bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival rate of primary molar restorations is not influenced by hand mixed or encapsulated GIC: 24 months RCT
Authors: Oliveira Rodolfo de Carvalho , Camargo Lucila Basto , Novaes Tatiane Fernandes , Pontes Laura Regina Antunes , Olegário Isabel Cristina , Gimenez Thais , Pássaro Ana Laura , Tedesco Tamara Kerber , Braga Mariana Minatel , Mendes Fausto Medeiros , Raggio Daniela Prócida
Published: July 2021

Background

Glass ionomer cements (GIC) have been considered the top option to restore primary teeth by dentists. The most common supply forms are hand mixed and encapsulated GIC. There is a lack of information about the impact of different GIC supply forms on restoration survival.

Methods

This randomized clinical trial compared the survival rate of occlusal and occlusoproximal restorations in primary molars using two glass ionomer cements versions: hand-mixed (H/M) and encapsulated (ENC) after 24 months. Children aged 3–10 years who presented dentin caries lesions in primary molars were selected at School of Dentistry, University of São Paulo, Brazil. They were randomly assigned to groups: H /M (Fuji IX®, GC Europe) or ENC (Equia Fill®, GC Europe). The occurrence of restoration failure was evaluated by two blinded and calibrated examiners. The analyses were performed in Stata 13 (StataCorp, USA). To evaluate the primary outcome (restoration survival),
we  performed a survival analysis. Additionally an intention to treat (ITT) analysis were done at 24 months of follow-up. Cox Regression with shared frailty was performed to assess association between restoration failure and independent variables (α = 5%).

Results

A total of 324 restorations were performed in 145 children. The survival for H/M group was 58.2% and 60.1% for ENC, with no difference (p = 0.738). Occlusoproximal restorations had lower survival rate when compared to occlusal ones (HR = 3.83; p < 0.001).

Conclusions

The survival rate in primary molars is not influenced by the different supply forms of GIC. Also, occlusoproximal restorations present reduced performances when compared to occlusal cavities.

Trial Registration

This randomized clinical trial was registered on ClinicalTrials.Gov on 10/15/2014 under protocol (NCT 02274142).
Single-inhaler triple vs single-inhaler dual therapy in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized control trials
Authors: Long Huanyu , Xu Hongxuan , Janssens Jean-Paul , Guo Yanfei
Published: July 2021

Background

In some RCTs comparing triple therapy with dual therapy in COPD, there might be a bias resulting from the use of multiple inhaler devices. This meta-analysis included only RCTs that compared ICS/LABA/LAMA vs. LABA/LAMA or ICS/LABA using a single device.

Methods

We systematically reviewed randomized controlled trials (RCTs) of single-inhaler triple therapy in patients with COPD. We searched the PubMed, MEDLINE (OvidSP), EMBASE and Cochrane Library databases to investigate the effect of single-inhaler triple therapy in COPD. The primary end points were the effect of single-inhaler triple therapy compared with single-inhaler dual therapy on all-cause mortality, the risk of acute exacerbation of COPD (AECOPD), and some safety endpoints. The Cochrane Collaboration tool was used to assess the quality of each randomized trial and the risk of bias.

Results

A total of 25,171 patients suffering from COPD were recruited for the 6 studies. This meta-analysis indicated that single-inhaler triple therapy resulted in a significantly lower rate of all-cause mortality than LABA/LAMA FDC (risk ratio, 0.70; 95% CI 0.56‐0.88). Single-inhaler triple therapy reduced the risk of exacerbation and prolonged the time to first exacerbation compared with single-inhaler dual therapy. The FEV1 increased significantly more under single-inhaler triple therapy than under ICS/LABA FDC (mean difference, 103.4 ml; 95% CI 64.65‐142.15). The risk of pneumonia was, however, significantly higher with ICS/LAMA/LABA FDC than with LABA/LAMA FDC (risk ratio, 1.55; 95% CI 1.35–1.80).

Conclusions

This meta-analysis suggests that single-inhaler triple therapy is effective in reducing the risk of death of any cause and of moderate or severe exacerbation in COPD patients. However, the risk of pneumonia is higher with ICS/LAMA/LABA FDC than with LABA/LAMA FDC.

Trial registration PROSPERO #CRD42020186726.
Emerging therapies for relapsed/refractory multiple myeloma: CAR-T and beyond
Authors: Su Christopher T. , Ye J. Christine
Published: July 2021

The pace of innovation of multiple myeloma therapy in recent years is remarkable with the advent of monoclonal antibodies and the approval of novel agents with new mechanisms of action. Emerging therapies are on the horizon for clinical approval with significant implications in extending patient survival and advancing closer to the goal of a cure, especially in areas of immunotherapy such as chimeric antigen receptor T cells, bispecific T cell engager antibodies, antibody drug conjugates, newer generations of monoclonal antibodies, and small molecule inhibitor and modulators. This review provides an update of current myeloma therapeutics in active preclinical and early clinical development and discusses the mechanism of action of several classes of novel therapeutics.
The histone chaperone Nrp1 is required for chromatin stability and nuclear division in Tetrahymena thermophila
Authors: Lian Yinjie , Hao Huijuan , Xu Jing , Bo Tao , Liang Aihua , Wang Wei
Published: July 2021

Histone chaperones facilitate DNA replication and repair by promoting chromatin assembly, disassembly and histone exchange. Following histones synthesis and nucleosome assembly, the histones undergo posttranslational modification by different enzymes and are deposited onto chromatins by various histone chaperones. In Tetrahymena thermophila, histones from macronucleus (MAC) and micronucleus (MIC) have been comprehensively investigated, but the function of histone chaperones remains unclear. Histone chaperone Nrp1 in Tetrahymena contains four conserved tetratricopepeptide repeat (TPR) domains and one C-terminal nuclear localization signal. TPR2 is typically interrupted by a large acidic motif. Immunofluorescence staining showed that Nrp1 is located in the MAC and MICs, but disappeared in the apoptotic parental MAC and the degraded MICs during the conjugation stage. Nrp1 was also colocalized with α-tubulin around the spindle structure. NRP1 knockdown inhibited cellular proliferation and led to the loss of chromosome, abnormal macronuclear amitosis, and disorganized micronuclear mitosis during the vegetative growth stage. During sexual developmental stage, the gametic nuclei failed to be selected and abnormally degraded in NRP1 knockdown mutants. Affinity purification combined with mass spectrometry analysis indicated that Nrp1 is co-purified with core histones, heat shock proteins, histone chaperones, and DNA damage repair proteins. The physical direct interaction of Nrp1 and Asf1 was also confirmed by pull-down analysis in vitro. The results show that histone chaperone Nrp1 is involved in micronuclear mitosis and macronuclear amitosis in the vegetative growth stage and maintains gametic nuclei formation during the sexual developmental stage. Nrp1 is required for chromatin stability and nuclear division in Tetrahymena thermophila.
An exploratory assessment of the applicability of direct-to-consumer genetic testing to translational research in Japan
Authors: Inoue Masahiro , Arichi Shota , Hachiya Tsuyoshi , Ohtera Anna , Kim Seok-Won , Yu Eric , Nishimura Masatoshi , Shiosakai Kazuhito , Ohira Takeshi
Published: July 2021

Objective

In order to assess the applicability of a direct-to-consumer (DTC) genetic testing to translational research for obtaining new knowledge on relationships between drug target genes and diseases, we examined possibility of these data by associating SNPs and disease related phenotype information collected from healthy individuals.

Results

A total of 12,598 saliva samples were collected from the customers of commercial service for SNPs analysis and web survey were conducted to collect phenotype information. The collected dataset revealed similarity to the Japanese data but distinguished differences to other populations of all dataset of the 1000 Genomes Project. After confirmation of a well-known relationship between ALDH2 and alcohol-sensitivity, Phenome-Wide Association Study (PheWAS) was performed to find association between pre-selected drug target genes and all the phenotypes. Association was found between GRIN2B and multiple phenotypes related to depression, which is considered reliable based on previous reports on the biological function of GRIN2B protein and its relationship with depression. These results suggest possibility of using SNPs and phenotype information collected from healthy individuals as a translational research tool for drug discovery to find relationship between a gene and a disease if it is possible to extract individuals in pre-disease states by properly designed questionnaire.
Association of quality of life, anxiety, and depression with restless leg syndrome in the hemodialysis patients
Authors: Yaseen Mahjabeen , Jarullah Furqan Ahmad , Yaqoob Sadia , Shakeel Hassan Abdullah , Maqsood Hamza , Naveed Sadiq
Published: July 2021

Objectives

Restless Legs Syndrome (RLS) is commonly known to cause morbidity in patients on hemodialysis, making them prone to chronic mental health illnesses such as depression and anxiety, and also adversely impact quality of life. In this study, we examined the association of quality of life, anxiety, and depression with restless leg syndrome in the hemodialysis patients at Karachi Institute of Kidney Diseases.

Results

About 26.7% of the participants reported RLS among the sample size Presence of RLS was not associated with quality of life, depression, and anxiety. However, p-values < 0.05 were significant for body-mass index (BMI), diabetes mellitus as a cause of end-stage renal disease, and serum albumin levels. Majority (82.5%) of the RLS-diagnosed patients had moderate to severe symptoms with 16 (40%) and 17 (42.5%) clients, respectively.
Intrabronchial application of extracellular histones shows no proinflammatory effects in swine in a translational pilot study
Authors: Ruemmler Robert , Ziebart Alexander , Britten Elisabeth , Gosling Moritz , Rissel Rene , Hartmann Erik K.
Published: July 2021

Objective

Extracellular histones have been identified as one molecular factor that can cause and sustain alveolar damage and were linked to high mortality rates in critically ill patients. In this pilot study, we wanted to validate the proinflammatory in vivo effects of local histone application in a prospective translational porcine model. This was combined with the evaluation of an experimental acute lung injury model using intrabronchial lipopolysaccharides, which has been published previously.

Results

The targeted application of histones was successful in all animals. Animals showed decreased oxygenation after instillation, but no differences could be detected between the sham and histone treatments. The histologic analyses and inflammatory responses indicated that there were no differences in tissue damage between the groups.
Assessment of TSLP, IL 25 and IL 33 in patients with shrimp allergy
Authors: Ukleja-Sokołowska Natalia , Żbikowska-Gotz Magdalena , Lis Kinga , Adamczak Rafał , Bartuzi Zbigniew
Published: July 2021

Background

Shrimp allergy is a growing problem among the European population. TSLP, IL-25 and IL-33 are involved in the pathophysiology of allergic diseases, including asthma and atopic dermatitis, as they activate the Th2-dependent immune response.

Methods

Thirty-seven patients (18 male and 19 female) with a positive history of symptoms associated with shrimp consumption were selected. All patients had blood samples taken to assess the concentration of allergen-specific IgE (sIgE) to house dust mites (HDM) and shrimp (Singleplex, quantitative method with cut off value > 0,35 kAU/L) as well as the level of allergen components using the ImmunoCap ISAC method (Microarray test, semi-quantitative with cut off value > 0,3 ISU-E). The concentrations of TSLP, IL-25 and IL-33 in the patients’ blood serum was assessed using the ELISA method (Cusabio). Twenty patients with negative allergy history of allergic disease tests were included in the control group.

Results

Among the 37 shrimp-allergic patients, ImmunoCap ISAC was identified the presence of sIgE to the available shrimp allergen components in only 14 cases (37.8%). TSLP and IL25 levels were significantly higher in the study group. No statistically significant correlation was found between the concentration of analyzed alarmins and the concentration of sIgE level to shrimp or HDM between the study and control groups. No statistically significant correlation was found between poly-sensitization occurring in patients and levels of TSLP, IL-25 and IL-33 .

Conclusion

In shrimp-allergic patients, the concentrations of TSLP and IL-25 were significantly higher than in the control group (1.33 vs. 0.49 and 157 vs. 39.36, respectively). There was no correlation between the concentrations of TSLP, IL-25 and IL-33 and the concentration of sIgE in the patients or the number of allergen components that the patients were sensitized to.

Trial registration: Bioethics Committee 147/2015, 11.03.2015.
Impact of lanadelumab in hereditary angioedema: a case series of 12 patients in Canada
Authors: Iaboni Aled , Kanani Amin , Lacuesta Gina , Song Christine , Kan Manstein , Betschel Stephen D.
Published: July 2021

Background

Hereditary angioedema (HAE) is a rare autosomal dominant disease resulting in recurring episodes of swelling, leading to considerable patient morbidity and mortality. Lanadelumab is a plasma kallikrein inhibitor that is approved as 1st line therapy in Canada for long term prophylaxis of HAE attacks.

Objective

To describe our clinical findings from a case series of adult patients with HAE type 1/2 who have been initiated on lanadelumab.

Methods

A chart review of HAE type 1/2 patients at three academic centers in Canada was undertaken with demographic and clinical data extracted. Patients were included if they had been receiving lanadelumab for at least 6 months. Patients with other causes of angioedema were excluded.

Results

12 patients meeting enrollment criteria were identified. Compared to pre-lanadelumab, patients had mean reductions of 72% and 62% in attack rate and treated attack rate respectively. 3 patients reported complete remission from attacks after starting lanadelumab. Most patients had significant improvements in HAE impact on social outings.

Conclusion

Our case series findings support the 2019 International/Canadian HAE guideline that lanadelumab is an effective therapy for long term prophylaxis. In our patient population, initiation of lanadelumab improved disease control, minimized the burden of treatment and improved HAE impact on social outings.
Decisions of persons, the pharmaceutical industry, and donors in disease contraction and recovery assuming virus mutation
Authors: Hausken Kjell , Ncube Mthuli
Published: July 2021

Background

The article develops an eight-period game between N persons and a pharmaceutical company. The choices of a donor and Nature are parametric.

Methods

Persons choose between safe and risky behavior, and whether or not to buy drugs. The pharmaceutical company chooses whether or not to develop drugs. The donor chooses parametrically whether to subsidize drug purchases and drug developments. Nature chooses disease contraction, recovery, death, and virus mutation. The game is solved with backward induction.

Results

The conditions are specified for each of seven outcomes ranging from safe behavior to risky behavior and buying no or one or both drugs. The seven outcomes distribute themselves across three outcomes for the pharmaceutical company, which are to develop no drugs, develop one drug, and develop two drugs if the virus mutates. For these three outcomes the donor’s expected utility is specified.

Conclusion

HIV/AIDS data is used to present a procedure for parameter estimation. The players’ strategic choices are exemplified. The article shows how strategic interaction between persons and a pharmaceutical company, with parametric choices of a donor and Nature, impact whether persons choose risky or safe behavior, whether a pharmaceutical company develops no drugs or one drug, or two drugs if a virus mutates, and the impact of subsidies by a donor.
Economic evaluation of process utility: elucidating preferences for a non-invasive procedure to treat restenosis
Authors: Aviles-Blanco Maria V.
Published: July 2021

Background

In health economic evaluation, utility associated with a health state is outcome-oriented and usually measured using the QALY methodology. Even though there is consistent evidence of utility not only being derived from outcomes but also from procedures, process utility has not been fully integrated in QALY calculations. The aim of this paper is twofold: first, to provide evidence of process utility associated with an alternative treatment to angioplasty, and second, to estimate a monetary value of such process utility using the willingness to pay (WTP) approach.

Methods

A total of 1514 people were polled on their WTP to avoid angioplasty to have a drug-eluting stent (DES) implanted. WTP is estimated with a contingent valuation (CV) survey. Individuals are also asked if they would be WTP for a non-invasive procedure with similar results being achieved. WTP responses were analyzed using a double bounded (DB) logit model.

Results

Most of the participants showed positive preferences for avoiding angioplasty, with an estimated mean WTP of €5692.87. Using QALY gains for avoiding angioplasty, varying from 0.0035 to 0.08 QALYs, our WTP estimate imply monetary values per QALY that range from €71,160.87 to €1,626,534.28.

Discussion

A WTP of €5692.87 to avoid angioplasty imply a monetary value per QALY that greatly exceed the cost per QALY thresholds established in different countries to consider health programs as beneficial to society. Our results reflect how different methodologies for HTA may lead to different conclusions. From the ICER perspective, the cost that would make the treatment with pills option cost-effective, using a threshold of €40,000/QALY, would be €224. However, a cost-benefit approach could support health programs even with a higher cost.

Conclusion

WTP methodology captures outcome and process factors related to angioplasty as our WTP estimations are non-significantly different for the costs of angioplasty. WTP approach must be considered as a genuine alternative to QALY approaches to value process utility.
Incident disease associations with mosaic chromosomal alterations on autosomes, X and Y chromosomes: insights from a phenome-wide association study in the UK Biobank
Authors: Lin Shu-Hong , Brown Derek W. , Rose Brandon , Day Felix , Lee Olivia W. , Khan Sairah M. , Hislop Jada , Chanock Stephen J. , Perry John R. B. , Machiela Mitchell J.
Published: July 2021

Background

Mosaic chromosomal alterations (mCAs) are large chromosomal gains, losses and copy-neutral losses of heterozygosity (LOH) in peripheral leukocytes. While many individuals with detectable mCAs have no notable adverse outcomes, mCA-associated gene dosage alterations as well as clonal expansion of mutated leukocyte clones could increase susceptibility to disease.

Results

We performed a phenome-wide association study (PheWAS) using existing data from 482,396 UK Biobank (UKBB) participants to investigate potential associations between mCAs and incident disease. Of the 1290 ICD codes we examined, our adjusted analysis identified a total of 50 incident disease outcomes associated with mCAs at PheWAS significance levels. We observed striking differences in the diseases associated with each type of alteration, with autosomal mCAs most associated with increased hematologic malignancies, incident infections and possibly cancer therapy-related conditions. Alterations of chromosome X were associated with increased lymphoid leukemia risk and, mCAs of chromosome Y were linked to potential reduced metabolic disease risk.

Conclusions

Our findings demonstrate that a wide range of diseases are potential sequelae of mCAs and highlight the critical importance of careful covariate adjustment in mCA disease association studies.
Understanding the complexities of antibiotic prescribing behaviour in acute hospitals: a systematic review and meta-ethnography
Authors: Wojcik Gosha , Ring Nicola , McCulloch Corrienne , Willis Diane S. , Williams Brian , Kydonaki Kalliopi
Published: July 2021

Background

Antimicrobial resistance poses a serious global public health threat. Hospital misuse of antibiotics has contributed to this problem and evidence-based interventions are urgently needed to change inappropriate prescribing practices. This paper reports the first theoretical stage of a longer-term project to improve antibiotic prescribing in hospitals through design of an effective behaviour-change intervention.

Methods

Qualitative synthesis using meta-ethnography of primary studies reporting doctors’ views and experiences of antibiotic prescribing in hospitals for example, their barriers to appropriate prescribing. Twenty electronic databases were systematically searched over a 10-year period and potential studies screened against eligibility criteria. Included studies were quality-appraised. Original participant quotes and author interpretations were extracted and coded thematically into NVivo. All study processes were conducted by two reviewers working independently with findings discussed with the wider team and key stakeholders. Studies were related by findings into clusters and translated reciprocally and refutationally to develop a new line-of-argument synthesis and conceptual model. Findings are reported using eMERGe guidance.

Results

Fifteen papers (13 studies) conducted between 2007 and 2017 reporting the experiences of 336 doctors of varying seniority working in acute hospitals across seven countries, were synthesised. Study findings related in four ways which collectively represented multiple challenges to appropriate antibiotic medical prescribing in hospitals: loss of ownership of prescribing decisions, tension between individual care and public health concerns, evidence-based practice versus bedside medicine, and diverse priorities between different clinical teams. The resulting new line-of-argument and conceptual model reflected how these challenges operated on both micro- and macro-level, highlighting key areas for improving current prescribing practice, such as creating feedback mechanisms, normalising input from other specialties and reducing variation in responsibility for antibiotic decisions.

Conclusions

This first meta-ethnography of doctors` experiences of antibiotic prescribing in acute hospital settings has enabled development of a novel conceptual model enhancing understanding of appropriate antibiotic prescribing. That is, hospital antibiotic prescribing is a complex, context-dependent and dynamic process, entailing the balancing of many tensions. To change practice, comprehensive efforts are needed to manage failures in communication and information provision, promote distribution of responsibility for antibiotic decisions, and reduce fear of consequences from not prescribing.

Trial registration

PROSPERO registration: CRD42017073740.
Assessment of laparoscopic instrument reprocessing in rural India: a mixed methods study
Authors: Robertson Daniel , Gnanaraj Jesudian , Wauben Linda , Huijs Jan , Samuel Vasanth Mark , Dankelman Jenny , Horeman-Franse Tim
Published: July 2021

Background

Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer post-surgical wound infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low to middle income countries (LMICs). Unfortunately, sterile processing departments in LMIC hospitals are faced with limited access to equipment and trained staff which poses an obstacle to safe surgical care. The reprocessing of laparoscopic devices requires specialised equipment and training. Therefore, when LMIC hospitals invest in laparoscopy, an update of the standard operating procedure in sterile processing is required. Currently, it is unclear whether LMIC hospitals, that already perform laparoscopy, have managed to introduce updated reprocessing methods that minimally invasive equipment requires. The aim of this study was to identify the laparoscopic sterile reprocessing procedures in rural India and to test the effectiveness of the sterilisation equipment.

Methods

We assessed laparoscopic instrument sterilisation capacity in four rural hospitals in different states in India using a mixed-methods approach. As the main form of data collection, we developed a standardised observational checklist based on reprocessing guidelines from several sources. Steam autoclave performance was measured by monitoring the autoclave cycles in two hospitals. Finally, the findings from the checklist data was supported by an interview survey with surgeons and nurses.

Results

The checklist data revealed the reprocessing methods the hospitals used in the reprocessing of laparoscopic instruments. It showed that the standard operating procedures had not been updated since the introduction of laparoscopy and the same reprocessing methods for regular surgical instruments were still applied. The interviews confirmed that staff had not received additional training and that they were unaware of the hazardous effects of reprocessing detergents and disinfectants.

Conclusion

As laparoscopy is becoming more prevalent in LMICs, updated policy is needed to incorporate minimally invasive instrument reprocessing in medical practitioner and staff training programmes. While reprocessing standards improve, it is essential to develop instruments and reprocessing equipment that is more suitable for resource-constrained rural surgical environments.
Steady-state kinetic analysis of mitochondrial respiratory enzymes from bovine heart mitochondria
Authors: Kim Dayoung , Ko Eun , Choi Moonsung , Shin Sooim
Published: July 2021

Mitochondria is a decisive organelle of cells that produces adenosine triphosphate (ATP) by the process of oxidative phosphorylation of the Krebs cycle and the electron transport chain. The electron transport chain system of mitochondria embodies multiple enzyme supercomplexes including complex I to V which located in the inner membrane. Although the simple enzyme activity of some as-isolated complex has been studied so far, the steady-state kinetic analysis of each complex within the form of mitochondrial supercomplex has not been studied in depth. To this end, kinetic parameters of mitochondrial complex I–IV were determined using steady-kinetic analysis using corresponding substrates of them. Catalytic activity and binding affinity between substrates and enzymes were obtained by fitting the data to the Michaelis–Menten equation. Acquired kinetic parameters represented distinctive values depending on the complexes that can be interpreted by the characteristics of the enzymes including the distinction of substrates or the ratio of the enzyme itself under the supercomplex form. The indirectkcatof the mitochondrial enzymes were varied from 0.0609 to 0.334 s−1in order of complex III, II, I, and IV andKmof substrates were also diverse from 5.1 μM to 12.14 mM. This is the first attempt to get exact kinetic values that should provide profound information to evaluate the mitochondrial function practically in advance.
Salmonella Typhimurium environmental reduction in a farrow-to-finish pig herd using a live attenuated Salmonella Typhimurium vaccine
Authors: van der Wolf Peter , Meijerink Maaike , Libbrecht Emile , Tacken Gerrit , Gijsen Emile , Lillie-Jaschniski Kathrin , Schüller Verena
Published: July 2021

Background

SalmonellaTyphimurium is an important zoonotic pathogen in pigs, that can cause clinical disease. Many sow herds and finishing herds are infected withSalmonella, and therefore pose a threat for the contamination of pork and pork products and ultimately consumers.

Case presentation

This case study describes a farrow-to-finish pig herd, producing its own replacement gilts, which had experienced clinical outbreaks of salmonellosis since 2002. Outbreaks were characterised by profuse diarrhoea, dead pigs and high antimicrobial use (colistin sulphate). The aim of this study was to see whether using vaccination of sows and piglets with Salmoporc®, a live attenuatedSalmonellaTyphimurium vaccine, in combination with standard hygienic precautions, it was possible to reduceSalmonellaTyphimurium to below the bacteriological detection limit. Monitoring of the presence ofSalmonellawas done using a total of 20 pooled faecal, sock and dust samples per herd visit in the period from September 2016 to October 2020. Within the first 10 months after the start of vaccination in August 2016, there was a rapid reduction in clinical symptoms, antimicrobial usage and the number ofSalmonella-positive samples. During the winters of 2017/2018 and 2018/2019 the number of positive samples increased again, however with minimal need to use antimicrobials to treat the affected animals. In July 2019, only two samples from a corridor were positive. In September and November 2019 and in October 2020 all three samplings were completely negative forS. Typhimurium.

Conclusions

This case, together with other longitudinal studies, can be seen as a proof of the principle that long term vaccination with a live attenuatedS.Typhimurium vaccine can reduce the level ofS. Typhimurium in the herd environment to very low levels within a farrow-to-finish herd initially suffering from clinical salmonellosis. Also, clinical symptoms indicating salmonellosis were no longer observed and antimicrobials to treat clinically diseased pigs were no longer needed.
Healthy Parent Carers: feasibility randomised controlled trial of a peer-led group-based health promotion intervention for parent carers of disabled children
Authors: Bjornstad Gretchen , Cuffe-Fuller Beth , Ukoumunne Obioha C. , Fredlund Mary , McDonald Annabel , Wilkinson Kath , Lloyd Jenny , Hawton Annie , Berry Vashti , Tarrant Mark , Borek Aleksandra , Fitzpatrick Katharine , Gillett Annette , Rhodes Shelley , Logan Stuart , Morris Christopher
Published: July 2021

Background

Parent carers of children with special educational needs or disability are at higher risk of poor mental and physical health. The need for a tailored, peer-led group programme was raised by parent carers, who co-developed the Healthy Parent Carers programme with researchers. This study aimed to test the feasibility of programme delivery in community settings, and the feasibility and acceptability of a randomised controlled trial design.

Methods

Participants were individually randomised with concealed allocation to a structured group programme and access to online resources (intervention), or access to the online resources only (control). Measures of wellbeing and secondary and economic outcomes were collected before randomisation, immediately post-intervention, and 6 months post-intervention. Descriptive statistics on recruitment and attrition, demographics, attendance, and fidelity of intervention delivery were analysed with feedback on the acceptability of the trial design.

Results

One hundred and ninety-three parent carers expressed an interest in taking part. Ninety-two participants recruited from across six sites were randomised (47 intervention, 45 control). Lead and assistant facilitators were trained and delivered the group sessions. Sixteen (34%) participants in the intervention arm did not attend any sessions, and attendance varied across sites and sessions. One participant withdrew post-randomisation, and 83 (90%) participants completed outcome measures at the six-month follow-up.

Conclusions

The study demonstrated that it was feasible to deliver the programme in community settings. The number of parent carers who expressed interest signifies the need for such a programme and the feasibility of recruiting to a definitive trial. Loss to follow-up was low. Further research is needed to explore ways to reduce barriers to participation in person and assess the feasibility and acceptability of programme content and delivery for more ethnically diverse groups, and potentially using interpreters. Given the Covid-19 pandemic and delivery format feedback, there is also a need to investigate remote or blended delivery strategies. Although the results indicate that a definitive trial is feasible, programme impact would be strengthened through exploration of these uncertainties.

Trial registration

ISRCTN, ISRCTN15144652, registered on 25 October 2018, ClinicalTrials.gov, NCT03705221, registered on 15 October 2018.
Investigation of nootropic potential of ethanol extract of Elettaria cardamomum Maton fruit (Cardamom): a spice of India
Authors: Saini Sapna , Choudhary Manjusha , Garg Ankur
Published: July 2021

Background

Cognitive impairment mainly affects learning and problem solving abilities of the person. Traditional medicines, due to fewer side effects, more efficacy and lesser cost are still the choice of treatment in India. The main objective of the present study is to explore the nootropic potential of ethanol extract of Elettaria cardamomum Maton fruits. The present study was conducted by using exteroceptive behavioral models like elevated plus maze, passive avoidance apparatus and object recognition task at doses 100, 300 and 500 mg/kg.

Results

Ethanol extract of E. cardamomum fruits significantly decreased transfer latency and increased step down latency and discrimination index respectively when compared to normal control groups. Piracetam and diazepam exhibited respective rise and fall in memory of the animals. The effect of plant extract on total serum cholesterol, acetylcholinesterase and malondialdehyde were more effective at two higher doses. However, it decreased serum glucose levels insignificantly whereas a significant rise in brain GSH levels was observed with increasing dose of the extract.

Conclusions

The study concludes that the nootropic effect of ethanol extract may be attributable to its anti-oxidant, anti-cholinesterase and cholesterol as well as glucose lowering potential.
Socio-cultural beliefs influence feeding practices of mothers and their children in Grand Popo, Benin
Authors: Lokossou Yrence Urielle Amoussou , Tambe Ayuk Betrand , Azandjèmè Colette , Mbhenyane Xikombiso
Published: July 2021

Background

Malnutrition is a major public health problem. It contributes to the high death rate among children in developing countries despite the various advocacies of institutions such as WHO and FAO and many other organisations. More research needs to be done in order to contribute to the achievement of the Sustainable Development Goals. The aim of this study was to explore socio-cultural practices and their influence on feeding practices of mothers and their children in Grand Popo, Benin.

Methods

A qualitative research methodology was used with an inductive approach. A pretested discussion guide was used to conduct focus group discussions with participants in their local language. Four focus group discussions were held in 4 villages located in both the rural and the semi-urban areas with each focus group comprising seven to eight participants. The study protocol was approved by the Health Research Ethics Committee of Stellenbosch University. Focus group discussions were recorded, transcribed and translated to English. The data was analysed following the Creswell data analysis steps.

Results

All the children were breastfed, and 56.1% of children under 6 months received breast milk exclusively. Children were introduced to family foods at 5 months with very low consumption of animal protein and fruits. Mothers and children had monotonous diets with high consumption of vegetables and maize-based meals. Food taboos, particularly during pregnancy, were revealed. Those cultural beliefs were still followed by some mothers, and food rich in nutrients were pushed aside.

Conclusions

There is a need for educational interventions to raise awareness of the negative impacts of some socio-cultural practices on the health of the mother and child.
Sleep quality and anxiety symptoms in Egyptian children and adolescents during COVID-19 pandemic lockdown
Authors: El Refay Amira Sayed , Hashem Shaimaa A. , Mostafa Hend H. , Kamel Iman H. , Sherif Lobna S.
Published: July 2021

Background

Coronavirus Disease Pandemic 2019 has a pervasive effect on all health aspects include psychological and mental health. This study aimed to assess the hidden stressful impact of COVID-19 pandemic on Egyptian children and adolescents’ lifestyles 2 months after lockdown in Egypt by detecting symptoms of anxiety and sleep disorders. Online questionnaire was used by snowball sampling approach 2 months after lockdown targeting children and adolescents.

Results

The overall mean Sleep Disturbance Scale for Children score (SDSC) in participated groups was 44.6 ± 11.72. Of 765 participants 502 (65.6%) showed the symptoms suggestive of sleep disorder. Disorders of initiating and maintaining sleep were the most common among participants as 168 (33.4%) of them were suffering from it while 79 (15.7%) children were suffering from excessive somnolence. Linear stepwise regression revealed that anxiety score, understanding safety measures, and following strict quarantine measures significantly predicted SDSC (p = 0.001, 0.009, 0.046). Significant positive correlations were found between SDSC and extra screen usage, understanding safety and quarantine measures, anxiety signs, and change in child lifestyle with (p = 0.029, 0.010, 0.001 and 0.001) sequentially. Significant positive correlation was found between family income affection, SDSC, and anxiety with p value (00.001, 00.4).

Conclusion

Child deprived of his or her normal lifestyle is vulnerable to develop anxiety symptoms and sleep disturbances. Low income, extra screen time, and restricted quarantine measures are all contributing factors that influence children and adolescent’s mental health.
Association between iron and folic acid supplementation and birth weight in Ethiopia: systemic review and meta analysis
Authors: Zenebe Andualem , Tegegne Kaleab Tesfaye , Bifato Berhanu , Assefa Abiyu Ayalew
Published: July 2021

Background

Previous studies on iron with folic acid supplementation and low birth weight indicated different findings. The aim of the current systemic review and meta-analysis was to examine the relationship between iron and folic acid supplementation and birth weight in Ethiopia.

Main body

The databases searched were PubMed, Google Scholar, Web of Science and Cochrane Library in January 2021. AZ, KTT and AAA carried out the data extraction and independently assessed the articles for inclusion in the review using risk-of-bias tool guided by PRISMA checklist. The combined Odds ratio with 95% confidence interval was calculated using random effect model. Twenty four observational studies involving 10,989 participants, 2423 newborns who were born LBW were included. The combined effect size (OR) for low birth weight comparing women who have Iron and Folic acid supplementation versus women who did not have iron and folic acid supplementation was 0.39 (95% CI 0.27–0.59,p < 0.00001, I2 = 91%). There was significant heterogeneity (Q = 264.16, I2 = 91%,p < 0.00001). No publication bias was observed (Egger’s test:p = 0.742, Begg’s test:p = 0.372). Overall 69.5% of women reported having iron and folic acid supplementation during current pregnancy. And the overall proportion of low birth weight was 22.1%.

Conclusions

Women who were supplied with iron and folic acid during pregnancy had a 67% decreased chance of delivering low birth weight new born in Ethiopia.
Estimation for two exponential life time models under joint multiply type-II censoring
Authors: Gadhvi Neha K.
Published: July 2021

Various types of censoring schemes basically type-I and type-II censoring schemes and their modified versions are used in life testing experiments. Most of the tests used in life testing experiments are based on a single sample. A joint censoring scheme is quite useful in conducting comparative life tests of products from different units within the same facility. In this article, we consider two exponential life time models under joint multiply type-II censoring scheme, which is a generalization of usual type-II censoring scheme, implemented on the two samples. We have considered maximum likelihood estimation and Bayesian estimation for estimating the reliability of the product under such a censoring scheme. The results are compared with the results obtained under usual type-II censoring scheme. In Bayes estimation the effect of prior parameters on mean life time and reliability of the product is discussed. We have used the local influence approach for identifying observations that strike a disproportionate effect in the maximum likelihood estimate of the reliability in the model. The life time data set of air-conditioning systems of two Boeing 720 jet airplanes “7914” and “7913” are used to apply the theory developed in the paper.
Post-traumatic stress disorder following COVID-19 pandemic among medical students in Riyadh: a cross-sectional study
Authors: Ifthikar Zainab , Fakih Saima Sajjad , Johnson Saumy , Alex Johnson
Published: July 2021

Background

In recent times, COVID-19 has been recognized as a public health emergency and thus far, most papers published on it are focused only on the clinical characteristics of infected patients. This pandemic has also made phenomenal emotional impact among the young and the old. We aimed to find out the impact of the COVID-19 pandemic on the psychological well-being of medical students in a University at Riyadh.

Results

There were 309 participants in the study. Out of them 44% did not have PTSD, 29% had score more than 37 which might contribute to immune suppression, in 18.4% PTSD was a clinical concern and 8.6% had probable PTSD. Female participants were the majority in the group and they also had higher chance of having consequences than the male counterparts (P< 0.001). Avoidance score between male and female gender was significantly different.

Conclusion

COVID-19 pandemic has not just affected the physiological functioning of the affected individuals but also has had a probable post-traumatic stress disorder among young college students. Screening for psychological well-being and the treatment for PTSD is imperative in college, school and general population.
Molecular Epidemiological Surveillance of CTX-M-15-producing Klebsiella pneumoniae from the patients of a teaching hospital.
Authors: Muzaheed Muzaheed , Sattar Shaikh Naveed , Sattar Shaikh Saeed , Acharya Sadananda , Sarwar Moosa Shajiya , Habeeb Shaikh Mohammad , M. Alzahrani Faisal , Ibrahim Alomar Amer
Published: July 2021

Background 

The presence of Extended-spectrum β-lactamase (ESBL) positive bacteria in hospital setting is an aggravating influential factor for hospitalized patients, and its consequences may be hazardous. Therefore, there is a need for rapid detection methods for newly emerging drug-resistant bacteria. This study was aimed at the molecular characterization of ESBL-positive Klebsiella pneumoniae isolates recovered from clinical samples.  

Methods 

A total of 513 K. pneumoniae isolates were obtained from various clinical samples during June 2019 to May 2020. The collected isolates were investigated for antimicrobial susceptibility (antibiogram), and PCR and DNA sequencing were performed to analyse the ESBL genes.  

Results 

Among the 513 isolates, as many as 359 (69.9%) were ESBL producers and 87.5% were multi-drug resistant, while none had resistance to imipenem. PCR scored 3% blaTEM, 3% blaSHV, and 60% blaCTX-M-15 genes for the tested isolates.  

Conclusion 

The study showed that CTX-M-15 was the major prevalent ESBL type among the isolates. Additionally, all the isolates were susceptible to carbapenems. Screening and detection of ESBL tests are necessary among all isolates from the enterobacteriaceae family in routine microbiology laboratory to prevent associated nosocomial infections. A larger study is essential to understand molecular epidemiology of ESBL producing organisms to minimize morbidities due to these multidrug resistant organisms.
Presence, flow, and narrative absorption: an interdisciplinary theoretical exploration with a new spatiotemporal integrated model based on predictive processing
Authors: Pianzola Federico , Riva Giuseppe , Kukkonen Karin , Mantovani Fabrizia
Published: July 2021

Presence, flow, narrative absorption, immersion, transportation, and similar subjective phenomena are studied in many different disciplines, mostly in relation to mediated experiences (books, film, VR, games). Moreover, since real, virtual, or fictional agents are often involved, concepts like identification and state empathy are often linked to engaging media use. Based on a scoping review that identified similarities in the wording of various questionnaire items conceived to measure different phenomena, we categorize items into the most relevant psychological aspects and use this categorization to propose an interdisciplinary systematization. Then, based on a framework of embodied predictive processing, we present a new cognitive model of presence-related phenomena for mediated and non-mediated experiences, integrating spatial and temporal aspects and also considering the role of fiction and media design. Key processes described within the model are: selective attention, enactment of intentions, and interoception. We claim that presence is the state of perceived successful agency of an embodied mind able to correctly enact its predictions. The difference between real-life and simulated experiences (“book problem,” “paradox of fiction”) lays in the different precision weighting of exteroceptive and interoceptive signals.
Deals or No Deals: Contract Design for Online Advertising
Authors: Kim Anthony , Mirrokni Vahab , Nazerzadeh Hamid
Published: July 2021

We present a formal study of first-look and preferred deals that are a recently introduced generation of contracts for selling online advertisements, which generalize traditional reservation contracts and are suitable for advertisers with advanced targeting capabilities. Under these deals, one or more advertisers gain priority access to an inventory of impressions before others and can choose to purchase in real time. In particular, we propose constant-factor approximation algorithms for maximizing the revenue that can be obtained from these deals when offered to all or a subset of the advertisers, whose valuation distributions can be independent or correlated through a common value component. We evaluate our algorithms using data from Google’s ad exchange platform and show they perform better than the approximation guarantees and obtain significantly higher revenue than auctions; in certain cases, the observed revenue is 85%–96% of the optimal revenue achievable. We also prove the NP-hardness of designing deals when advertisers’ valuations are arbitrarily correlated and the optimality of menus of deals among a certain class of selling mechanisms in an incomplete distributional information setting.
Kluver-Bucy Syndrome: A Rare Complication of Herpes Simplex Encephalitis
Authors: Costa Raquel , Mendes Tiago , Fontes Joana , Pereira Marta , Gonçalves Carlos
Published: July 2021

Kluver-Bucy syndrome (KBS) is a characterized by a group of cognitive dysfunctions that include hypersexuality, placidity, hyperorality, memory deficits and hypermetamorphosis. This syndrome is often seen in pathological states that destroy the temporal lobes, normally bilaterally. Herpes simplex encephalitis (HSE) is one of the causes of KBS, as the herpes virus can cause dysfunction/destruction of the temporal lobes. KBS is a very rare syndrome, with just a few cases described in the literature. We present the case of a 21-year-old-man who was diagnosis with KBS after HSE.