bluuebunny/crossref_metadata_2025_split huggingface dataset:
2 IIH Pressure – a randomised, controlled, double blind physiology study of the effect of Exenatide on intracranial pressure
Authors: Mitchell James , Walker Jessica , Lyons Hannah , Brock Kristian , Vijay Vivek , Yiangou Andreas , Alimajstorovic Zerin , Grech Olivia , Mollan Susan , Tsermoulas Georgios , Sinclair Alexandra 
Published: May 2021

IntroductionRaised intracranial pressure (ICP) causes significant morbidity and mortality in a range of conditions including idiopathic intracranial hypertension (IIH) and traumatic brain injury (TBI). Exenatide is a GLP-1 receptor agonist; pre-clinical data demonstrates its ability to reduce ICP. GLP-1R agonists have also been shown to have neuro-protective properties in pre-clinical models of TBI. The objectives of this study are to assess the biological effect of a Glucagon-like Peptide 1 (GLP-1) agonist on ICP in a cohort of participants with IIH, a raised ICP model.MethodsRandomised, placebo controlled, double-blind physiology study of Exenatide in women with active IIH (>25 cmCSF lumbar puncture opening pressure and papilloedema). Telemetric, intraparenchymal ICP monitors were implanted to enable gold standard, long-term ICP monitoring (Raumedic p-Tel, Helmbrechts, Germany). Participants were randomised 1:1 to receive Exenatide (10 mcg BD sub-cutaneous) or placebo for 12 weeks. ICP was recorded over a 24-hour baseline visit, at two weeks and 12 weeks. Monthly headache diaries were completed at baseline and 8–12 weeks. Significance was set at p<0.1 as an early phase trial.ResultsOf the 16 participants recruited, 15 were randomised and completed the study: age 29.5 ±9.5 years, BMI 38.1 ±6.2 kg/m2, ICP 30.6±5.1 cmCSF. All ICP monitor implants were well tolerated and allowed successful ICP quantification. A significant reduction in ICP was noted at all timepoints: at 2.5 hours -5.7 cm CSF (p=0.031), at 24 hours -6.3 cmCSF (p=0.095), and at 12 weeks -5.6 cmCSF (p=0.064).ConclusionsWe report the first human study to assess the biological effect of the GLP-1 agonist Exenatide on ICP in IIH utilising highly accurate implantable telemetric ICP monitors. Exenatide reduced ICP at all timepoints including acutely at 2.5 hrs and during chronic dosing. New therapies for ICP modulation are a significant un-met need in both military and civilian spheres.
6 COVID-19 outbreak investigation in a London army barracks. Understanding prevalence, seroconversion, transmission risk factors and control measures for COVID-19
Authors: Taylor Hannah , Ross David , Wall William 
Published: May 2021

IntroductionMilitary Establishments are at increased risk of rapid spread of respiratory infections. Little was known in March 2020 about SARS-CoV-2 prevalence, serological conversion, asymptomatic transmission or risk factors for transmission, particularly in military populations. Early identification, swift implementation of control measures, and investigation of a potential outbreak with Public Health England in an Army barracks following one confirmed case and 11 symptomatic personnel, allowed exploration of these questions.MethodsAll adult personnel, including civilians working or living at the Barracks were invited to participate at initial visit and day-36 follow-up. Participants completed a symptom and transmission risk factor questionnaire; gave nasal and throat swabs for SARS-CoV-2 RT-PCR, infectious virus isolation, whole genome sequencing (WGS); and blood samples to detect SARS-CoV-2 and neutralising antibodies. Risk factors were statistically analysed using STATA v15.0, described in univariate analysis by relative risks and assessed using Fisher’s Exact test.ResultsAt first visit, 24/304 (8%) participants were RT-PCR positive and infectious virus recovered from 7/24 (29%). Seropositivity was 7% (19/285). 64% of all positive participants were asymptomatic. WGS identified more than three separate introductions, and evidence of asymptomatic transmission through genetically indistinguishable samples. Significant transmission risk factors included contact with a confirmed case, female gender, and two-person shared bathrooms. After 36 days, there were no new cases, all previously RT-PCR positive participants seroconverted, but not all developed neutralising antibodies; seropositivity was 13% (25/193).ConclusionsMost positive military personnel were asymptomatic, but those with symptoms reported ageusia or anosmia. Some RT-PCR positive participants, but none who were simultaneously positive for neutralising antibodies, had infectious virus. Initial infection rates were five times general London estimates, but effective implementation of control measures including enhanced cleaning, social distancing, and prompt isolation mitigated on-site spread. 36 days later seropositivity was below London’s rate. Ongoing risks include new COVID-19 introduction into the barracks from off-site personnel, asymptomatic transmission between cases and contacts, and use of two-person bathrooms.
Effectiveness of acupuncture therapy for postherpetic neuralgia: an umbrella review protocol
Authors: Zhao Yan , Ling Di-Yang , Zhang Juan , Wu Qiong , Zhang Zhen-Wu , Wang Zhe-Yin 
Published: May 2021

IntroductionSeveral systematic reviews and meta-analysis indicate that acupuncture and related therapies may be a valuable adjunctive technique to pharmacological interventions for pain management of postherpetic neuralgia (PHN). However, the robustness of the results of these studies has not been evaluated. The aim of this proposed umbrella review is to provide more reliable evidence of the effectiveness of acupuncture therapy for PHN based on medical references for healthcare decision makers.Methods and analysisPubMed, EMBASE, The Cochrane Library, Web of Science, Chinese BioMedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure and Wan fang Database will be used to retrieve reviews. The time of publication will be limited from inception to March 2021. Two reviewers will screen all retrieved articles independently to identify their eligibility and extract the data. The quality will be assessed independently by two trained reviewers using Assessment of Multiple Systematic Reviews-2 for methodological quality, Risk of Bias in Systematic Review for level of bias, Preferred Reporting Items for Systematic Reviews and Meta-Analysis for reporting quality and Grading of Recommendations Assessment, Development and Evaluation for the quality of evidence. Any disagreements will be settled by discussion or the involvement of a third reviewer.Ethics and disseminationThe protocol of this review does not require ethical approval because the research will be based on publicly available data. The findings will be disseminated through publication in peer-reviewed international journals or presentation in academic conference.PROSPERO registration numberCRD42020173341.Reporting checklistPRISMA-P, 2015.
Intestinal barrier function in obesity with or without metabolic syndrome: a systematic review protocol
Authors: Bona Mariana Duarte , Torres Carlos Henrique de Medeiros , Lima Severina Carla Vieira Cunha , Lima Aldo Angelo Moreira , Maciel Bruna Leal Lima 
Published: May 2021

IntroductionIntestinal barrier function is dependent on the structure and function of intestinal epithelial cells and paracellular pathway. The derangement of the intestinal barrier function can originate from conditions involving local and systemic chronic inflammation and metabolic diseases such as obesity and metabolic disorders. This study aims to describe a systematic review protocol investigating if obesity with or without metabolic syndrome is associated with an altered intestinal barrier function.Methods and analysisThis protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases to be searched are PubMed, Embase, Scopus, Science Direct and Web of Science. The systematic review will include original articles with adults and the elderly, who present obesity with or without metabolic syndrome, that address the intestinal barrier function. Two independent reviewers will perform study selection, data extraction and methodological quality assessment. Key information will be tabulated and a narrative synthesis will be conducted. The Grading of Recommendation, Assessment, Development and Evaluation framework will be used to assess the quality of evidence concerning the associations between intestinal barrier function and obesity with or without metabolic syndrome. The present protocol will assist in producing a systematic review that addresses if obesity with or without metabolic syndrome alters intestinal barrier function.Ethics and disseminationNo ethical statement will be required. The results will be disseminated through a peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42020178658.
Addressing the psychological impact of COVID-19 on healthcare workers: learning from a systematic review of early interventions for frontline responders
Authors: Hooper Jasmine Jean , Saulsman Lisa , Hall Tammy , Waters Flavie 
Published: May 2021

ObjectivesProtecting healthcare workers from psychological harm is an urgent clinical issue within the current COVID-19 pandemic. Research on early psychological programmes that aim to prevent or reduce mental health symptoms and that have been tested in frontline responders may assist service providers with choosing a suitable intervention for rapid dissemination in healthcare settings.Design and outcome measuresFirst, Embase, Web of Science, PsycINFO and Google Scholar were searched through a systematic literature review of early psychological interventions administered to frontline responders in the last 15 years. Interventions were included if they were designed to prevent or reduce psychological impact and had outcome measures of psychological distress (eg, general psychopathology, post-traumatic stress disorder and stress) and/or positive mental health domains (eg, resilience, self-efficacy and life satisfaction). Second, the suitability of these programmes for the healthcare workforce was evaluated according to the criteria of effectiveness, content applicability and feasibility.ResultsOf 320 articles retrieved, 12 relevant studies were included that described six early psychological interventions. Although the evidence base is limited, psychological first aid, eye movement desensitisation and reprocessing, and trauma risk management showed effectiveness across at least two studies each with frontline workers. Resilience and coping for the healthcare community; anticipate, plan, and deter; and resilience at work programmes found promising results in single studies. Concerning other suitability criteria, all programmes appear applicable to healthcare settings and have acceptable feasibility for rapid implementation.ConclusionsDespite the limited evidence, several interventions were identified as potentially suitable and useful for improving psychological functioning of healthcare workers across a variety of disaster situations. Service providers should continue to implement and evaluate early psychological interventions in frontline workers in order to refine best practices for managing the psychological impact of future disasters.
Physicians’ perspective on potentially non-beneficial treatment when assessing patients with advanced disease for ICU admission: a qualitative study
Authors: Escher Monica , Nendaz Mathieu R , Cullati Stéphane , Hudelson Patricia 
Published: May 2021

ObjectiveThe use of intensive care at the end of life can be high, leading to inappropriate healthcare utilisation, and prolonged suffering for patients and families. The objective of the study was to determine which factors influence physicians’ admission decisions in situations of potentially non-beneficial intensive care.DesignThis is a secondary analysis of a qualitative study exploring the triage process. In-depth interviews were analysed using an inductive approach to thematic content analysis.SettingData were collected in a Swiss tertiary care centre between March and June 2013.Participants12 intensive care unit (ICU) physicians and 12 internists routinely involved in ICU admission decisions.ResultsPhysicians struggled to understand the request for intensive care for patients with advanced disease and full code status. Physicians considered patients’ long-term vital and functional prognosis, but they also resorted to shortcuts, that is, a priori consensus about reasons for admitting a patient. Family pressure and unexpected critical events were determinants of admission to the ICU. Patient preferences, ICU physician’s expertise and collaborative decision making facilitated refusal. Physicians were willing to admit a patient with advanced disease for a limited amount of time to fulfil a personal need.ConclusionsIn situations of potentially non-beneficial intensive care, the influence of shortcuts or context-related factors suggests that practice variations and inappropriate admission decisions are likely to occur. Institutional guidelines and timely goals of care discussions with patients with advanced disease and their families could contribute to ensuring appropriate levels of care.
Investigating the impact of HIV on patients with first episode psychosis: a study protocol for a longitudinal cohort study
Authors: Chhagan Usha , Ntlantsana Vuyokazi , Tomita Andrew , Naidu Thirusha , Chiliza Bonginkosi , Paruk Saeeda 
Published: May 2021

IntroductionSouth Africa (SA) has a high HIV prevalence and limited mental healthcare resources. Neuropsychiatric complications such as psychosis onset in people living with HIV (PLWHIV) remains poorly understood. The study aims to compare the socio-demographic, clinical, substance use, cognitive and trauma profile of PLWHIV presenting with first episode psychosis (FEP) to those with the condition but without HIV.Methods and analysisThis study will compare presentation, course, and outcome of a cohort of PLWHIV and FEP with a control group recruited over a 3-year period. We will prospectively test the hypothesis that the 2 groups are socio-demographically, clinically and cognitively distinct at illness presentation, with higher trauma burden and poorer outcomes in those with the dual burden of HIV and FEP. FEP participants, confirmed by a structured neuropsychiatric interview, will have their socio-demographic, psychosis, mood, motor, trauma and substance use variables assessed. A neuropsychological battery will be completed to assess cognition, while quality of life, psychotic symptoms and HIV markers will be measured at 3, 6 and 12 months.Ethics and disseminationThe study protocol has been reviewed and ethics approval obtained from the Biomedical Research Ethics Committee (BC 571/18) of the University of KwaZulu-Natal. The results from this investigation will be actively disseminated through peer-reviewed journal publications and conference presentations.
Predicting outcomes of COVID-19 from admission biomarkers: a prospective UK cohort study
Authors: Arnold David T , Attwood Marie , Barratt Shaney , Morley Anna , Elvers Karen T , McKernon Jorgen , Donald Charmaine , Oates Adrian , Noel Alan , MacGowan Alasdair , Maskell Nick A , Hamilton Fergus W 
Published: May 2021

IntroductionCOVID-19 has an unpredictable clinical course, so prognostic biomarkers would be invaluable when triaging patients on admission to hospital. Many biomarkers have been suggested using large observational datasets but sample timing is crucial to ensure prognostic relevance. The DISCOVER study prospectively recruited patients with COVID-19 admitted to a UK hospital and analysed a panel of putative prognostic biomarkers on the admission blood sample to identify markers of poor outcome.MethodsConsecutive patients admitted to hospital with proven or clinicoradiological suspected COVID-19 were consented. Admission bloods were extracted from the clinical laboratory. A panel of biomarkers (interleukin-6 (IL-6), soluble urokinase plasminogen activator receptor (suPAR), Krebs von den Lungen 6, troponin, ferritin, lactate dehydrogenase, B-type natriuretic peptide, procalcitonin) were performed in addition to routinely performed markers (C reactive protein (CRP), neutrophils, lymphocytes, neutrophil:lymphocyte ratio). Age, National Early Warning Score (NEWS2), CURB-65 and radiographic severity score on initial chest radiograph were included as comparators. All biomarkers were tested in logistic regression against a composite outcome of non-invasive ventilation, intensive care admission or death, with area under the curve (AUC) (figures calculated).Results187 patients had 28-day outcomes at the time of analysis. CRP (AUC: 0.69, 95% CI: 0.59 to 0.78), lymphocyte count (AUC: 0.62, 95% CI: 0.53 to 0.72) and other routine markers did not predict the primary outcome. IL-6 (AUC: 0.77, 0.65 to 0.88) and suPAR (AUC: 0.81, 0.72 to 0.88) showed some promise, but simple clinical features alone such as NEWS2 score (AUC: 0.70, 0.60 to 0.79) or age (AUC: 0.70, 0.62 to 0.77) performed nearly as well.DiscussionAdmission blood biomarkers have only moderate predictive value for predicting COVID-19 outcomes, while simple clinical features such as age and NEWS2 score outperform many biomarkers. IL-6 and suPAR had the best performance, and further studies should focus on the additive value of these biomarkers to routine care.
Trophic ecology of the European eel (Anguilla anguilla) across different salinity habitats inferred from fatty acid and stable isotope analysis
Authors: Parzanini Camilla , Arts Michael T. , Power Michael , Rohtla Mehis , Skiftesvik Anne Berit , Koprivnikar Janet , Browman Howard I. , Milotic Dino , Durif Caroline M.F. 
Published: May 2021

We combined fatty acid (FA) and stable isotope (SI) analyses to investigate the trophic ecology of different stages of European eels (Anguilla anguilla) across seawater (SW), brackish water (BW), and freshwater (FW) habitats. Salinity was the main driver of differences in the biochemical composition, and the greatest variation occurred between SW and FW eels. SW eels had a higher content of the FA indicator of carnivory, as well as the highest stable isotope ratios (C, N). In contrast, FW eels exhibited the highest lipid content and omega-6 polyunsaturated FA, but the lowest stable isotope ratios, suggesting major dietary differences between the eels in these two habitats. While the biochemical composition of BW eels was closer to those of SW eels, BW eels had the largest SI range, indicating higher dietary plasticity. FW individuals had better overall condition compared to SW eels. Independent of habitat, larger individuals were in the best condition, and had higher lipid content and monounsaturated FA. These findings suggest a biological advantage for eels to maintain a catadromous life history strategy.
Systematic Pharmacology Reveals the Antioxidative Stress and Anti-Inflammatory Mechanisms of Resveratrol Intervention in Myocardial Ischemia-Reperfusion Injury
Authors: Xing Zuzhong , He Qi , Xiong Yinliang , Zeng Xiaomei 
Published: May 2021

Objective. To explore the oxidative stress and inflammatory mechanisms of resveratrol intervention in myocardial ischemia-reperfusion injury (MIRI). Methods. The potential targets of resveratrol were predicted by PharmMapper. The MIRI genes were collected by Online Mendelian Inheritance in Man (OMIM), GeneCards is used to collect related disease genes, and String is used for enrichment analysis. Animal experiments were then performed to verify the systematic pharmacological results. Hematoxylin-eosin (HE) staining was used to observe myocardial damage. The levels of serum interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) in each experimental group were detected. The protein and mRNA expressions of Toll-like receptor 4 (TLR4), nuclear factor-kappa (NF-κB) p65, IL-1β, IL-6, and TNF-α in rat myocardial tissue were measured. Results. The results of systematic pharmacology showed that insulin resistance, FoxO signaling pathway, adipocytokine signaling pathway, insulin signaling pathway, PI3K-Akt signaling pathway, ErbB signaling pathway, T-cell receptor signaling pathway, peroxisome proliferator-activated receptors (PPAR) signaling pathway, Ras signaling pathway, TNF signaling pathway, and so on were regulated to improve MIRI. The results of animal experiments showed that the myocardial cells of the sham operation group were arranged in fibrous form, and the myocardial ischemia-reperfusion injury group had obvious cell morphology disorder. Compared with the MIRI group, the resveratrol group had a certain degree of relief. Compared with the MIRI group, serum IL-1β, TNF-α, and IL-6 in the resveratrol group was significantly reduced (

P

< 0.05), and myocardial tissue TLR4, NF-κB p65, IL-1β, IL-6, and TNF-α mRNA and protein expressions were significantly reduced (

P

< 0.05). Conclusion. Resveratrol can effectively improve MIRI, and its mechanism may be related to antioxidative stress and anti-inflammatory.
The Future Burden of Head and Neck Cancers Attributable to Modifiable Behaviors in Australia: A Pooled Cohort Study
Authors: Laaksonen Maarit A. , Canfell Karen , MacInnis Robert J. , Banks Emily , Byles Julie E. , Giles Graham G. , Magliano Dianna J. , Shaw Jonathan E. , Hirani Vasant , Gill Tiffany K. , Mitchell Paul , Cumming Robert G. , Salagame Usha , Vajdic Claire M. 
Published: May 2021

Abstract

Background:
Estimates of future burden of cancer attributable to current modifiable causal exposures can guide cancer prevention. We quantified future head and neck cancer burden in Australia attributable to individual and joint causal exposures, and assessed whether these burdens differ between population subgroups.

Methods:
We estimated the strength of the associations between exposures and head and neck cancer using adjusted proportional hazards models from pooled data from seven Australian cohorts (N = 367,058) linked to national cancer and death registries and estimated exposure prevalence from the 2017 to 2018 Australian National Health Survey. We calculated population attributable fractions (PAF) with 95% confidence intervals (CI), accounting for competing risk of death, and compared PAFs for population subgroups.

Results:
Contemporary levels of current and former smoking contribute 30.6% (95% CI, 22.7%–37.8%), alcohol consumption exceeding two standard drinks per day 12.9% (95% CI, 7.6%–17.9%), and these exposures jointly 38.5% (95% CI, 31.1%–45.0%) to the future head and neck cancer burden. Alcohol-attributable burden is triple and smoking-attributable burden is double for men compared with women. Smoking-attributable burden is also at least double for those consuming more than two alcoholic drinks daily or doing less than 150 minutes of moderate or 75 minutes of vigorous activity weekly, and for those aged under 65 years, unmarried, with low or intermediate educational attainment or lower socioeconomic status, compared with their counterparts.

Conclusions:
Two-fifths of head and neck cancers in Australia are preventable by investment in tobacco and alcohol control.

Impact:
Targeting men and other identified high-burden subgroups can help to reduce head and neck cancer burden disparities.