bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Neutral Electrolyzed Water for Inactivation of Human Norovirus
Authors: Moorman Eric , Montazeri Naim , Jaykus Lee-Ann
Published: June 2017

Human norovirus (NoV) is the leading cause of acute gastroenteritis worldwide. Persistence on surfaces and resistance to many conventional disinfectants contribute to widespread transmission of norovirus. We examined the efficacy of neutral electrolyzed water (NEW; pH 7) for inactivation of human NoV GII.4 Sydney in suspension (ASTM method 1052-11) and on stainless steel surfaces (ASTM method 1053-11) with and without an additional soil load. The impact of the disinfectant on viral capsid was assessed using reverse transcriptase quantitative PCR (RT-qPCR; with an RNase pretreatment), SDS-PAGE, transmission electron microscopy, and a histo-blood group antigen (HBGA) receptor-binding assay. These studies were done in parallel with those using Tulane virus (TuV), a cultivable human NoV surrogate. Neutral electrolyzed water at 250 ppm free available chlorine produced a 4.8- and 0.4-log
10
reduction in NoV genome copy number after 1 min in suspension and on stainless steel, respectively. Increasing the contact time on surfaces to 5, 10, 15, and 30 min reduced human NoV genomic copies by 0.5, 1.6, 2.4, and 5.0 log
10
and TuV infectious titers by 2.4, 3.0, 3.8, and 4.1 log
10
PFU, respectively. Increased soil load effectively eliminated antiviral efficacy regardless of testing method and virus. Exposure to NEW induced a near complete loss of receptor binding (5 ppm, 30 s), degradation of VP1 major capsid protein (250 ppm, 5 min), and increased virus particle aggregation (150 ppm, 30 min). Neutral electrolyzed water at 250 ppm shows promise as an antinoroviral disinfectant when used on precleaned stainless steel surfaces.

IMPORTANCE
Norovirus is the leading cause of acute viral gastroenteritis worldwide. Transmission occurs by fecal-oral or vomitus-oral routes. The persistence of norovirus on contaminated environmental surfaces exacerbates its spread, as does its resistance to many conventional disinfectants. The purpose of this research was to evaluate the antinoroviral efficacy of neutral electrolyzed water (NEW), a novel chlorine-based disinfectant that can be used at reduced concentrations, making it more environmentally friendly and less corrosive than bleach. An industrial-scale electrochemical activation device capable of producing relatively stable electrolyzed water at a wide pH range was used in this study. Experiments showed that 250 ppm NEW effectively eliminated (defined as a 5-log
10
reduction) human norovirus GII.4 Sydney (epidemic strain) on clean stainless steel surfaces after a 30-min exposure. Supporting studies showed that, like bleach, NEW causes inactivation by disrupting the virus capsid. This product shows promise as a bleach alternative with antinoroviral efficacy.
Vibrio cholerae Colonization of Soft-Shelled Turtles
Authors: Wang Jiazheng , Yan Meiying , Gao He , Lu Xin , Kan Biao
Published: June 2017

Vibrio cholerae
is an important human pathogen and environmental microflora species that can both propagate in the human intestine and proliferate in zooplankton and aquatic organisms. Cholera is transmitted through food and water. In recent years, outbreaks caused by
V. cholerae
-contaminated soft-shelled turtles, contaminated mainly with toxigenic serogroup O139, have been frequently reported, posing a new foodborne disease public health problem. In this study, the colonization by toxigenic
V. cholerae
on the body surfaces and intestines of soft-shelled turtles was explored. Preferred colonization sites on the turtle body surfaces, mainly the carapace and calipash of the dorsal side, were observed for the O139 and O1 strains. Intestinal colonization was also found. The colonization factors of
V. cholerae
played different roles in the colonization of the soft-shelled turtle's body surface and intestine. Mannose-sensitive hemagglutinin (MSHA) of
V. cholerae
was necessary for body surface colonization, but no roles were found for toxin-coregulated pili (TCP) or
N
-acetylglucosamine-binding protein A (GBPA). Both TCP and GBPA play important roles for colonization in the intestine, whereas the deletion of MSHA revealed only a minor colonization-promoting role for this factor. Our study demonstrated that
V. cholerae
can colonize the surfaces and the intestines of soft-shelled turtles and indicated that the soft-shelled turtles played a role in the transmission of cholera. In addition, this study showed that the soft-shelled turtle has potential value as an animal model in studies of the colonization and environmental adaption mechanisms of
V. cholerae
in aquatic organisms.

IMPORTANCE
Cholera is transmitted through water and food. Soft-shelled turtles contaminated with
Vibrio cholerae
(commonly the serogroup O139 strains) have caused many foodborne infections and outbreaks in recent years, and they have become a foodborne disease problem. Except for epidemiological investigations, no experimental studies have demonstrated the colonization by
V. cholerae
on soft-shelled turtles. The present studies will benefit our understanding of the interaction between
V. cholerae
and the soft-shelled turtle. We demonstrated the colonization by
V. cholerae
on the soft-shelled turtle's body surface and in the intestine and revealed the different roles of major
V. cholerae
factors for colonization on the body surface and in the intestine. Our work provides experimental evidence for the role of soft-shelled turtles in cholera transmission. In addition, this study also shows the possibility for the soft-shelled turtle to serve as a new animal model for studying the interaction between
V. cholerae
and aquatic hosts.
Novel Microbial Assemblages Dominate Weathered Sulfide-Bearing Rock from Copper-Nickel Deposits in the Duluth Complex, Minnesota, USA
Authors: Jones Daniel S. , Lapakko Kim A. , Wenz Zachary J. , Olson Michael C. , Roepke Elizabeth W. , Sadowsky Michael J. , Novak Paige J. , Bailey Jake V.
Published: June 2017

The Duluth Complex in northeastern Minnesota hosts economically significant deposits of copper, nickel, and platinum group elements (PGEs). The primary sulfide mineralogy of these deposits includes the minerals pyrrhotite, chalcopyrite, pentlandite, and cubanite, and weathering experiments show that most sulfide-bearing rock from the Duluth Complex generates moderately acidic leachate (pH 4 to 6). Microorganisms are important catalysts for metal sulfide oxidation and could influence the quality of water from mines in the Duluth Complex. Nevertheless, compared with that of extremely acidic environments, much less is known about the microbial ecology of moderately acidic sulfide-bearing mine waste, and so existing information may have little relevance to those microorganisms catalyzing oxidation reactions in the Duluth Complex. Here, we characterized the microbial communities in decade-long weathering experiments (kinetic tests) conducted on crushed rock and tailings from the Duluth Complex. Analyses of 16S rRNA genes and transcripts showed that differences among microbial communities correspond to pH, rock type, and experimental treatment. Moreover, microbial communities from the weathered Duluth Complex rock were dominated by taxa that are not typically associated with acidic mine waste. The most abundant operational taxonomic units (OTUs) were from the genera
Meiothermus
and
Sulfuriferula
, as well as from diverse clades of uncultivated
Chloroflexi
,
Acidobacteria
, and
Betaproteobacteria
. Specific taxa, including putative sulfur-oxidizing
Sulfuriferula
spp., appeared to be primarily associated with Duluth Complex rock, but not pyrite-bearing rocks subjected to the same experimental treatment. We discuss the implications of these results for the microbial ecology of moderately acidic mine waste with low sulfide content, as well as for kinetic testing of mine waste.

IMPORTANCE
Economic sulfide mineral deposits in the Duluth Complex may represent the largest undeveloped source of copper and nickel on Earth. Microorganisms are important catalysts for sulfide mineral oxidation, and research on extreme acidophiles has improved our ability to manage and remediate mine wastes. We found that the microbial assemblages associated with weathered rock from the Duluth Complex are dominated by organisms not widely associated with mine waste or mining-impacted environments, and we describe geochemical and experimental influences on community composition. This report will be a useful foundation for understanding the microbial biogeochemistry of moderately acidic mine waste from these and similar deposits.
Physical stimulation of newborn infants in the delivery room
Authors: Gaertner Vincent D , Flemmer Sophie A , Lorenz Laila , Davis Peter G , Kamlin C Omar Farouk
Published: June 2017

Objective

Neonatal resuscitation guidelines recommend that newborn infants are stimulated to assist with the establishment of regular respirations. The mode, site of application and frequency of stimulations are not stipulated in these guidelines. The effectiveness of stimulation in improving neonatal transition outcomes is poorly described.

Methods

We conducted a retrospective review of video recordings of neonatal resuscitation at a tertiary perinatal centre. Four different types of stimulation (drying, chest rub, back rub and foot flick) were defined a priori and the frequency and infant response were documented.

Results

A total of 120 video recordings were reviewed. Seventy-five (63%) infants received at least one episode of stimulation and 70 (58%) infants were stimulated within the first minute after birth. Stimulation was less commonly provided to infants <30 weeks’ gestation (median (IQR) number of stimulations: 0 (0–1)) than infants born ≥30 weeks’ gestation (1 (1–3); p<0.001). The most common response to stimulation was limb movement followed by infant cry and facial grimace. Truncal stimulation (drying, chest rub, back rub) was associated with more crying and movement than foot flicks.

Conclusion

Less mature infants are stimulated less frequently compared with more mature infants and many very preterm infants do not receive any stimulation. Most infants were stimulated within the first minute as recommended in resuscitation guidelines. Rubbing the trunk may be most effective but this needs to be confirmed in prospective studies.
Evaluation of optical coherence tomography angiographic findings in Alzheimer’s type dementia
Authors: Bulut Mehmet , Kurtuluş Fatma , Gözkaya Onursal , Erol Muhammet Kazım , Cengiz Ayşe , Akıdan Melih , Yaman Aylin
Published: June 2017

Background/Aims

To identify the retinal vascular pathologies in patients with Alzheimer’s type dementia (ATD) through optical coherence tomography angiography (OCTA) imaging.

Methods

Our study included 26 patients in the patient group, and age-matched and sex-matched 26 subjects in the control group. A detailed ophthalmological and neurological examination was performed for all subjects included in the study. The retinal, choroidal vascular structures and choroidal thickness (CT) of all subjects were analysed in a detailed way with a commercial spectral domain OCTA. Moreover, all participants underwent detailed neurological examination including Mini Mental State Examination (MMSE) test to evaluate cognitive function.

Results

In the group of patients with ATD, the MMSE score was significantly lower than that of the control group (p<0.001). The retinal vascular density was significantly lower than that of the control group in all zones (p<0.05). Foveal avascular zone (FAZ) was significantly enlarged compared with the control group (p=0.001). CT was significantly lower in the group of patients with ATD (p<0.001). Outer retinal and choroidal flow rates were lower in the group of patients with ATD, while the difference was not significant (p>0.05). Furthermore, significant correlation was found between the MMSE and all vascular density parameters, CT parameter and FAZ tested with OCTA imaging (p<0.05).

Conclusions

In patients with ATD, retinal and choroidal vascular pathologies detected through OCTA imaging can be used as a new biomarker in the early diagnosis of the disease, follow-up of its progression and in investigating the efficacy of the drugs.
Are self-reported unhealthy food choices associated with an increased risk of breast cancer? Prospective cohort study using the British Food Standards Agency nutrient profiling system
Authors: Deschasaux Mélanie , Julia Chantal , Kesse-Guyot Emmanuelle , Lécuyer Lucie , Adriouch Solia , Méjean Caroline , Ducrot Pauline , Péneau Sandrine , Latino-Martel Paule , Fezeu Léopold K , Fassier Philippine , Hercberg Serge , Touvier Mathilde
Published: June 2017

Objectives

French authorities are considering the implementation of a simplified nutrition labelling system on food products to help consumers make healthier food choices. One of the most documented candidates (Five-Colour Nutrition Label/Nutri-score) is based on the British Food Standards Agency Nutrient Profiling System (FSA-NPS), a score calculated for each food/beverage using the 100 g amount of energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits and vegetables. To assess its potential public health relevance, studies were conducted on the association between the nutritional quality of the diet, measured at the individual level by an energy-weighted mean of all FSA-NPS scores of foods usually consumed (FSA-NPS dietary index (FSA-NPS DI)), and the risk of chronic diseases. The present study aimed at investigating the relationship between the FSA-NPS DI and breast cancer risk.

Design

Prospective study.

Setting

Population based, NutriNet-Santé cohort, France.

Participants

46 864 women aged ≥35 years who completed ≥3 24-hour dietary records during their first 2 year of follow-up.

Primary outcome measure

Associations between FSA-NPS DI and breast cancer risk (555 incident breast cancers diagnosed between 2009 and 2015) were characterised by multivariable-adjusted Cox proportional hazard models.

Results

A higher FSA-NPS DI (lower nutritional quality of the diet) was associated with an increased breast cancer risk (HR1-point increment=1.06 (1.02–1.11), p=0.005; HRQ5vs.Q1=1.52 (1.11–2.08), p trend=0.002). Similar trends were observed in premenopausal and postmenopausal women (HR1-point increment=1.09 (1.01–1.18) and 1.05 (1.00–1.11), respectively).

This study was based on an observational cohort using self-reported dietary data, thus residual confounding cannot be entirely ruled out. Finally, this holistic approach does not allow investigating which factors in the diet most specifically influence breast cancer risk.

Conclusions

These results suggested that unhealthy food choices, as characterised by the FSA-NPS, may be associated with an increase in breast cancer risk, supporting the potential public health relevance of using this profiling system in the framework of public health nutritional measures.
Coding of Barrett’s oesophagus with high-grade dysplasia in national administrative databases: a population-based cohort study
Authors: Chadwick Georgina , Varagunam Mira , Brand Christian , Riley Stuart A , Maynard Nick , Crosby Tom , Michalowski Julie , Cromwell David A
Published: June 2017

Objectives

The International Classification of Diseases 10th Revision (ICD-10) system used in the English hospital administrative database (Hospital Episode Statistics (HES)) does not contain a specific code for oesophageal high-grade dysplasia (HGD). The aim of this paper was to examine how patients with HGD were coded in HES and whether it was done consistently.

Setting

National population-based cohort study of patients with newly diagnosed with HGD in England. The study used data collected prospectively as part of the National Oesophago-Gastric Cancer Audit (NOGCA). These records were linked to HES to investigate the pattern of ICD-10 codes recorded for these patients at the time of diagnosis.

Participants

All patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014 in England, who had data submitted to the NOGCA.

Outcomes measured

The main outcome assessed was the pattern of primary and secondary ICD-10 diagnostic codes recorded in the HES records at endoscopy at the time of diagnosis of HGD.

Results

Among 452 patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014, Barrett’s oesophagus was the only condition coded in 200 (44.2%) HES records. Records for 59 patients (13.1%) contained no oesophageal conditions. The remaining 193 patients had various diagnostic codes recorded, 93 included a diagnosis of Barrett’s oesophagus and 57 included a diagnosis of oesophageal/gastric cardia cancer.

Conclusions

HES is not suitable to support national studies looking at the management of HGD. This is one reason for the UK to adopt an extended ICD system (akin to ICD-10-CM).
Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults
Authors: Owolabi Eyitayo Omolara , Goon Daniel Ter , Adeniyi Oladele Vincent , Seekoe Eunice
Published: June 2017

Objectives

This study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape.

Design

A cross-sectional analytical study.

Settings

The three largest outpatient clinics in BCMM.

Participants

Ambulatory adults (aged 18 years and over) attending the study settings during the study period (n=998).

Primary outcome measure

The prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg).

Secondary outcome measure

Associated factors of hypertension, hypertension unawareness and uncontrolled hypertension.

Results

Of the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness.

Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension.

Conclusion

The prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.
A self-efficacy education programme on foot self-care behaviour among older patients with diabetes in a public long-term care institution, Malaysia: a Quasi-experimental Pilot Study
Authors: Sharoni Siti Khuzaimah Ahmad , Abdul Rahman Hejar , Minhat Halimatus Sakdiah , Shariff Ghazali Sazlina , Azman Ong Mohd Hanafi
Published: June 2017

Objective

A pilot self-efficacy education programme was conducted to assess the feasibility, acceptability and potential impact of the self-efficacy education programme on improving foot self-care behaviour among older patients with diabetes in a public long-term care institution.

Method

A prequasi-experimental and postquasi-experimental study was conducted in a public long-term care institution in Selangor, Malaysia. Patients with diabetes aged 60 years and above who fulfilled the selection criteria were invited to participate in this programme. Four self-efficacy information sources; performance accomplishments, vicarious experience, verbal persuasion and physiological information were translated into programme interventions. The programme consisted of four visits over a 12-week period. The first visit included screening and baseline assessment and the second visit involved 30 min of group seminar presentation. The third and fourth visits entailed a 20-min one-to-one follow-up discussion and evaluation. A series of visits to the respondents was conducted throughout the programme. The primary outcome was foot self-care behaviour. Foot self-efficacy (efficacy-expectation), foot care outcome expectation, knowledge of foot care, quality of life, fasting blood glucose and foot condition were secondary outcomes. Data were analysed with descriptive and inferential statistics (McNemar's test and Wilcoxon signed-rank test) using the Statistical Package for the Social Sciences V.20.0.

Results

Fifty-two residents were recruited but only 31 met the inclusion criteria and were included in the analysis at baseline and at 12 weeks postintervention. The acceptability rate was moderately high. At postintervention, foot self-care behaviour (p<0.001), foot self-efficacy (efficacy-expectation), (p<0.001), foot care outcome expectation (p<0.001), knowledge of foot care (p<0.001), quality of life (physical symptoms) (p=0.003), fasting blood glucose (p=0.010), foot hygiene (p=0.030) and anhydrosis (p=0.020) showed significant improvements.

Conclusion

Findings from this pilot study would facilitate the planning of a larger study among the older population with diabetes living in long-term care institutions.

Trial registration number

ACTRN12616000210471; Pre-results.
Timing of two versus three doses of quadrivalent HPV vaccine and associated effectiveness against condyloma in Sweden: a nationwide cohort study
Authors: Lamb F , Herweijer E , Ploner A , Uhnoo I , Sundström K , Sparén P , Arnheim-Dahlström L
Published: June 2017

Objective

To assess incidence of condyloma after two doses of quadrivalent human papillomavirus (qHPV) vaccine, by time since first vaccine dose, in girls and women initiating vaccination before age 20 years.

Design

Register-based nationwide open cohort study.

Setting

Sweden.

Participants

Girls and women initiating qHPV vaccination before age 20 years between 2006 and 2012. The study cohort included 264 498 girls, of whom 72 042 had received two doses of qHPV vaccine and 185 456 had received all three doses.

Main outcome measure

Incidence rate ratios (IRRs) of condyloma estimated by time between first and second doses of qHPV in months (m) and age at vaccination, adjusted for attained age.

Results

For girls first vaccinated with two doses before the age of 17 years, the IRR of condyloma for 0–3 months between the first and second doses was 1.96 (95% CI 1.43 to 2.68) as compared with the standard three-dose schedule. The IRRs were 1.27 (95% CI 0.63 to 2.58) and 4.36 (95% CI 2.05 to 9.28) after receipt of two doses with 4–7 months and 8+ months between doses, respectively. For women first vaccinated after the age of 17 years, vaccination with two doses of qHPV vaccine and 0–3 months between doses was associated with an IRR of 2.12 (95% CI 1.62 to 2.77). For an interval of 4–7 months between doses, the IRR did not statistically significantly differ to the standard three-dose schedule (IRR=0.81, 95% CI 0.36 to 1.84). For women with 8+ months between dose 1 and dose 2 the IRR was 3.16 (95% CI 1.40 to 7.14).

Conclusion

A two-dose schedule for qHPV vaccine with 4–7 months between the first and second doses may be as effective against condyloma in girls and women initiating vaccination under 20 years as a three-dose schedule. Results from this nationwide study support immunogenicity data from clinical trials.
Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study
Authors: Lovink Marleen Hermien , Persoon Anke , van Vught Anneke JAH , Schoonhoven Lisette , Koopmans Raymond TCM , Laurant Miranda GH
Published: June 2017

Introduction

In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare.

Methods and analysis

This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context–mechanism–outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory.

Ethics and dissemination

The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government.
The Optimal Screening for Prediction of Referral and Outcome (OSPRO) in patients with musculoskeletal pain conditions: a longitudinal validation cohort from the USA
Authors: George Steven Z , Beneciuk Jason M , Lentz Trevor A , Wu Samuel S
Published: June 2017

Purpose

There is an increased need for determining which patients with musculoskeletal pain benefit from additional diagnostic testing or psychologically informed intervention. TheOptimalScreening forPrediction ofReferral andOutcome (OSPRO) cohort studies were designed to develop and validate standard assessment tools for review of systems and yellow flags. This cohort profile paper provides a description of and future plans for the validation cohort.

Participants

Patients (n=440) with primary complaint of spine, shoulder or knee pain were recruited into the OSPRO validation cohort via a nationalOrthopaedicPhysicalTherapy-InvestigativeNetwork. Patients were followed up at 4 weeks, 6 months and 12 months for pain, functional status and quality of life outcomes. Healthcare utilisation outcomes were also collected at 6 and 12 months.

Findings to date

There are no longitudinal findings reported to date from the ongoing OSPRO validation cohort. The previously completed cross-sectional OSPRO development cohort yielded two assessment tools that were investigated in the validation cohort.

Future plans

Follow-up data collection was completed in January 2017. Primary analyses will investigate how accurately the OSPRO review of systems and yellow flag tools predict 12-month pain, functional status, quality of life and healthcare utilisation outcomes. Planned secondary analyses include prediction of pain interference and/or development of chronic pain, investigation of treatment expectation on patient outcomes and analysis of patient satisfaction following an episode of physical therapy.

Trial registration number

The OSPRO validation cohort was not registered.
Cohort profile: the Nordic Antireflux Surgery Cohort (NordASCo)
Authors: Maret-Ouda John , Wahlin Karl , Artama Miia , Brusselaers Nele , Färkkilä Martti , Lynge Elsebeth , Mattsson Fredrik , Pukkala Eero , Romundstad Pål , Tryggvadóttir Laufey , Euler-Chelpin My von , Lagergren Jesper
Published: June 2017

Purpose

To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk of cancers, other diseases and mortality.

Participants

Included were individuals with a GORD diagnosis recorded in any of the nationwide patient registries in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) in 1964–2014 (with various start and end years in different countries). Data regarding cancer, other diseases and mortality were retrieved from the nationwide registries for cancer, patients and causes of death, respectively.

Findings to date

The NordASCo includes 945 153 individuals with a diagnosis of GORD. Of these, 48 433 (5.1%) have undergone primary antireflux surgery. Median age at primary antireflux surgery ranged from 47 to 52 years in the different countries. The coding practices of GORD seem to have differed between the Nordic countries.

Future plans

The NordASCo will initially be used to analyse the risk of developing known or potential GORD-related cancers, that is, tumours of the oesophagus, stomach, larynx, pharynx and lung, and to evaluate the mortality in the short-term and long-term perspectives. Additionally, the cohort will be used to evaluate the risk of non-malignant respiratory conditions that might be caused by aspiration of gastric contents.
Adverse Drug reactions in an Ageing PopulaTion (ADAPT) study protocol: a cross-sectional and prospective cohort study of hospital admissions related to adverse drug reactions in older patients
Authors: Cahir Caitriona , Curran Carmel , Byrne Catherine , Walsh Caroline , Hickey Anne , Williams David J , Bennett Kathleen
Published: June 2017

Introduction

Older people experience greater morbidity with a corresponding increase in medication use resulting in a potentially higher risk of adverse drug reactions (ADRs). The aim of this study is to determine the prevalence and characteristics of ADR-related hospital admissions among older patients (≥65 years) and their associated health and cost outcomes.

Methods and analysis

The proposed study will include a cross-sectional study of ADR prevalence in all patients aged ≥65 years admitted acutely to a large tertiary referral hospital in Ireland over a 9-month period (2016–2017) and a prospective cohort study of patient-reported health outcomes and costs associated with ADR-related hospital admissions. All acute medical admissions will be screened for a suspected ADR-related hospital admission. A number of validated algorithms will be applied to assess the type, causative medications, preventability and severity of each ADR. ADRs will be determined, using a consensus method, by an expert panel. Patients who provide consent will be followed up 3 months post-discharge to establish patient-reported health outcomes (health service use, health-related quality of life, adherence) and costs associated with ADR-related hospital admissions. A random sample of patients admitted to hospital without a suspected ADR will be invited to take part in the study as a control group.

Ethics and dissemination

Ethical approval was obtained from Beaumont Hospital Ethics Committee. Findings will be disseminated through presentations and peer-reviewed publications.
Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State
Authors: Campbell Lauren , Li Yue
Published: June 2017

Background

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care.

Objectives

To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality.

Research design

Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals’ Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of ‘likes’) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio.

Subjects

One hundred and thirty-six acute care hospitals in New York State in 2015.

Results

An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of ‘likes’ is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio.

Conclusions

Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of ‘likes’ may not be a useful measure of patient satisfaction.
A collaborative approach to simulation development
Authors: Gonzalez Laura , Allred Kelly
Published: June 2017

Background

Meeting employer expectations is a challenge for new nurse graduates and their nurse educators. Designing studies to collect specific data on hospital expectations and new nursing graduate deficiencies is needed.

Sample

Hospital-based educators and preceptors (n=13) participated in one of two focus groups, to identify problem areas. Senior nursing students (n=64) participated in simulations developed from data obtained in the sessions.

Methods

Audio-recorded focus groups were conducted with the goal to identify deficiencies in new graduate nurses. Recordings were transcribed and analysed using thematic analysis.

Results

Hospital employer expectation themes identified include attending to basic patient needs, organisational skills, anticipation of risks and consequences, higher order technical skills, communication and ownership/accountability. Two simulations for senior nursing students were developed to address identified deficiencies.

Conclusion

Developing meaningful simulations which address deficiencies prior to graduation, in collaboration with potential employers, has the potential to lower the cost of graduate nurse orientation, improve patient outcomes, provide a greater sense of readiness to the graduate nurse and ultimately meet the needs of both the student and employer.
Establishing a legal service for major trauma patients at a major trauma centre in the UK
Authors: Seligman William H , Thompson Julian , Thould Hannah E , Tan Charlotte , Dinsmore Andrew , Lockey David J
Published: June 2017

Background

Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.

A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK.

Methods

In 2013, a legal service was established at North Bristol NHS Trust. Referrals are made by trauma nurse practitioners and it operates within a strict ethical framework. A retrospective analysis of the activity of this legal service between September 2013 and October 2015 was undertaken.

Results

66 major trauma patients were seen by the legal teams at the MTC. 535 hours of free legal advice were provided on non-compensation issues—an average of 8 hours per patient.

Discussion

This initiative confirms a demand for the early availability of legal advice for major trauma patients to address a range of non-compensation issues as well as for identification of potential compensation claims. The availability of advice at the MTC is convenient for relatives who may be spending the majority of their time with injured relatives in hospital. More data are needed to establish the rehabilitation and health effects of receiving non-compensation advice after major injury; however, the utilisation of this service suggests that it should be considered at the UK MTCs.
Cervical intraepithelial neoplasia (CIN) in African women living with HIV: role and effect of rigorous histopathological review by a panel of pathologists in the HARP study endpoint determination
Authors: Doutre Sylviane , Omar Tanvier , Goumbri-Lompo Olga , Kelly Helen , Clavero Omar , Zan Souleymane , Chikandiwa Admire , Sawadogo Bernard , Delany-Moretlwe Sinead , Costes Valérie , Mayaud Philippe , Segondy Michel
Published: June 2017

AIMS

To analyse the effect of the expert end-point committee (EPC) review on histological endpoint classification of cervical intraepithelial neoplasia (CIN).

Methods

A cohort of women living with HIV were recruited in Burkina Faso (BF) and South Africa (SA) and followed over 18 months. Four-quadrant cervical biopsies were obtained in women with abnormalities detected by at least one screening test. A central review by a panel of five pathologists was organised at baseline and at endline.

Results

At baseline the prevalence of high-grade CIN (CIN2+) was 5.1% (28/554) in BF and 23.3% (134/574) in SA by local diagnosis, and 5.8% (32/554) in BF and 22.5% (129/574) in SA by the EPC. At endline the prevalence of CIN2+ was 2.3% (11/483) in BF and 9.4% (47/501) in SA by local diagnosis, and 1.4% (7/483) in BF and 10.2% (51/501) in SA by EPC. The prevalence of borderline CIN1/2 cases was 2.8% (32/1128) and 0.8% (8/984) at baseline and endline. Overall agreement between local diagnosis and final diagnosis for distinguishing CIN2+ from ≤CIN1 was 91.2% (κ=0.82) and 88.9% (κ=0.71) for BF at baseline and endline, and 92.7% (κ=0.79) and 98.7% (κ=0.97) for SA at baseline and endline. Among the CIN1/2 cases, 12 (37.5%) were graded up to CIN2 and 20 (62.5%) were graded down to CIN1 at baseline, and 3 (37.5%) were graded up to CIN2 and 5 (62.5%) were graded down to CIN1 at endline.

Conclusions

This study highlights the importance of a centralised rigorous re-reading with exchange of experiences among pathologists from different settings.
A multicenter study evaluating the frequency and time requirement of mechanical thrombectomy
Authors: Wilson Taylor A , Leslie-Mazwi Thabele , Hirsch Joshua A , Frey Casey , Kim Teddy E , Spiotta Alejandro M , Leacy Reade de , Mocco J , Albuquerque Felipe C , Ducruet Andrew F , Cheema Ahmed , Arthur Adam , Srinivasan Visish M , Kan Peter , Mokin Maxim , Dumont Travis , Rai Ansaar , Singh Jasmeet , Wolfe Stacey Q , Fargen Kyle M
Published: June 2017

Introduction

There are few published data evaluating the incidence of mechanical thrombectomy among stroke centers or the times at which they occur.

Methods

A multicenter retrospective study was performed to identify all patients undergoing emergent thrombectomy for acute ischemic stroke during a 3-month period (June through August 2016). Consultations that did not undergo thrombectomy were not included.

Results

Ten institutions participated in the study. During the 92-day study period, a total of 189 patients underwent mechanical thrombectomy. The average number of procedures per hospital over the study period was 18.9 (average of 0.2 cases per day per or 75.6 cases per year). This ranged from 0.09 cases per day at the lowest volume center to 0.49 cases per day at the highest volume center. Procedures were more common on weekdays (p<0.001) and during non-work hours (p<0.001). The most common period for thrombectomy procedures was between 20:00 and 21:00 hours. The median time from notification to groin puncture was 84 min (IQR 56–145 min) and from puncture to closure was 57 min (IQR 33–80 min). The median time from imaging completion to procedural start was 52 min longer for non-work hours than during work hours (p<0.001). There were no differences in procedural length based on day of the week or time of day.

Conclusions

These findings indicate that the majority of mechanical thrombectomy cases occur during non-work hours, with associated off-hours delays, which has important operational implications for hospitals implementing stroke call coverage.
Blood pressure gradients in cerebral arteries: a clue to pathogenesis of cerebral small vessel disease
Authors: Blanco Pablo J , Müller Lucas O , Spence J David
Published: June 2017

Rationale

The role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the ‘vascular centrencephalon’), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called ‘lacunes’, probably have different aetiologies.

Objectives

We studied pressure gradients from proximal to distal regions of the cerebral vasculature by mathematical modelling.

Methods and results

Blood flow/pressure equations were solved in an Anatomically Detailed Arterial Network (ADAN) model, considering a normotensive and a hypertensive case. Model parameters were suitably modified to account for structural changes in arterial vessels in the hypertensive scenario. Computations predict a marked drop in blood pressure from large and medium-sized cerebral vessels to cerebral peripheral beds. When blood pressure in the brachial artery is 192/113 mm Hg, the pressure in the small arterioles of the posterior parietal artery bed would be only 117/68 mm Hg. In the normotensive case, with blood pressure in the brachial artery of 117/75 mm Hg, the pressure in small parietal arterioles would be only 59/38 mm Hg.

Conclusion

These findings have important implications for understanding small vessel disease. The marked pressure gradient across cerebral arteries should be taken into account when evaluating the pathogenesis of small WMIs on MRI. Hypertensive small vessel disease, affecting the arterioles at the base of the brain should be distinguished from small vessel disease in subcortical regions of the convexity and venous disease in the periventricular white matter.
An update on nonoperative management of the spleen in adults
Authors: Zarzaur Ben L , Rozycki Grace S
Published: June 2017

Many patients with blunt splenic injury are considered for nonoperative management and, with proper selection, the success rate is high. This paper aims to provide an update on the treatments and dilemmas of nonoperative management of splenic injuries in adults and to offer suggestions that may improve both consensus and patient outcomes.
Long‐term efficacy of imepitoin in the treatment of naive dogs affected by idiopathic epilepsy
Authors: Gallucci A. , Gagliardo T. , Menchetti M. , Bianchi E. , Bucci D. , Gandini G.
Published: June 2017

The purpose of this study was to evaluate the long‐term (12 months) efficacy and tolerability of imepitoin as first‐choice treatment in 56 dogs suffering from idiopathic epilepsy and identify possible factors affecting the outcome. Primary treatment success (PTS) was defined as the achievement of a seizure‐free interval three times longer than the pretreatment interictal interval (at least three months). Secondary treatment success (STS) was achieved by a decrease in seizure frequency ≥50 per cent compared with the pretreatment frequency. In the long‐term follow‐up, PTS was recorded in 14 (25 per cent) dogs and responder‐dogs (PTS+STS) were 30 (54 per cent) showing significant reduction in the monthly average number of seizures (P<0.001). Median seizure frequency per month was 1.69 pretreatment and 0.3 at 12‐month follow‐up. Dogs with cluster seizures were significantly reduced (P=0.02). PTS at three and six months was associated with PTS (P=0.006 and <0.001, respectively) and with the status of responder dogs (P=0.002) at 12‐month follow‐up. Dogs aged >36 months at the start of imepitoin treatment had a positive association to become responder dogs (P<0.001) and achieve PTS (P=0.004). 16 dogs (29 per cent) discontinued imepitoin due to its inefficacy. The receiver operator curve highlighted ≥19 mg/kg twice a day as the most effective minimal dosage. Mild and transient side effects were observed in 16 dogs (29 per cent).
The role of mycorrhizal symbioses in phytotechnology
Authors: Chagnon P.L. , Brisson J.
Published: June 2017

There is a growing interest in using plants to provide low-cost ecosystem services in a diversity of environments (e.g., polluted, degraded, urban). These utilizations of plants are collectively referred to as phytotechnologies. Many plants used in phytotechnological applications are naturally found to associate with mycorrhizal fungi. These fungal associates can provide numerous ecosystem services, or help plants to do so. There is thus an obvious incentive to better understand how mycorrhizal symbioses can assist phytotechnologies. For some phytotechnological applications, the benefits of using mycorrhizal fungi seem well-established, while for others, these benefits are either uncertain or simply unexplored. In all cases, a trait-based, mechanistic understanding of what allows mycorrhizal fungi to provide any benefit/service is urgently needed. This will help to develop reliable, mycorrhiza-assisted phytotechnologies in the future, while also improving our fundamental understanding of the evolution of stress tolerance in these important plant-associated symbionts.
Elevated radioactive contamination from the Fukushima nuclear power plant accident in aquatic biota from a river with a lake in its upper reaches
Authors: Yoshimura Mayumi , Akama Akio
Published: June 2017

Five years have passed since the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident occurred. Forests, streams, and lakes remain radioactively contaminated, with slight sign of convergence. The radiocesium concentration of brown trout (Salmo trutta) in Lake Chuzenji (160 km from the FDNPP) still exceeds the Japanese regulatory limit of 100 Bq·kg−1, likely due to elevated contamination in Lake Chuzenji. In this study, the concentration of 134Cs and 137Cs in algae, litter, sand substrate, and aquatic insects in a river originating from Lake Chuzenji (Daiya site) and in a nearby river (Watarase site) from 2013 to 2015 were compared. At the Daiya site, 134Cs and 137Cs concentrations of algae and aquatic insects were high (e.g., 137Cs in algae: 160 Bq·kg−1 at the Watarase site and 320 Bq·kg−1 at the Daiya site) and still increasing in some groups such as Perlodidae and Heptageniidae, though the mean air dose rate (0.05 μSv·h−1) was lower than that at the Watarase site (0.11 μSv·h−1). We attributed this to high flow out of higher 134Cs and 137Cs concentration originating from Lake Chuzenji. Thus, lower reaches fed by contaminated headwaters will likely experience prolonged contamination.