bluuebunny/crossref_metadata_2025 huggingface dataset:
MenQuadfi (MenACWY-TT): A New Vaccine for Meningococcal Serogroups ACWY
Authors: Huston Jessica , Galicia Kevin , Egelund Eric F.
Published: August 2021

Objective

This article reviews data encompassing the pharmacology, efficacy, and safety of MenACWY-TT (MenQuadfi), a conjugate vaccine to prevent meningococcal disease from serogroups A, C, W, Y.

Data Sources

A literature review was conducted in PubMed, MEDLINE, and ClinicalTrials.gov from inception up to July 2021, using the search terms MenQuadfi, meningococcal ACWY vaccine, MCV4, and menacwy. Articles from reference lists were included to identify potential relevant literature.

Study Selection and Data Extraction

Data were limited to randomized phase II and III clinical studies published in the English language, evaluating the efficacy and safety of MenACWY-TT. Animal studies and studies not utilizing MenACWY-TT were excluded.

Data Synthesis

One phase II and 4 phase III randomized clinical studies, enrolling approximately 7700 participants, aged 2 years to 97 years old found that MenACWY-TT was noninferior when compared to established MenACWY vaccines, as measured by surrogate immunogenicity end points. In studies evaluating primary dose vaccination, conducted in those aged 2 to 97 years of age, the difference in seroresponse rates, reported by the lower bound of the 95% CI, was (A) 1.1% to 14.8%, (C) 21% to 42.2%, (Y) 7.7% to 24.6%, and (W) 8.9% to 22.5%.

Relevance to Patient Care and Clinical Practice

Despite the low incidence of meningococcal disease in the United States, meningococcal disease causes significant morbidity and mortality if not prevented.

Conclusion

MenACWY-TT is noninferior to currently approved quadrivalent meningococcal vaccines and shows similar immunogenicity and safety as both an initial vaccine for prevention as well as a booster dose.
A hybrid method of predicting the acoustical properties of multi-layered materials
Authors: Li Zechao , Yang Lin , Ren Hongbin , Chen Sizhong , Liu Zheng , Feng Jianbo , Gao Zepeng , Chen Yong
Published: August 2021

Many numerical and measuring approaches are widely used in predicting and analysing the acoustic performances of laminated materials for noise control applications. However, numerical methods generally require a set of non-acoustic parameters, and the measuring methods are not available for exceedingly thick materials. The main aim of this article is to address a hybrid approach of evaluating the normal incidence sound transmission loss and absorption coefficients of multi-layered materials. This method is performed with some special parameters that contain the sound transmission and reflection coefficients of each sub-layer of a multi-layer specimen and can be measured by a standing wave tube system. The accuracy and feasibility of the present method are validated by the experimental and numerical comparisons between different methods and samples. Moreover, this present approach can be applied as a numerical tool of estimating the acoustical behaviours of multi-layered structures in noise control treatments, such as automotive, building and aerospace industries.
Collagen XI Alpha 1 (COL11A1) Expression in the Tumor Microenvironment Drives Neuroblastoma Dissemination
Authors: Truong Dinh Quang , Ho Ban Tran , Chau Gia-Cac , Truong Dinh Khai , Pham Thuy Thi Thanh , Nakagawara Akira , Bui Chi-Bao
Published: August 2021

Background

Neuroblastoma (NB) is among the most common cancers in children. A highly aggressive form of cancer, NB relies on cells in the microenvironment for dissemination particularly cancer associated fibroblast (CAFs). CAFs synthesise the extracellular matrix to create a scaffold for tumor growth thus enabling the carcinogenesis of NB, Collagen, an abundant scaffold protein produced by CAFs, has been implicated in the creation of an optimal tumor microenvironment, however, the expression profile of collagen within NB is not yet known.

Methods

We characterised collagen expression within the tumor-stroma boundary by microarray and confirmed by qRT-PCR and immunohistochemistry.

Results

The collagen marker, COL11A1, was also upregulated in NB CD45+ cells and SMA+ CAFs. Furthermore, SMA+ CAFs led to neuroblastoma cell invasion in an in vitro co-culture system which was subsequently attenuated by gene silencing COL11A1. Immunohistochemical staining of clinical tumor samples revealed that high COL11A1 expression in the stroma adjacent to tumour site, significantly associated with advanced cancer stages, age ≥18 months, undifferentiated tumor status, relapse and poor overall survival.

Conclusion

Collectively, these results suggest that a COL11A1 signature in the NB microenvironment could represent a novel target for therapeutic intervention.
Living with landmines: Inhabiting a war-altered landscape
Authors: Arensen Lisa
Published: August 2021

Mined land in Cambodia possesses hazardous potential for those willing to risk its inhabitation, but this potentiality is commingled with threat and uncertainty. Mined terrain creates sites where the affordances of place clash with its dangerous materialities. Village residents in this study were engaged in ongoing efforts to physically alter the place they inhabited, but these tectonic processes were not always successful. The presence of military waste transformed the landscape into an unfamiliar ecological terrain of intermingled organic and potentially explosive inorganic elements. By 2009, large swathes of village land had been cleared of both mines and wild vegetation, giving villagers a hard-earned sense of safety. However, ongoing uncertainty remained about the state of the ground and the things buried within it. Amidst the struggle to reclaim the landscape for agriculture, mines sometimes interposed themselves, their detonations damaging bodies and lives and unsettling residents’ sense of place.
Two different paths to sustainability? A comparison of a Finnish and a Swedish public pension reserve fund
Authors: Väänänen Niko
Published: August 2021

The role played by finance in allocating resources has become crucial in modern economies. Responsible Investing, i.e., the integration of non-financial criteria (such as environmental, social, and governance (ESG), negative/positive screening, and active ownership) into the investment process, has gained an important role. Does this apply to pension funds, too? This article compares two public pension reserve funds, one from Finland and one from Sweden, and describes their path towards responsible investments. The article shows that although having taken different paths, responsible investing has been clearly integrated into the investment process of both funds during the last decades. In Finland, the role played by pension fund insiders has been remarkable. In Sweden, legislators have played an active and significant role in the process. The design of the pension system equally plays an important role in the overall process. In Sweden, cooperation is promoted in responsible investments. In Finland, pension system design fosters competition, thereby reducing cooperation in investments. This article adds more information on the scarce comparative research on public pension reserve funds.
Gendered encounters in mobility: Women researching migrant construction workers
Authors: Gama Gato Luana , Matyska Anna
Published: August 2021

Writing about sexism and sexual harassment in the field is still generally discouraged outside gender ethnography, despite a growing gender reflexivity in research. This is mostly due to certain established norms and expectations about ethnographic work that tend to ignore how these issues contribute to women’s fieldwork experiences and subsequent ethnographic accounts. In this article, we go against this tendency by setting out our gendered experiences as female ethnographers conducting research on labor mobility in the male-dominated construction industry among Brazilian internal migrants in Rio de Janeiro and among Polish migrant workers in Europe. We foreground how gendered dynamics affected our fieldwork experience and how they generated a degree of self-doubt and self-blame about our methodological choices. Our hope is that writing about our experiences will help female ethnographers to better prepare for and consider the different kinds of sexism that will inevitably shape their knowledge production.
CFD modeling of pre-spark heat release in a boosted direct-injection spark-ignition engine
Authors: Guo Hengjie , Torelli Roberto , Szybist James P , Som Sibendu
Published: August 2021

Accurate predictions of low-temperature heat release (LTHR) are critical for modeling auto-ignition processes in internal combustion engines. While LTHR is typically obscured by deflagration, extremely late ignition phasing can lead to LTHR prior to the spark, a behavior known as pre-spark heat release (PSHR). In this research, PSHR in a boosted direct-injection spark-ignition engine was studied using 3-D computational fluid dynamics (CFD) and detailed chemical kinetics. The turbulent combustion was modeled via a hybrid approach that incorporates the G-equation model for tracking the turbulent flame front, and the well-stirred reactor model with detailed chemistry for assessing the low-temperature reactions in unburnt gas. Simulations were conducted using Co-Optima alkylate and E30 fuels at operating conditions characterized by different PSHR intensities. The predicted in-cylinder pressure and heat release rate were found to agree well with experiments. It was found the estimate of previous-cycle trapped residuals is of utmost importance for capturing PSHR correctly. A simulation best practice was developed which keeps the detailed chemistry solver active throughout the entire simulation, allowing to track the evolution of intermediate species from one cycle to the next. Following the validation, the dynamics of PSHR were analyzed in detail employing the pressure-temperature (P-T) trajectory framework. It was shown that PSHR correlated with the first-stage ignition delay of the fuel, hence showing close relation to the in-cylinder P-T trajectory and the chemical kinetics. Besides, it was indicated that LTHR is a self-limiting process that has the effect of attenuating the thermal stratification in the combustion chamber. Furthermore, it was observed the occurrence of PSHR caused the P-T trajectory of end-gas to overlap with the negative temperature coefficient region of the fuel’s ignition-delay maps. This effect was more significant in the fuel-rich regions where engine knock tendency would be generally higher, with potential implications on knock control and mitigation.
The “PERFECT” Call: Congressional Representation by Tweet in the Midst of the Ukraine Whistleblower Scandal
Authors: McKee Seth C. , Evans Heather K. , Clark Jennifer Hayes
Published: August 2021

In this article we examine every tweet congresspersons sent from the time the media broke the news of President Trump’s fateful July 2019 phone call with Ukrainian President Zelensky up to a week after House Speaker Pelosi announced a formal impeachment inquiry. Our aim is to understand the type of rhetoric Members of Congress (MCs) engaged in with respect to what we call the Ukraine Whistleblower Scandal (UWS). It is evident from our analysis that Democrats were more likely to sound off on the UWS, which comports with the fact that it was a Republican President who got into trouble. Further, there are characteristics of MCs that make them more likely to frame and discuss the UWS in certain ways, like House Representatives holding law degrees or serving on one of the House committees investigating the UWS. Finally, in this age of hyper-polarized parties, party affiliation was consistently the most important factor shaping representatives’ Twitter statements on the UWS. In historical perspective, the overriding importance of party affiliation is lamentable since the charges against President Trump were solemn and serious.
Effect of MicroRNA-146a Modified Adipose-Derived Stem Cell Exosomes on Rat Back Wound Healing
Authors: Chen, MD Gangquan , Wu, MD Yaling , Zou, MD Lijin , Zeng, MD Yuanlin
Published: August 2021

Objective: To investigate the effect of MicroRNA-146a modified adipose-derived stem cell exosomes on the proliferation and migration of fibroblasts and the therapeutic effect on wound healing. Methods: Culture and identification of human adipose-derived stem cells (hASCs), miRNA-146a minic vector was constructed and transfected into hASCs, the exosomes of the empty group and overexpression group were extracted, identified, and quantitatively analyzed after 24 h of successful transfection. The exosomes were added into National Institute of Health Mouse Embryonic Fibroblasts (NIH/3T3) and cultured for 48 h, the proliferation and migration ability of NIH/3T3 fibroblasts was detected. The expression of serpin family H member 1 (SERPINH1) and phosphorylated extracellular regulated protein kinase (p-ERK) was detected by Western blot. The model of back wound was established. The exosomes were injected into 4 different sites with the shape of “cross” around the wound, and the scar diameter of the skin defect was measured at 3, 7, and 11 days, the skin of the defect was taken on the 14th day. platelet endothelial cell adhesion molecule-1 (CD31) was detected by immunofluorescence staining to evaluate angiogenesis, and Western blot was used to detect the expression of SERPINH1 and p-ERK. Results: The miR-146a mimic-exosome promoted the proliferation and migration of fibroblasts, and the expression of SERPINH1 and p-ERK2 was up-regulated. After the rats were treated with exosomes, the wound area decreased rapidly, neovascularization was promoted, and the expression of SERPINH1 and p-ERK2 was up-regulated. Conclusions: MicroRNA-146a modified adipose stem cell exosomes could regulate the expression of SERPINH1 and p-ERK, promote the migration and proliferation of fibroblasts, and neovascularization to promote the wound healing of rat back.
The effects of emotionality and lexical category on L2 word processing in different tasks: Evidence from late Chinese–English bilinguals
Authors: Liao Xiaogen , Ni Chuanbin
Published: August 2021

Although it has been well established that emotional content influences language comprehension, the effects of emotionality on L2 (second language: English) word processing require further clarification. Notably, most previous studies unsystematically mixed words of different lexical categories, although they often showed processing differences. Here, using the same set of tightly matched negative, positive, and neutral words across three lexical categories (i.e., nouns, verbs, adjectives), we examined the effects of emotionality and lexical category on L2 word processing by conducting three experiments. In these experiments, three groups of late Chinese–English bilinguals performed three tasks: the emotional Stroop task (Experiment 1), the lexical decision task (Experiment 2), and the emotional categorisation task (Experiment 3), respectively. Overall, our data suggested that emotionality and lexical category exerted no influence on L2 word processing in the emotional Stroop task, but acted interactively to influence it in the other two tasks. The results evidenced that the processing of L2 emotional words was sensitive to task type. Therefore, we conclude that future research on L2 word processing should fully consider the emotionality, lexical category, and task type.
Environmental contamination and personal protective equipment contamination with SARS-CoV-2 virus in a real-life clinical setting
Authors: Shahi Avneet K , Ahmed-Saeed Nusreen , Taylor Isobel , Kiernan Sharon , Mahobia Nitin , Pelosi Emanuela , Saeed Kordo
Published: August 2021

The importance of SARS-CoV-2 transmission via contact routes and its stability on surfaces is becoming increasingly recognised. There is ongoing concern that patients can become infected through person-to-person spread and environment-to-person spread. This study assessed whether SARS-CoV-2 viral RNA can be detected in the environment either on staff members’ personal protective equipment (PPE), on high-touch surfaces or around the bedspace of COVID-19–positive patients in a range of different ward settings to evaluate if there was any contamination of these. Results showed all PPE and high-touch surface swabs were negative. All swabs taken in the negative-pressure room where aerosol-generating procedures (AGPs) were being undertaken detected viral RNA (5/5 positive), whereas there was minimal contamination in the intensive therapy unit (1/5 positive) and none detected in the cohort bay. These findings would be consistent with the understanding that areas where AGPs are regularly performed are at higher risk of environmental contamination.
Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study
Authors: Shrestha Sailesh Kumar , Shrestha Swarup , Ingnam Sisham
Published: August 2021

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.
Periprosthetic joint infections of the shoulder: A 10-year retrospective analysis outlining the heterogeneity among these patients
Authors: Paziuk Taylor , Cox Ryan M , Gutman Michael J , Rondon Alexander J , Nicholson Thema , Belden Katherine , Namdari Surena
Published: August 2021

Background

Diagnosis and treatment of shoulder periprosthetic joint infection is a difficult problem. The purpose of this study was to utilize the 2018 International Consensus Meeting definition of shoulder periprosthetic joint infection to categorize revision shoulder arthroplasty cases and determine variations in clinical presentation by presumed infection classification.

Methods

Retrospective review of patients undergoing revision shoulder arthroplasty at a single institution. Likelihood of periprosthetic joint infection was determined based on International Consensus Meeting scoring. All patients classified as definitive or probable periprosthetic joint infection were classified as periprosthetic joint infection. All patients classified as possible or unlikely periprosthetic joint infection were classified as aseptic. The periprosthetic joint infection cohort was subsequently divided into culture-negative, non-virulent microorganism, and virulent microorganism cohorts based on culture results.

Results

Four hundred and sixty cases of revision shoulder arthroplasty were reviewed. Eighty (17.4%) patients were diagnosed as definite or probable periprosthetic joint infection, of which 29 (36.3%), 39 (48.8%), and 12 (15.0%) were classified as virulent, non-virulent, or culture-negative periprosthetic joint infection, respectively. There were significant differences among periprosthetic joint infection subgroups with regard to preoperative C-reactive protein (p = 0.020), erythrocyte sedimentation rate (p = 0.051), sinus tract presence (p = 0.008), and intraoperative purulence (p < 0.001). The total International Consensus Meeting criteria scores were also significantly different between the periprosthetic joint infection cohorts (p < 0.001).

Discussion

While the diagnosis of shoulder periprosthetic joint infection has improved with the advent of International Consensus Meeting criteria, there remain distinct differences between periprosthetic joint infection classifications that warrant further investigation to determine the accurate diagnosis and optimal treatment.
Teachers as researchers: Life, death, and making waves
Authors: Wilson-Ali Nadia , Yelland Nicola , Marie Iorio Jeanne
Published: August 2021

In this colloquium we share stories from two schools located in Western Australia that were inspired from the Reggio Emilia education project. The focus is on a view of children as capable citizens of the now. The examples in practice describe learning scenarios in which educators work as researchers using the ordinary moments of daily classroom life. It is in these ordinary moments where a pedagogy of listening is enacted.
Attitudes about containment measures during the 2020/2021 coronavirus pandemic: self-interest, or broader political orientations?
Authors: Diehl Claudia , Wolter Felix
Published: August 2021

We analyze opposition towards Covid-19 containment measures by assessing the role of self-interest, sociotropic threat, political predispositions, and infection rates. We base our analyses on two waves of survey data from Germany ( N = 3258/3201). Our measure of self-interest includes objective indicators for and subjective perceptions of individual threat from containment measures in the economic sphere and in the family and health domains. We also analyze whether the role of self-interest changes as the pandemic proceeds in its course. Our results show that self-interest plays a limited role in explaining attitudes about containment measures. More important are broader political predispositions such as trust in institutions, including the government. Attitudes are unrelated to local rates of infection or death. This pattern has remained stable over the course of the pandemic. We discuss the relevance of these findings with respect to the general enforceability of public policies that serve collective goals, such as efforts to limit climate change. Parts of the population may be reluctant to comply with these public policies even if the associated costs to the individual are small. This is less because of people’s personal circumstances, and more because of their opposition to government interventions as such.
Systematic identification of non-canonical transcription factor motifs
Authors: Chumpitaz-Diaz Luis , Samee Md. Abul Hassan , Pollard Katherine S.
Published: August 2021

Sequence-specific transcription factors (TFs) recognize motifs of related nucleotide sequences at their DNA binding sites. Upon binding at these sites, TFs regulate critical molecular processes such as gene expression. It is widely assumed that a TF recognizes a single “canonical” motif, although recent studies have identified additional “non-canonical” motifs for some TFs. A comprehensive approach to identify non-canonical DNA binding motifs and the functional importance of those motifs’ matches in the human genome is necessary for fully understanding the mechanisms of TF-regulated molecular processes in human cells. To address this need, we developed a statistical pipeline for in vitro HT-SELEX data that identifies and characterizes the distributions of non-canonical TF motifs in a stringent manner. Analyzing ~170 human TFs’ HT-SELEX data, we found non-canonical motifs for 19 TFs (11%). These non-canonical motifs occur independently of the TFs’ canonical motifs. Non-canonical motif occurrences in the human genome show similar evolutionary conservation to canonical motif occurrences, explain TF binding in locations without canonical motifs, and occur within gene promoters and epigenetically marked regulatory sequences in human cell lines and tissues. Our approach and collection of non-canonical motifs expand current understanding of functionally relevant DNA binding sites for human TFs.
Estimating the impact of non-pharmaceutical interventions against COVID-19 on mumps incidence in Sichuan, China
Authors: Zhang Wenqiang , Luan Rongsheng
Published: August 2021

Background

A series of social and public health measures have been implemented to contain coronavirus disease 2019 (COVID-19) in China. We examined the impact of non-pharmaceutical interventions against COVID-19 on mumps incidence as an agent to determine the potential reduction in other respiratory virus incidence.

Methods

We modelled mumps incidence per month in Sichuan using a seasonal autoregressive integrated moving average (ARIMA) model, based on the reported number of mumps cases per month from 2017 to 2020.

Results

The epidemic peak of mumps in 2020 is lower than in the preceding years. Whenever compared with the projected cases or the average from corresponding periods in the preceding years (2017–2019), the reported cases in 2020 markedly declined (P < 0.001). From January to December, the number of mumps cases was estimated to decrease by 36.3% (33.9–38.8%), 34.3% (31.1–37.8%), 68.9% (66.1–71.6%), 76.0% (73.9–77.9%), 67.0% (65.0–69.0%), 59.6% (57.6–61.6%), 61.1% (58.8–63.3%), 49.2% (46.4–52.1%), 24.4% (22.1–26.8%), 30.0% (27.5–32.6%), 42.1% (39.6–44.7%), 63.5% (61.2–65.8%), respectively. The total number of mumps cases in 2020 was estimated to decrease by 53.6% (52.9–54.3%).

Conclusion

Our study shows that non-pharmaceutical interventions against COVID-19 have had an effective impact on mumps incidence in Sichuan, China.
Acute tubulointerstitial nephritis associated with antineutrophil cytoplasmic antibody following cimetidine treatment: a case report
Authors: Morimoto Keita , Kanzaki Go , Niikura Takahito , Koike Kentaro , Matsuo Nanae , Maruyama Yukio , Tsuboi Nobuo , Yokoo Takashi
Published: August 2021

Background

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis usually induces rapidly progressive glomerulonephritis, including pauci-immune necrotizing crescentic glomerulonephritis. Acute tubulointerstitial nephritis (ATIN), which is often drug-induced, is a frequent cause of kidney injury. However, ATIN associated with ANCA without any glomerular lesions has been rarely reported, and drug-induced ATIN associated with ANCA is not well recognized. Here we present a case of an older woman with ATIN associated with myeloperoxidase-ANCA (MPO-ANCA) following cimetidine treatment.

Case presentation

A 70-year-old woman was admitted to our hospital due to acute kidney injury and mild proteinuria. She had a one-year history of chronic thyroiditis and dyslipidemia, for which she was taking levothyroxine sodium and atorvastatin, respectively. Two weeks before admission she had started cimetidine, methylmethionine sulfonium chloride, and itopride hydrochloride for gastric discomfort persistent since a month. She had experienced fatigue for two weeks and later appetite loss. The patient demonstrated a positive titer for MPO-ANCA (192 IU/mL) and a positive drug-induced lymphocyte stimulation test for cimetidine. She underwent two kidney biopsies that revealed ATIN without any glomerular lesions. Despite discontinuation of cimetidine on admission, renal injury continued with the presence of high MPO-ANCA titer. Oral steroid treatment was closely related with the recovery of her renal function and disappearance of MPO-ANCA.

Conclusions

In this case, ATIN presented as sustained renal insufficiency and high MPO-ANCA titer despite withdrawal of cimetidine. Therefore, we reason that the development of ANCA-associated ATIN was caused by cimetidine. Serologic follow-up with measurement of MPO-ANCA titers and renal biopsy are recommended when the clinical history is inconsistent with the relatively benign course of drug-induced ATIN.
Does women’s place of birth affect their opportunity for an informed choice about Down syndrome screening? A population-based study in France
Authors: Anselem Olivia , Saurel-Cubizolles Marie-Josèphe , Khoshnood Babak , Blondel Béatrice , Sauvegrain Priscille , Bertille Nathalie , Azria Elie ,   for the BiP study group, Anselem Olivia , Azria Elie , Bonnet Marie-Pierre , Cognet Marguerite , Deneux-Tharaux Catherine , Guedj Romain , Linard Morgane , Ngo Charlotte , Richetin Juliette , Rousseau Anne , Saurel Marie-Josèphe , Sauvegrain Priscille
Published: August 2021

Background

To examine disparities by maternal place of birth in the opportunity to make an informed choice about Down syndrome screening, in France, where the national guidelines recommend that physicians offer it to all pregnant women.

Methods

We used population-based data from the nationally representative French Perinatal Surveys in 2010 and 2016 (N=24,644 women) to analyze the opportunity for an informed choice for prenatal screening, measured by a composite indicator.

Results

Among the 24 644 women in the study, 20 612 (83.6%) were born in France, 861 (3.5%) elsewhere in Europe, 1550 (6.3%) in North Africa, and 960 (3.9%) in sub-Saharan Africa. The probability of screening was lower for women born outside France. After adjustment for survey year, maternal age, parity, education level, and the maternity unit’s level of perinatal care, women born outside France had the opportunity to make an informed choice less often than women born in France. This association remained essentially the same even after excluding women without adequate prenatal care.

Conclusions

Women born outside France, including those with adequate prenatal care, had less opportunity than women born in France to make an informed choice about prenatal screening for Down syndrome.
Behavioral impact of national health campaigns on healthy lifestyle practices among young adults in Singapore: a cross-sectional study
Authors: Khow Yong Zhi , Lim Talia Li Yin , Ng Jarret Shoon Phing , Wu Jiaxuan , Tan Chuen Seng , Chia Kee Seng , Luo Nan , Seow Wei Jie
Published: August 2021

Background

National health campaigns are often used to improve lifestyle behaviors in the general population. However, evidence specifically in the young adult population is scarce. Given the general deterioration of healthy lifestyle practices from adolescence to young adulthood, it is imperative to study this age group. This study aimed to investigate the behavioral impact of a national health campaign in Singapore on the lifestyle practices of young adults, and whether sex or full-time working and schooling status affected lifestyle practices.

Methods

A total of 594 Singaporean respondents aged 18–39 years old were interviewed via a cross-sectional study in December 2019. Lifestyle practices assessed were diet, exercise, alcohol consumption, current tobacco use, and participation in health screening programs. Other factors investigated included exposure to the national health campaign “War on Diabetes” (WoD), sex, ethnicity, and working/schooling status. Multivariable modified Breslow-Cox proportional hazards models were used to estimate prevalence risk ratios (PRRs) as measures for the associations in this study, after adjusting for potential confounders.

Results

Exposure to the WoD campaign had a significant association with meeting dietary recommendations (PRR = 1.6, 95% CI: 1.0–2.5,p = 0.037), participation in screening (PRR = 1.2, 95% CI: 1.0–1.5,p = 0.028), and current tobacco use (PRR = 0.5, 95% CI: 0.3–0.8,p = 0.003). Males were significantly more likely to meet exercise recommendations (PRR = 2.0, 95% CI: 1.5–2.7,p < 0.001), currently use tobacco (PRR = 3.9, 95% CI: 2.2–6.9, p < 0.001), and consume alcohol excessively (PRR = 1.5, 95% CI: 1.0–2.3,p = 0.046), as compared to females. Working young adults were significantly less likely to meet exercise recommendations (PRR = 0.7, 95% CI: 0.5–0.9,p = 0.019) but significantly more likely to be current tobacco users (PRR = 1.8, 95% CI: 1.1–3.1,p = 0.024), as compared to those who were in school.

Conclusions

While this paper affirms that national health campaigns have significant beneficial associations in diet, health screenings and current tobacco use, policymakers should acknowledge that young adults are an age group with different influences that impact their healthy lifestyle habits. Specific interventions that target these subgroups may be required for better health outcomes. Future studies should evaluate other socio-environmental factors that could play a role in modifying the effect of health campaigns among young adults.
A survey of pharmacists' knowledge, attitudes and barriers in pharmaceutical care concept in Poland
Authors: Kopciuch Dorota , Paczkowska Anna , Zaprutko Tomasz , Ratajczak Piotr , Nowakowska Elżbieta , Kus Krzysztof
Published: August 2021

Background

The major goals of pharmaceutical care (PC) are to improve the patient’s quality of life and ensure safety of pharmacotherapy. Inclusion of a pharmacist in the multidisciplinary team caring for the patient and integration of state-of-the-art pharmaceutical services with medical care and nursing are some of the most important challenges that the health care system in Poland is facing.

Objectives

To evaluate the pharmacists attitudes towards practice in, and knowledge of PC in Poland and to identify the barriers in PC provision.

Methods

The study was designed as a multicenter study, conducted among Polish pharmacists. Random sampling technique was employed to select the study group. Face-to-face questionnaire method was used to interview the pharmacists, upon obtaining their prior verbal consent to participate in the study. The study was conducted between January 2017 and September 2019.

Results

Only 15% of the pharmacists have ever attended a training on PC. 72% believed PC provision was necessary to ensure pharmacotherapy safety. Only 63% of the pharmacists believed that preventing and solving health-related and drug therapy problems for patients were their responsibilities. The main reason for non-provision of PC by the pharmacists was the lack of time for such activities, lack of legal regulations, lack of organizational facilities.

Conclusion

This study indicates that implementation of PC is expected in Poland. Educational programs in this respect are urgently needed. PC provision should be included in the curricula of academic pharmaceutical courses.
Supporting medicines management for older people at care transitions – a theory-based analysis of a systematic review of 24 interventions
Authors: Tomlinson Justine , Marques Iuri , Silcock Jonathan , Fylan Beth , Dyson Judith
Published: August 2021

Background

Older patients are at severe risk of harm from medicines following a hospital to home transition. Interventions aiming to support successful care transitions by improving medicines management have been implemented. This study aimed to explore which behavioural constructs have previously been targeted by interventions, which individual behaviour change techniques have been included, and which are yet to be trialled.

Method

This study mapped the behaviour change techniques used in 24 randomised controlled trials to the Behaviour Change Technique Taxonomy. Once elicited, techniques were further mapped to the Theoretical Domains Framework to explore which determinants of behaviour change had been targeted, and what gaps, if any existed.

Results

Common behaviour change techniques used were: goals and planning; feedback and monitoring; social support; instruction on behaviour performance; and prompts/cues. These may be valuable when combined in a complex intervention. Interventions mostly mapped to between eight and 10 domains of the Theoretical Domains Framework. Environmental context and resources was an underrepresented domain, which should be considered within future interventions.

Conclusion

This study has identified behaviour change techniques that could be valuable when combined within a complex intervention aiming to support post-discharge medicines management for older people. Whilst many interventions mapped to eight or more determinants of behaviour change, as identified within the Theoretical Domains Framework, careful assessment of the barriers to behaviour change should be conducted prior to intervention design to ensure all appropriate domains are targeted.
Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2
Authors: Bes Taniela , Nagano Debora , Martins Roberta , Marchi Ana Paula , Perdigão-Neto Lauro , Higashino Hermes , Prado Gladys , Guimaraes Thais , Levin Anna S. , Costa Silvia
Published: August 2021

Carbapenem-resistant Enterobacteriaceae are a worldwide health problem and isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe the microbiological and clinical characteristics of five cases of bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae and Serratia marcescens having both blaKPC-2 and blaNDM-1. Of the five blood samples, three are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a surgical patient. All patients lived in low-income neighbourhoods and had no travel history. Despite antibiotic treatment, four out of five patients died. The phenotypic susceptibility assays showed that meropenem with the addition of either EDTA, phenylboronic acid (PBA), or both, increased the zone of inhibition in comparison to meropenem alone. Molecular tests showed the presence of blaKPC-2 and blaNDM-1 genes. K. pneumoniae isolates were assigned to ST258 or ST340 by whole genome sequencing. This case-series showed a high mortality among patients with BSI caused by Enterobacteriae harbouring both carbapenemases. The detection of carbapenemase-producing isolates carrying both blaKPC-2 and blaNDM-1 remains a challenge when using only phenotypic assays. Microbiology laboratories must be alert for K. pneumoniae isolates producing both KPC-2 and NDM-1.
Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation
Authors: Chai Yanfei , Ma Yuchao , Feng Wei , Lu Hongwei , Jin Longyu
Published: August 2021

Background

The standard treatment of stage III N2 small cell lung cancer (SCLC) is concurrent chemoradiation, and surgery is not recommended. This study was aimed to evaluate whether surgery has survival benefits in patients with stage III N2 SCLC and investigate the factors influencing survival of surgery.

Methods

Patients diagnosed with stage T1-4N2M0 SCLC from 2004 to 2015 were selected from the Surveillance Epidemiology End Results database. Propensity score matching (PSM) was used to balance confounders between patients who underwent surgery and those treated with radiation and/or chemotherapy. We compared overall survival (OS) of the two groups using Kaplan-Meier curves and a Cox proportional hazard model. We also identified prognostic factors in patients with surgical resection, and a nomogram was developed and validated for predicting postoperative OS.

Results

−A total of 5576 patients were included in the analysis; of these, 211 patients underwent surgery. PSM balanced the differences between the two groups. The median OS was longer in the surgery group than in the non-surgery group (20 vs. 15 months; p = 0.0024). Surgery was an independent prognostic factor for longer OS in the multivariate Cox regression analysis, and subgroup analysis revealed a higher survival rate in T1 stage patients treated with surgery (hazard ratio = 0.565, 95% confidence interval: 0.401–0.798; p = 0.001). In patients who underwent surgery, four prognostic factors, including age, T stage, number of positive lymph nodes, and radiation, were selected into nomogram development for predicting postoperative OS. C-index, decision curve analyses, integrated discrimination improvement, and time-dependent receiver operating characteristics showed better performance in nomogram than in the tumor-node-metastasis staging system. Calibration plots demonstrated good consistency between nomogram predicted survival and actual observed survival. The patients were stratified into three different risk groups by prognostic scores and Kaplan-Meier curves showed significant difference between these groups.

Conclusions

These results indicate that surgery can prolong survival in patients with operable stage III N2 SCLC, particularly those with T1 disease. A nomogram that includes age, T stage, number of positive lymph nodes, and radiation can be used to predict their long-term postoperative survival.
TAK1 mediates neuronal pyroptosis in early brain injury after subarachnoid hemorrhage
Authors: Xu Pengfei , Tao Chunrong , Zhu Yuyou , Wang Guoping , Kong Lingqi , Li Wenyu , Li Rui , Li Juanji , Zhang Chao , Wang Li , Liu Xinfeng , Sun Wen , Hu Wei
Published: August 2021

Background

Innate immunity can facilitate early brain injury (EBI) following subarachnoid hemorrhage (SAH). Numerous studies suggest that pyroptosis could exacerbate extracellular immune responses by promoting secretion of inflammatory cytokines. Transforming growth factor-β-activated kinase 1 (TAK1) is a quintessential kinase that positively regulates inflammation through NF-κB and MAPK signaling cascades. However, the effects of TAK1 on neuroinflammation in EBI following SAH are largely unknown.

Methods

Two hundred and forty-six male C57BL/6J mice were subjected to the endovascular perforation model of SAH. A selective TAK1 inhibitor, 5Z-7-oxozeaenol (OZ) was administered by intracerebroventricular (i.c.v) injection at 30 min after SAH induction. To genetic knockdown of TAK1, small interfering RNA (siRNA) was i.c.v injected at 48 h before SAH induction. SAH grade, brain water content, BBB permeability, neurological score, western blot, real-time PCR, ELISA, transmission electron microscope, and immunofluorescence staining were performed. Long-term behavioral sequelae were evaluated by the rotarod and Morris water maze tests. Furthermore, OZ was added to the culture medium with oxyhemoglobin (OxyHb) to mimic SAH in vitro. The reactive oxygen species level was detected by DCFH-DA staining. Lysosomal integrity was assessed by Lyso-Tracker Red staining and Acridine Orange staining.

Results

The neuronal phosphorylated TAK1 expression was upregulated following SAH. Pharmacologic inhibition of TAK1 with OZ could alleviate neurological deficits, brain edema, and brain-blood barrier (BBB) disruption at 24 h after SAH. In addition, OZ administration restored long-term neurobehavioral function. Furthermore, blockade of TAK1 dampened neuronal pyroptosis by downregulating the N-terminal fragment of GSDMD (GSDMD-N) expression and IL-1β/IL-18 production. Mechanistically, both in vivo and in vitro, we demonstrated that TAK1 can induce neuronal pyroptosis through promoting nuclear translocation of NF-κB p65 and activating nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain containing 3 (NLRP3) inflammasome. TAK1 siRNA treatment mitigated SAH-induced neurobehavioral deficits and restrained phosphorylated NF-κB p65 expression and NLRP3 inflammasome activation. TAK1 blockade also ameliorated reactive oxygen species (ROS) production and prevented lysosomal cathepsin B releasing into the cytoplasm.

Conclusions

Our findings demonstrate that TAK1 modulates NLRP3-mediated neuronal pyroptosis in EBI following SAH. Inhibition of TAK1 may serve as a potential candidate to relieve neuroinflammatory responses triggered by SAH.
Optimization and validation of RT-LAMP assay for diagnosis of SARS-CoV2 including the globally dominant Delta variant
Authors: Jamwal Vijay Lakshmi , Kumar Natish , Bhat Rahul , Jamwal Piyush Singh , Singh Kaurab , Dogra Sandeep , Kulkarni Abhishek , Bhadra Bhaskar , Shukla Manish R. , Saran Saurabh , Dasgupta Santanu , Vishwakarma Ram A. , Gandhi Sumit G.
Published: August 2021

Background

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19 pandemic, has infected more than 179 million people worldwide. Testing of infected individuals is crucial for identification and isolation, thereby preventing further spread of the disease. Presently, Taqman™ Reverse Transcription Real Time PCR is considered gold standard, and is the most common technique used for molecular testing of COVID-19, though it requires sophisticated equipments, expertise and is also relatively expensive.

Objective

Development and optimization of an alternate molecular testing method for the diagnosis of COVID-19, through a two step Reverse Transcription Loop-mediated isothermal AMPlification (RT-LAMP).

Results

Primers for LAMP were carefully designed for discrimination from other closely related human pathogenic coronaviruses. Care was also taken that primer binding sites are present in conserved regions of SARS-CoV2. Our analysis shows that the primer binding sites are well conserved in all the variants of concern (VOC) and variants of interest (VOI), notified by World Health Organization (WHO). These lineages include B.1.1.7, B.1.351, P.1, B.1.617.2, B.1.427/B.1.429, P.2, B.1.525, P.3, B.1.526 and B.1.617.1. Various DNA polymerases with strand displacement activity were evaluated and conditions were optimized for LAMP amplification and visualization. Different LAMP primer sets were also evaluated using synthetic templates as well as patient samples.

Conclusion

In a double blind study, the RT-LAMP assay was validated on more than 150 patient samples at two different sites. The RT-LAMP assay appeared to be 89.2% accurate when compared to the Taqman™ rt-RT-PCR assay.
When actions do not match aspirations - comparison of the European Union policy claims against what has been negotiated for health services, trade and investment
Authors: Koivusalo Meri , Heinonen Noora , Tynkkynen Liina-Kaisa
Published: August 2021

Background

Obligations arising from trade and investment agreements can affect how governments can regulate and organise health systems. The European Union has made explicit statements of safeguarding policy space for health systems. We assessed to what extent health systems were safeguarded in trade negotiations using the European Union (EU) negotiation proposals for the Transatlantic Trade and Investment Partnership (TTIP) and the negotiated agreement for the EU-Canada Comprehensive Economic and Trade Agreement (CETA).

Methods

We assessed if and to what extent the European Union policy assurances were upheld in trade negotiations. Our assessment was made using three process tracing informed tests. The tests examined: i) what was covered in negotiation proposals of services and investment chapters, ii) if treatment of health services differed from treatment of another category of services (audiovisual services) with similar EU Treaty considerations, and iii) if other means of general exceptions, declarations or emphases on right to regulate could have resulted in the same outcome.

Results

Our analysis shows that the European Union had sought to secure policy space for publicly funded health services for services chapter, but not for investment and investment protection chapters. In comparison to audiovisual services, exceptions for health services fall short from those on audiovisual services. There is little evidence that the same outcome could have been achieved using other avenues.

Conclusions

The European Union has not achieved its own assurances of protection of regulatory policy space for health services in trade negotiations. The European Union trade negotiation priorities need to change to ensure that its negotiation practices comply with its own assurances for health services and sustainable financing of health systems.