Fisher & Paykel Healthcare (New Zealand)

Muco-obstructive diseases change airway mucus properties,impairingmucociliary transport and increasing the likelihood of infections.To investigate the sorption properties and nanostructures of mucusin health and disease, we investigated mucus samples from patientsand cell cultures (cc) from healthy, chronic obstructive pulmonarydisease (COPD), and cystic fibrosis (CF) airways. Atomic force microscopy(AFM) revealed mucin monomers with typical barbell structures, wherethe globule to spacer volume ratio was the highest for CF mucin. Accordingly,synchrotron small-angle X-ray scattering (SAXS) revealed more pronouncedscattering from CF mucin globules and suggested shorter carbohydrateside chains in CF mucin and longer side chains in COPD mucin. Quartzcrystal microbalance with dissipation (QCM-D) analysis presented watersorption isotherms of the three types of human airway mucus, where,at high relative humidity, COPD mucus had the highest water contentcompared to cc-CF and healthy airway mucus (HAM). The higher hydrationof the COPD mucus is consistent with the observation of longer sidechains of the COPD mucins. At low humidity, no dehydration-inducedglass transition was observed in healthy and diseased mucus, suggestingmucus remained in a rubbery state. However, in dialyzed cc-HAM, asorption–desorption hysteresis (typically observed in the glassystate) appeared, suggesting that small molecules present in mucussuppress the glass transition.

ABSTRACT The COVID-19 pandemic has elevated levels of distress and resulted in anti-Asian discrimination in many countries. We aimed to determine the 10-month prevalence of depression symptoms in Asian adults in New Zealand during the pandemic and to see if this was related to experience of racism. An online survey was conducted and a stratified sample of 402 respondents completed the brief Centre for Epidemiological Studies-Depression (CES-D) scale. Analyses included: descriptive statistics, depression scores by age/gender, factor analysis of the 10 item CES-D and partial correlation network analysis of CES-D items together with questions about experience of racism. Results show that half of the sample reported clinically significant symptoms of depression. Depression was higher among younger participants but there was no gender difference. Internal consistency was high (α = 0.85) for the CES-D which revealed a clear two-factor structure. Network analysis suggested that sleeping problems might be the bridge between experiences of racism and depression. The prevalence of low mood was high with clinically significant levels of depressive symptoms. Depression was higher in younger people and had a modest positive correlation with personal experience of racism.

Although geographical differences in treatment and outcomes after stroke have been described, we lack evidence on differences in the costs of treatment between urban and nonurban regions. Additionally, it is unclear whether greater costs in one setting are justified given the outcomes achieved. We aimed to compare costs and quality-adjusted life years in people with stroke admitted to urban and nonurban hospitals in New Zealand. Observational study of patients with stroke admitted to the 28 New Zealand acute stroke hospitals (10 in urban areas) recruited between May and October 2018. Data were collected up to 12 months poststroke including treatments in hospital, inpatient rehabilitation, other health service utilization, aged residential care, productivity, and health-related quality of life. Costs in New Zealand dollars were estimated from a societal perspective and assigned to the initial hospital that patients presented to. Unit prices for 2018 were obtained from government and hospital sources. Multivariable regression analyses were conducted when assessing differences between groups. Of 1510 patients (median age 78 years, 48% female), 607 presented to nonurban and 903 to urban hospitals. Mean hospital costs were greater in urban than nonurban hospitals ($13 191 versus $11 635, P=0.002), as were total costs to 12 months ($22 381 versus $17 217, P<0.001) and quality-adjusted life years to 12 months (0.54 versus 0.46, P<0.001). Differences in costs and quality-adjusted life years remained between groups after adjustment. Depending on the covariates included, costs per additional quality-adjusted life year in the urban hospitals compared to the nonurban hospitals ranged from $65 038 (unadjusted) to $136 125 (covariates: age, sex, prestroke disability, stroke type, severity, and ethnicity). Better outcomes following initial presentation to urban hospitals were associated with greater costs compared to nonurban hospitals. These findings may inform greater targeted expenditure in some nonurban hospitals to improve access to treatment and optimize outcomes.

[Purpose] The aim of this study was to examine the relationships between oral and mental/physical functions of community-dwelling older adults. [Participants and Methods] We conducted a mail questionnaire survey of 1,940 community-dwelling persons aged 65 years or older. Using a basic checklist, we investigated oral function, motor function, low nutrition, depressive tendencies, cognitive function, and confinement, and compared the results between the groups with and without impaired oral function. [Results] We found that motor function, low nutrition, and cognitive function were associated with oral function. [Conclusion] We found a relationship between oral function and psychosomatic function in the elderly. The results suggest that a decline in psychosomatic function may be caused by a decline in oral function.

AimsIn anticipation of increasing rates of bronchiolitis post-easing of Covid restrictions, the UK began ‘respiratory surge planning’. This study compares the frequency and severity of bronchiolitis admissions prior-to and during the Covid-19 pandemic, with the hypothesis that there would be an increase in severity and volume of admissions.MethodsWe conducted a retrospective cohort study of all infants aged 0-6 months at a single district-general hospital (DGH) in the UK requiring inpatient admission between 01 April 2016 and 31 January 2022, with a discharge diagnosis of bronchiolitis.Primary outcome measures included length of stay, requirement for heated-humidified high-flow nasal cannulae (HHHFNC) oxygen and tertiary-centre retrieval to regional PICU. RSV and Covid statuses were also recorded.Each year was divided into Summer (1 April to 30 September) and Winter (1 October – 31 March). Data pre-pandemic (before 31 March 2020) and peri-pandemic (post 1 April 2020) were included. Patient data was collected retrospectively using electronic discharge summaries and microbiology results. Severity of bronchiolitis was indexed by the requirement for HHHFNC or retrieval.Parametric data was analysed using Student’s t-test. Non-parametric data was evaluated with the Chi-square test. A p value <0.05 was deemed statistically significant (confidence interval 95%).ResultsOver the six-year period, 667 patients were identified, of which 535 met the inclusion criteria. The mean age was 83.5 +/- 31 days.Pre-pandemic, over 92% (408/442) of cases were in the winter. During the pandemic, this fell to 61% (57/93), with no peak seen during winter 2020 (October 2020- March 2021), and an increased incidence during summer 2021 (figure 1).Winter mean lengths of stay (LOS) for pre- and peri-pandemic were 2.47+/- 2.2 and 1.89 +/- 2.0 days respectively (figure 2). This was statistically significant (p=0.047). Summer mean LOS for pre- and peri-pandemic were 2.62 +/-2.0 and 2.28 +/- 1.8 days respectively (p=0.47). The all-seasons mean LOS pre- and peri-pandemic were 2.48 +/- 2.15 and 2.04 +/- 1.9 day respectively (p=0.05).There was no significant difference in requirement for HHHFNC, with rates of 21% (91/442) pre-pandemic, and 22% (20/93) peri-pandemic (p=0.84). The frequency of admission to PICU is thankfully very small. There was no distinct seasonal trend, with a range of zero to five retrievals per 6-month period. 776 Figure 1Bronchiolitis management 776 Figure 2Length of StayConclusionThis study shows a dramatic decrease in overall admissions for bronchiolitis during ‘lockdown’ at the start of the Covid-19 pandemic, then a subsequent summer spike in 2021; but no overall difference in severity. The length of stay was in fact marginally shorter during the pandemic. We conclude that there is no indication that the Covid-19 pandemic led to delays in presentation causing more severe disease in these patients, which may be useful for future service planning.