compliance and outcome in Korea to evaluate and improve the implemented policy.

Methods

A draft monitoring system was developed after reviewing Korea’s social distancing measures (central and local government briefings) and checking available data about social distancing behavior. The modified Delphi process was used to evaluate the draft of the social distancing monitoring system. In total, 27 experts participated in the evaluation. The round 1 evaluation includes (1) commenting on the composition of the monitoring fields (open response), (2) monitoring indicators for each monitoring field (10-point Likert scale), and (3) commenting on the source of data used to develop the monitoring system (open response). In the round 2 evaluation, 55 indicators, excepting open responses, were re-evaluated.

Results

The response rate for the Delphi survey was 100% in both the first and second rounds. Of the 55 indicators, 1 indicator, which did not satisfy the quantitative criteria, was excluded. According to the experts’ open response comments, 15 indicators were excluded, as these indicators overlapped with other indicators or had little relevance to social distancing. Instead, 23 new indicators were added. Finally, 62 indicators were included with 12 available data sources. The monitoring system domain was divided into ‘social distancing measures state, social distancing measures compliance, social distancing outcome’.

Conclusions

This study is significant in that it is the first in Korea to develop a comprehensive monitoring system for checking if social distancing measures are being followed well, and is applicable to estimates utilizing data that are immediately available for each indicator. Furthermore, the developed monitoring system could be a reference for other countries that require the development of such systems to monitor social distancing.
Airway inflammatory profile among cleaning workers from different workplaces
Authors: da Paz Edinéia Rosa , de Lima Cynthia Mafra Fonseca , Felix Soraia Nogueira , Schaeffer Bruna , Galvão Clóvis Eduardo Santos , Correia Aristides Tadeu , Righetti Renato Fraga , de Arruda Martins Milton , de Fátima Lopes Calvo Tibério Iolanda , Saraiva-Romanholo Beatriz Mangueira
Published: April 2022

Background

Cleaning workers represent a significant proportion of the active population worldwide, with poor remuneration, particularly in developing countries. Despite this, they remain a relatively poorly studied occupational group. They are constantly exposed to agents that can cause symptoms and respiratory problems. This study aimed to evaluate upper airway inflammation in professional cleaning workers in three different occupational settings by comparing nasal cytology inflammation and clinical profiles.

Methods

We performed a cross-sectional study on the prevalence of upper airway inflammation and symptoms of asthma/rhinitis related to cleaning work, according to workplace. A total of 167 participants were divided into four groups: hospital, university, housekeeper and control. A nasal swab was collected for upper airway inflammation evaluation. Clinical profiles and respiratory symptom employee evaluations were performed using specific questionnaires (European Community Respiratory Health Survey—ECRS and the International Study of Asthma and Allergies in Childhood—ISAAC).

Results

Cleaning workers showed increased neutrophils and lymphocytes; the hospital and university groups showed increased macrophages compared to the housekeeper and control groups. The hospital and housekeeper groups showed increased eosinophils when they performed cleaning services for up to one year and reported having more asthma symptoms than the control group. Cleaning workers showed increased rhinitis symptoms. The university group showed increased rhinitis symptoms aggravated by the workplace compared with the hospital and housekeeper groups. Cleaning workers showed an increased affirmative response when directly asked about rhinitis symptoms compared to the control group.

Conclusions

Cleaning workers showed airway inflammation, asthma symptoms and rhinitis, regardless of the occupational environment to which they were exposed, as well as showed increased rhinitis and asthma symptoms. Hospital cleaning workers showed increased macrophages, lymphocytes and eosinophils compared to the others. The length of time spent performing cleaning work was not related to nasal inflammation or respiratory symptoms in this population. However, there were differences in workplaces. Registered on ClinicalTrials.gov. Trial registration number: NCT03311048. Registration date: 10.16.2017. Retrospectively registered.
Interstitial lung abnormalities and interstitial lung diseases associated with cigarette smoking in a rural cohort undergoing surgical resection
Authors: Sangani Rahul G. , Deepak Vishal , Ghio Andrew J. , Forte Michael J. , Zulfikar Rafia , Patel Zalak , King Austin , Alshaikhnassir Esra , Abbas Ghulam , Vos Jeffrey
Published: April 2022

Background

Cigarette smoking is a risk factor for interstitial lung abnormalities (ILAs) and interstitial lung diseases (ILDs). Investigation defining the relationships between ILAs/ILDs and clinical, radiographic, and pathologic findings in smokers have been incomplete. Employing a cohort undergoing surgical resection for lung nodules/masses, we (1) define the prevalence of ILAs/ILDs, (2) delineate their clinical, radiographic and pathologic predictors, and (3) determine their associations with mortality.

Methods

Patients undergoing resection of lung nodules/masses between 2017 and 2020 at a rural Appalachian, tertiary medical center were retrospectively investigated. Predictors for ILAs/ILDs and mortality were assessed using multivariate logistic regression analysis.

Results

In the total study cohort of 352 patients, radiographic ILAs and ILDs were observed in 35.2% and 17.6%, respectively. Among ILA patterns, subpleural reticular changes (14.8%), non-emphysematous cysts, centrilobular (CL) ground glass opacities (GGOs) (8% each), and mixed CL-GGO and subpleural reticular changes (7.4%) were common. ILD patterns included combined pulmonary fibrosis emphysema (CPFE) (3.1%), respiratory bronchiolitis (RB)-ILD (3.1%), organizing pneumonitis (2.8%) and unclassifiable (4.8%). The group with radiographic ILAs/ILDs had a significantly higher proportion of ever smokers (49% vs. 39.9%), pack years of smoking (44.57 ± 36.21 vs. 34.96 ± 26.22), clinical comorbidities of COPD (35% vs. 26.5%) and mildly reduced diffusion capacity (% predicated 66.29 ± 20.55 vs. 71.84 ± 23). Radiographic centrilobular and paraseptal emphysema (40% vs. 22.2% and 17.6% vs. 9.6%, respectively) and isolated traction bronchiectasis (10.2% vs. 4.2%) were associated with ILAs/ILDs. Pathological variables of emphysema (34.9% vs. 18.5%), any fibrosis (15.9% vs. 4.6%), peribronchiolar metaplasia (PBM, 8% vs. 1.1%), RB (10.3% vs. 2.5%), and anthracosis (21.6% vs. 14.5%) were associated with ILAs/ILDs. Histologic emphysema showed positive correlations with any fibrosis, RB, anthracosis and ≥ 30 pack year of smoking. The group with ILAs/ILDs had significantly higher mortality (9.1% vs. 2.2%, OR 4.13, [95% CI of 1.84–9.25]).

Conclusions

In a rural cohort undergoing surgical resection, radiographic subclinical ILAs/ILDs patterns were highly prevalent and associated with ever smoking and intensity of smoking. The presence of radiographic ILA/ILD patterns and isolated honeycomb changes were associated with increased mortality. Subclinical ILAs/ILDs and histologic fibrosis correlated with clinical COPD as well as radiographic and pathologic emphysema emphasizing the co-existence of these pulmonary injuries in a heavily smoking population.
Safe provision of systemic anti-cancer treatment for urological cancer patients during COVID-19: a tertiary centre experience in the first wave of COVID-19
Authors: So Alfred Chung Pui , Karampera Christina , Khan Muhammad , Russell Beth , Moss Charlotte , Monroy-Iglesias Maria J. , Thillai Kiruthikah , Josephs Debra Hannah , Pintus Elias , Rudman Sarah , Van Hemelrijck Mieke , Dolly Saoirse , Enting Deborah
Published: April 2022

Background

Safe provision of systemic anti-cancer treatment (SACT) during the COVID-19 pandemic remains an ongoing concern amongst clinicians.

Methods

Retrospective analysis on uro-oncology patients who continued or started SACT between 1st March and 31st May 2020 during the pandemic (with 2019 as a comparator).

Results

441 patients received SACT in 2020 (292 prostate, 101 renal, 38 urothelial, 10 testicular) compared to 518 patients in 2019 (340 prostate, 121 renal, 42 urothelial, 15 testicular). In 2020, there were 75.00% fewer patients with stage 3 cancers receiving SACT (p < 0.0001) and 94.44% fewer patients receiving radical treatment (p = 0.00194). The number of patients started on a new line of SACT was similar between both years (118 in 2019 vs 102 in 2020;p = 0.898) but with 53.45% fewer patients started on chemotherapy in 2020 (p < 0.001). Overall, 5 patients tested positive for COVID-19 (one asymptomatic, one mild, two moderate, one severe resulting in death). Compared to 2019, 30-day mortality was similar (1.69% in 2019 vs 0.98% in 2020;p = 0.649) whereas 6-month mortality was lower (9.32% in 2019 vs 1.96% in 2020;p = 0.0209) in 2020.

Conclusion

This study suggests that delivery of SACT to uro-oncology patients during COVID-19 pandemic may be safe in high-incidence areas with appropriate risk-reduction strategies.
Impact of Cotadutide drug on patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Ali Mahmoud M. , Hafez Ahmed , Abdelgalil Mahmoud Shaban , Hasan Mohammed Tarek , El-Ghannam Mohammed Magdy , Ghogar Osama M. , Elrashedy Asmaa Ahmed , Abd-ElGawad Mohamed
Published: April 2022

Background

The food and drug administration approved many drugs to treat diabetes mellitus, but those drugs do not have a noticeable effect on weight management. Recently, glucagon-like peptide 1 agonist known as Cotadutide serve as a potent drug in treating type 2 diabetes by reducing blood glucose levels and body weight indices. This study aimed to explore the safety and efficacy of Cotadutide as a treatment for type 2 diabetes individuals.

Methods

A comprehensive literature search was done on different databases, including PubMed, Scopus, Web of Science, and Cochrane Library to capture all relevant articles using an established search strategy. The inclusion criteria were randomized controlled trials that assessed the safety and efficacy of Cotadutide versus placebo or any anti-diabetes drugs in patients with type 2 diabetes mellitus and a BMI between 22 kg/m2 and 40 kg/m2. We conducted the analysis using Revman software version 5.4.

Results

We found 663 relevant articles. From which nine studies were included and subjected to qualitative analysis and eight for quantitative analysis. The pooled effect showed that Cotadutide was better than placebo in reducing body weight (kg) (Mean difference (MD) = 3.31, p < 0.00001), glycated hemoglobin (HbA1c) (MD = 0.68, p > 0.00001), glucose area under the plasma concentration curve (AUC [0-4 h]) (MD = 30.15, p < 0.00001), and fasting plasma glucose over time (mg/dl) (MD = 31.31, p < 0.00001).

Conclusion

Cotadutide is safe and effective in reducing plasma glucose levels, HbA1c and body weight in individuals with type 2 diabetes.

Trial registration

The study protocol was registered on PROSPERO (CRD: CRD42021257670).
Do changes in income and social networks influence self-rated oral health trajectories among civil servants in Brazil? Evidence from the longitudinal Pró-Saúde study
Authors: Vettore Mario Vianna , Abreu Mauro Henrique Nogueira Guimarães , da Rocha Mendes Suellen , Faerstein Eduardo
Published: April 2022

Background

Social factors are important determinants of health. However, evidence from longitudinal studies on the possible role of changes in socioeconomic circumstances on adult’s oral health is scarce. This study aimed to test whether changes in income and changes in social networks of family members and friends were associated with trajectories of self-rated oral health (SROH) among adults over a 13-year period.

Methods

A prospective cohort study (Pro-Saude Study) was conducted involving non-faculty civil servants at university campi in Rio de Janeiro, Brazil. Individual data was collected through self-completed questionnaires in four waves (1999, 2001, 2007 and 2012). SROH trajectories between 2001 and 2012 were “Good-stable SROH”, “Changed SROH”, “Poor-stable SROH”.Per capitafamily income and social networks of family members and friends data obtained in 1999 and 2012 were grouped into “High stable”, “Increase”, “Decrease”, “Low stable”. Ordinal logistic regression using complete data of 2118 participants was used to estimate odds ratio (OR) and 95% CIs of changes in income and changes in social networks with SROH trajectories, adjusted for age, sex, skin colour and marital status.

Results

Participants in the low income-stable and small social networks-stable groups showed 2.44 (95% CI 1.68–3.55) and 1.98 (95% CI 1.38–2.85) higher odds for worst trajectory of SRHO than those in the respective high-stable groups. Those in the decrease income group and decrease social networks group were 78% (95% CI 1.25–2.54) and 58% (95% CI 1.07–2.34) more likely to worst trajectory of SRHO than those in the high income-stable and high social networks-stable groups.

Conclusions

Adults reporting low income and low social networks of family members and friends over 13 years and those with income and social networks decrease during the study period were at higher risk of having worsened their self-rated oral health.
A prognostic model for oral squamous cell carcinoma using 7 genes related to tumor mutational burden
Authors: Wu Fei , Du Yuanyuan , Hou Xiujuan , Cheng Wei
Published: April 2022

Background

Oral squamous cell carcinoma (OSCC) is a rising problem in global public health. The traditional physical and imageological examinations are invasive and radioactive. There is a need for less harmful new biomarkers. Tumor mutational burden (TMB) is a novel prognostic biomarker for various cancers. We intended to explore the relationship between TMB-related genes and the prognosis of OSCC and to construct a prognostic model.

Methods

TMB-related differential expressed genes (DEGs) were screened by differential analysis and optimized via the univariate Cox and LASSO Cox analyses. Risk Score model was constructed by expression values of screened genes multiplying coefficient of LASSO Cox.

Results

Seven TMB-related DEGs (CTSG, COL6A5, GRIA3, CCL21, ZNF662, TDRD5 and GSDMB) were screened. Patients in high-risk group (Risk Score >  − 0.684511507) had worse prognosis compared to the low-risk group (Risk Score <  − 0.684511507). Survival rates of patients in the high-risk group were lower in the gender, age and degrees of differentiation subgroups compared to the low-risk group.

Conclusions

The Risk Score model constructed by 7 TMB-related genes may be a reliable biomarker for predicting the prognosis of OSCC patients.
Acceptability and feasibility of a pilot randomized controlled trial of Narrative e-Writing Intervention (NeW-I) for parent-caregivers of children with chronic life-threatening illnesses in Singapore
Authors: Dutta Oindrila , Tan-Ho Geraldine , Low Xinyi Casuarine , Tan Toh Hsiang Benny , Ganapathy Sashikumar , Car Josip , Ho Ringo Moon-Ho , Miao Chun Yan , Ho Andy Hau Yan
Published: April 2022

Background

Narrative e-Writing Intervention (NeW-I) is a novel psycho-socio-spiritual intervention which aims to bridge gaps in paediatric palliative care by providing anticipatory grief support to parent-caregivers who are looking after their child with a chronic life-threatening illness in Singapore. This is done via a therapist-facilitated smartphone app that focuses on strengths and meaning derived from parents’ caregiving journey. NeW-I is empirically informed by an international systematic review and a Singapore-based qualitative inquiry on the lived experience of parental bereavement and supported by anticipatory grief interventions literature for improving the holistic well-being for parent-caregivers of seriously ill children. NeW-I is implemented in Singapore as an open-label two-armed randomized controlled trial comprising an intervention and control group.

Methods

This study examined the acceptability (via analysis of participants’ post-intervention qualitative feedback and responses to a post-intervention evaluation survey) and feasibility (via records and memos of therapists’ experience of delivering the intervention) of NeW-I among 26 intervention participants drawn from the larger trial.

Results

Framework analysis of participants’ post-intervention feedback revealed four themes, namely: (i) Meaningful opportunity for reflection, (ii) Congruity with parent-caregivers’ needs, (iii) Compatibility of online narrative writing and (iv) Sustainability and enhancement recommendations. The post-intervention evaluation survey showed that participants were overall satisfied with their NeW-I experience with a large number of participants acknowledging that NeW-I had improved their spiritual well-being, hopefulness about the future and perception of social support that was available to them, as well as lessened their feelings of sadness and depression, caregiver burden and fear and anxiety about their child’s illness. The research team found it feasible to deliver the intervention in the current setting.

Conclusion

NeW-I is an innovative e-health tool that could immeasurably value-add to paediatric palliative care services for Asian families in Singapore and around the world.

Trial registration

ClinicalTrials.gov, ID: NCT03684382, Verified: September 2018.
What do primary care staff think about patients accessing electronic health records? A focus group study
Authors: Louch Gemma , Albutt Abigail , Smyth Kate , O’Hara Jane K.
Published: April 2022

Background

Patients have expressed a growing interest in having easy access to their personal health information, and internationally there has been increasing policy focus on patient and care records being more accessible. Limited research from the UK has qualitatively explored this topic from the primary care staff perspective. This study aimed to understand what primary care staff think about patients accessing electronic health records, highlighting errors in electronic health records, and providing feedback via online patient portals.

Methods

A focus group study involving 19 clinical and non-clinical primary care staff.

Primary care practices were purposively sampled based on practice size and the percentage of patients using online services. Data were analysed inductively using reflexive thematic analysis.

Results

Three themes were generated: (1) Information – what, why and when? (2) Changing behaviours and protecting relationships, and (3) Secure access and safeguarding. The emotional considerations and consequences for staff and patients featured prominently in the data as an overarching theme.

Conclusions

Primary care staff described being invested and supportive of patients accessing their electronic health records, and acknowledged the numerous potential benefits for safety. Uncertainty around the parameters of access, the information available and what this might look like in the future, processes for patients highlighting errors in records, relational issues, security and safeguarding and equitable access, were key areas warranting examination in future research.