• Assessment of sodium and iodine intake among university students in Casablanca, Morocco

      Jafri, Ali; Elarbaoui, Maria; Elkardi, Younes; Makhlouki, Houria; Ellahi, Basma; Derouiche, Abdelfettah
      Introduction Iodine deficiency is still a matter of public health concern despite salt fortification and especially with global recommendations to lower salt intake, this is mainly due to dietary habits. University students have a diet based on street food high in sodium and low in other micronutrients (i.e. iodine and potassium). In this study, we aim to measure sodium and iodine levels in university students to assess their risk of developing complications later in life. Methodology A sample of 120 students aged between 18 and 25 years old was recruited and asked to collect their 24-hours urine samples in special containers containing. Samples were stored then analyzed for sodium, potassium, iodine and creatinine levels. Results The average urinary excretion of sodium was 3066.8±1196.0mg/day. Overall, 72.6% of participants consume more than 2g/day of sodium. Average potassium intake is 1805.9±559.4mg/day, and all participants consume less than the adequate amount. Daily urinary excretion of iodine is 135.6±88.9mg/day, and 69.2% of participants consume less than the recommended amount. Sodium, potassium and iodine intakes were higher in male participants (P-values=0.008; 0.044 and 0.003, respectively). The lowest average iodine intake was observed in underweight participants (119.4±31.4) with 87.5% of underweight participants and 80% of female participants below the recommended intake. Conclusion Sodium intake is high while iodine intake is low in this studied population, especially in women.
    • COVID-19 presenting as intussusception in infants: A case report with literature review

      Athamnah, Mohammad N.; Masade, Salim; Hamdallah, Hanady; orcid: 0000-0001-6314-0236; Banikhaled, Nasser; Shatnawi, Wafa; Elmughrabi, Marwa; Al Azzam, Hussein S.O.
      The novel Corona virus disease 2019 (COVID-19) first presented in Wuhan, China. The virus was able to spread throughout the world, causing a global health crisis. The virus spread widely in Jordan after a wedding party held in northern Jordan. In most cases of COVID-19 infection, respiratory symptoms are predominant. However, in rare cases the disease may present with non-respiratory symptoms. The presentation of COVID-19 as a case of intussusception in children is a strange and rare phenomenon. We present here a case of a two-and-a-half month old male baby who was brought to hospital due to fever, frequent vomiting, dehydration and blood in stool. He was diagnosed as intussusception. The child was tested for corona due to the large societal spread of the virus and because he was near his mother, who was suffering from symptoms similar to corona or seasonal flu (she did not conduct a corona test). Patient was treated without surgery and recovered quickly. The COVID-19 infection was without respiratory symptoms, and there was no need for the child to remain in hospital after treatment of intussusception. The relationship between viruses, mesenteric lymphoid hyperplasia, and intussusception is a confirmed relation. ACE2 is the key receptor required for SARA-COV-2 to enter the host cells. ACE2 has been also found in the brush border of the intestinal mucosa, as well as it is a key inflammatory regulator in the intestine. This may suggest that SARSA-COV-2 could invade the respiratory tract as well as gastrointestinal tract or both. Few case reports documented the presentation of COVID-19 as intussusception in children. In the light of the wide-spread of corona virus, performing COVID-19 tests for children with intussusception can help linking the two entities. Development of gastrointestinal symptoms in COVID-19 positive children should raise concern about the development of intussusception.
    • COVID-19 presenting as intussusception in infants: A case report with literature review

      Athamnah, Mohammad N.; Masade, Salim; Hamdallah, Hanady; orcid: 0000-0001-6314-0236; Banikhaled, Nasser; Shatnawi, Wafa; Elmughrabi, Marwa; Al Azzam, Hussein S.O. (Elsevier, 2021-01-12)
      The novel Corona virus disease 2019 (COVID-19) first presented in Wuhan, China. The virus was able to spread throughout the world, causing a global health crisis. The virus spread widely in Jordan after a wedding party held in northern Jordan. In most cases of COVID-19 infection, respiratory symptoms are predominant. However, in rare cases the disease may present with non-respiratory symptoms. The presentation of COVID-19 as a case of intussusception in children is a strange and rare phenomenon. We present here a case of a two-and-a-half month old male baby who was brought to hospital due to fever, frequent vomiting, dehydration and blood in stool. He was diagnosed as intussusception. The child was tested for corona due to the large societal spread of the virus and because he was near his mother, who was suffering from symptoms similar to corona or seasonal flu (she did not conduct a corona test). Patient was treated without surgery and recovered quickly. The COVID-19 infection was without respiratory symptoms, and there was no need for the child to remain in hospital after treatment of intussusception. The relationship between viruses, mesenteric lymphoid hyperplasia, and intussusception is a confirmed relation. ACE2 is the key receptor required for SARA-COV-2 to enter the host cells. ACE2 has been also found in the brush border of the intestinal mucosa, as well as it is a key inflammatory regulator in the intestine. This may suggest that SARSA-COV-2 could invade the respiratory tract as well as gastrointestinal tract or both. Few case reports documented the presentation of COVID-19 as intussusception in children. In the light of the wide-spread of corona virus, performing COVID-19 tests for children with intussusception can help linking the two entities. Development of gastrointestinal symptoms in COVID-19 positive children should raise concern about the development of intussusception.
    • Evidence-based practice and evidence-informed practice competencies in undergraduate pre-registration nursing curricula: A document analysis at a university in England

      Kumah, Dr Elizabeth Adjoa; orcid: 0000-0002-3787-5615; Bettany-Saltikov, Dr Josette; van Schaik, Dr Paul; orcid: 0000-0001-5322-6554; McSherry, Dr Robert (Elsevier, 2021-06-22)
      Background In response to the heightened emphasis on incorporating the best available evidence into healthcare decision-making, healthcare training institutions have been actively incorporating Evidence-Based Practice (EBP), and/or Evidence-Informed Practice (EIP) competencies into undergraduate healthcare curricula. However, there is a gap in the scientific knowledge about the actual contents, as well as the extent of integration of EBP and EIP in undergraduate pre-registration nursing programmes. Method A document analysis utilising Rohwer et al.’s (2014) framework was conducted to review and analyse the content of EBP and EIP competencies in the 2018/2019 curriculum of the undergraduate pre-registration nursing programme of a University located in England, United Kingdom. Results Competencies relevant to EBP were included in four nursing modules. However, EIP competencies were not included in the curriculum. Conclusion There is an urgent need for a more structured and holistic way of teaching and assessing EBP competencies through the integration of the principles of EIP, in order to enhance the effective application of evidence into clinical nursing practice.
    • Millimeter-wave free-space dielectric characterization

      Liu, Xiaoming; Gan, Lu; Yang, Bin (Elsevier, 2021-05-12)
      Millimeter wave technologies have widespread applications, for which dielectric permittivity is a fundamental parameter. The non-resonant free-space measurement techniques for dielectric permittivity using vector network analysis in the millimeter wave range are reviewed. An introductory look at the applications, significance, and properties of dielectric permittivity in the millimeter wave range is addressed first. The principal aspects of free-space millimeter wave measurement methods are then discussed, by assessing a variety of systems, theoretical models, extraction algorithms and calibration methods. In addition to conventional solid dielectric materials, the measurement of artificial metamaterials, liquid, and gaseous-phased samples are separately investigated. The pros of free-space material extraction methods are then compared with resonance and transmission line methods, and their future perspective is presented in the concluding part.
    • Millimeter-Wave Free-Space Dielectric Characterization

      Liu, Xiaoming; Gan, Lu; Yang, Bin
      Millimeter wave technologies have widespread applications, for which dielectric permittivity is a fundamental parameter. The non-resonant free-space measurement techniques for dielectric permittivity using vector network analysis in the millimeter wave range are reviewed. An introductory look at the applications, significance, and properties of dielectric permittivity in the millimeter wave range is addressed first. The principal aspects of free-space millimeter wave measurement methods are then discussed, by assessing a variety of systems, theoretical models, extraction algorithms and calibration methods. In addition to conventional solid dielectric materials, the measurement of artificial metamaterials, liquid, and gaseous-phased samples are separately investigated. The pros of free-space material extraction methods are then compared with resonance and transmission line methods, and their future perspective is presented in the concluding part.
    • Opinion of the Scientific Committee on Consumer safety (SCCS) – Final Opinion on propylparaben (CAS No 94-13-3, EC No 202-307-7)

      Bodin, Laurent; Rogiers, Vera; Bernauer, Ulrike; Chaudhry, Qasim; Coenraads, Pieter Jan; orcid: 0000-0001-9458-7129; Dusinska, Maria; Ezendam, Janine; Gaffet, Eric; Galli, Corrado Ludovico; Granum, Berit; et al.
      In cosmetic products, the ingredient propylparaben (CAS No 94-13-3, EC No 202-307-7) with the chemical names Propyl 4-hydroxybenzoate and 4-Hydroxybenzoic acid propyl ester is currently regulated as a preservative in a concentration up to 0.14 % (as acid) (Annex V/12a). In addition, a safe concentration was established for mixtures of parabens, where the sum of the individual concentrations should not exceed 0.8 % (as acid). However, in such mixtures the sum of the individual concentrations of butyl- and propylparaben and their salts should not exceed 0.14 %. Propylparaben was subject to different safety evaluations in 2005 (SCCP/0874/05), 2006 (SCCP/1017/06), 2008 (SCCP/1183/08), 2010 (SCCS/1348/10), 2011 (SCCS/1446/11), 2013 (SCCS/1514/13). On the basis of the safety assessment of propylparaben, and considering the concerns related to potential endocrine disrupting properties, the SCCS has concluded that propylparaben is safe when used as a preservative in cosmetic products up to a maximum concentration of 0.14 %. The available data on propylparaben provide some indications for potential endocrine effects. However, the current level of evidence is not sufficient to regard it as an endocrine disrupting substance, or to derive a toxicological point of departure based on endocrine disrupting properties for use in human health risk assessment. The SCCS mandates do not address environmental aspects. Therefore, this assessment did not cover the safety of propylparaben for the environment.
    • Prophylactic Treatment in People with Severe Hemophilia B in the US: An Analysis of Real-World Healthcare System Costs and Clinical Outcomes

      Noone, Declan; Pedra, Gabriel; Asghar, Sohaib; O'Hara, Jamie; Sawyer, Eileen K; Li, Nanxin (Nick) (Elsevier, 2021-06-24)
      Introduction The treatment paradigm for people with severe hemophilia B in the US typically involves prophylaxis with factor IX (FIX) replacement therapy, the primary aim of which is to provide sufficient FIX levels to reduce the frequency of bleeding events. The clinical benefits of FIX prophylaxis are well understood, however the cost of FIX products as well as costs associated with healthcare resource utilization present a significant burden to the healthcare system. Substantive costs may also accrue in patients who continue to bleed while on prophylaxis, due to the impact on both short and long-term joint-related outcomes. In the absence of existing data in the US, the ‘Cost of Hemophilia Across the USA: a Socioeconomic Survey’ (CHESS US) study was conducted to establish a population-based estimate of the real-world US healthcare system burden associated with severe hemophilia. Using data drawn from the CHESS US study, this analysis examines the real-world healthcare system costs and clinical outcomes of people with severe hemophilia B on FIX prophylaxis. Methods CHESS US, a retrospective, cross-sectional dataset of adults with severe hemophilia in the USA, gathered information on patient cost via a patient record form. Data on the following parameters are included in this analysis: FIX consumption, annualized bleeding rate (ABR), the presence of one or more chronically damaged joints (“problem joint”), as well as costs associated with annual (prophylactic) factor consumption and hospitalizations (i.e., number of admissions, number of day cases, total inpatient days, and total intensive care unit [ICU] days). All variables report retrospective data of the 12 months prior to enrolment in the study. Results are presented as mean (± standard deviation) or N (%). Results In total, 132 of 576 patients profiled in the CHESS US study had severe hemophilia B. Among them, 77 patients were on FIX prophylaxis, of whom 44 patients reported FIX dosing regimen and were included in the current analyses. Among them, 20 patients were treated with conventional FIX and 24 patients with extended half-life (EHL) FIX products. The cohort has a mean age of 27.64 (± 11.05) and mean weight (kg) of 75.71 (± 13.41). In the last 12 months, the mean number of international units (IU) prescribed for FIX prophylaxis across the full cohort was 257,216 IU (± 213,591), with an associated annual cost of $610,966 (± $495,869). Among patients treated with conventional FIX, mean prescribed FIX was 287,141 IU (± 264,906) at an annual cost of $397,491 (± $359,788), while patients treated with EHL FIX reported a mean prescribed FIX of 232,278 IU (± 160,914) at an annual cost of $788,861 (± $529,258). The cohort reported a mean ABR of 1.73 (± 1.39); 8 (18%) were reported to have a target joint meeting the International Society on Thrombosis and Haemostasis (ISTH) definition; and 11% were reported to have had at least one chronically damaged joint (i.e., problem joint). Healthcare resource utilization associated with bleed events were reported as follows: hospital admissions days [0.18 (± 0.62)]; inpatient days [0.34 (± 1.22)]; and ICU days [0.23 (± 0.86)]. The direct medical cost to the healthcare system was $2,885 (± $7,857; excluding FIX cost) and $614,886 (± $498,839; including FIX cost). Discussion Data from the CHESS US study showed substantial costs and resource utilization among patients with severe hemophilia B receiving FIX prophylaxis, of which the cost of FIX replacement therapy constituted most of the total cost to healthcare system. Although the ABR observed in the analysis population was low, bleed-related hospitalizations comprised a significant non-drug cost to the healthcare system. A proportion of patients also still experienced joint arthropathy. Such substantial clinical and economic burden highlights that unmet needs remain in patients with severe hemophilia B on FIX prophylaxis in the US. Disclosures Noone: HCD Economics: Employment. Pedra: HCD Economics: Employment. Asghar: HCD Economics: Employment. O'Hara: HCD Economics: Employment, Equity Ownership. Sawyer: uniQure Inc.: Employment. Li: uniQure Inc.: Employment.
    • Reframing how we care for people with persistent non-traumatic musculoskeletal pain. Suggestions for the rehabilitation community

      Lewis, Jeremy S.; orcid: 0000-0001-7870-9165; Stokes, Emma K.; Gojanovic, Boris; orcid: 0000-0001-5075-9371; Gellatly, Pamela; orcid: 0000-0001-7401-2096; Mbada, Chidozie; orcid: 0000-0003-3666-7432; Sharma, Saurab; orcid: 0000-0002-9817-5372; Diener, Ina; orcid: 0000-0001-7426-4840; O’Sullivan, Peter
      There have been repeated calls to re-evaluate how clinicians provide care for people presenting with persistent non-traumatic musculoskeletal conditions. One suggestion is to move away from the ‘we can fix and cure you’ model to adopting an approach that is more consistent with approaches used when managing other persistent non-communicable diseases; education, advice, a major focus on self-management including lifestyle behavioural change, physical activity and medications as required. Currently the global delivery of musculoskeletal care has many of the elements of a ‘super wicked problem’, namely conflict of interest from stake-holders due to the consequences of change, prevailing expectation of a structural diagnosis and concomitant fix for musculoskeletal pain, persistent funding of high risk, more expensive care when low risk more economic viable options that don’t impact on the quality of outcome exist, and an unquestionable need to find a solution now with the failure resulting in a growing social and economic burden for future generations. To address these issues, 100 participants included clinicians, educators and researchers from low-, middle- and high-income countries, 8 presenters representing the physiotherapy, sport medicine and the orthopaedic professions and the insurance industry, together with 3 people who shared their lived experiences of persistent musculoskeletal pain, discussed the benefits and barriers of implementing change to address this problem. This paper presents the results from the stakeholders’ contextual analysis and forms the basis for the proposed next steps from an action and advocacy perspective.
    • Reframing how we care for people with persistent non-traumatic musculoskeletal pain. Suggestions for the rehabilitation community

      Lewis, Jeremy S.; orcid: 0000-0001-7870-9165; Stokes, Emma K.; Gojanovic, Boris; orcid: 0000-0001-5075-9371; Gellatly, Pamela; orcid: 0000-0001-7401-2096; Mbada, Chidozie; orcid: 0000-0003-3666-7432; Sharma, Saurab; orcid: 0000-0002-9817-5372; Diener, Ina; orcid: 0000-0001-7426-4840; O’Sullivan, Peter (Elsevier, 2021-06-05)
      There have been repeated calls to re-evaluate how clinicians provide care for people presenting with persistent non-traumatic musculoskeletal conditions. One suggestion is to move away from the ‘we can fix and cure you’ model to adopting an approach that is more consistent with approaches used when managing other persistent non-communicable diseases; education, advice, a major focus on self-management including lifestyle behavioural change, physical activity and medications as required. Currently the global delivery of musculoskeletal care has many of the elements of a ‘super wicked problem’, namely conflict of interest from stake-holders due to the consequences of change, prevailing expectation of a structural diagnosis and concomitant fix for musculoskeletal pain, persistent funding of high risk, more expensive care when low risk more economic viable options that don’t impact on the quality of outcome exist, and an unquestionable need to find a solution now with the failure resulting in a growing social and economic burden for future generations. To address these issues, 100 participants included clinicians, educators and researchers from low-, middle- and high-income countries, eight presenters representing the physiotherapy, sport medicine and the orthopaedic professions and the insurance industry, together with three people who shared their lived experiences of persistent musculoskeletal pain, discussed the benefits and barriers of implementing change to address this problem. This paper presents the results from the stakeholders’ contextual analysis and forms the basis for the proposed next steps from an action and advocacy perspective.
    • Sexuality and the human rights of persons with dementia

      Peisah, Carmelle; Ayalon, Liat; Verbeek, Hilde; Benbow, Susan Mary; Wiskerke, Esther; Rabheru, Kiran; Sorinmade, Oluwatoyin
      We explore barriers to enjoyment of human rights to sexuality of persons with dementia and remedies for addressing these. Enjoyment of sexuality is contingent upon actualisation of rights to dignity, autonomy, respect for will and preferences, abuse safeguarding and equitable access to highest standards of sexual health. Persons with dementia living at home or in care face systemic barriers to enjoyment of sexuality fuelled by ageism, apathy and ignorance, compounded by complex legal barriers in relation to consent. Such challenges can be tackled with awareness raising and education of care staff, families and physicians, including training for capacity assessment with dimensional, non-categorical conceptualisation of capacity, leaving room for supported decision-making. These measures, together with strengthened legislative and human rights frameworks to cater to the specific needs of older people, may allow people to live well with dementia and exercise their human rights to enjoy sexuality in a safe and lawful manner.
    • Simulating Topological Robustness of Fano Resonance in Rotated Honeycomb Photonic Crystals

      Hajivandi, J.; Kaya, E.; Edwards, G.; Kurt, H.
      The Fano resonance with a distinctive ultra-sharp, asymmetric line shape and high quality factor, is a widely occurring phenomena, that has a large variety of optical, plasmonic and microwave manifestations. In this paper, we explore the characteristic robustness of a Fano resonance mode, which is topologically protected by engineering a band inversion, induced by breaking the mirror symmetry of a two-dimensional honeycomb photonic crystal (HPC), associated with C 6 point group symmetry. Dark and bright topological edge modes appear in the band gap which arise when Dirac cone is opened up. Destructive and constructive interference of the dark and bright modes leads to the asymmetric line shape of the Fano resonance. The Fano resonance is very sensitive to the material changes and structural perturbations. This property can be applied to obtain new sensor designs. Here we demonstrate that the topological Fano resonance mode preserves its asymmetric, ultra-sharp line shape in the presence of the disorder, defects and cavities.The stability of the Fano resonance mode has useful optical device applications such as in low threshold lasers, and extremely precise interferometers.
    • Simulating topological robustness of Fano resonance in rotated Honeycomb photonic crystals

      Hajivandi, J.; Kaya, E.; Edwards, G.; Kurt, H. (Elsevier, 2021-07-08)
      The Fano resonance with a distinctive ultra-sharp, asymmetric line shape and high quality factor, is a widely occurring phenomena, that has a large variety of optical, plasmonic and microwave manifestations. In this paper, we explore the characteristic robustness of a Fano resonance mode, which is topologically protected by engineering a band inversion, induced by breaking the mirror symmetry of a two-dimensional honeycomb photonic crystal (HPC), associated with C 6 point group symmetry. Dark and bright topological edge modes appear in the band gap which arise when Dirac cone is opened up. Destructive and constructive interference of the dark and bright modes leads to the asymmetric line shape of the Fano resonance. The Fano resonance is very sensitive to the material changes and structural perturbations. This property can be applied to obtain new sensor designs. Here we demonstrate that the topological Fano resonance mode preserves its asymmetric, ultra-sharp line shape in the presence of the disorder, defects and cavities.The stability of the Fano resonance mode has useful optical device applications such as in low threshold lasers, and extremely precise interferometers.
    • The long-term impact of infant rearing background on the behavioural and physiological stress response of adult common marmosets (Callithrix jacchus)

      Ash, Hayley; orcid: 0000-0002-2743-2183; Smith, Tessa E.; Buchanan-Smith, Hannah M. (Elsevier, 2020-12-26)
      Although triplet litters are increasing in captive colonies of common marmosets, parents can rarely rear more than two infants without human intervention. There is however much evidence that early life experience, including separation from the family, can influence both vulnerability and resilience to stress. The current study investigated the behavioural and hypothalamic pituitary adrenal (HPA) axis response to the routine stressor of capture and weighing in adult common marmosets (Callithrix jacchus), reared as infants under 3 different conditions: family reared twins (n = 6 individuals), family reared animals from triplet litters where only 2 remain (2stays: n = 8) and triplets receiving supplementary feeding from humans (n = 7). In the supplementary feeding condition, infants remained in contact with each other when they were removed from the family. There were no significant differences (P > 0.5) in cortisol level or behaviour between the rearing conditions. In all conditions, salivary cortisol decreased from baseline to post capture, which was accompanied by increases in agitated locomotion. Familyreared 2stays demonstrated significant cortisol decreases from baseline to post capture (post 5 min.: P = 0.005; post 30 min.: P = 0.018), compared to the other conditions. Family reared twins displayed significantly more behavioural changes following the stressor than the other conditions, including significant increases in scent marking (post 5 min. and post 30 min.: P = 0.028) and significant decreases in inactive alert (post 5 min.: P = 0.042), calm locomotion (post 5 min.: P = 0.028; post 30 min.: P = 0.046) and proximity to partner (post 5 min.: P = 0.046). There were increases in behaviour suggesting reduced anxiety, including significantly more exploration post capture in supplementary fed triplets (post 5 min.: P = 0.041), and significantly more foraging post capture in family reared 2stays (post 5 min. .: P = 0.039). However, as differences between rearing conditions were minimal, supplementary feeding of large litters of marmosets at this facility did not have a major effect on stress vulnerability, suggesting that this rearing practice may be the preferred option if human intervention is necessary to improve the survival of large litters.