bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of lanadelumab in hereditary angioedema: a case series of 12 patients in Canada
Authors: Iaboni Aled , Kanani Amin , Lacuesta Gina , Song Christine , Kan Manstein , Betschel Stephen D. 
Published: July 2021

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

AbstractBackgroundSalmonellaTyphimurium is an important zoonotic pathogen in pigs, that can cause clinical disease. Many sow herds and finishing herds are infected withSalmonella, and therefore pose a threat for the contamination of pork and pork products and ultimately consumers.Case presentationThis case study describes a farrow-to-finish pig herd, producing its own replacement gilts, which had experienced clinical outbreaks of salmonellosis since 2002. Outbreaks were characterised by profuse diarrhoea, dead pigs and high antimicrobial use (colistin sulphate). The aim of this study was to see whether using vaccination of sows and piglets with Salmoporc®, a live attenuatedSalmonellaTyphimurium vaccine, in combination with standard hygienic precautions, it was possible to reduceSalmonellaTyphimurium to below the bacteriological detection limit. Monitoring of the presence ofSalmonellawas done using a total of 20 pooled faecal, sock and dust samples per herd visit in the period from September 2016 to October 2020. Within the first 10 months after the start of vaccination in August 2016, there was a rapid reduction in clinical symptoms, antimicrobial usage and the number ofSalmonella-positive samples. During the winters of 2017/2018 and 2018/2019 the number of positive samples increased again, however with minimal need to use antimicrobials to treat the affected animals. In July 2019, only two samples from a corridor were positive. In September and November 2019 and in October 2020 all three samplings were completely negative forS. Typhimurium.ConclusionsThis case, together with other longitudinal studies, can be seen as a proof of the principle that long term vaccination with a live attenuatedS.Typhimurium vaccine can reduce the level ofS. Typhimurium in the herd environment to very low levels within a farrow-to-finish herd initially suffering from clinical salmonellosis. Also, clinical symptoms indicating salmonellosis were no longer observed and antimicrobials to treat clinically diseased pigs were no longer needed.
Healthy Parent Carers: feasibility randomised controlled trial of a peer-led group-based health promotion intervention for parent carers of disabled children
Authors: Bjornstad Gretchen , Cuffe-Fuller Beth , Ukoumunne Obioha C. , Fredlund Mary , McDonald Annabel , Wilkinson Kath , Lloyd Jenny , Hawton Annie , Berry Vashti , Tarrant Mark , Borek Aleksandra , Fitzpatrick Katharine , Gillett Annette , Rhodes Shelley , Logan Stuart , Morris Christopher 
Published: July 2021

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

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

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

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

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

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

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

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

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

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

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

Conclusions
There is a need for educational interventions to raise awareness of the negative impacts of some socio-cultural practices on the health of the mother and child.