Tag: pubmed

J Hazard Mater. 2021 Oct 8;424(Pt B):127456. doi: 10.1016/j.jhazmat.2021.127456. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has put unprecedented pressure on public health resources around the world. From adversity, opportunities have arisen to measure the state and dynamics of human disease at a scale not seen before. In the United Kingdom, the evidence that wastewater could be used to monitor the SARS-CoV-2 virus prompted the development of National wastewater surveillance programmes. The scale and pace of this work has proven to be unique in monitoring of virus dynamics at a national level, demonstrating the importance of wastewater-based epidemiology (WBE) for public health protection. Beyond COVID-19, it can provide additional value for monitoring and informing on a range of biological and chemical markers of human health. A discussion of measurement uncertainty associated with surveillance of wastewater, focusing on lessons-learned from the UK programmes monitoring COVID-19 is presented, showing that sources of uncertainty impacting measurement quality and interpretation of data for public health decision-making, are varied and complex. While some factors remain poorly understood, we present approaches taken by the UK programmes to manage and mitigate the more tractable sources of uncertainty. This work provides a platform to integrate uncertainty management into WBE activities as part of global One Health initiatives beyond the pandemic.

PMID:34655869 | DOI:10.1016/j.jhazmat.2021.127456

Cancer Treat Res Commun. 2021 Sep 25;29:100466. doi: 10.1016/j.ctarc.2021.100466. Online ahead of print.

ABSTRACT

Evidence-based US guidelines provide recommendations for the use of granulocyte colony-stimulating factor (G-CSF) as supportive therapy in patients with cancer receiving chemotherapy. Pegfilgrastim is recommended for FN prophylaxis in patients with non-myeloid malignancies receiving a high-risk chemotherapy regimen, or an intermediate-risk regimen if one or more risk factors are present. The guidelines highlight the patient characteristics and chemotherapy regimens for solid tumors and hematologic malignancies that may influence a patient’s overall risk of FN and may benefit from pegfilgrastim support. This review aimed to evaluate how pegfilgrastim use in patients with cancer receiving myelosuppressive chemotherapy in routine clinical practice aligns with evidence-based US guidelines. Examination of the literature revealed widespread deviation in relation to under- and over-prescribing, and timing of administration in US clinical practice. Pegfilgrastim is often over-prescribed in patients receiving palliative chemotherapy and those at low risk of FN. Potential under-prescribing of pegfilgrastim was also observed. In this literature search, data that appear to support same-day administration of pegfilgrastim were from uncontrolled studies that were limited in size. Analyses of healthcare claims data clearly favored next-day use, with statistically significant increases in FN incidence among patients receiving same-day pegfilgrastim versus those treated 1-4 days post-chemotherapy. Earlier-than-recommended administration typically occurs at the physician’s discretion where next-day administration might present barriers to the patient receiving supportive therapy.There is a need to ensure appropriate prescribing to optimize patient outcomes, as deviation from the guideline recommendations was associated with increased incidence of FN and hospitalization.

PMID:34655862 | DOI:10.1016/j.ctarc.2021.100466

Transbound Emerg Dis. 2021 Oct 16. doi: 10.1111/tbed.14345. Online ahead of print.

ABSTRACT

Since the outbreak of African swine fever (ASF) in Shengyang, it has kept spreading in China. In the early stage of the epidemic, multi-point and concentrated outbreaks were mainly in the swill feeding areas. In this paper, we developed compartmental models to investigate the transmission of ASF in several raising units including Guquan, Jinba and Liancheng. Using the data collected from these three infected premises, we calibrated the models to estimate that the average incubation period was between 8-11 days, the onset period was about 2-3 days, and the basic reproductive number was about 4.83-11.90. We also estimated the infection on the day before culling to be 45.24% (Guquan), 89.20% (Jinba), and 16.35% (Liancheng), respectively. The infection rate of Guquan could reach about 74.8% if culling were postponed two days. We found that the infection was significantly higher than the morbidities (22.11% (Guquan), 49.35% (Jinba), and 12.94% (Liancheng)) calculated by actual statistical data. Besides, we simulated and compared the control effect of stopping transport, disinfecting, stopping swill, and culling. Our findings suggest that any single measure was not enough to prevent the spread of ASF on a regional level but the combined measures is the key. Under the current situation, fully culling was recognized as most effective in controlling the epidemic, despite the culling of innocent pigs. This article is protected by copyright. All rights reserved.

PMID:34655504 | DOI:10.1111/tbed.14345

Trop Med Int Health. 2021 Oct 16. doi: 10.1111/tmi.13695. Online ahead of print.

ABSTRACT

OBJECTIVE: Delays in seeking health care for dengue are associated with poor health outcomes. Despite this, the factors influencing such delays remain unclear, rendering interventions to improve health care-seeking for dengue ineffective. This systematic review aimed to synthesise the factors influencing health care-seeking of patients with dengue and form a comprehensive framework.

METHODS: This review included both qualitative and quantitative studies. Studies were obtained by searching five databases, contacting field experts, and performing backward reference searches. The best-fit meta-synthesis approach was used during data synthesis, where extracted data were fitted into the social-ecological model. Sub-analyses were conducted to identify the commonly reported factors and their level of statistical significance.

RESULTS: Twenty studies were selected for meta-synthesis. Eighteen factors influencing health care-seeking in dengue were identified and categorised under four domains: individual (11 factors), interpersonal (1 factor), organisational (4 factors), and community (2 factors). The most reported factors were knowledge of dengue, access to health care, quality of health service and resource availability. Overall, more barriers to dengue health seeking than facilitators were found. History of dengue infection and having knowledge of dengue were found to be ambiguous as they both facilitated and hindered dengue health care-seeking. Contrary to common belief, women were less likely to seek help for dengue than men.

CONCLUSIONS: The factors affecting dengue health care-seeking behaviour are diverse, can be ambiguous and are found across multiple social-ecological levels. Understanding these complexities is essential for the development of effective interventions to improve dengue health care-seeking behaviour.

PMID:34655508 | DOI:10.1111/tmi.13695

Mycoses. 2021 Oct 16. doi: 10.1111/myc.13380. Online ahead of print.

ABSTRACT

BACKGROUND: Several severity indexes have been reported for critically ill patients. The Pitt bacteremia score (PBS) is commonly used to predict the risk of mortality in patients with bacteremia.

OBJECTIVES: To develop a scoring system for predicting mortality in candidemia patients.

METHODS: Medical records at five Japanese tertiary hospitals were reviewed. Factors associated with mortality were analysed using logistic regression modelling. The discriminatory power of scoring models was evaluated by assessing the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI) and integrated discrimination improvement (IDI).

RESULTS: In total, 422 candidemia patients were included. Higher PBS, dialysis, and retainment of central venous catheter were independent risk factors for all-cause 30-day mortality. However, among the five PBS components, fever was not associated with mortality; therefore, we developed a modified version of the PBS (mPBS) by replacing fever with dialysis. AUC for PBS and mPBS was 0.74 (95% confidence interval [CI]: 0.68-0.80) and 0.76 (95% CI: 0.71-0.82), respectively. The increase in predictive ability of mPBS for 30-day mortality was statistically significant as assessed by NRI (0.24, 95% CI: 0.01-0.46, P=0.04) and IRI (0.04, 95% CI: 0.02-0.06, P=0.0008). When patients were stratified by mPBS into low (scores 0-3), moderate (4-7), and high risk (≥8), there were significant differences among the survival curves (P<0.0001, log-rank test), and 30-day mortality rates were 13.8% (40/290), 36.8% (28/76), and 69.4% (34/49), respectively.

CONCLUSIONS: mPBS can be a useful tool for predicting mortality in candidemia patients.

PMID:34655487 | DOI:10.1111/myc.13380

Pediatr Allergy Immunol. 2021 Oct 16. doi: 10.1111/pai.13680. Online ahead of print.

ABSTRACT

BACKGROUND: Alexithymia is a multifaceted personality construct described as “a lack of words to express emotions” that includes difficulty identifying feelings, difficulty describing feelings and a concrete, externally oriented cognitive style. Among patients with FA, alexithymia has been found higher than in general population and associated with dysfunctional coping strategies. Childhood traumatic experiences and/or dysfunctional parent-child relationship can contribute to alexithymia. The study aimed to explore possible associations between child alexithymia and mother alexithymia and anxiety, as well as previous anaphylaxis.

METHODS: 65 mother-child pairs have been recruited. Children had a medical diagnosis of FA. The Toronto Alexithymia Scale-20 (TAS-20) was used to assess alexithymia in participants. The State-Trait Anxiety Inventory (STAI) was used to assess trait anxiety in mothers. Statistical analysis was performed to investigate the influence of variables sex, previous anaphylaxis and adrenaline auto-injector prescription on child and mother’s alexithymia and to explore possible association between maternal and child alexithymia.

RESULTS: A substantial percentage of children were alexithymic (21.5%) or borderline (33.8%), while mothers’ frequencies were lower and in line with prevalence in general population. Child alexithymia was positively associated with previous anaphylaxis and mothers’ trait anxiety (p < .05). Mother trait anxiety was also associated with maternal alexithymia. Furthermore, a positive association between child and mother alexithymia has been found.

CONCLUSIONS: Clinicians must be aware of the role of alexithymia and its association with maternal anxiety and previous anaphylaxis in children with FA, encouraging seeking psychological support when needed. A multidisciplinary patient-centered approach should be put in place for the effective care of FA.

PMID:34655502 | DOI:10.1111/pai.13680

Wound Repair Regen. 2021 Oct 16. doi: 10.1111/wrr.12972. Online ahead of print.

ABSTRACT

Non-healing wounds are steadily becoming a global-health issue. Prolonged hypoxia propagates wound chronicity; yet, oxygenating treatments are considered inadequate to date. Dissolved oxygen (DO) in aqueous solutions introduces a novel approach to enhanced wound oxygenation, and is robustly evaluated for clinical applications. A systematic literature search was conducted, whereby experimental and clinical studies of DO technologies were categorized per engineering approach. Technical principles, methodology, endpoints and outcomes were analysed for both oxygenating and healing effects. Forty articles meeting our inclusion criteria were grouped as follows: DO solutions (17), oxygen (O₂ ) dressings (9), O₂ hydrogels (11) and O₂ emulsions (3). All technologies improved wound oxygenation, each to a variable degree. They also achieved at least one statistically significant outcome related to wound healing, mainly in epithelialization, angiogenesis and collagen synthesis. Scarcity in clinical data and methodological variability precluded quantitative comparisons among the biotechnologies studied. DO technologies warrantee further evaluation for wound oxygenation in the clinical setting. Standardised methodologies and targeted research questions are pivotal to facilitate global integration in healthcare.

PMID:34655455 | DOI:10.1111/wrr.12972

Int J Cancer. 2021 Oct 16. doi: 10.1002/ijc.33846. Online ahead of print.

ABSTRACT

The relationship between cancer and COVID-19 infection and severity remains poorly understood. We conducted a population-based cohort study between 1 March and 6 May 2020 describing the associations between cancer and risk of COVID-19 diagnosis, hospitalisation, and COVID-19-related death. Data was obtained from the SIDIAP database, including primary care electronic health records from ~80% of the population in Catalonia, Spain. Cancer was defined as any primary invasive malignancy excluding non-melanoma skin cancer. We estimated adjusted hazard ratios (aHRs) for the risk of COVID-19 (outpatient) clinical diagnosis, hospitalisation (with or without a prior COVID-19 diagnosis) and COVID-19-related death using Cox proportional hazard regressions. Models were estimated for the overall cancer population and by years since cancer diagnosis (<1-year, 1-5-years, ≥5-years), sex, age, and cancer type; and adjusted for age, sex, smoking status, deprivation, and comorbidities. We included 4,618,377 adults, of which 260,667 (5.6%) had a history of cancer. A total of 98,951 individuals (5.5% with cancer) were diagnosed and 6,355 (16.4% with cancer) were directly hospitalised with COVID-19. Of those diagnosed, 6,851 were subsequently hospitalised (10.7% with cancer) and 3,227 died without being hospitalised (18.5% with cancer). Among those hospitalised, 1,963 (22.5% with cancer) died. Cancer was associated with an increased risk of COVID-19 diagnosis (aHR: 1.08; 95% CI [1.05-1.11]); direct COVID-19 hospitalisation (1.33 [1.24-1.43]); and death following hospitalisation (1.12 [1.01-1.25]). These associations were stronger for patients recently diagnosed with cancer, aged <70 years, and with haematological cancers. These patients should be prioritised in COVID-19 vaccination campaigns and continued non-pharmaceutical interventions. This article is protected by copyright. All rights reserved.

PMID:34655476 | DOI:10.1002/ijc.33846

Cell Oncol (Dordr). 2021 Oct 16. doi: 10.1007/s13402-021-00641-w. Online ahead of print.

ABSTRACT

PURPOSE: Investigation of nipple aspirate fluid (NAF)-based microRNAs (miRNAs) as a potential screening tool for women at increased risk of developing breast cancer is the scope of our research. While aiming to identify discriminating NAF-miRNAs between women with different mammographic densities, we were confronted with an unexpected confounder: NAF sample appearance. Here we report and alert for the impact of NAF color and cloudiness on miRNA assessment.

METHODS: Seven classes of NAF colors coupled with cloudiness appearance were established. Using 173 NAF samples from 154 healthy women (19 samples were bilaterally collected), the expression of 14 target and 2 candidate endogenous control (EC) miRNAs was investigated using Taqman Advanced miRNA assays to identify significant differential expression patterns between color-cloudiness classes. Inter- and intra-individual variation of miRNA expression was analyzed using the coefficient of variation (CV).

RESULTS: We found that between the seven NAF classes, fold change miRNA expression differences ranged between 2.4 and 19.6 depending on the interrogated miRNA. Clear NAF samples exhibited higher miRNA expression levels compared to cloudy NAF samples with fold change differences ranging between 1.1 and 6.2. Inter-individual and intra-individual miRNA expression was fairly stable (CV < 15 %), but nevertheless impacted by NAF sample appearance. Within NAF classes, inter-individual variation was largest for green samples (CV 6-15 %) and smallest for bloody samples (CV 2-6 %).

CONCLUSIONS: Our data indicate that NAF color and cloudiness influence miRNA expression and should, therefore, be systematically registered using an objective color classification system. Given that sample appearance is an inherent feature of NAF, these variables should be statistically controlled for in multivariate data analyses. This cautionary note and recommendations could be of value beyond the field of NAF-miRNAs, given that variability in sample color and cloudiness is likewise observed in liquid biopsies such as urine, cerebrospinal fluid and sputum, and could thereby influence the levels of miRNAs and other biomarkers.

PMID:34655415 | DOI:10.1007/s13402-021-00641-w

Matern Child Health J. 2021 Oct 16. doi: 10.1007/s10995-021-03244-x. Online ahead of print.

ABSTRACT

INTRODUCTION: This systematic review aims to determine the efficacy of interventions to support the self-management for parents of children with a chronic condition. An overview of prior research, regardless of the children’s diagnosis, is lacking. Therefore, this systematic review provides an overview of the most recent available scientific literature that describes interventions to support self-management for parents of children with a chronic condition.

METHODS: A systematic search of Randomised Controlled Trials (RCTs) was conducted in CENTRAL, CINAHL, EMBASE, MEDLINE and PsychInfo. Studies that describe any type of self-management intervention or a combination of self-management interventions that support parents of children with a chronic condition between 0 and 18 years were included. The interventions and results were reported, hence categorized in the four areas of self-management: medical management, adjustment of lifestyle, shared decision-making and managing the consequences of a chronic condition.

RESULTS: The study included 23 RCTs. Due to the heterogeneity of the included studies a meta-analysis was impossible. Twenty studies showed statistically significant effects in favour of the intervention on at least one of the outcomes. Twenty-two studies showed risk of bias. The results indicate that disease management, (parent) group training, psycho-education and the Triple P intervention are effective interventions to support self-management. There were limited studies found in the areas lifestyle adjustment and shared decision making.

DISCUSSION: Effective interventions to support self-management for parents of children with a chronic condition are described, but the moderate quality of the studies hampers firm conclusions.

PMID:34655426 | DOI:10.1007/s10995-021-03244-x