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  • Oxford University Press (OUP)  (5)
  • 2020-2024  (5)
  • 1
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Abstract: There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 2
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 73, No. 3 ( 2021-08-02), p. e699-e709
    Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibody measurements can be used to estimate the proportion of a population exposed or infected and may be informative about the risk of future infection. Previous estimates of the duration of antibody responses vary. Methods We present 6 months of data from a longitudinal seroprevalence study of 3276 UK healthcare workers (HCWs). Serial measurements of SARS-CoV-2 anti-nucleocapsid and anti-spike IgG were obtained. Interval censored survival analysis was used to investigate the duration of detectable responses. Additionally, Bayesian mixed linear models were used to investigate anti-nucleocapsid waning. Results Anti-spike IgG levels remained stably detected after a positive result, for example, in 94% (95% credibility interval [CrI] 91–96%) of HCWs at 180 days. Anti-nucleocapsid IgG levels rose to a peak at 24 (95% CrI 19–31) days post first polymerase chain reaction (PCR)-positive test, before beginning to fall. Considering 452 anti-nucleocapsid seropositive HCWs over a median of 121 days from their maximum positive IgG titer, the mean estimated antibody half-life was 85 (95% CrI 81–90) days. Higher maximum observed anti-nucleocapsid titers were associated with longer estimated antibody half-lives. Increasing age, Asian ethnicity, and prior self-reported symptoms were independently associated with higher maximum anti-nucleocapsid levels and increasing age and a positive PCR test undertaken for symptoms with longer anti-nucleocapsid half-lives. Conclusions SARS-CoV-2 anti-nucleocapsid antibodies wane within months and fall faster in younger adults and those without symptoms. However, anti-spike IgG remains stably detected. Ongoing longitudinal studies are required to track the long-term duration of antibody levels and their association with immunity to SARS-CoV-2 reinfection.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2002229-3
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  • 3
    In: ICES Journal of Marine Science, Oxford University Press (OUP), Vol. 77, No. 6 ( 2020-11-01), p. 2089-2105
    Abstract: Species in the brackish and estuarine ecosystems will experience multiple changes in hydrographic variables due to ongoing climate change and nutrient loads. Here, we investigate how a glacial relict species (Saduria entomon), having relatively cold, low salinity biogeographic origin, could be affected by the combined scenarios of climate change and eutrophication. It is an important prey for higher trophic-level species such as cod, and a predator of other benthic animals. We constructed habitat distribution models based occurrence and density of this species across the entire Baltic and estimated the relative importance of different driving variables. We then used two regional coupled ocean-biogeochemical models to investigate the combined impacts of two future climate change and nutrient loads scenarios on its spatial distribution in 2070–2100. According to the scenarios, the Baltic Sea will become warmer and fresher. Our results show that expected changes in salinity and temperature outrank those due to two nutrient-load scenarios (Baltic Sea Action Plan and business as usual) in their effect on S. entomon distribution. The results are relatively similar when using different models with the same scenarios, thereby increasing the confidence of projections. Overall, our models predict a net increase (and local declines) of suitable habitat area, total abundance and biomass for this species, which is probably facilitated by strong osmoregulation ability and tolerance to temperature changes. We emphasize the necessity of considering multiple hydrographic variables when estimating climate change impacts on species living in brackish and estuarine systems.
    Type of Medium: Online Resource
    ISSN: 1054-3139 , 1095-9289
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2463178-4
    detail.hit.zdb_id: 1468003-8
    detail.hit.zdb_id: 29056-7
    SSG: 12
    SSG: 21,3
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  • 4
    In: Brain, Oxford University Press (OUP), ( 2023-07-12)
    Abstract: KPTN-related disorder is an autosomal recessive disorder associated with germline variants in KPTN (previously known as kaptin), a component of the mTOR regulatory complex KICSTOR. To gain further insights into the pathogenesis of KPTN-related disorder, we analysed mouse knockout and human stem cell KPTN loss-of-function models. Kptn −/− mice display many of the key KPTN-related disorder phenotypes, including brain overgrowth, behavioural abnormalities, and cognitive deficits. By assessment of affected individuals, we have identified widespread cognitive deficits (n = 6) and postnatal onset of brain overgrowth (n = 19). By analysing head size data from their parents (n = 24), we have identified a previously unrecognized KPTN dosage-sensitivity, resulting in increased head circumference in heterozygous carriers of pathogenic KPTN variants. Molecular and structural analysis of Kptn−/− mice revealed pathological changes, including differences in brain size, shape and cell numbers primarily due to abnormal postnatal brain development. Both the mouse and differentiated induced pluripotent stem cell models of the disorder display transcriptional and biochemical evidence for altered mTOR pathway signalling, supporting the role of KPTN in regulating mTORC1. By treatment in our KPTN mouse model, we found that the increased mTOR signalling downstream of KPTN is rapamycin sensitive, highlighting possible therapeutic avenues with currently available mTOR inhibitors. These findings place KPTN-related disorder in the broader group of mTORC1-related disorders affecting brain structure, cognitive function and network integrity.
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1474117-9
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2022
    In:  Nephrology Dialysis Transplantation Vol. 37, No. Supplement_3 ( 2022-05-03)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 37, No. Supplement_3 ( 2022-05-03)
    Abstract: Living kidney donation is the preferred kidney replacement therapy considering graft function and survival rates. To donate a kidney is a life-changing experience, and there is a diverse spectrum of emotions connected to this process. The aim of this study was to investigate kidney donors' perceived and measured stress levels before and after donation. Furthermore, to investigate if the level of perceived stress could be linked to the degree of metabolic stress measured using saliva cortisol, serum glucose and insulin levels. METHOD A prospective observational study including 83 patients (46 ± 10.9 years, 63% women), who donated a kidney at Sahlgrenska University Hospital, Gothenburg, during 2009–2010. Three self-rating surveys concerning stress (Everyday Life Stress Scale), vital exhaustion (Maastricht Questionnaire of vital exhaustion) and depressive symptoms (Depressive Mood Scale) were answered on the day before surgery, and then 2 and 6 months after kidney donation (see score details, Table 1). Blood samples of insulin, glucose and saliva cortisol were collected at the same time points. Statistical analyses were carried out to investigate changes over time, potential gender differences, and correlations between laboratory data and survey results. RESULTS Kidney donors generally scored low in self-rating stress mean 15.5 and depression symptom scales mean 10.8 pre-donation. The Maastricht's questionnaire showed a trend toward significant gender difference at 2 months; women mean score was 32.1 ± 9.3 and men 35.8 ± 6.9,  P = .092. At 6 months, there was a significant gender difference in self-reported vital exhaustion, where women scored higher 36.9 ± 7.1 than men 30.7 ± 11.6;  P = .037 and a near significant difference on the Depressive Mood Scale, 12.2 ± 12.5 versus 6.4 ± 8.2 at 6 months; P = .058. No significant difference over time in experienced well-being (Everyday Life Stress Scale) was found, 15.6 ± 8.2 vs 14.3 ± 7.6,  P = .554. Data are displayed in detail in Table 1 and Figure 1. No correlations between metabolic stress measured as salivary cortisol (morning, noon and evening) and HOMA-IR, and perceived stress were found. CONCLUSION Kidney donors self-reported stress level and depressive symptoms did not change pre-donation to 6 months after donation. However, women reported more feelings of exhaustion and stress than men did at 6 months post-donation. In the future, a more structured psychosocial follow-up of kidney donors after at least 6 months is suggested.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1465709-0
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