bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic Screening for Perinatal Mood and Anxiety Disorders to Promote Onsite Mental Health Consultations: A Quality Improvement Report
Authors: Johnson Amber , Stevenson Eleanor , Moeller Loralie , McMillian‐Bohler Jacquelyn
Published: May 2021

Introduction

Perinatal mood and anxiety disorders are the most common complication during pregnancy and postpartum. Screening, diagnosis, and treatment for these disorders are inhibited by limited mental health resources for patients and health care providers, lack of provider training, and time constraints. Systematic screening combined with onsite mental health consultation is an evidence‐based method to increase timely diagnosis and treatment. The purpose of this quality improvement project was to promote and improve onsite mental health consultations through the implementation of a systematic screening guideline.

Process

The systematic screening guidelines included administration of the Patient Health Questionnaire‐9 at the perinatal intake visit, the Edinburgh Perinatal Depression Scale between 28 and 32 weeks’ gestation and again between 2 and 8 weeks postpartum. The guidelines included onsite mental health consultations for eligible women. Screening rates, attended onsite mental health consultations, and health care provider satisfaction and feedback surveys were collected over a 3‐month period, before and after guideline implementation.

Outcomes

Perinatal mood and anxiety disorder screening rates were significantly increased from 24.9% to 64.2% (P < .001) at the perinatal intake visit and in the third trimester from 0.3% to 32.8% (P < .001) with the implementation of a systematic screening guideline. Onsite mental health consultations significantly increased from 7.2% to 15.2% (P < .001). Perinatal care providers (n = 9, 100%) were satisfied with the screening guideline and reported that it added 5 minutes or less to their office visits.

Discussion

The implementation of a systematic perinatal mood and anxiety disorder screening guideline increased completed screenings in the perinatal period and increased the number of attended onsite mental health consultations. Systematic screening combined with onsite mental health consultation is a successful way to identify at‐risk women and offer critical and convenient maternal mental health care without increasing the burden on perinatal care providers.
High‐resolution magnetic resonance and mass spectrometry imaging of the human larynx
Authors: Kishimoto Ayami Ohno , Kishimoto Yo , Shi Xudong , Hutchinson Elizabeth B. , Zhang Hua , Shi Yatao , Oliveira Gisele , Li Lingjun , Welham Nathan V. , Rowland Ian J.
Published: May 2021

High‐resolution, noninvasive and nondestructive imaging of the subepithelial structures of the larynx would enhance microanatomic tissue assessment and clinical decision making; similarly, in situ molecular profiling of laryngeal tissue would enhance biomarker discovery and pathology readout. Towards these goals, we assessed the capabilities of high‐resolution magnetic resonance imaging (MRI) and matrix‐assisted laser desorption/ionisation‐mass spectrometry (MALDI‐MS) imaging of rarely reported paediatric and adult cadaveric larynges that contained pathologies. The donors were a 13‐month‐old male, a 10‐year‐old female with an infraglottic mucus retention cyst and a 74‐year‐old female with advanced polypoid degeneration and a mucus retention cyst. MR and molecular imaging data were corroborated using whole‐organ histology. Our MR protocols imaged the larynges at 45–117 μm2 in‐plane resolution and capably resolved microanatomic structures that have not been previously reported radiographically—such as the vocal fold superficial lamina propria, vocal ligament and macula flavae; age‐related tissue features—such as intramuscular fat deposition and cartilage ossification; and the lesions. Diffusion tensor imaging characterised differences in water diffusivity, primary tissue fibre orientation, and fractional anisotropy between the intrinsic laryngeal muscles, mucosae and lesions. MALDI‐MS imaging revealed peptide signatures and putative protein assignments for the polypoid degeneration lesion and the N‐glycan constituents of one mucus retention cyst. These imaging approaches have immediate application in experimental research and, with ongoing technology development, potential for future clinical application.
Psychological responses and coping behaviour of visiting family members during and following unplanned hospital admission
Authors: Rückholdt Monica , Tofler Geoffrey H. , Randall Sue , Whitfield Victoria , Washington Kristy , Fethney Judith , Buckley Thomas
Published: May 2021

Aims

To describe the psychological symptoms and coping behaviours of visiting family members following the unplanned hospitalisation of their relative.

Background

Hospitalisation of a patient is recognised as a stressful time for visiting family members, who experience psychological morbidity and elevated health risk.

Design

This prospective longitudinal evaluation included 40 family members of patients with unplanned admission to coronary or intensive care. Assessments were conducted at 3 timepoints: in‐hospital within 1 week of admission and again at 2 weeks and 3 months post‐discharge. Measures included symptoms of anxiety, depression, and anger, coping strategies and social support. This paper adhered to STROBE guidelines.

Results

At the initial in‐hospital assessment study participants reported higher anxiety, depression and anger symptoms levels compared to community matched control participants. Compared to in‐hospital assessment, anxiety and depression levels were lower at 2 weeks and 3 months following hospital discharge. The use of active coping and the use of religion during early hospitalisation were associated with higher anxiety and depression symptoms at 3 months post‐discharge. Conversely, use of instrumental support (getting help and advice from others), planning and venting during early hospitalisation were associated with lower depression symptoms at 3 months. Venting during the hospitalisation period was also associated with lower anxiety symptoms at 3 months.

Conclusion

Results demonstrate the significant psychological impact of unplanned hospitalisation on visiting family members both during and following hospitalisation. The finding that prolonged psychological response is associated with individual coping strategies employed in the early hospitalised period informs potential preventative approaches for family members at risk of prolonged psychological morbidity following hospitalisation of their loved one.

Relevance to clinical practice

The reported psychological impact of hospitalisation on family members provides a strong imperative for nurses and health professionals to provide early individualised support to reduce the risk of long‐term psychological morbidity.
Increased hydraulic constraints in Eucalyptus plantations fertilized with potassium
Authors: Guillemot Joannès , Asensio Verónica , Bordron Bruno , Nouvellon Yann , le Maire Guerric , Bouillet Jean‐Pierre , Domec Jean‐Christophe , Delgado Rojas Juan Sinforiano , Abreu‐Junior Cassio Hamilton , Battie‐Laclau Patricia , Cornut Ivan , Germon Amandine , De Moraes Gonçalves José Leonardo , Robin Agnès , Laclau Jean‐Paul
Published: May 2021

Fertilization is commonly used to increase growth in forest plantations, but it may also affect tree water relations and responses to drought. Here, we measured changes in biomass, transpiration, sapwood‐to‐leaf area ratio (As:Al) and sap flow driving force (ΔΨ) during the 6‐year rotation of tropical plantations of Eucalyptus grandis under controlled conditions for throughfall and potassium (K) fertilization. K fertilization increased final tree height by 8 m. Throughfall exclusion scarcely affected tree functioning because of deep soil water uptake. Tree growth increased in K‐supplied plots and remained stable in K‐depleted plots as tree height increased, while growth per unit leaf area increased in all plots. Stand transpiration and hydraulic conductance standardized per leaf area increased with height in K‐depleted plots, but remained stable or decreased in K‐supplied plots. Greater Al in K‐supplied plots increased the hydraulic constraints on water use. This involved a direct mechanism through halved As:Al in K‐supplied plots relative to K‐depleted plots, and an indirect mechanism through deteriorated water status in K‐supplied plots, which prevented the increase in ΔΨ with tree height. K fertilization in tropical plantations reduces the hydraulic compensation to growth, which could increase the risk of drought‐induced dieback under climate change.
What Do Easy Inferences Get Us?
Authors: Thomasson Amie L.
Published: May 2021

In Ontology Made Easy (2015), I defend the idea that there are ‘easy’ inferences that begin from uncontroversial premises and end with answers to disputed ontological questions. But what do easy inferences really get us? Bueno and Cumpa (this journal, 2020) argue that easy inferences don’t tell us about the natures of properties—they don’t tell us what properties are. Moreover, they argue, by accepting an ontologically neutral quantifier we can also resist the conclusion that properties or numbers exist. Here I address these two issues in turn—in ways that help clarify both the scope and results of easy ontology.

First, it is important to see that easy inferences were never intended to address modal questions. Modal questions are addressed by a different part of the total deflationary view—modal normativism. So understood, metaphysical modal questions nonetheless do not provide a remaining area for serious metaphysical inquiry. Second, I argue that we have reason to resist adopting an ontologically neutral quantifier, if we aim to answer ontological questions (without begging the question). Addressing these issues helps to clarify both what does (and does not) follow from easy inferences, and how they form part of a larger deflationary metametaphysical view.
The usefulness of a hydrolysed fish and rice starch elimination diet for the diagnosis of adverse food reactions in cats: an open clinical trial
Authors: Noli Chiara , Beltrando Giorgia
Published: May 2021

Background

Diagnosis of adverse food reaction (AFR) is based on an eight week elimination diet (ED) and is confirmed by relapse upon re‐challenge with the previously fed diet. Hydrolysed EDs are commonly used for this purpose.

Objective

To evaluate the commercially available hydrolysed fish protein and rice starch ED Farmina UltraHypo (FUH) for the diagnosis of feline AFR.

Animals

Thirty‐two nonseasonally pruritic cats.

Methods and materials

Pruritus was assessed with a new dual Visual Analog Scale, lesions with the Scoring Feline Allergic Dermatitis scale and Quality of Life with a validated questionnaire on days 0 and 56. Short‐acting corticosteroids or oclacitinib were permitted during the first six weeks. Cats showing 50% pruritus and/or lesional improvement were separately challenged with their prior diet, fish and rice. Cats not responding to the study diet were fed another hydrolysed diet for two months.

Results

Twenty‐five cats completed the ED: four dropped out due to vomiting and/or diarrhoea, one owing to low palatability and two were lost to follow‐up. In 17 cats, pruritus improved by >50% and these underwent dietary challenges. Of these, nine reacted to their prior diet and/or fish and/or rice and were diagnosed with AFR, while eight did not relapse (and a diagnosis of AFR was considered to be doubtful). Of the eight cats in which pruritus did not improve, four underwent a second ED with no improvement.

Conclusion and clinical importance

FUH may be a useful ED for the diagnosis of feline AFR, even in cats reacting to fish or rice.
Analysis of the Open University of Brazil Program as a National Policy for Public Distance Education in Brazil
Authors: Arruda Eucidio Pimenta
Published: May 2021

This paper aims to understand how free distance education policies in Brazil, the Open University of Brazil (OUB) System, and public relations between this program and the weakening of distance education in Brazilian public education. Discuss the relationships between DE and teacher training in Brazil, as well as the program's weaknesses in directing teaching, and engage in dialogue with DE resistances in other areas of training in Brazilian public universities. We point out the ineffectiveness of expanding vacancies to train teachers and the perspective of planning the use of distance education in public universities, or what leads to the growing resistance to this model of education within institutions. Finally, that to strengthen distance education in Brazilian public education, and it is necessary to set aside programs of unstable duration, such as the OUB, and to think about public policies that affect the regularity and breadth of training areas in distance education.
Reviewer Acknowledgements
Authors: Smith Robert
Published: May 2021

Journal of Education and Training Studies (JETS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JETS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 9, Number 5 John Cowan, Edinburgh Napier University, UKJohn Mark Asio, Gordon College, PhilippinesKeyla Ferrari Lopes, UNICAMP, BrazilMichael Baron, University of Melbourne, AustraliaRichard H. Martin, Mercer University, USASamah El-Sakka, Suez University, EgyptThada Jantakoon, Rajabhat Maha Sarakham University, ThailandVeronica Velasco Gonzalez, University of Valladolid, Spain Robert SmithEditorial AssistantOn behalf of,The Editorial Board of Journal of Education and Training StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAE-mail 1: jets@redfame.comE-mail 2: jets@redfame.orgURL: http://jets.redfame.com
Perceptual similarity between piano notes: Simulations with a template-based perception model
Authors: Osses Vecchi Alejandro , Kohlrausch Armin
Published: May 2021

In this paper, the auditory model developed by Dau, Kollmeier, and Kohlrausch [(1997). J. Acoust. Soc. Am. 102, 2892–2905] was used to simulate the perceptual similarity between complex sounds. As complex sounds, a set of piano recordings was used, whose perceptual similarity has recently been measured by Osses, Kohlrausch, and Chaigne [(2019). J. Acoust. Soc. Am. 146, 1024–1035] using a three-alternative forced-choice discrimination task in noise. To simulate this discrimination task, the auditory model required a new back-end stage, the central processor, which is preceded by several processing stages that are to a greater or lesser extent inspired by physiological aspects of the normal-hearing system. Therefore, a comprehensive review of the model parameters as used in the literature is given, indicating the fixed set of parameter values that is used in all simulations. Due to the perceptual relevance of the piano note onsets, this review includes an in-depth description of the auditory adaptation stage, the adaptation loops. A moderate to high correlation was found between the simulation results and existing experimental data.
Aircraft noise—Auralization-based assessment of weather-dependent effects on loudness and sharpness
Authors: Dreier Christian , Vorländer Michael
Published: May 2021

This paper deals with the question of how specific weather conditions affect the perception of aircraft noise. Auralization is a suitable method by enabling parametrical decompositions of the overall aircraft noise scenario into source and propagation components. Considering influences on the auditory perception, the signal processing chain contains different virtual receivers and post processing using psychoacoustic hearing models. For broad coverage, generic standardized as well as measurement-based atmosphere models with variation of ground impedances such as soil data are evaluated. These variations are given aircraft noise measurement values based on A-weighted sound pressure levels LA and psychoacoustic measures regarding loudness, N, and sharpness, S. The results show an immense influence of weather conditions on A-weighted sound pressure levels and on psychoacoustic perception of aircraft noise, too. The weather-dependent differences of A-weighted sound pressure levels are up to 15 dBA and relative differences regarding loudness of factor 1.6 and sharpness of factor 2.0 occur. The approach can be used to get a better understanding of how the temporal statistics of specific local weather conditions and their perceptual consequences may lead to improved taxation of actual noise events and to an improved basis for long-term averages of aircraft noise effects.
Phosphorylation of Pal2 by the protein kinases Kin1 and Kin2 modulates
HAC1
mRNA splicing in the unfolded protein response in yeast
Authors: Ghosh Chandrima , Uppala Jagadeesh Kumar , Sathe Leena , Hammond Charlotte I. , Anshu Ashish , Pokkuluri P. Raj , Turk Benjamin E. , Dey Madhusudan
Published: May 2021

Phosphorylated Pal2 promotes the cytosolic splicing of
HAC1
to restore homeostasis in yeast undergoing ER stress.
Valproate-induced fatal acute hyperammonaemia-related encephalopathy in late-onset ornithine transcarbamylase deficiency
Authors: Kazmierski Daniel , Sharma Nishant , O'Leary Kelly , Ochieng Pius
Published: May 2021

Ornithine transcarbamylase (OTC) deficiency is a genetic disorder of the urea cycle characterised by deficiency in the enzyme OTC, resulting in an accumulation of ammonia. Valproic acid (VPA), a commonly used medication in the treatment of neurologic and psychiatric conditions, has been known to cause episodes of acute hyperammonaemia in patients with OTC deficiency. We present the case of a 29-year-old man with a long history of non-specific psychiatric disorders, who suffered from a hyperammonaemic crisis following the administration of VPA, leading to the diagnosis of OTC deficiency. The patient’s hospital course was complicated by progressive cerebral oedema, which resulted in worsening encephalopathy, seizures and death. We discuss the pathophysiology of hyperammonaemia in OTC deficiency, and various management strategies, including lactulose, levocarnitine, scavenger therapy and haemodialysis.
Bilateral peripheral facial paralysis during pregnancy: a presentation of acute HIV seroconversion
Authors: Ladzinski Adam T , George Nicholas B , Jagger Brett W
Published: May 2021

A G7P5A1 woman in her 40s presented to the emergency department at 37 weeks 3 days’ estimated gestational age (EGA) with headache, lip tingling and several days of difficulty speaking. Physical examination demonstrated bilateral facial weakness in a peripheral distribution, as well as decreased corneal reflexes and cervical lymphadenopathy. Routine fourth generation HIV screening had previously been negative at 14 and 28 weeks’ EGA. Brain MRI was unremarkable, and lumbar puncture disclosed a low-grade, mononuclear cerebrospinal fluid pleocytosis; the patient was treated supportively. She returned for induction of labour at 39 weeks, at which time HIV infection was unexpectedly diagnosed. While unilateral idiopathic peripheral facial paralysis is associated with the third trimester of pregnancy and the early postpartum period, bilateral facial paralysis is rare and should prompt work-up for an underlying systemic cause, such as HIV infection.
Predicting the propagation of COVID-19 at an international scale: extension of an SIR model
Authors: Lavielle Marc , Faron Matthieu , Lefevre Jérémie H , Zeitoun Jean-David
Published: May 2021

Objectives

Several epidemiological models have been published to forecast the spread of the COVID-19 pandemic, yet many of them have proven inaccurate for reasons that remain to be fully determined. We aimed to develop a novel model and implement it in a freely accessible web application.

Design

We built an SIR-type compartmental model with two additional compartments:D(deceased patients);L(individuals who will die but who will not infect anybody due to social or medical isolation) and integration of a time-dependent transmission rate and a periodical weekly component linked to the way in which cases and deaths are reported.

Results

The model was implemented in a web application (as of 2 June 2020). It was shown to be able to accurately capture the changes in the dynamics of the pandemic for 20 countries whatever the type of pandemic spread or containment measures: for instance, the model explains 97% of the variance of US data (daily cases) and predicts the number of deaths at a 2-week horizon with an error of 1%.

Conclusions

In early performance evaluation, our model showed a high level of accuracy between prediction and observed data. Such a tool might be used by the global community to follow the spread of the pandemic.
Neuropsychiatric safety of varenicline in the general and COPD population with and without psychiatric disorders: a retrospective cohort study in a real-world setting
Authors: Wang Yuanyuan , Bos Jens H. , Schuiling-Veninga Catharina C.M. , Boezen H. Marike , van Boven Job F. M. , Wilffert Bob , Hak Eelko
Published: May 2021

Objectives

To evaluate the real-world association between varenicline and neuropsychiatric adverse events (NPAEs) in general and chronic obstructive pulmonary disease (COPD) population with and without psychiatric disorders compared with nicotine replacement therapy (NRT) to strengthen the knowledge of varenicline safety.

Design

A retrospective cohort study.

Setting

Prescription database IADB.nl, the Netherlands.

Participants

New users of varenicline or NRT among general (≥18 years) and COPD (≥40 years) population. Psychiatric subcohort was defined as people prescribed psychotropic medications (≥2) within 6 months before the index date.

Outcome measures

The incidence of NPAEs including depression, anxiety and insomnia, defined by new or naive prescriptions of related medications in IADB.nl within 24 weeks after the first treatment initiation of varenicline or NRT.

Results

For the general population in non-psychiatric cohort, the incidence of total NPAEs in varenicline (4480) and NRT (1970) groups was 10.5% and 12.6%, respectively (adjusted OR (aOR) 0.85, 95% CI 0.72 to 1.00). For the general population in psychiatric cohort, the incidence of total NPAEs was much higher, 75.3% and 78.5% for varenicline (1427) and NRT (1200) groups, respectively (aOR 0.82, 95% CI 0.68 to 0.99). For the COPD population (1598), there were no differences in the incidence of NPAEs between comparison groups in both the psychiatric cohort (aOR 0.97, 95% CI 0.66 to 1.44) and non-psychiatric cohort (aOR 0.81, 95% CI 0.54 to 1.20). Results from subgroup or sensitivity analyses also did not reveal increased risks of NPAEs but showed decreased risk of some subgroup NPAEs associated with varenicline.

Conclusions

In contrast to the concerns of a possible increased risk of NPAEs among varenicline users, we found a relative decreased risk of total NPAEs in varenicline users of the general population in psychiatric or non-psychiatric cohorts compared with NRT and no difference for NPAEs between varenicline and NRT users in smaller population with COPD.
Association between dyslipidemia and risk of type 2 diabetes mellitus in middle-aged and older Chinese adults: a secondary analysis of a nationwide cohort
Authors: Peng Jieru , Zhao Fei , Yang Xue , Pan Xiongfei , Xin Jue , Wu Mengjun , Peng Yong G
Published: May 2021

Aims

To evaluate the type 2 diabetes mellitus (T2DM) risk of individuals with different types of dyslipidaemia and compare the predictive value of distinct lipid parameters in predicting T2DM.

Methods

We conducted a secondary analysis of data from the China Health and Retirement Longitudinal Study (CHARLS). 17 708 individuals over 45 years old were interviewed, and 11 847 blood samples were collected at the baseline survey (2011–2012). Outcome of T2DM was confirmed during two follow-up surveys (2013–2014 and 2015–2016). The HRs and 95% CI of T2DM associated with dyslipidaemia were estimated by Cox proportional hazards regressions model. The discriminatory value of eight lipid parameters were compared by the area under the receiver operating characteristic (ROC) curve (AUC).

Results

A total of 7329 participants were enrolled in our analysis; during the mean follow-up time of 3.4 years, 387 (5.28%) participants developed new-onset diabetes. Compared with participants in normal lipid levels, the T2DM risk of those with hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein cholesterol (HDL-C) were significantly increased (HRs (95% CI) were 1.48 (1.11 to 1.96), 1.92 (1.49 to 2.46) and 1.67 (1.35 to 2.07), respectively). The AUCs of non-HDL-C (0.685, 95% CI 0.659 to 0.711), triglyceride (TG) (0.684, 95% CI 0.658 to 0.710), total cholesterol (TC)/HDL-C (0.685, 95% CI 0.659 to 0.712) and TG/HDL-C (0.680, 95% CI 0.654 to 0.706) were significantly (p<0.005) larger than that of other lipid parameters.

Conclusion

Middle-aged and elderly adults with hypertriglyceridaemia, hypercholesterolaemia and low HDL-C were at higher risk for developing diabetes. Non-HDL-C, TG, TC/HDL and TG/HDL have greater performance than other lipid parameters in predicting T2DM incidence.
Comparison of short-term outcomes and quality of life in totally laparoscopic distal gastrectomy and totally robotic distal gastrectomy for clinical stage I–III gastric cancer: study protocol for a multi-institutional randomised clinical trial
Authors: Cui Hao , Cao Bo , Liu Guoxiao , Xi Hongqing , Chen Zhida , Liang Wenquan , Zhang Kecheng , Cui Jianxin , Xie Tianyu , Deng Huan , Tang Yun , Chen Lin , Wei Bo
Published: May 2021

Introduction

Laparoscopic distal gastrectomy (LDG) is regarded as a standard treatment for patients with clinical stage I–III gastric cancer. With the popularisation of theDa Vincirobotic system in the 21st century, robotic distal gastrectomy has been increasingly applied, and its potential advantages over LDG have been proved by several studies. Intraperitoneal anastomosis is a hot topic in research as it highlights the superiority of minimally invasive surgery and is safe and feasible. We intend to conduct this randomised clinical trial to focus on short-term outcomes and quality of life (QOL) in totally laparoscopic distal gastrectomy (TLDG) and totally robotic distal gastrectomy (TRDG) for patients with clinical stage I–III gastric cancer.

Methods and analysis

This study is a prospective, multi-institutional, open-label randomised clinical trial that will recruit 722 patients with a 1:1 ratio (361 patients in the TLDG group and 361 patients in the TRDG group) from eight large-scale gastrointestinal medical centres in China. The primary endpoint is 30-day postoperative morbidity. The secondary endpoints include QOL, 30-day severe postoperative morbidity and mortality, anastomotic-related complication rate, conversion to open surgery rate, intraoperative and postoperative indicators, operative and total costs during hospitalisation, 1-year overall survival and disease-free survival. QOL is determined by the The European Organization for Reasearch and Treatment of Cancer Quality of Life Questionnare-Core 30 and Stomach22 (EORTC QLQ-C30 and STO22) questionnaires which are completed before surgery and 1, 3, 6 months, and 1 year after surgery. χ2test will be used for the primary endpoint, while analysis of covariance will be used to compare the overall changes of QOL between the two groups.

Ethics and dissemination

This trial was approved by the Ethics Committee of the Chinese PLA General Hospital. The trial’s results will be disseminated via peer-reviewed scientific journals and conference presentations.

Trial registration number

ChiCTR2000032670.
Associations of diarised sleep onset time, period and duration with total and central adiposity in a biethnic sample of young children: the Born in Bradford observational cohort study
Authors: Collings Paul James , Blackwell Jane Elizabeth , Pal Elizabeth , Ball Helen L , Wright John
Published: May 2021

Objectives

To investigate associations of parent-reported sleep characteristics with adiposity levels in a biethnic sample of young children.

Design

A cross-sectional observational study.

Setting

The Born in Bradford 1000 study, UK.

Participants

Children aged approximately 18 months (n=209; 40.2% South Asian; 59.8% white) and 36 months (n=162; 40.7% South Asian; 59.3% white).

Primary and secondary outcome measures

Children’s body mass index (BMI) z-score, sum of two-skinfolds (triceps and subscapular) and waist circumference. Adjusted regression was used to quantify associations of sleep parameters with adiposity stratified by ethnicity and age group. The results are beta coefficients (95% CIs) and unless otherwise stated represent the difference in outcomes for every 1-hour difference in sleep parameters.

Results

The average sleep onset time was markedly later in South Asian (21:26±68 min) than white children (19:41±48 min). Later sleep onset was associated with lower BMI z-score (−0.3 (−0.5 to −0.0)) and sum of two-skinfolds (−1.5 mm (−2.8 mm to −0.2 mm)) in white children aged 18 months and higher BMI z-score in South Asian children aged 36 months (0.3 (0.0–0.5)). Longer sleep duration on weekends than weekdays was associated with higher BMI z-score (0.4 (0.1–0.8)) and waist circumference (1.2 cm (0.3–2.2 cm)) in South Asian children aged 18 months, and later sleep onset on weekends than weekdays was associated with larger sum of two-skinfolds (1.7 mm (0.3–3.1 mm)) and waist circumference (1.8 cm (0.6–2.9 cm)). Going to sleep ≥20 min later on weekends than weekdays was associated with lower waist circumference in white children aged 18 months (−1.7 cm (−3.2 cm to −0.1 cm)).

Conclusions

Sleep timing is associated with total and central adiposity in young children but associations differ by age group and ethnicity. Sleep onset times and regular sleep schedules may be important for obesity prevention.
Multimodal measurement approach to identify individuals with mild cognitive impairment: study protocol for a cross-sectional trial
Authors: Grässler Bernhard , Herold Fabian , Dordevic Milos , Gujar Tariq Ali , Darius Sabine , Böckelmann Irina , Müller Notger G , Hökelmann Anita
Published: May 2021

Introduction

The diagnosis of mild cognitive impairment (MCI), that is, the transitory phase between normal age-related cognitive decline and dementia, remains a challenging task. It was observed that a multimodal approach (simultaneous analysis of several complementary modalities) can improve the classification accuracy. We will combine three noninvasive measurement modalities: functional near-infrared spectroscopy (fNIRS), electroencephalography and heart rate variability via ECG. Our aim is to explore neurophysiological correlates of cognitive performance and whether our multimodal approach can aid in early identification of individuals with MCI.

Methods and analysis

This study will be a cross-sectional with patients with MCI and healthy controls (HC). The neurophysiological signals will be measured during rest and while performing cognitive tasks: (1) Stroop, (2) N-back and (3) verbal fluency test (VFT). Main aims of statistical analysis are to (1) determine the differences in neurophysiological responses of HC and MCI, (2) investigate relationships between measures of cognitive performance and neurophysiological responses and (3) investigate whether the classification accuracy can be improved by using our multimodal approach. To meet these targets, statistical analysis will include machine learning approaches.

This is, to the best of our knowledge, the first study that applies simultaneously these three modalities in MCI and HC. We hypothesise that the multimodal approach improves the classification accuracy between HC and MCI as compared with a unimodal approach. If our hypothesis is verified, this study paves the way for additional research on multimodal approaches for dementia research and fosters the exploration of new biomarkers for an early detection of nonphysiological age-related cognitive decline.

Ethics and dissemination

Ethics approval was obtained from the local Ethics Committee (reference: 83/19). Data will be shared with the scientific community no more than 1 year following completion of study and data assembly.

Trial registration number

ClinicalTrials.gov,NCT04427436, registered on 10 June 2020,https://clinicaltrials.gov/ct2/show/study/NCT04427436.
Association between obesity and chronic rhinosinusitis with nasal polyps: a national population-based study
Authors: Nam Jae-Sung , Roh Yun Ho , Fahad Wasan Almazouq , Noh Hae-Eun , Ha Jong-Gyun , Yoon Joo-Heon , Kim Chang-Hoon , Cho Hyung-Ju
Published: May 2021

Objectives

We performed a cross-sectional analysis of data from the nationwide Korea National Health and Nutrition Examination Survey to evaluate the association between obesity and chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyp (CRSsNP).

Design

Retrospective cross-sectional analysis of health survey data.

Setting

Voluntary survey of representative South Korean populations.

Participants

In total, 32 384 individuals aged 19 years or older with available data on CRS and obesity were included.

Primary and secondary outcome measures

Diagnosis of CRSwNP or CRSsNP was performed by trained otolaryngologists through sinus endoscopy and surveys of medical history. General and central obesity was diagnosed using body mass index (BMI) and waist circumference (WC), respectively.

Methods

A multivariate logistic regression analysis was used to clarify the association between CRSwNP or CRSsNP and obesity according to BMI and WC. Non-obese individuals were recruited as controls.

Results

The prevalence of CRSwNP was higher in the general (OR, 1.438; 95% CI, 1.170 to 1.768; p<0.001) and central (OR, 1.251; 95% CI, 1.031 to 1.520; p=0.033) obesity groups than in the control group. Prevalence of CRSsNP was not correlated with obesity. In a logistic regression analysis, olfactory dysfunction (OR, 1.329; 95% CI, 1.137 to 1.553; p<0.001) and purulent discharge (OR, 1.383; 95% CI, 1.193 to 1.603; p<0.001) showed a higher incidence in the central obesity group than in the control group.

Conclusions

We demonstrated an association between CRSwNP and general and central obesity. Further investigations on the mechanism underlying this correlation are necessary for an improved understanding of the pathogenesis of CRSwNP.
BOugie or stylet in patients UnderGoing Intubation Emergently (BOUGIE): protocol and statistical analysis plan for a randomised clinical trial
Authors: Driver Brian , Semler Matthew W , Self Wesley H , Ginde Adit A , Gandotra Sheetal , Trent Stacy A , Smith Lane M , Gaillard John P , Page David B , Whitson Micah R , Vonderhaar Derek J , Joffe AM , West Jason R , Hughes Christopher , Landsperger Janna S , Howell Michelle P , Russell Derek W , Gulati Swati , Bentov Itay , Mitchell Steven , Latimer Andrew , Doerschug Kevin , Koppurapu Vikas , Gibbs Kevin W , Wang Li , Lindsell Christopher John , Janz David , Rice Todd W , Prekker Matthew E , Casey Jonathan D
Published: May 2021

Introduction

Intubation-related complications are less frequent when intubation is successful on the first attempt. The rate of first attempt success in the emergency department (ED) and intensive care unit (ICU) is typically less than 90%. The bougie, a semirigid introducer that can be placed into the trachea to facilitate a Seldinger-like technique of tracheal intubation and is typically reserved for difficult or failed intubations, might improve first attempt success. Evidence supporting its use, however, is from a single academic ED with frequent bougie use. Validation of these findings is needed before widespread implementation.

Methods and analysis

The BOugie or stylet in patients UndergoingIntubation Emergently trial is a prospective, multicentre, non-blinded randomised trial being conducted in six EDs and six ICUs in the USA. The trial plans to enrol 1106 critically ill adults undergoing orotracheal intubation. Eligible patients are randomised 1:1 for the use of a bougie or use of an endotracheal tube with stylet for the first intubation attempt. The primary outcome is successful intubation on the first attempt. The secondary outcome is severe hypoxaemia, defined as an oxygen saturation less than 80% between induction until 2 min after completion of intubation. Enrolment began on 29 April 2019 and is expected to be completed in 2021.

Ethics and dissemination

The trial protocol was approved with waiver of informed consent by the Central Institutional Review Board at Vanderbilt University Medical Center or the local institutional review board at an enrolling site. The results will be submitted for publication in a peer-reviewed journal and presented at scientific conferences.

Trial registration number

ClinicalTrials.gov Registry (NCT03928925).
Equity in vaccine trials for higher weight people? Protocol for a rapid review of inclusion and exclusion criteria for higher weight people in clinical trials for COVID-19
Authors: Campbell Jessica , Hobbs Matthew , O’Hara Lily , Ballantyne Angela , Heywood Anita , Gray Lesley
Published: May 2021

Introduction

Vaccination is a public health strategy that aims to reduce the burden of viral illness, especially important for populations known or likely to be at increased risk for inequitable outcomes due to the disease itself or disparities in care accessed and received. The role of weight status in COVID-19 susceptibility and disease burden remains unclear. Despite this, higher weight is frequently described as a definitive risk factor for both susceptibility and disease severity. Therefore, COVID-19 vaccine trials should recruit a study group representative of the full weight spectrum, and undertake appropriate subgroup analysis by weight status to evaluate response and titrate dose regimes where indicated to ensure equitable outcomes for higher weight people.

Methods and analysis

We aim to review inclusion and exclusion criteria of clinical trial protocols registered with ClinicalTrials.gov, ISRCTN Register, the WHO official vaccine trial register, and ‘The COVID-19 Vaccine Tracker’. To determine the number of trials including higher weight (body mass index >30 kg/m2) individuals and the number of trials conducting efficacy subgroup analyses by weight status. Screening, data extraction and quality appraisal of trial protocols will be completed independently by a minimum of two reviewers. Clinical trials will be assessed for risk of bias using the Risk of Bias-2 tool. We will conduct a descriptive analysis of extracted data. The following subsets are proposed: participation of higher weight people in COVID-19 vaccine trials by trial phase, country and vaccine platform.

Ethics and dissemination

Ethical approval was not required for this review. The results of this rapid review will be presented at appropriate conferences and published in a suitable peer reviewed journal.

PROSPERO registration number

CRD42020226573
Altered faecal microbiome and metabolome in IgG4-related sclerosing cholangitis and primary sclerosing cholangitis
Authors: Liu Qiaoyan , Li Bo , Li Yikang , Wei Yiran , Huang Bingyuan , Liang Jubo , You Zhengrui , Li You , Qian Qiwei , Wang Rui , Zhang Jun , Chen Ruiling , Lyu Zhuwan , Chen Yong , Shi Mingxia , Xiao Xiao , Wang Qixia , Miao Qi , Fang Jing-Yuan , Gershwin Merrill Eric , Lian Min , Ma Xiong , Tang Ruqi
Published: May 2021

Objective

Multiple clinical similarities exist between IgG4-related sclerosing cholangitis (IgG4-SC) and primary sclerosing cholangitis (PSC), and while gut dysbiosis has been extensively studied in PSC, the role of the gut microbiota in IgG4-SC remains unknown. Herein, we aimed to evaluate alterations of the gut microbiome and metabolome in IgG4-SC and PSC.

Design

We performed 16S rRNA gene amplicon sequencing of faecal samples from 135 subjects with IgG4-SC (n=34), PSC (n=37) and healthy controls (n=64). A subset of the samples (31 IgG4-SC, 37 PSC and 45 controls) also underwent untargeted metabolomic profiling.

Results

Compared with controls, reduced alpha-diversity and shifted microbial community were observed in IgG4-SC and PSC. These changes were accompanied by differences in stool metabolomes. Importantly, despite some common variations in the microbiota composition and metabolic activity, integrative analyses identified distinct host–microbe associations in IgG4-SC and PSC. The disease-associated genera and metabolites tended to associate with the transaminases in IgG4-SC. Notable depletion ofBlautiaand elevated succinic acid may underlie hepatic inflammation in IgG4-SC. In comparison, potential links between the microbial or metabolic signatures and cholestatic parameters were detected in PSC. Particularly, concordant decrease ofEubacteriumand microbiota-derived metabolites, including secondary bile acids, implicated novel host–microbial metabolic pathways involving cholestasis of PSC. Interestingly, the predictive models based on metabolites were more effective in discriminating disease status than those based on microbes.

Conclusions

Our data reveal that IgG4-SC and PSC possess divergent host–microbe interplays that may be involved in disease pathogenesis. These data emphasise the uniqueness of IgG4-SC.
Megarectum: systematic histopathological evaluation of 35 patients and new common pathways in chronic rectal dilatation
Authors: Martin Joanne E , English William , Kendall John V , Sheshappanavar Vinayata , Peroos Sara , West Milly , Cleeve Stewart , Knowles Charles
Published: May 2021

Aims

Megarectum is well described in the surgical literature but few contemporary pathological studies have been undertaken. There is uncertainty whether ‘idiopathic’ megarectum is a primary neuromuscular disorder or whether chronic dilatation leads to previously reported and unreported pathological changes. We sought to answer this question.

Methods

Systematic histopathological evaluation (in accord with international guidance) of 35 consecutive patients undergoing rectal excision surgery for megarectum (primary: n=24) or megarectum following surgical correction of anorectal malformation (secondary: n=11) in a UK university hospital with adult/paediatric surgical and gastrointestinal neuropathology expertise.

Results

We confirmed some previously reported observations, notably hypertrophy of the muscularis propria (27 of 35, 77.1% of patients) and extensive fibrosis (30 of 35, 85.7% of patients). We also observed unique and previously unreported features including elastosis (19 of 33, 57.6%) and the presence of polyglucosan bodies (15 of 32, 46.9% of patients). In contrast to previous literature, few patients had any strong evidence of specific forms of visceral neuropathy (5 of 35, including 3 plexus duplications) or myopathy (6 of 35, including 3 muscle duplications). All major pathological findings were common to both primary and secondary forms of the disease, implying that these may be a response to chronic rectal distension rather than of primary aetiology.

Conclusions

In the largest case series reported to date, we challenge the current perception of idiopathic megarectum as a primary neuromuscular disease and propose a cellular pathway model for the features present. The severe morphological changes account for some of the irreversibility of the condition and reinforce the need to prevent ongoing rectal distension when first identified.
Subjective cognitive complaints at age 70: associations with amyloid and mental health
Authors: Pavisic Ivanna M. , Lu Kirsty , Keuss Sarah E. , James Sarah-Naomi , Lane Christopher A. , Parker Thomas D. , Keshavan Ashvini , Buchanan Sarah M. , Murray-Smith Heidi , Cash David M. , Coath William , Wong Andrew , Fox Nick C. , Crutch Sebastian J. , Richards Marcus , Schott Jonathan M.
Published: May 2021

Objective

To investigate subjective cognitive decline (SCD) in relation to β-amyloid pathology and to test for associations with anxiety, depression, objective cognition and family history of dementia in the Insight 46 study.

Methods

Cognitively unimpaired ~70-year-old participants, all born in the same week in 1946 (n=460, 49% female, 18% amyloid-positive), underwent assessments including the SCD-Questionnaire (MyCog). MyCog scores were evaluated with respect to18F-Florbetapir-PET amyloid status (positive/negative). Associations with anxiety, depression, objective cognition (measured by the Preclinical Alzheimer Cognitive Composite, PACC) and family history of dementia were also investigated. The informant’s perspective on SCD was evaluated in relation to MyCog score.

Results

Anxiety (mean (SD) trait anxiety score: 4.4 (3.9)) was associated with higher MyCog scores, especially in women. MyCog scores were higher in amyloid-positive compared with amyloid-negative individuals (adjusted means (95% CIs): 5.3 (4.4 to 6.1) vs 4.3 (3.9 to 4.7), p=0.044), after accounting for differences in anxiety. PACC (mean (SD) −0.05 (0.68)) and family history of dementia (prevalence: 23.9%) were not independently associated with MyCog scores. The informant’s perception of SCD was generally in accordance with that of the participant.

Conclusions

This cross-sectional study demonstrates that symptoms of SCD are associated with both β-amyloid pathology, and more consistently, trait anxiety in a population-based cohort of older adults, at an age when those who are destined to develop dementia are still likely to be some years away from symptoms. This highlights the necessity of considering anxiety symptoms when assessing Alzheimer’s disease pathology and SCD.
Psychological interventions to reduce postoperative pain and opioid consumption: a narrative review of literature
Authors: Gorsky Kevin , Black Nick D , Niazi Ayan , Saripella Aparna , Englesakis Marina , Leroux Timothy , Chung Frances , Niazi Ahtsham U
Published: May 2021

Background

Evidence suggests that over half of patients undergoing surgical procedures suffer from poorly controlled postoperative pain. In the context of an opioid epidemic, novel strategies for ameliorating postoperative pain and reducing opioid consumption are essential. Psychological interventions defined as strategies targeted towards reducing stress, anxiety, negative emotions and depression via education, therapy, behavioral modification and relaxation techniques are an emerging approach towards these endpoints.

Objective

This review explores the efficacy of psychological interventions for reducing postoperative pain and opioid use in the acute postoperative period.

Evidence review

An extensive literature search was conducted in MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Medline In-Process/ePubs, Embase, Ovid Emcare Nursing, and PsycINFO, Web of Science (Clarivate), PubMed-NOT-Medline (NLM), CINAHL and ERIC, and two trials registries, ClinicalTrials.Gov (NIH) and WHO ICTRP. Included studies were limited to those investigating adult human subjects, and those published in English.

Findings

Three distinct forms of psychological interventions were identified: relaxation, psychoeducation and behavioral modification therapy. Study results showed a reduction in both postoperative opioid use and pain scores (n=5), reduction in postoperative opioid use (n=3), reduction in postoperative pain (n=5), no significant reduction in pain or opioid use (n=7), increase in postoperative opioid use (n=1) and an increase in postoperative pain (n=1).

Conclusion

Some preoperative psychological interventions can reduce pain scores and opioid consumption in the acute postoperative period; however, there is a clear need to strengthen the evidence for these interventions. The optimal technique, strategies, timing and interface requires further investigation.