bluuebunny/crossref_metadata_2025 huggingface dataset:
Losartan improves visceral sensation and gut barrier in a rat model of irritable bowel syndrome
Authors: Nozu Tsukasa , Miyagishi Saori , Nozu Rintaro , Takakusaki Kaoru , Okumura Toshikatsu
Published: February 2020

Background

Lipopolysaccharide (LPS) or repeated water avoidance stress (WAS) induces visceral allodynia and colonic hyperpermeability via corticotropin‐releasing factor (CRF) and proinflammatory cytokines, which is considered to be a rat irritable bowel syndrome (IBS) model. As losartan is known to inhibit proinflammatory cytokine release, we hypothesized that it improves these visceral changes.

Methods

The threshold of visceromotor response (VMR), that is, abdominal muscle contractions induced by colonic balloon distention was electrophysiologically measured in rats. Colonic permeability was determined in vivo by quantifying the absorbed Evans blue in colonic tissue for 15 minutes spectrophotometrically.

Key Results

Lipopolysaccharide (1 mg kg−1) subcutaneously (s.c.) reduced the threshold of VMR and increased colonic permeability. Losartan (5‐25 mg kg−1 s.c.) for 3 days inhibited these changes in a dose‐dependent manner. Moreover, repeated WAS (1 hour daily for 3 days) or intraperitoneal injection of CRF (50 µg kg−1) induced the similar visceral changes as LPS, which were also eliminated by losartan. These effects by losartan in LPS model were reversed by GW9662 (a peroxisome proliferator‐activated receptor‐γ [PPAR‐γ] antagonist), NG‐nitro‐L‐arginine methyl ester (a nitric oxide [NO] synthesis inhibitor), or naloxone (an opioid receptor antagonist). Moreover, it also inhibited by sulpiride (a dopamine D2 receptor antagonist) or domperidone (a peripheral dopamine D2 antagonist).

Conclusion & Inferences

Losartan prevented visceral allodynia and colonic hyperpermeability in rat IBS models. These actions may be PPAR‐γ–dependent and also mediated by the NO, opioid, and dopamine D2 pathways. Losartan may be useful for IBS treatment.
Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery: A computational fluid dynamics study
Authors: Shirazawa Yoshito , Iwasaki Tomonori , Ooi Kazuhiro , Kobayashi Yutaka , Yanagisawa‐Minami Ayaka , Oku Yoichiro , Yokura Anna , Ban Yuusuke , Suga Hokuto , Kawashiri Shuichi , Yamasaki Youichi
Published: February 2020

Objectives

This study aimed to determine the anteroposterior depth (APD) of the pharyngeal airway (PA) where post‐operative PA obstruction was predicted, using computer fluid dynamics (CFD), in order to prevent obstructive sleep apnoea after mandibular setback surgery.

Settings and sample population

Nineteen skeletal Class III patients (8 men; mean age, 26.7 years) who required mandibular setback surgery had computed tomography images taken before and 6 months after surgery.

Methods

The APD of each site of the four cross‐sectional reference planes (retropalatal airway [RA], second cervical vertebral airway, oropharyngeal airway and third cervical vertebral airway) were measured. The Maximum negative pressure (Pmax) of the PA was measured at inspiration using CFD, based on a three‐dimensional PA model. Intersite differences were determined using analysis of variance and the Friedman test with Bonferroni correction. The relationship between APD and Pmax was evaluated by Spearman correlation coefficients and non‐linear regression analysis.

Results

The smallest PA site was the RA. Pmax was significantly correlated with the APD of the RA (rs = .628, P < .001). The relationship between Pmax and the APD‐RA was fitted to a curve, which showed an inversely proportional relationship of Pmax to the square of the APD‐RA. Pmax substantially increased even with a slight reduction of the APD‐RA. In particular, when the APD‐RA was 7 mm or less, Pmax increased greatly, suggesting that PA obstruction was more likely to occur.

Conclusions

The results of this study suggest that APD‐RA is a useful predictor of good PA ventilation after surgery.
Human reproductive system microbiomes exhibited significantly different heterogeneity scaling with gut microbiome, but the intra‐system scaling is invariant
Authors: Ma Zhanshan (Sam) , Taylor Robin A. J.
Published: February 2020

Maintaining sexual reproduction in a highly competitive world is still one of the major mysteries of biology given the apparently high efficiency of asexual reproduction. Co‐evolutionary theories such as the Red Queen hypothesis would suggest that the microbiomes in human reproductive systems, specifically the microbiomes contained in semen and vaginal fluids, should reach some level of homogeneity thanks to arguably the most conspicuous microbiome transmission between two sexes. The long‐term sexual coevolution should favor the dynamic homogeneity or stability, which should also be beneficial for sexual reproduction such as sperm survival or fertilization on physiological/ecological time scale. We present a piece of quantitative evidence in the form of microbial community spatial heterogeneity to support the stability notion by analyzing three big datasets of the human vaginal, semen and gut microbiome. Methodologically, we applied a recent community‐level extension to the classic Taylor's power law, which reached the rare status of ecological law and has found applications beyond biology. Both ecological and evolutionary theories, such as hologenome/holobiont and Red Queen, as well as consideration of first principles, would predict that microbiome transmissions between two sexes should have homogenizing effects on the composition and stability of the microbiomes in human reproductive systems, and therefore have similar variance structures. This is supported by the finding that the power law analysis revealed human vaginal and semen microbiomes exhibited the same scaling parameter size in their community spatial (inter‐individual) heterogeneities, while the both exhibited significantly different heterogeneity scaling parameter size with the human gut microbiome.
What Determines Voting Behaviors of Muslim Minorities in Europe: Muslim Identity or Left‐Right Ideology?
Authors: Baysu Gülseli , Swyngedouw Marc
Published: February 2020

Voting is key to political integration of immigrant‐background minorities, but what determines their voting preferences remains unclear. Moreover, dual‐citizen minorities can vote differently in their country of residence and origin. Using a representative survey of Turkish‐Muslim minorities in two cities in Belgium (N = 447, M_age = 36.3), we asked whether left‐right ideology or religious identity predicted their voting in their country of residence and origin, besides typical predictors of right‐wing voting (i.e., efficacy, deprivation, and authoritarianism). Authoritarianism, low political efficacy, and high deprivation predicted voting for right‐wing parties in Turkey, whereas the latter two, surprisingly, predicted voting for the left in Belgium. Latent class analyses of their religious practices distinguished “moderate” versus “strict” Muslims. While “strict” Muslims voted for right‐wing parties in Turkey, ideology did not predict their voting. Conversely, in Belgium, while Muslim identity did not predict their voting, ideology did. Analyzing their combined effects, “moderate” Muslims voted based on their ideology—right‐leaning voting for the right, whereas “strict” Muslims voted according to their interests as a disadvantaged minority in Belgium—thus voting for the left—or as a devout Muslim in Turkey—thus voting for the right. Our results elucidate processes underlying the voting behaviors of European‐Muslim minorities.
River‐dominated and tide‐influenced shelf‐edge delta systems: Coarse‐grained deltas straddling the Early–Middle Jurassic shelf–slope break and transforming downslope, Lajas–Los Molles formations, Neuquén Basin, Argentina
Authors: Almeida Junior Flavio N. , Steel Ronald J. , Olariu Cornel , Gan Yuqian , Gomes paim Paulo S.
Published: February 2020

The three‐dimensional facies and architecture variability of shelf‐edge deltaic units cropping out at the transition between the Lower–Middle Jurassic Lajas and Los Molles formations of southern Neuquén Basin, Argentina, is presented here, as well as their stratigraphic relationship to uppermost deep‐water slope channel systems. Deep‐water, slope mudstones with thin turbidite beds merge upward with prodelta mudstones and thin sandstones, which are truncated by delta‐front to mouth‐bar sandstones. The latter sandstones are then downcut by large‐scale, trough cross‐stratified coarse‐grained sandstones and conglomerates of distributary channel systems and along‐strike, amalgamated with cross‐bedded sandy units showing evidence of tidal reworking. Proximal–distal facies and architecture variability within a shelf‐edge deltaic succession demonstrates that distributary channel‐complexes become wider and deeper basinward, forming channelized river‐dominated distributary fairways separated by tidally reworked inter‐distributary sand belts at the shelf edge. Evidence from depositional‐dip oriented outcrops shows a lack of collapsed and slumped strata at the shelf edge, and that the coarse shelf‐edge distributary channel fills continue far down the deepwater slope, and conglomerates transform to become high‐density turbidites to mainly thick‐bedded, sand‐matrix‐supported debrites. The interplay between flood tides and river currents is interpreted to have primarily modulated the focusing of river drainages, and consequently coarse‐grained sediment transport, along preferential routes on the outer‐shelf to shelf‐edge and down onto the slope. This contribution documents a unique example of coarse‐grained (mostly conglomeratic) shelf‐edge delta systems, tying bed‐scale facies and architecture data to a seismic‐scale shelf‐margin morphology, thus providing outcrop analogue data for the characterization of shelf‐edge delta systems in the subsurface.
Imaginator: A Proof‐of‐Concept Feasibility Trial of a Brief Imagery‐Based Psychological Intervention for Young People Who Self‐Harm
Authors: Di Simplicio Martina , Appiah‐Kusi Elizabeth , Wilkinson Paul , Watson Peter , Meiser‐Stedman Caroline , Kavanagh David J. , Holmes Emily A.
Published: February 2020

Objectives

The Imaginator study tested the feasibility of a short mental imagery‐based psychological intervention for young people who self‐harm and used a stepped‐wedge design to investigate effects on self‐harm frequency reduction at 3 and 6 months.

Method

A total of 38 participants aged 16–25 were recruited via community self‐referral and mental health services. Participants were randomized to immediate delivery of Functional Imagery Training (FIT) or usual care followed by delayed delivery after 3 months. FIT comprised two face‐to‐face sessions, five phone sessions, and use of a smartphone app. Outcomes’ assessment was blind to allocation.

Results

Three quarters of those who began treatment completed face‐to‐face sessions, and 57% completed five or more sessions in total. Self‐harm frequency data were obtained on 76% of the sample at 3 months (primary outcome) and 63% at 6 months. FIT produced moderate reductions in self‐harm frequency at 3 months after immediate (d = 0.65) and delayed delivery (d = 0.75). The Immediate FIT group maintained improvements from 3 to 6 months (d = 0.05). Participants receiving usual care also reduced self‐harm (d = 0.47).

Conclusions

A brief mental imagery‐based psychological intervention targeting self‐harm in young people is feasible and may comprise a novel transdiagnostic treatment for self‐harm.
Central cardiovascular system limits to aerobic capacity
Authors: Joyner Michael J. , Dominelli Paolo B.
Published: February 2020

New Findings

What is the topic of this review?

The limits to maximal aerobic capacity.

What advances does it highlight?

A synthesis of data and ideas about what limits maximal aerobic capacity demonstrates the central roles of cardiac output, stroke volume and red blood cell mass in the complex physiological responses to maximal exercise. In healthy humans these factors, along with skeletal muscle blood flow, dominate systemic delivery of oxygen to the contracting muscles and set the upper limit of aerobic energy production by skeletal muscles. In elite athletes and patients with pulmonary disease the lungs can also limit oxygen uptake and delivery.

In this paper we review the physiological determinants of and discuss the role this variable plays as a determinant of endurance exercise performance. Because the ability to sustain a given pace during a competitive athletic event requires competitors to ‘manage’ fatigue and go as fast as possible without fatiguing prematurely, is one of the variables that sets the physiological upper limit for sustained energy production by the contracting skeletal muscles.
Resilience after trauma: The role of memory suppression
Authors: Mary Alison , Dayan Jacques , Leone Giovanni , Postel Charlotte , Fraisse Florence , Malle Carine , Vallée Thomas , Klein-Peschanski Carine , Viader Fausto , de la Sayette Vincent , Peschanski Denis , Eustache Francis , Gagnepain Pierre
Published: February 2020

Memory suppression can help after trauma

Therapists have discussed for a long time whether attempts to voluntarily suppress the intrusion of trauma memories are helpful to combat the distressing impacts of trauma. Mary
et al.
studied survivors of the 2015 Paris terrorist attacks who developed posttraumatic stress disorder and those who did not (see the Perspective by Ersche). Using functional magnetic resonance imaging, they investigated the neural networks underlying the control and suppression of memory retrieval. The results suggest that the characteristic symptoms of the disorder are not related to the memory itself but to its maladaptive control. These results offer new insights into the development of post-traumatic stress disorder and potential avenues for treatment.

Science
, this issue p.
eaay8477
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734
Fewer defects, better catalysis?
Authors: Chen Liyu , Xu Qiang
Published: February 2020

Defect-free magnesium oxide provides a better route for carbon dioxide conversion
Crossing thresholds on the way to ecosystem shifts
Authors: Hirota Marina , Oliveira Rafael
Published: February 2020

Meshing evidence from multiple datasets unveils Earth's mechanisms for adapting to environmental changes
Engineering Bacillus subtilis as a Versatile and Stable Platform for Production of Nanobodies
Authors: Yang Mengdi , Zhu Ge , Korza George , Sun Xin , Setlow Peter , Li Jiahe
Published: February 2020

It is highly desirable to produce biologics for diagnoses and therapeutic interventions on demand that could be used in a variety of settings. Among the many biologics, Nbs have attracted attention due to their small size, thermal stability, and broad utility in diagnoses, therapies, and fundamental research. Nbs originate from antibodies found in camelids, and >10 companies have invested in Nbs as potential drugs. Here, we present a system using cells of the bacteriumBacillus subtilisas a versatile platform for production of Nbs and then antigen detection via customized affinity columns. Importantly,B. subtiliscarrying engineered genes for Nbs can form spores, which survive for years in a desiccated state. However, upon rehydration and exposure to nutrients, spores rapidly transition to growing cells which secrete encoded Nbs, thus allowing their manufacture and purification.
Reconstructing Tonian seawater 87Sr/86Sr using calcite microspar
Authors: Zhou Ying , Pogge von Strandmann Philip A.E. , Zhu Maoyan , Ling Hongfei , Manning Christina , Li Da , He Tianchen , Shields Graham A.
Published: February 2020

The Tonian Period followed a long interval of relative stasis and led into the climatic extremes and biological radiations of multicellular life during the Cryogenian and Ediacaran Periods, respectively. However, despite its pivotal situation, it remains relatively understudied, in large part due to the lack of robust age constraints. A combination of fossil evidence, radiometric ages, and isotopic constraints reveal that carbonate strata on the North China craton were deposited between ca. 980 and ca. 920 Ma, thereby filling a gap in marine archives. Here we present 87Sr/86Sr data from selected calcite microspar cements, which filled early diagenetic “molar tooth” cracks, along with data from demonstrably well-preserved bulk carbonate samples. These new data show that seawater 87Sr/87Sr rose in stages from ∼0.7052 at ca. 980 Ma to ∼0.7063 by ca. 920 Ma, after which a return to low values coincided with the eruption of the Dashigou large igneous province across the North China craton. We also present a new Neoproterozoic seawater 87Sr/86Sr curve, which reveals that the general trend toward higher 87Sr/87Sr during the Tonian Period was checked repeatedly by the input of less-radiogenic strontium from a series of eruptive events, both coincident with and prior to the main breakup of Rodinia. The weathering of Tonian volcanic provinces has been linked to higher carbon burial, glaciation, and oxygenation due to the high phosphorus content of flood basalts. Here we show that the weathering of major volcanic provinces affected material fluxes and ocean chemistry much earlier than previously envisaged.
Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma
Authors: Sanford Brittany , Hoeppner Catherine , Ju Tammy , Theisen Brian K , BuAbbud Anna , Estroff Jordan M
Published: February 2020

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.
Very unusual case of a primary sinonasal germ cell tumour
Authors: Sadler Katie Ann , Hanna Catherine , Melia Louise , White Jeff
Published: February 2020

Sinonasal malignancies are a very rare diagnosis. We present a unique case of a 32-year-old man who presented with symptoms of worsening sinusitis and periorbital cellulitis. Investigation found a sinonasal malignancy and pathology confirmed this to be a primary germ cell tumour. The patient was managed with chemotherapy, surgery and consolidation radiotherapy and has remained well to date. This case report outlines an unusual presentation and diagnostic challenge for the primary care physician, ear, nose and throat surgeon, pathologist and oncologist with review of the surrounding literature.
Primary cutaneousAspergillus fumigatusinfection in immunocompetent host
Authors: Mada Pradeep Kumar , Saldaña Koppel Daniel Alexander , Al Shaarani Majd , Joel Chandranesan Andrew Stevenson
Published: February 2020

Primary cutaneous aspergillosis (PCA) occurs through inoculation of fungal spores directly into the skin from the environment through disrupted skin such as in burns, surgery or penetrating trauma patients. Most cases reported in literature were in the immunocompromised, rarely in immunocompetent patients. The characteristic lesion of cutaneous aspergillosis is a black eschar on a red plaque, or nodule at the site of skin injury. The diagnosis of PCA can be made by identifying hyphal forms on routine H&E staining or special stains such as periodic acid-Schiff or Gomori methenamine-silver stains on skin biopsy and by fungal cultures. We report a case of an 80-year-old farmer who developed cutaneous aspergillosis after a surgical procedure without any systemic spread. The diagnosis was made by histopathology and tissue fungal cultures. He was treated with incision and drainage followed by oral voriconazole for 4 weeks; which led to clinical recovery.
Guillain-Barré syndrome complicated by takotsubo cardiomyopathy: an under-recognised association
Authors: Jones Timothy , Umaskanth Neelan , De Boisanger James , Penn Henry
Published: February 2020

A 41-year-old woman was admitted with progressive paraesthesia and weakness and was diagnosed with Guillain-Barré syndrome. Following an initial period of recovery with intravenous immunoglobulin treatment, she developed acute chest pain associated with electrocardiographic changes. Investigations excluded acute coronary syndrome and instead confirmed a diagnosis of takotsubo cardiomyopathy, which was treated medically. The patient made an excellent neurological and cardiac recovery. Here we discuss the rarely described association between these two conditions and suggest that patients admitted with Guillain-Barré syndrome may benefit from routine screening with echocardiography.
The distance-quality trade-off in women’s choice of family planning provider in North Eastern Tanzania
Authors: Elewonibi Bilikisu , Sato Ryoko , Manongi Rachel , Msuya Sia , Shah Iqbal , Canning David
Published: February 2020

Introduction

Studies on the determinants of contraceptive use often consider distance to the nearest health facility offering contraception as a key explanatory variable. Women, however, may not seek contraception from the nearest facility, rather opting for a more distant facility with better quality services or to ensure greater privacy and anonymity.

Methods

The dataset used include the name of facility where each women obtained contraception, measures of facility quality, and the distance between each woman’s home and 39 potential facilities she might visit. We use a conditional-multinomial logit model to estimate the determinants of her facility choice to visit and how women tradeoff travelling longer distances to use higher quality facilities.

Results

Only 33% of woman who received contraception from a health facility used their nearest facility. While the nearest facility was 1.2 km away, the average distance to facility used was 2.9 km, indicating women are willing to travel significantly longer distances for higher quality. Women prefer facilities that specialise in providing contraception, provide a large range of methods, do not suffer from stock outs and do not charge fees. Furthermore, on average, women are willing to travel an additional 2 km for a facility that offers more family planning methods, 4.7 km for a facility without one additional health service, 9 km for a facility without fees for contraception and 11 km for a facility not experiencing stock out of an additional contraception.

Conclusion

Our results suggest that quality of services provided is an important driver of facility choice in addition to distance to facility.
Study protocol for efficacy and safety of steroid-containing mouthwash to prevent chemotherapy-induced stomatitis in women with breast cancer: a multicentre, open-label, randomised phase 2 study
Authors: Kuba Sayaka , Yamanouchi Kosho , Matsumoto Megumi , Maeda Shigeto , Hatachi Toshiko , Sakiko Soutome , Kawashita Yumiko , Morita Michi , Sakimura Chika , Inamasu Eiko , Shibata Kenichiro , Otsubo Ryota , Yano Hiroshi , Nose Seiichi , Miyamoto Junya , Sato Shuntaro , Kanetaka Kengo , Taniguchi Hideki , Umeda Masahiro , Nagayasu Takeshi , Eguchi Susumu
Published: February 2020

Introduction

Stomatitis is a frequent adverse event in patients undergoing chemotherapy for breast cancer. Stomatitis can hamper oral nutrition resulting in malnutrition, reduce quality of life and introduce the need for dose reductions and interruption of chemotherapy; however, there is currently no standard approach for preventing chemotherapy-induced stomatitis. We aimed to assess the safety and efficacy of a dexamethasone-based elixir mouthwash for preventing chemotherapy-induced stomatitis in patients with early breast cancer.

Methods and analysis

In this multicenter, randomised, controlled phase 2 trial, we will randomly assign 120 women with early breast cancer undergoing chemotherapy to use of a dexamethasone-based elixir or standard oral care, to compare their preventive effects on chemotherapy-induced stomatitis. Patients will be assigned in a 1:1 ratio. Patients in the intervention group will receive chemotherapy, oral care and a dexamethasone-based elixir (10 mL 0.1 mg/mL; swish for 2 min and spit, four times daily for 9 weeks), and patients in the control group will receive chemotherapy and oral care. The primary endpoint is the difference in incidence of stomatitis between the two groups. The sample size allows for the detection of a minimum difference of 20% in the incidence of stomatitis between the two groups. Secondary endpoints are severity of stomatitis, duration of stomatitis, completion rate of chemotherapy and adverse events.

Ethics and dissemination

All participants signed a written consent form, and the study protocol has been reviewed and approved by the Clinical Research Review Board of Nagasaki University (CRB7180001).

Trial registration number

UMIN Clinical Trials Registry (UMIN000030489).
Effectiveness and cost of integrating a pragmatic pathway for prescribing liraglutide 3.0 mg in obesity services (STRIVE study): study protocol of an open-label, real-world, randomised, controlled trial
Authors: Papamargaritis Dimitris , Al-Najim Werd , Lim Jonathan , Crane James , Lean Mike , le Roux Carel , McGowan Barbara , O'Shea Donal , Webb David , Wilding John , Davies Melanie J
Published: February 2020

Introduction

In the UK and Ireland, severe and complex obesity is managed in specialist weight management services (SWMS), which provide multicomponent lifestyle interventions to support weight loss, and use of medication if available. Liraglutide 3 mg (LIRA 3 mg) is an effective weight-loss medication, but weight loss in individual patients is variable, and its efficacy has not been assessed in SWMS. This study aims to investigate whether a targeted prescribing pathway for LIRA 3 mg with multiple prespecified stopping rules could help people with severe obesity and established complications achieve ≥15% weight loss in order to determine whether this could be considered a clinically effective and cost-effective strategy for managing severe and complex obesity in SWMS.

Methods and analysis

In this 2-year, multicentre, open-label, real-world randomised controlled trial, 384 adults with severe and complex obesity (defined as body mass index ≥35 kg/m2plus either prediabetes, type 2 diabetes, hypertension or sleep apnoea) will be randomised via a 2:1 ratio to receive either standard SWMS care (n=128) or standard SWMS care plus a targeted prescribing pathway for LIRA 3 mg with prespecified stopping rules at 16, 32 and 52 weeks (n=256).

The primary outcome is to compare the proportion of participants achieving a weight loss of ≥15% at 52 weeks with a targeted prescribing pathway versus standard care. Secondary outcomes include a comparison of (1) the weight loss maintenance at 104 weeks and (2) the budget impact and cost effectiveness between the two groups in a real-world setting.

Ethics and dissemination

The Health Research Authority and the Medicines and Healthcare products Regulatory Authority in UK, the Health Products Regulatory Authority in Ireland, the North West Deanery Research Ethics Committee (UK) and the St Vincent’s University Hospital European Research Ethics Committee (Ireland) have approved the study. The findings of the study will be published in peer-reviewed journals.

Trial registration number

ClinicalTrials.gov—Identifier:NCT03036800.

European Clinical Trials Database—Identifier: EudraCT Number 2017-002998-20.
Individual participant data (IPD) meta-analysis of psychological relapse prevention interventions versus control for patients in remission from depression: a protocol
Authors: Breedvelt Josefien J F , Warren Fiona C , Brouwer Marlies E , Karyotaki Eirini , Kuyken Willem , Cuijpers Pim , van Oppen Patricia , Gilbody Simon , Bockting Claudi L H
Published: February 2020

Introduction

Psychological interventions and antidepressant medication can be effective interventions to prevent depressive relapse for patients currently in remission of depression. Less is known about overall factors that predict or moderate treatment response for patients receiving a psychological intervention for recurrent depression. This is a protocol for an individual participant data (IPD) meta-analysis which aims to assess predictors and moderators of relapse or recurrence for patients currently in remission from depression.

Methods and analysis

Searches of PubMed, PsycINFO, Embase and Cochrane Central Register of Controlled Trials were completed on 13 October 2019. Study extractions and risk of bias assessments have been completed. Study authors will be asked to contribute IPD. Standard aggregate meta-analysis and IPD analysis will be conducted, and the outcomes will be compared with assess whether results differ between studies supplying data and those that did not. IPD files of individual data will be merged and variables homogenised where possible for consistency. IPD will be analysed via Cox regression and one and two-stage analyses will be conducted.

Ethics and dissemination

The results will be published in peer review journals and shared in a policy briefing as well as accessible formats and shared with a range of stakeholders. The results will inform patients and clinicians and researchers about our current understanding of more personalised ways to prevent a depressive relapse. No local ethics approval was necessary following consultation with the legal department. Guidance on patient data storage and management will be adhered to.

PROSPERO registration number

CRD42019127844.
Race-ethnic and gender differences in representation within the English National Health Service: a quantitative analysis
Authors: Milner Adrienne , Baker Elizabeth , Jeraj Samir , Butt Jabeer
Published: February 2020

Objectives

To evaluate race-ethnic and gender disparities in National Health Service (NHS) England employment in position, prestige and pay.

Design

National study using data from NHS Digital.

Setting

Trusts and clinical commissioning groups in England.

Participants

1 105 390 NHS Hospital and Community Health Service staff.

Results

Chinese people (42.9%, 95% CI 41.7% to 44.1%) are the most likely to be employed as doctors, followed by Asians (28.6%, 95% CI 28.3% to 28.8%) and people of mixed race/ethnicity (17.9%, 95% CI 17.3% to 18.4%); while white people (6.8%, 95% CI 6.7% to 6.8%) are less likely to be employed as doctors. However, white doctors are the most likely to be in the highest paid positions: 46.0% (95% CI 45.6% to 46.4%) of white doctors are consultants, whereas only 33.4% (95% CI 31.6% to 35.2%) of Chinese doctors are consultants. Black people are under-represented both among doctors and as consultants: 6.5% (95% CI 6.4% to 6.7%) of black employees are doctors and 30.6% (95% CI 29.2% to 32.0%) of black doctors are consultants. We found similar results for nurses and health visitors, where white people are over-represented in the higher pay bands. However, among support staff for doctors, nurses and midwives, we found that Chinese people were over-represented in the higher pay bands. These race-ethnic differences were similar for women and men. Additionally, we found that men were more likely to be employed in higher pay bands than women, and this gender disparity was apparent across race-ethnic groups.

Conclusions

Race-ethnic and gender disparities exist in the NHS in position, prestige and pay. To begin to overcome such disparities, the NHS must collect data using consistent race-ethnic categories in order to examine differences over time.
Reproducible research practices, openness and transparency in health economic evaluations: study protocol for a cross-sectional comparative analysis
Authors: Catalá-López Ferrán , Caulley Lisa , Ridao Manuel , Hutton Brian , Husereau Don , Drummond Michael F , Alonso-Arroyo Adolfo , Pardo-Fernández Manuel , Bernal-Delgado Enrique , Meneu Ricard , Tabarés-Seisdedos Rafael , Repullo José Ramón , Moher David
Published: February 2020

Introduction

There has been a growing awareness of the need for rigorously and transparent reported health research, to ensure the reproducibility of studies by future researchers. Health economic evaluations, the comparative analysis of alternative interventions in terms of their costs and consequences, have been promoted as an important tool to inform decision-making. The objective of this study will be to investigate the extent to which articles of economic evaluations of healthcare interventions indexed in MEDLINE incorporate research practices that promote transparency, openness and reproducibility.

Methods and analysis

This is the study protocol for a cross-sectional comparative analysis. We registered the study protocol within the Open Science Framework (osf.io/gzaxr). We will evaluate a random sample of 600 cost-effectiveness analysis publications, a specific form of health economic evaluations, indexed in MEDLINE during 2012 (n=200), 2019 (n=200) and 2022 (n=200). We will include published papers written in English reporting an incremental cost-effectiveness ratio in terms of costs per life years gained, quality-adjusted life years and/or disability-adjusted life years. Screening and selection of articles will be conducted by at least two researchers. Reproducible research practices, openness and transparency in each article will be extracted using a standardised data extraction form by multiple researchers, with a 33% random sample (n=200) extracted in duplicate. Information on general, methodological and reproducibility items will be reported, stratified by year, citation of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement and journal. Risk ratios with 95% CIs will be calculated to represent changes in reporting between 2012–2019 and 2019–2022.

Ethics and dissemination

Due to the nature of the proposed study, no ethical approval will be required. All data will be deposited in a cross-disciplinary public repository. It is anticipated the study findings could be relevant to a variety of audiences. Study findings will be disseminated at scientific conferences and published in peer-reviewed journals.
Time to recovery from severe acute malnutrition and its predictors: a multicentre retrospective follow-up study in Amhara region, north-west Ethiopia
Authors: Baraki Adhanom Gebreegziabher , Akalu Temesgen Yihunie , Wolde Haileab Fekadu , Takele Wubet Worku , Mamo Worku Nigussu , Derseh Behailu , Desyibelew Hanna Demelash , Dadi Abel Fekadu
Published: February 2020

Objectives

This study aimed to determine the time to recovery from severe acute malnutrition (SAM) and its predictors in selected public health institutions in Amhara Regional State, Ethiopia.

Design

An institution-based retrospective follow-up study was conducted using data extracted from 1690 patient cards from September 2012 to November 2016.

Setting

Selected government health institutions in the Amhara region, Ethiopia.

Participants

Children treated in therapeutic feeding units for SAM were included.

Outcome measures

Time to recovery from SAM.

Results

One thousand and fifty children have recovered from SAM, 62.13% (95% CI 59.8% to 64.5%). The median time to recovery was 16 days (IQR=11–28). Female gender (adjusted HR (AHR)=0.81, 95% CI 0.67 to 0.98), oedematous malnutrition (AHR=0.74 95% CI 0.59 to 0.93), pneumonia (AHR=0.66, 95% CI 0.53 to 0.83), tuberculosis (AHR=0.53, 95% CI 0.36 to 0.77), HIV/AIDS (AHR=0.47, 95% CI 0.28 to 0.79), anaemia (AHR=0.73, 95% CI 0.60 to 0.89) and receiving vitamin A (AHR=1.43, 95% CI 1.12 to 1.82) were notably associated with time to recovery.

Conclusions

The time to recovery in this study was acceptable but the proportion of recovery was far below the minimum standard. Special emphasis should be given to the prevention and treatment of comorbidities besides the therapeutic feeding. Supplementing vitamin A would also help to improve the recovery rate.
Psychometric properties of the Georgian version of the Safety Attitudes Questionnaire: a cross-sectional study
Authors: Gambashidze Nikoloz , Hammer Antje , Ernstmann Nicole , Manser Tanja
Published: February 2020

Objective

To study the psychometric properties of the Georgian version of the Safety Attitudes Questionnaire short version.

Design

Cross-sectional study.

Setting

Three Georgian hospitals.

Participants

Personnel of participating hospitals (n=305 responses, estimated response rate 30%).

Interventions

None.

Primary and secondary outcome measures

Psychometric properties (model fit, internal consistency, construct validity, convergent and discriminant validity) of the instrument, factor structure derived from the data.

Results

The Georgian version of Safety Attitudes Questionnaire demonstrated acceptable construct validity and internal consistency (Cronbach’s alpha 0.61–0.91). Three factors, Teamwork Climate, Safety Climate and Working Conditions, had limited convergent and discriminant validity. Confirmatory factor analysis with the original six-factor model resulted in limited model fit (χ2/df=2.14, root mean square error of approximation (RMSEA)=0.06, goodness of fit index (GFI)=0.83, CFI=0.88, TLI=0.86). Exploratory factor analysis resulted in a modified four-factor model with satisfactory model fit (χ2/df=2.09, RMSEA=0.06, GFI=0.88, CFI=0.93, TLI=0.91).

Conclusions

The Georgian version of the Safety Attitudes Questionnaire (short version) demonstrated acceptable psychometric properties, with acceptable to good internal consistency and construct validity. While the whole model had limited fit to the data, a modified factor model resulted in good model fit. Our findings suggest the dimension Working Conditions has questionable psychometric properties and should be interpreted with caution. Other two correlated dimensions Teamwork Climate and Safety Climate share considerable variance and may be merged. Overall, the instrument can provide valuable information relevant for advancement of patient safety culture in Georgian hospitals.
Assessment of staffing needs for physicians and nurses at Upazila health complexes in Bangladesh using WHO workload indicators of staffing need (WISN) method
Authors: Joarder Taufique , Tune Samiun Nazrin Bente Kamal , Nuruzzaman Md , Alam Sabina , de Oliveira Cruz Valeria , Zapata Tomas
Published: February 2020

Objective

This study aimed to assess the current workload and staffing need of physicians and nurses for delivering optimum healthcare services at the Upazila Health Complexes (UpHCs) in Bangladesh.

Design

Mixed-methods, combining qualitative (eg, document reviews, key informant interviews, in-depth interviews, observations) and quantitative methods (time-motion survey).

Setting

Study was conducted in 24 health facilities of Bangladesh. However, UpHCs being the nucleus of primary healthcare in Bangladesh, this manuscript limits itself to reporting the findings from the providers at four UpHCs under this project.

Participants

18 physicians and 51 nurses, males and females.

Primary outcome measures

Workload components were defined based on inputs from five experts, refined by nine service providers. Using WHO Workload Indicator of Staffing Need (WISN) software, standard workload, category allowance factor, individual allowance factor, total required number of staff, WISN difference and WISN ratio were calculated.

Results

Physicians have very high (WISN ratio 0.43) and nurse high (WISN ratio 0.69) workload pressure. 50% of nurses’ time are occupied with support activities, instead of nursing care. There are different workloads among the same staff category in different health facilities. If only the vacant posts are filled, the workload is reduced. In fact, sanctioned number of physicians and nurses is more than actual need.

Conclusions

It is evident that high workload pressures prevail for physicians and nurses at the UpHCs. This reveals high demand for these health workforces in the respective subdistricts. WISN method can aid the policy-makers in optimising utilisation of existing human resources. Therefore, the government should adopt flexible health workforce planning and recruitment policy to manage the patient load and disease burden. WISN should, thus, be incorporated as a planning tool for health managers. There should be a regular review of health workforce management decisions, and these should be amended based on periodic reviews.
Establishing a case definition of thiamine responsive disorders among infants and young children in Lao PDR: protocol for a prospective cohort study
Authors: Hess Sonja Y , Smith Taryn J , Fischer Philip R , Trehan Indi , Hiffler Laurent , Arnold Charles D , Sitthideth Dalaphone , Tancredi Daniel J , Schick Michael A , Yeh Jay , Stein-Wexler Rebecca , McBeth Christine N , Tan Xiuping , Nhiacha Kouyang , Kounnavong Sengchanh
Published: February 2020

Introduction

Diagnosis of infantile thiamine deficiency disorders (TDD) is challenging due to the non-specific, highly variable clinical presentation, often leading to misdiagnosis. Our primary objective is to develop a case definition for thiamine responsive disorders (TRD) to determine among hospitalised infants and young children, which clinical features and risk factors identify those who respond positively to thiamine administration.

Methods and analysis

This prospective study will enrol 662 children (aged 21 days to <18 months) seeking treatment for TDD symptoms. Children will be treated with intravenous or intramuscular thiamine (100 mg daily for a minimum of 3 days) alongside other interventions deemed appropriate. Baseline assessments, prior to thiamine administration, include a physical examination, echocardiogram and venous blood draw for the determination of thiamine biomarkers. Follow-up assessments include physical examinations (after 4, 8, 12, 24, 36, 48 and 72 hours), echocardiogram (after 24 and 48 hours) and one cranial ultrasound. During the hospital stay, maternal blood and breast-milk samples and diet, health, anthropometric and socio-demographic information will be collected for mother–child pairs. Using these data, a panel of expert paediatricians will determine TRD status for use as the dependent variable in logistic regression models. Models identifying predictors of TRD will be developed and validated for various scenarios. Clinical prediction model performance will be quantified by empirical area under the receiver operating characteristic curve, using resampling cross validation. A frequency-matched community-based cohort of mother–child pairs (n=265) will serve as comparison group for evaluation of potential risk factors for TRD.

Ethics and dissemination

Ethical approval has been obtained from The National Ethics Committee for Health Research, Ministry of Health, Lao PDR and the Institutional Review Board of the University of California Davis. The results will be disseminated via scientific articles, presentations and workshops with representatives of the Ministry of Health.

Trial registration number

NCT03626337.
The relationship between chronic diseases and number of sexual partners: an exploratory analysis
Authors: Grabovac Igor , Smith Lee , Yang Lin , Soysal Pinar , Veronese Nicola , Turan Isik Ahmet , Forwood Suzanna , Jackson Sarah
Published: February 2020

Background

We investigated sex-specific associations between lifetime number of sexual partners and several health outcomes in a large sample of older adults in England.

Methods

We used cross-sectional data from 2537 men and 3185 women aged ≥50 years participating in the English Longitudinal Study of Ageing. Participants reported the number of sexual partners they had had in their lifetime. Outcomes were self-rated health and self-reported limiting long-standing illness, cancer, coronary heart disease, and stroke. We used logistic regression to analyse associations between lifetime number of sexual partners and health outcomes, adjusted for relevant sociodemographic and health-related covariates.

Results

Having had 10 or more lifetime sexual partners was associated with higher odds of reporting a diagnosis of cancer than having had 0–1 sexual partners in men (OR 1.69, 95% CI 1.01 to 2.83) and women (OR 1.91, 95% CI 1.04 to 3.51), respectively. Women who had 10 or more lifetime sexual partners also had higher odds of reporting a limiting long-standing illness (OR 1.64, 95% CI 1.15 to 2.35). No other statistically significant associations were observed.

Conclusions

A higher lifetime number of sexual partners is associated with increased odds of reported cancer. Longitudinal research is required to establish causality. Understanding the predictive value of lifetime number of sexual partners as a behavioural risk factor may improve clinical assessment of cancer risk in older adults.
Covert administration of medication in food: a worthwhile moral gamble?
Authors: Guidry-Grimes Laura , Dean Megan , Victor Elizabeth Kaye
Published: February 2020

The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time.
Algebraic treatment of the Pais–Uhlenbeck oscillator and its PT-variant
Authors: Fernández Francisco M.
Published: February 2020

The algebraic method enables one to study the properties of the spectrum of a quadratic Hamiltonian through the mathematical properties of a matrix representation called regular or adjoint. This matrix exhibits exceptional points where it becomes defective and can be written in canonical Jordan form. It is shown that any quadratic function of K coordinates and K momenta leads to a 2K differential equation for those dynamical variables. We illustrate all these features of the algebraic method by means of the Pais–Uhlenbeck oscillator and its PT-variant.
Hidden-bottom and -charm hexaquark states in QCD sum rules
Authors: Wan Bing-Dong , Tang Liang , Qiao Cong-Feng
Published: February 2020

In this paper, we investigate the spectra of the prospective hidden-bottom and -charm hexaquark states with quantum numbers $$J^{PC }= 0^{++}$$JPC=0++, $$0^{-+}$$0-+, $$1^{++}$$1++ and $$1^{--}$$1-- in the framework of QCD sum rules. By constructing appropriate interpreting currents, the QCD sum rules analyses are performed up to dimension 12 of the condensates. Results indicate that there exist two possible baryonium states in b-quark sector with masses $$11.84 \pm 0.22$$11.84±0.22 GeV and $$11.72 \pm 0.26$$11.72±0.26 GeV for $$0^{++}$$0++ and $$1^{--}$$1--, respectively. The corresponding hidden-charm partners are found lying respectively at $$5.19 \pm 0.24$$5.19±0.24 GeV and $$4.78 \pm 0.23$$4.78±0.23 GeV. Note that these baryonium states are all above the dibaryon thresholds, which enables their dominant decay modes could be measured at BESIII, BELLEII, and LHCb detectors.