bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin potentiates the response to capsaicin in dorsal root ganglion neurons in vitro and muscle afferents ex vivo in normal healthy rodents
Authors: Hori Amane , Hotta Norio , Fukazawa Ayumi , Estrada Juan A. , Katanosaka Kimiaki , Mizumura Kazue , Sato Jun , Ishizawa Rie , Kim Han‐Kyul , Iwamoto Gary A. , Vongpatanasin Wanpen , Mitchell Jere H. , Smith Scott A. , Mizuno Masaki 
Published: December 2021

AbstractSystemic insulin administration evokes sympathoexcitatory actions, but the mechanisms underlying these observations are unknown. We reported that insulin sensitizes the response of thin‐fibre primary afferents, as well as the dorsal root ganglion (DRG) that subserves them, to mechanical stimuli. However, little is known about the effects of insulin on primary neuronal responses to chemical stimuli. TRPV1, whose agonist is capsaicin (CAP), is widely expressed on chemically sensitive metaboreceptors and/or nociceptors. The aim of this investigation was to determine the effects of insulin on CAP‐activated currents in small DRG neurons and CAP‐induced action potentials in thin‐fibre muscle afferents of normal healthy rodents. Additionally, we investigated whether insulin potentiates sympathetic nerve activity (SNA) responses to CAP. In whole‐cell patch‐clamp recordings from cultured mice DRG neurons in vitro, the fold change in CAP‐activated current from pre‐ to post‐application of insulin (n = 13) was significantly (P < 0.05) higher than with a vehicle control (n = 14). Similar results were observed in single‐fibre recording experiments ex vivo as insulin potentiated CAP‐induced action potentials compared to vehicle controls (n = 9 per group, P < 0.05). Furthermore, insulin receptor blockade with GSK1838705 significantly suppressed the insulin‐induced augmentation in CAP‐activated currents (n = 13) as well as the response magnitude of CAP‐induced action potentials (n = 9). Likewise, the renal SNA response to CAP after intramuscular injection of insulin (n = 8) was significantly (P < 0.05) greater compared to vehicle (n = 9). The findings suggest that insulin potentiates TRPV1 responsiveness to CAP at the DRG and muscle tissue levels, possibly contributing to the augmentation in sympathoexcitation during activities such as physical exercise.Key points
Evidence suggests insulin centrally activates the sympathetic nervous system, and a chemical stimulus to tissues activates the sympathetic nervous system via thin fibre muscle afferents.
Insulin is reported to modulate putative chemical‐sensitive channels in the dorsal root ganglion neurons of these afferents.
In the present study, it is demonstrated that insulin potentiates the responsiveness of thin fibre afferents to capsaicin at muscle tissue levels as well as at the level of dorsal root ganglion neurons. In addition, it is demonstrated that insulin augments the sympathetic nerve activity response to capsaicin in vivo.
These data suggest that sympathoexcitation is peripherally mediated via insulin‐induced chemical sensitization.
The present study proposes a possible physiological role of insulin in the regulation of chemical sensitivity in somatosensory thin fibre muscle afferents.
Twelve-Month Stability of Accelerometer-Measured Occupational and Leisure-Time Physical Activity and Compensation Effects
Authors: Gay Jennifer L. , Buchner David M. 
Published: December 2021

Introduction: Little is known about the stability of occupational physical activity (PA) and documented compensation effects over time. Study objectives were to (a) determine the stability of accelerometer estimates of occupational and nonoccupational PA over 6 months and 1 year in adults who do not change jobs, (b) examine PA stability in office workers relative to employees with nonoffice jobs who may be more susceptible to seasonal perturbations in work tasks, and (c) examine the stability data for compensation effects seen at baseline in this sample. Methods: City/county government workers from a variety of labor sectors wore an accelerometer at initial data collection, and at 6 (n = 98) and 12 months (n = 38) following initial data collection. Intraclass correlation coefficients (ICCs) were calculated for accelerometer counts and minutes by intensity, domain, and office worker status. Partial correlation coefficients were examined for compensation effects. Results: ICCs ranged from .19 to .91 for occupational and nonwork activity variables. ICCs were similar by office worker status. In both counts and minutes, greater occupational PA correlated with lower total nonwork PA. However, as minutes of occupational moderate to vigorous physical activity increased, nonoccupational moderate to vigorous physical activity did not decrease. Conclusions: There was moderate to high stability in occupational and nonoccupational PA over 6- and 12-month data collection. Occupational PA stability was greater in nonoffice workers, suggesting that those employees’ PA may be less prone to potential cyclical factors at the workplace. Confirmation of the compensation effect further supports the need for workplace intervention studies to examine changes in all intensities of activity during and outside of work time.
Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study
Authors: Wijayaratna Sasini , Lee Arier , Park Hyun Young , Jo Emmanuel , Wu Fiona , Bagg Warwick , Cundy Tim 
Published: December 2021

IntroductionYoung people with type 2 diabetes (T2D) develop complications earlier than those with type 1 diabetes (T1D) of comparable duration, but it is unclear why. This apparent difference in phenotype could relate to relative inequality.Research design and methodsCross-sectional study of young people referred to secondary diabetes services in Auckland, Aotearoa-New Zealand (NZ): 731 with T1D and 1350 with T2D currently aged<40 years, and diagnosed between 15 and 30 years. Outcome measures were risk factors for complications (glycemic control, urine albumin/creatinine ratio (ACR), cardiovascular disease (CVD) risk) in relation to a validated national index of deprivation (New Zealand Deprivation Index (NZDep)).ResultsYoung people with T2D were an average 3 years older than those with T1D but had a similar duration of diabetes. 71% of those with T2D were of Māori or Pasifika descent, compared with 24% with T1D (p<0.001). T1D cases were distributed evenly across NZDep categories. 78% of T2D cases were living in the lowest four NZDep categories (p<0.001). In both diabetes types, body mass index (BMI) increased progressively across the NZDep spectrum (p<0.002), as did mean glycated hemoglobin (HbA1c) (p<0.001), the prevalence of macroalbuminuria (p≤0.01), and CVD risk (p<0.001). Adjusting for BMI, diabetes type, and duration and age, multiple logistic regression revealed deprivation was the strongest risk factor for poorly controlled diabetes (defined as HbA1c>64 mmol/mol, >8%); OR 1.17, 95% CI 1.13 to 1.22, p<0.0001. Ordinal logistic regression showed each decile increase in NZDep increased the odds of a higher ACR by 11% (OR 1.11, 95% CI 1.06 to 1.16, p<0.001) following adjustment for BMI, blood pressure, diabetes type and duration, HbA1c, and smoking status. Multiple linear regression indicated a 4% increase in CVD risk for every decile increase in NZDep, regardless of diabetes type.ConclusionsThe apparent more aggressive phenotype of young-onset T2D is at least in part explicable by relative deprivation.
Sex differences over time for glycemic control, pump use and insulin dose in patients aged 10–40 years with type 1 diabetes: a diabetes registry study
Authors: Boettcher Claudia , Tittel Sascha R , Meissner Thomas , Gohlke Bettina , Stachow Rainer , Dost Axel , Wunderlich Sybille , Lowak Iris , Lanzinger Stefanie 
Published: December 2021

IntroductionTo evaluate sex differences in people with type 1 diabetes concerning changes in glycemic control and trends in insulin pump use and insulin dose over two decades in adolescents and one-and-a-half decades in adults.Research design and methodsPeople aged 10–20 years (data years 1999–2018) and 21–40 years (data years 2004–2018) with type 1 diabetes were identified in the Diabetes Prospective Follow-up Registry (DPV). All available patients’ data sets of the respective period were used for linear regression analyses to investigate trends in HbA1c, pump use, insulin doses and body mass index SD scores (BMI-SDS) in females and males. In addition, stratification by migrant background was made for the adolescent group.ResultsIn the youth group (n=68 662), both boys and girls showed an HbA1c decrease over the period examined. After stratification for migrant background, an HbA1c convergence between boys and girls was seen in those without migrant background as of 2016. Usage of insulin pumps increased continuously from 3% (boys and girls) to 47% (boys) and 54% (girls), respectively. The daily insulin dose in units per kilogram body weight and day increased continuously from 1999 to 2018. An insulin dose leveling between boys and girls occurred. BMI-SDS consistently increased in girls whereas only slight variations were observed in boys.The adult group (n=15 380) showed constant HbA1c sex differences from 2004 to 2018 with lower HbA1c level in females. The use of insulin pump therapy rose from 18% to 35% (males) and 30% to 50% (females).ConclusionsThe gap in metabolic control between boys and girls with type 1 diabetes seems to close, but predominantly in adolescents without a migrant background. Improved HbA1c was associated with increased insulin pump use, especially in girls.In adult patients, sex differences in metabolic control and insulin pump use persist: women show constantly lower HbA1c values and higher insulin pump use.
Understanding factors impacting global priority of emergency care: a qualitative policy analysis
Authors: Chipendo Portia I , Shawar Yusra R , Shiffman Jeremy , Razzak Junaid Abdul 
Published: December 2021

IntroductionThe high burden of emergency medical conditions has not been met with adequate financial and political prioritisation especially in low and middle-income countries. We examined the factors that have shaped the priority of global emergency care and highlight potential responses by emergency care advocates.MethodsWe conducted semistructured interviews with key experts in global emergency care practice, public health, health policy and advocacy. We then applied a policy framework based on political ethnography and content analysis to code for underlying themes.ResultsWe identified problem definition, coalition building, paucity of data and positioning, as the main challenges faced by emergency care advocates. Problem definition remains the key issue, with divergent ideas on what emergency care is, should be and what solutions are to be prioritised. Proponents have struggled to portray the urgency of the issue in a way that commands action from decision-makers. The lack of data further limits their effectiveness. However, there is much reason for optimism given the network’s commitment to the issue, the emerging leadership and the existence of policy windows.ConclusionTo improve global priority for emergency care, proponents should take advantage of the emerging governance structure and build consensus on definitions, generate data-driven solutions, find strategic framings and engage with non-traditional allies.
Eliminating malaria in conflict zones: public health strategies developed in the Sri Lanka Civil War
Authors: Ahmed Abrar , Hounsell Kara Grace , Sadiq Talha , Naguib Mariam , Koswin Kirstyn , Dharmawansa Chetha , Rasan Thavachchelvi , McGahan Anita M 
Published: December 2021

Despite the 26-year long civil war, Sri Lanka was declared malaria-free by WHO in 2016. This achievement was the result of nearly 30 years of elimination efforts following the last significant resurgence of malaria cases in Sri Lanka. The resurgence occurred in 1986–1987, when about 600 000 cases of malaria were detected. Obstacles to these efforts included a lack of healthcare workers in conflict zones, a disruption of vector control efforts, gaps in the medication supply chain, and rising malaria cases among the displaced population.This article seeks to describe the four strategies deployed in Sri Lanka to mitigate the aforementioned obstacles to ultimately achieve malaria elimination. The first approach was the support for disease elimination by the government of Sri Lanka and the Liberation Tamil Tigers of Elam. The second strategy was the balance of centralised leadership of the federal government and the decentralised programme operation at the regional level. The third strategy was the engagement of non-governmental stakeholders to fill in gaps left by the conflict to continue the elimination efforts. The last strategy is the ongoing efforts by the government, military and non-profit organisations to prevent the reintroduction of malaria.The lessons learnt from Sri Lanka have important implications for malaria-endemic nations that are in conflict such as Ethiopia, Afghanistan, Yemen and Somalia. To accomplish the World Health Assembly goal of reducing the global incidence and mortality of malaria by 90% by 2030, significant efforts are required to lessen the disease burden in conflict zones. In addition to the direct impacts of conflict on population health, conflicts may lead to increased risk of spread of malaria, both within a country and consequently, abroad.
Exploration of implementation, financial and technical considerations within allied health professional (AHP) telehealth consultation guidance: a scoping review including UK AHP professional bodies’ guidance
Authors: Leone Enza , Eddison Nicola , Healy Aoife , Royse Carolyn , Chockalingam Nachiappan 
Published: December 2021

ObjectivesThe COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK allied health professionals (AHPs) and compare them with the UK AHP professional bodies’ guidelines.DesignScoping review following Aksey and O’ Malley methodological framework.Data sourcesCINHAL and MEDLINE were searched from inception to March 2021 using terms related to ‘telehealth’, ‘guidelines’ and ‘AHPs’. Additionally, the UK AHP professional bodies were contacted requesting their guidelines.Study selectionArticles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites were considered eligible for review.Data extractionOne reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations.Results2632 articles were identified through database searches with 21 articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of 29 included articles/guidelines. Most articles were published in the last two years; there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family’s and caregiver’s roles and the costs. There was lack of clarity on the AHPs’ registration requirements, costs and coverage, and legal aspects.ConclusionThis study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth consultations. Future research and collaborative work across AHP groups and the world’s leading health institutions are suggested to establish common guidelines that will improve AHP telehealth services.
Medicine treatment of glaucoma in Australia 2012–2019: prevalence, incidence and persistence
Authors: Daniels Benjamin , Healey Paul , Bruno Claudia , Kaan Iain , Zoega Helga 
Published: December 2021

ObjectiveMedical therapy can halt or significantly slow the progression of glaucoma if medicines are used in accordance with the guidelines. We used dispensing claims for a 10% sample of all Australians dispensed publicly subsidised glaucoma medicines to determine the prevalence and incidence of glaucoma medicine treatment and to examine treatment persistence between July 2012 and June 2019.MethodsWe estimated incidence and prevalence per 10 000 population for Australian financial years (1 July to 30 June). We defined prevalence as at least one dispensing of any glaucoma medicine and incidence as a dispensing of any glaucoma medicine with no previous dispensing during the preceding 12 months. We estimated duration of treatment for a cohort initiating glaucoma medicines and used Kaplan-Meier methods to estimate the proportion of people persisting on treatment at 6, 12, 18 and 36 months after initiation. We stratified analyses by the number of repeats prescribed at initiation, age, sex and medicine class.ResultsPrevalence remained stable over the study period at around 180/10 000 people/year; incidence was also stable around 36/10 000/year. Among 34 900 people initiating glaucoma medicines, 37.0% remained on treatment at 6 months from initiation, 29.8% at 12 months and 19.2% at 36 months. Median duration of treatment was 13.2 months (IQR: 2.5—not reached) for people initiating prostaglandin analogues and less than 3 months for those initiating other medicine classes.ConclusionPrevalence and incidence of glaucoma treatment have not changed in Australia over the past decade. Persistence to treatment increased with age but remained poor throughout the study period.
Risk factors for death in Welsh infants with a congenital anomaly
Authors: Ho Peter S Y , Quigley Maria , Tucker David F , Kurinczuk Jenny 
Published: December 2021

ObjectivesTo investigate risk factors associated with death of infants with a congenital anomaly in Wales, UK.DesignA population-based cohort study.SettingData from the Welsh Congenital Anomaly Register and Information Service (CARIS) linked to live births and deaths from the Office for National Statistics.PatientsAll live births between 1998 and 2016 with a diagnosis of a congenital anomaly, which was defined as a structural, metabolic, endocrine or genetic defect, as well as rare disease of hereditary origin.Main outcome measuresAdjusted ORs (aORs) were estimated for socio-demographic, maternal, infant and intervention factors associated with death in infancy, using logistic regression for all, isolated, multiple and cardiovascular anomalies.Results30 424 live births affected by congenital anomalies were identified, including 1044 infants who died by the age of 1 year (infant mortality rate: 16.5 per 10 000 live births, case fatality: 3.4%, 30.3% of all infant deaths). Risk factors for infant death were non-white versus white ethnicity (aOR: 2.25; 95% CI: 1.77–2.86); parous versus nulliparous (aOR: 1.24; 95% CI: 1.08–1.41); smoking during pregnancy versus non-smokers/ex-smokers (aOR: 1.20; 95% CI: 1.02–1.40); preterm versus term birth (aOR: 4.38; 95% CI 3.86–4.98); female versus male infants (aOR: 1.28; 95% CI: 1.13–1.46) and the earlier years of the birth cohort (aOR: 0.96; 95% CI: 0.95–0.98 per yearly increase). Infants with a cardiovascular anomaly who received surgery had a lower odds of death than those who did not (aOR: 0.34; 95% CI: 0.15–0.75). Preterm birth was a significant factor for death for all anomalies but the effect of the other characteristics varied according to anomaly group.ConclusionsNearly a third of all infant deaths had an associated anomaly. Improving access to prenatal care, smoking cessation advice, optimising care for preterm infants and surgery may help lower the risk of infant death.
Information provision to older patients receiving palliative chemotherapy: a quality study
Authors: Lindhardt Christina Louise , Winther Stine Brændegaard , Pfeiffer Per , Ryg Jesper 
Published: December 2021

ObjectivesCancer treatment has become increasingly successful. However, prolonging and preserving life has become an important goal of therapy since many patients generally receive palliative chemotherapy. The perception of life changes when patients are informed, that no curative treatment is possible. This raises new dilemmas for patients with incurable cancer, but only sparse information is available about the thoughts of these patients.The aim of this study was to explore how older patients experience the information on absence of curative treatment options.MethodsQualitative interviews were performed in eleven older patients with incurable upper gastrointestinal cancer receiving first-line palliative chemotherapy. Median age was 74 (65–76) years. We used a qualitative approach to collect data through semistructured individual interviews conducted at the hospital or by telephone interviews by an experienced researcher. The thematic analysis was conveyed by Braun and Clarke.ResultsThe interview findings were grouped around three main themes: hope of being cured, hearing but not comprehending, and desired milestones to reach. Further, it was determined that patients hid their feelings and avoided talking about the disease with the health professionals due to fear of being told the truth.ConclusionsReceiving information about their incurable cancer was an ongoing dilemma for the patients. Following the message, patients shared thoughts about reaching important milestones in life, spending time with their family or hope for a cure to be found.
Losing a child due to a life-limiting diagnosis—parental well-being and quality of life: nationwide survey
Authors: Lykke Camilla , Sjøgren Per , Ekholm Ola 
Published: December 2021

ObjectiveLosing a child is burdensome with potential long-term impact on the parents’ well-being and quality of life. The aim was to investigate parental well-being and quality of life 3–5 years after losing a child due to life-limiting diagnoses and to identify associated factors in order to target future interventions.MethodsAll parents, who lost a child (<18 years) due to life-limiting diagnoses in the period 2012–2014 in Denmark, were invited to complete a self-administered questionnaire. A seven-point Visual Digital Scale (VDS) was used to assess issues of well-being and quality of life including physical health, anxiety, depression and sleep quality which were combined into a cumulative symptom index. Associations were assessed by means of ordinal logistic regression models.ResultsIn all, 152 (38%) children were represented by 136 mothers and 57 fathers. Totally, 17.6% of the mothers and 14.0% of the fathers had ≥2 symptoms (assessed by the symptom index). Parents with lower education had 2.11 (95% CI: 1.01 to 4.40) times higher odds of having more symptoms than parents with higher education. Unmarried parents had 2.14 (95% CI: 1.03 to 4.42) times higher odds of having more symptoms than married parents. Ten per cent of the parents reported poor overall quality of life.ConclusionAccording to the VDS, 1 out of 10 parents experienced poor overall quality of life 3–5 years after the loss. Every sixth had two or more symptoms assessed by the symptom index. Associated factors for poor quality of life suggest attention to particularly unmarried parents and parents with lower education.