bluuebunny/crossref_metadata_2025 huggingface dataset:
Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma: a double-blind placebo-controlled trial
Authors: Dreßler M. , Fussbroich D. , Böhler L. , Herrmann E. , Benker N. , Tytyk M. , Schulze J. , Schubert R. , Beermann C. , Zielen S.
Published: July 2020

Background

Many patients suffering from exercise-induced asthma (EIA) have normal lung function at rest and show symptoms and a decline in FEV1 when they do sports or during exercise-challenge. It has been described that long-chain polyunsaturated fatty acids (LCPUFA) could exert a protective effect on EIA.

Methods

In this study the protective effect of supplementation with a special combination of n-3 and n-6 LCPUFA (sc-LCPUFA) (total 1.19 g/ day) were investigated in an EIA cold air provocation model. Primary outcome measure: Decrease in FEV1 after exercise challenge and secondary outcome measure: anti-inflammatory effects monitored by exhaled NO (eNO) before and after sc-LCPUFA supplementation versus placebo.

Results

Ninety-nine patients with exercise-induced symptoms aged 10 to 45 were screened by a standardized exercise challenge in a cold air chamber at 4 °C. Seventy-three patients fulfilled the inclusion criteria of a FEV1 decrease > 15% and were treated double-blind placebo-controlled for 4 weeks either with sc-LCPUFA or placebo. Thirty-two patients in each group completed the study. Mean FEV1 decrease after cold air exercise challenge and eNO were unchanged after 4 weeks sc-LCPUFA supplementation.

Conclusion

Supplementation with sc-LCPUFA at a dose of 1.19 g/d did not have any broncho-protective and anti-inflammatory effects on EIA.

Trial registration

Clinical trial registration number: NCT02410096. Registered 7 February 2015 at Clinicaltrial.gov
The impact of irritable bowel syndrome on health-related quality of life in women with polycystic ovary syndrome
Authors: Bazarganipour Fatemeh , Taghavi Seyed-Abdolvahab , Asemi Zatollah , Allan Helen , Khashavi Zahra , Safarzadeh Tahereh , Pourchangiz Shamsi , Zare Fatemeh , Ghasemi Samaneh , Karimi Zivar , Azizi Kutenaee Maryam
Published: July 2020

Background

The objectives of this study were to compare the prevalence and quality of life (QOL) of irritable bowel syndrome (IBS) in women with polycystic ovary syndrome (PCOS) compared with healthy women.

Methods

This was a case-control study of 201 women recruited at an infertility clinic in Iran. The control group were healthy women (n = 100) and the comparison group, women with PCOS (n = 101). Data were collected by clinical Rome III criteria to determine the IBS, Bristol scale for stool consistency and IBS QOL.

Results

The reporting of IBS symptoms were higher in PCOS (20.7%) than control group (11%) (P = 0.05). The IBS QOL score in the IBS + PCOS group was lower than other groups (IBS+ non PCOS, non IBS + PCOS, non IBS+ non PCOS; scores in food avoidance and worries about health domains were significant (P < 0.01).

Conclusions

We conclude that having PCOS and an increased level of LH/FSH tends to cause IBS symptoms. IBS + PCOS women experience significant impaired quality of life scores particularly in relation to worries about health and food avoidance. These results offer further insights into IBS in PCOS women and their functional status and wellbeing.
Correction to: White-coat hypertension and incident end‑stage renal disease in patients with non‑dialysis chronic kidney disease: results from the C‑STRIDE Study
Authors: Wang Qin , Wang Yu , Wang Jinwei , Zhang Luxia , Zhao Ming-hui ,   the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE), Zhao Ming-Hui , Zhang Luxia , Wang Xiaoqin , Yuan Jun , Zhou Qiaoling , Yuan Qiongjing , Chen Menghua , Zhou Xiaoling , Fu Shuxia , Li Shaomei , Zha Yan , Huang Rongsai , Liu Zhangsuo , Zhang JunJun , Wang Li , Pu Lei , Liu Jian , Li Suhua , Xiong Zuying , Liang Wei , Zhao Jinghong , Mu Jiao , Lian Xiyan , Liao Yunjuan , Gan Hua , Liao Liping , Wang Rong , Lv Zhimei , Liao Yunhua , Pan Ling , Yang Xiaoping , Lin Zhifeng , Tong Zongwu , Zhu Yun , He Qiang , Wu Fuquan , Li Rong , Rong Kai , Wang Caili , Zhang Yanhui , Wang Yue , Tang Wen , Wu Hua , Zhao Ban , Li Rongshan , Wang Lihua , Li Detian , Du Feng , Wu Yonggui , Zhang Wei , Lin Shan , Xu Pengcheng , Lin Hongli , Hu Zhao , Pei Fei , Zhang Haisong , Gao Yan , Sun Luying , Li Xia , Wang Wenke , Lv Fengling , Wang Deguang , Wang Xuerong , Xu Dongmei , Tang Lijun , Ma Yingchun , Wang Tingting , Fu Ping , Wang Tingli , Xing Changying , Zhang Chengning , Xu Xudong , He Haidong , Liao Xiaohui , Xie Shuqin , Hu Guicai , Huang Lan
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Longitudinal TSPO expression in tau transgenic P301S mice predicts increased tau accumulation and deteriorated spatial learning
Authors: Eckenweber Florian , Medina-Luque Jose , Blume Tanja , Sacher Christian , Biechele Gloria , Wind Karin , Deussing Maximilian , Briel Nils , Lindner Simon , Boening Guido , von Ungern-Sternberg Barbara , Unterrainer Marcus , Albert Nathalie L. , Zwergal Andreas , Levin Johannes , Bartenstein Peter , Cumming Paul , Rominger Axel , Höglinger Günter U. , Herms Jochen , Brendel Matthias
Published: July 2020

Background

P301S tau transgenic mice show age-dependent accumulation of neurofibrillary tangles in the brainstem, hippocampus, and neocortex, leading to neuronal loss and cognitive deterioration. However, there is hitherto only sparse documentation of the role of neuroinflammation in tau mouse models. Thus, we analyzed longitudinal microglial activation by small animal 18 kDa translocator protein positron-emission-tomography (TSPO μPET) imaging in vivo, in conjunction with terminal assessment of tau pathology, spatial learning, and cerebral glucose metabolism.

Methods

Transgenic P301S (n = 33) and wild-type (n = 18) female mice were imaged by 18F-GE-180 TSPO μPET at the ages of 1.9, 3.9, and 6.4 months. We conducted behavioral testing in the Morris water maze, 18F-fluordesoxyglucose (18F-FDG) μPET, and AT8 tau immunohistochemistry at 6.3–6.7 months. Terminal microglial immunohistochemistry served for validation of TSPO μPET results in vivo, applying target regions in the brainstem, cortex, cerebellum, and hippocampus. We compared the results with our historical data in amyloid-β mouse models.

Results

TSPO expression in all target regions of P301S mice increased exponentially from 1.9 to 6.4 months, leading to significant differences in the contrasts with wild-type mice at 6.4 months (+ 11–23%, all p < 0.001), but the apparent microgliosis proceeded more slowly than in our experience in amyloid-β mouse models. Spatial learning and glucose metabolism of AT8-positive P301S mice were significantly impaired at 6.3–6.5 months compared to the wild-type group. Longitudinal increases in TSPO expression predicted greater tau accumulation and lesser spatial learning performance at 6.3–6.7 months.

Conclusions

Monitoring of TSPO expression as a surrogate of microglial activation in P301S tau transgenic mice by μPET indicates a delayed time course when compared to amyloid-β mouse models. Detrimental associations of microglial activation with outcome parameters are opposite to earlier data in amyloid-β mouse models. The contribution of microglial response to pathology accompanying amyloid-β and tau over-expression merits further investigation.
Bioinformatic analysis reveals MIR502 as a potential tumour suppressor in ovarian cancer
Authors: Li Yan , Wang Qi , Ning Ning , Tang Fanglan , Wang Yan
Published: July 2020

Background

Ovarian cancer (OC) is a major cause of death among women due to the lack of early screening methods and its complex pathological progression. Increasing evidence has indicated that microRNAs regulate gene expression in tumours by interacting with mRNAs. Although the research regarding OC and microRNAs is extensive, the vital role of MIR502 in OC remains unclear.

Methods

We integrated two microRNA expression arrays from GEO to identify differentially expressed genes. The Kaplan–Meier method was used to screen for miRNAs that had an influence on survival outcome. Upstream regulators of MIR502 were predicted by JASPAR and verified by ChIP-seq data. The LinkedOmics database was used to study genes that were correlated with MIR502. Gene Set Enrichment Analysis (GSEA) was conducted for functional annotation with GO and KEGG pathway enrichment analyses by using the open access WebGestalt tool. We constructed a PPI network by using STRING to further explore the core proteins.

Results

We found that the expression level of MIR502 was significantly downregulated in OC, which was related to poor overall survival. NRF1, as an upstream regulator of MIR502, was predicted by JASPAR and verified by ChIP-seq data. In addition, anti-apoptosis and pro-proliferation genes in the Hippo signalling pathway, including CCND1, MYC, FGF1 and GLI2, were negatively regulated by MIR502, as shown in the GO and KEGG pathway enrichment results. The PPI network further demonstrated that CCND1 and MYCN were at core positions in the development of ovarian cancer.

Conclusions

MIR502, which is regulated by NRF1, acts as a tumour suppressor gene to accelerate apoptosis and suppress proliferation by targeting the Hippo signalling pathway in ovarian cancer.
Cabin temperature during prehospital patient transport – a prospective observational study
Authors: Svendsen Tuva , Lund-Kordahl Inger , Fredriksen Knut
Published: July 2020

Background

Few studies have investigated the patient compartment temperatures during ambulance missions or its relation to admission hypothermia. Still hypothermia is a known risk factor for increased mortality and morbidity in both trauma and disease. This has special relevance to our sub-arctic region’s pre-hospital services, and we prospectively studied the environmental temperature in the patient transport compartment in both ground and air ambulances.

Methods

We recorded cabin temperature during patient transport in two ground ambulances and one ambulance helicopter in the catchment area of the University Hospital of North Norway using automatic temperature loggers. The data were collected for one month in each of the four seasons. We calculated the sum of degrees Celsius below 18 min by minute to describe the patient exposure to unfavourably low cabin temperature, and present the data as box plots. The statistical differences between transport mode and season were analysed with ANCOVA.

Results

The recorded cabin temperatures were higher during the summer than the other three seasons. However, we also found that helicopter transports were performed at lower cabin temperatures and with significantly more exposure to unfavourably low temperatures than the ground ambulance transports. Furthermore, the helicopter cabin reached the final temperature much slower than the ground ambulance cabins did or remained at a lower than comfortable temperature.

Conclusions

Helicopter cabin temperature during ambulance missions should be monitored closer, particularly for patients at risk for developing admission hypothermia.
Pelvic circumferential compression devices for prehospital management of suspected pelvic fractures: a rapid review and evidence summary for quality indicator evaluation
Authors: Pap Robin , McKeown Rachel , Lockwood Craig , Stephenson Matthew , Simpson Paul
Published: July 2020

Background

Pelvic fractures, especially when unstable, may cause significant haemorrhage. The early application of a pelvic circumferential compression device (PCCD) in patients with suspected pelvic fracture has established itself as best practice. Ambulance services conduct corresponding performance measurement. Quality indicators (QIs) are ideally based on high-quality evidence clearly demonstrating that the desirable effects outweigh the undesirable effects. In the absence of high-quality evidence, best available evidence should be combined with expert consensus.

Objectives

The aim of the present study was to identify, appraise and summarize the best available evidence regarding PCCDs for the purpose of informing an expert panel tasked to evaluate the validity of the following QI: A patient with suspected pelvic fracture has a PCCD applied.

Methods

A rapid review of four databases was conducted to identify relevant literature published up until 9 June 2020. Systematic reviews, experimental, quasi-experimental and observational analytic studies written in English were included. One author was responsible for study selection and quality appraisal. Data extraction using a priori extraction templates was verified by a second reviewer. Study details and key findings were summarized in tables.

Results

A total of 13 studies were assessed to be eligible for inclusion in this rapid review. Of these, three were systematic reviews, one was a randomized clinical trial (crossover design), two were before-after studies, and seven were retrospective cohort studies. The systematic reviews included mostly observational studies and could therefore not be considered as high-level evidence. Overall, the identified evidence is of low quality and suggests that PCCD may provide temporary pelvic ring stabilization and haemorrhage control, although a potential for adverse effects exists.

Conclusion

Given the low quality of the best available evidence, this evidence would need to be combined with expert consensus to evaluate the validity of a related quality indicator before its implementation.
Echinococcus granulosus (sensu stricto) (G1, G3) and E. ortleppi (G5) in Pakistan: phylogeny, genetic diversity and population structural analysis based on mitochondrial DNA
Authors: Alvi Mughees Aizaz , Ohiolei John Asekhaen , Saqib Muhammad , Li Li , Tayyab Muhammad Haleem , Alvi Anum Aizaz , Wu Yan-Tao , Fu Bao-Quan , Yan Hong-Bin , Jia Wan-Zhong
Published: July 2020

Background

Cystic echinococcosis (CE) is a serious tapeworm infection caused by Echinococcus granulosus (sensu lato) which infects a wide range of animals and humans worldwide. Despite the millions of livestock heads reared in Pakistan, only a few reports on CE prevalence and even fewer on the genetic diversity are available for the country. Meanwhile, the available reports on the genetic diversity are predominantly based on short sequences of the cox1 gene.

Methods

To close this knowledge gap, this study was designed to investigate the genetic diversity and population structure of Echinococcus spp. in Pakistan using the complete mitochondrial cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 1 (nad1) genes.

Results

Based on BLAST searches of the generated cox1 and nad1 gene sequences from a total of 60 hydatid cysts collected from cattle (n = 40) and buffalo (n = 20), 52 isolates were identified as E. granulosus (s.s.) (G1, G3) and 8 as E. ortleppi (G5). The detection of the G5 genotype represents the first in Pakistan. The phylogeny inferred by the Bayesian method using nucleotide sequences of cox1-nad1 further confirmed their identity. The diversity indices indicated a high haplotype diversity and a low nucleotide diversity. The negative values of Tajima’s D and Fu’s Fs test demonstrated deviation from neutrality suggesting a recent population expansion.

Conclusions

To the best of our knowledge, this report described the genetic variation of E. granulosus population for the first time in Pakistan using the complete cox1 and nad1 mitochondrial genes and confirms E. ortleppi as one of the causative agents of CE among livestock in Pakistan. While this report will contribute to baseline information for CE control, more studies considering species diversity and distribution in different hosts across unstudied regions of Pakistan are highly needed.
Feasibility of postural lung recruitment maneuver in children: a randomized, controlled study
Authors: Acosta Cecilia M. , Volpicelli Giovanni , Rudzik Nadia , Venturin Nicolás , Gerez Sebastián , Ricci Lila , Natal Marcela , Tusman Gerardo
Published: July 2020

Background

Pulmonary atelectasis in anesthetized children is easily reverted by lung recruitment maneuvers. However, the high airways pressure reached during the maneuver could negatively affect hemodynamics. The aim of this study is to assess the effect and feasibility of a postural lung recruitment maneuver (P-RM); i.e., a new maneuver that opens up the atelectatic lung areas based on changing the child’s body position under constant ventilation with moderated driving pressure (12 cmH2O) and of positive end-expiratory pressure (PEEP, 10 cmH2O). Forty ASA I–II children, aged 6 months to 7 years, subjected to general anesthesia were studied. Patients were ventilated with volume control mode using standard settings with 5 cmH2O of PEEP. They were randomized into two groups: (1) control group (C group,n = 20)—ventilation was turned to pressure control ventilation using a fixed driving pressure of 12 cmH2O. PEEP was increased from 5 to 10 cmH2O during 3 min maintaining the supine position. (2) P-RM group (n = 20)—patients received the same increase in driving pressure and PEEP, but they were placed, respectively, in the left lateral position, in the right lateral position (90 s each), and back again into the supine position after 3 min. Then, ventilation returned to baseline settings in volume control mode. Lung ultrasound-derived aeration score and respiratory compliance were assessed before (T1) and after (T2) 10 cmH2O of PEEP was applied.

Results

At baseline ventilation (T1), both groups showed similar aeration score (P-RM group 9.9 ± 1.9 vs C group 10.4 ± 1.9;p = 0.463) and respiratory compliance (P-RM group 15 ± 6 vs C group 14 ± 6 mL/cmH2O; p = 0.517). At T2, the aeration score decreased in the P-RM group (1.5 ± 1.6 vs 9.9 ± 2.1;p < 0.001), but remained without changes in the C group (9.9 ± 2.1;p = 0.221). Compliance was higher in the P-RM group (18 ± 6 mL/cmH2O) when compared with the C group (14 ± 5 mL/cmH2O;p = 0.001).

Conclusion

Lung aeration and compliance improved only in the group in which a posture change strategy was applied.
Postpartum women’s perception of stressors in the delivery ward: a qualitative study
Authors: Kazemi Farideh , Masoumi Seyedeh Zahra , Soltani Farzaneh , Oshvandi Khodayar , Ghelichkhani Samereh , Niazy Ziba
Published: July 2020

Objective

Delivery is a challenging event in women’s lives. What happens during childbirth is stressful for most women. Regarding the short and long-term effects of stressors of the delivery ward on childbirth and neonatal outcomes, and given that understanding the stressors are influenced by existing social culture and factors, the present qualitative study was conducted to investigate women’s perception of stressors in the delivery ward. Participants were 13 newly delivered women who were monitored in the recovery room at the Fatemieh Hospital of Hamadan, Iran. Purposive sampling was performed and continued until data saturation. The data collection method was in-depth and semi-structured.

Results

The content analysis of qualitative data led to the emergence of two themes of human stressors and environmental stressors as well as four categories; i.e., personal factors, care staff-related factors, environmental factors, and equipment-related factors. The research findings indicated that several personal, environmental, staff-related, and equipment-related factors could lead to stress in the labor and delivery ward. Although ignoring them and increasing stress during childbirth may jeopardize the childbirth consequences, most of them are ignored and overlooked. It is necessary to consider measures to control these factors as much as possible.
A decision support system based on support vector machine for diagnosis of periodontal disease
Authors: Farhadian Maryam , Shokouhi Parisa , Torkzaban Parviz
Published: July 2020

Objective

Early diagnosis of many diseases is essential for their treatment. Furthermore, the existence of abundant and unknown variables makes more complicated decision making. For this reason, the diagnosis and classification of diseases using machine learning algorithms have attracted a lot of attention. Therefore, this study aimed to design a support vector machine (SVM) based decision-making support system to diagnosis various periodontal diseases. Data were collected from 300 patients referring to Periodontics department of Hamadan University of Medical Sciences, west of Iran. Among these patients, 160 were Gingivitis, 60 were localized periodontitis and 80 were generalized periodontitis. In the designed classification model, 11 variables such as age, sex, smoking, gingival index, plaque index and so on used as input and output variable show the individual’s status as a periodontal disease.

Results

Using different kernel functions in the design of the SVM classification model showed that the radial kernel function with an overall correct classification accuracy of 88.7% and the overall hypervolume under the manifold (HUM) value was to 0.912 has the best performance. The results of the present study show that the designed classification model has an acceptable performance in predicting periodontitis.
Value of 18F-FDG PET/CT-based radiomics model to distinguish the growth patterns of early invasive lung adenocarcinoma manifesting as ground-glass opacity nodules
Authors: Shao Xiaonan , Niu Rong , Shao Xiaoliang , Jiang Zhenxing , Wang Yuetao
Published: July 2020

Background

To establish and validate 18F-fluorodeoxyglucose (18F-FDG) PET/CT-based radiomics model and use it to predict the intermediate-high risk growth patterns in early invasive adenocarcinoma (IAC).

Methods

Ninety-three ground-glass nodules (GGNs) from 91 patients with stage I who underwent a preoperative 18F-FDG PET/CT scan and histopathological examination were included in this study. The LIFEx software was used to extract 52 PET and 49 CT radiomic features. The least absolute shrinkage and selection operator (LASSO) algorithm was used to select radiomic features and develop radiomics signatures. We used the receiver operating characteristics curve (ROC) to compare the predictive performance of conventional CT parameters, radiomics signatures, and the combination of these two. Also, a nomogram based on conventional CT indicators and radiomics signature score (rad-score) was developed.

Results

GGNs were divided into lepidic group (n = 18) and acinar-papillary group (n = 75). Four radiomic features (2 for PET and 2 for CT) were selected to calculate the rad-score, and the area under the curve (AUC) of rad-score was 0.790, which was not significantly different as the attenuation value of the ground-glass opacity component on CT (CTGGO) (0.675). When rad-score was combined with edge (joint model), the AUC increased to 0.804 (95% CI [0.699–0.895]), but which was not significantly higher than CTGGO (P = 0.109). Furthermore, the decision curve of joint model showed higher clinical value than rad-score and CTGGO, especially under the purpose of screening for intermediate-high risk growth patterns.

Conclusion

PET/CT-based radiomics model shows good performance in predicting intermediate-high risk growth patterns in early IAC. This model provides a useful method for risk stratification, clinical management, and personalized treatment.
Pharmacokinetics of high-dose tigecycline in critically ill patients with severe infections
Authors: De Pascale Gennaro , Lisi Lucia , Ciotti Gabriella Maria Pia , Vallecoccia Maria Sole , Cutuli Salvatore Lucio , Cascarano Laura , Gelormini Camilla , Bello Giuseppe , Montini Luca , Carelli Simone , Di Gravio Valentina , Tumbarello Mario , Sanguinetti Maurizio , Navarra Pierluigi , Antonelli Massimo
Published: July 2020

Background

In critically ill patients, the use of high tigecycline dosages (HD TGC) (200 mg/day) has been recently increasing but few pharmacokinetic/pharmacodynamic (PK/PD) data are available. We designed a prospective observational study to describe the pharmacokinetic/pharmacodynamic (PK/PD) profile of HD TGC in a cohort of critically ill patients with severe infections.

Results

This was a single centre, prospective, observational study that was conducted in the 20-bed mixed ICU of a 1500-bed teaching hospital in Rome, Italy. In all patients admitted to the ICU between 2015 and 2018, who received TGC (200 mg loading dose, then 100 mg q12) for the treatment of documented infections, serial blood samples were collected to measure steady-state TGC concentrations. Moreover, epithelial lining fluid (ELF) concentrations were determined in patients with nosocomial pneumonia. Amongst the 32 non-obese patients included, 11 had a treatment failure, whilst the other 21 subjects successfully eradicated the infection. There were no between-group differences in terms of demographic aspects and main comorbidities. In nosocomial pneumonia, for a target AUC0-24/MIC of 4.5, 75% of the patients would be successfully treated in presence of 0.5 mcg/mL MIC value and all the patients obtained the PK target with MIC ≤ 0.12 mcg/mL. In intra-abdominal infections (IAI), for a target AUC0-24/MIC of 6.96, at least 50% of the patients would be adequately treated against bacteria with MIC ≤ 0.5 mcg/mL. Finally, in skin and soft-tissue infections (SSTI), for a target AUC0-24/MIC of 17.9 only 25% of the patients obtained the PK target at MIC values of 0.5 mcg/mL and less than 10% were adequately treated against germs with MIC value ≥ 1 mcg/mL. HD TGC showed a relevant pulmonary penetration with a median and IQR ELF/plasma ratio (%) of 152.9 [73.5–386.8].

Conclusions

The use of HD TGC is associated with satisfactory plasmatic and pulmonary concentrations for the treatment of severe infections due to fully susceptible bacteria (MIC < 0.5 mcg/mL). Even higher dosages and combination strategies may be suggested in presence of difficult to treat pathogens, especially in case of SSTI and IAI.
The quality of clinical practice guidelines for preoperative care using the AGREE II instrument: a systematic review
Authors: Ciapponi Agustín , Tapia-López Elena , Virgilio Sacha , Bardach Ariel
Published: July 2020

Background

Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs).

Methods

Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase, and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists, and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence, and strength of recommendations according to the GRADE methodology.

Results

We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last 5 years and seven used GRADE. The median (percentile 25–75) AGREE-II scores for rigor of development was 49% (35–76%) and the domain “applicability” obtained the worst score 16% (9–31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. “Guidelines’ applicability” and “monitoring” were the most deficient domains. Only half of the EB-CPGs were updated in the past 5 years.

Conclusions

We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.
Screening strategies for adults with type 2 diabetes mellitus: a systematic review protocol
Authors: Mearns Helen , Otiku Paul Kuodi , Shelton Mary , Kredo Tamara , Kagina Benjamin M. , Schmidt Bey-Marrié
Published: July 2020

Background

There is limited evidence on whether screening for type 2 diabetes mellitus affects health outcomes. A recent systematic review of randomised clinical trials found only one trial that met their inclusion criteria; therefore, current guidelines for screening interventions for type 2 diabetes mellitus are based on expert opinions and best practice rather than synthesised evidence. This systematic review seeks to collate evidence from non-randomised studies to investigate the effect of screening for adults with type 2 diabetes on outcomes including diabetes-related morbidity, mortality (all-cause and diabetes-related) and harms.

Methods

This systematic review will follow Effective Practice and Organisation of Care (EPOC) guidelines for the synthesis of non-randomised studies. We will search PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Academic Search Premier and Health Source Nursing Academic (from inception onwards). We will include non-randomised trials, controlled before-after studies, interrupted time-series studies, repeated measures studies and concurrently controlled prospective cohort studies. The primary outcome will be diabetes-related morbidity (microvascular complications of diabetic retinopathy, nephropathy or neuropathy or macrovascular complications of non-fatal myocardial infarction, peripheral arterial disease or non-fatal stroke). The secondary outcomes will be mortality (all-cause and diabetes-related) and harms of screening strategies to patients (including psychological harms or adverse events following treatments) or to health care system (including resource allocation for false-positives or overdiagnosis). Two reviewers will independently screen all citations and full-text articles. Data will be abstracted by one reviewer and checked by a second. The risk of bias of individual studies will be appraised using the ROBINS-I tool. GRADE will be used to determine the quality of the scientific evidence. If feasible, we will conduct random effects meta-analysis where appropriate. If necessary, analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, sex, socio-economic status, rural versus urban or low-middle income versus high-income country). We will disseminate the findings via publications and through relevant networks.

Discussion

The protocol outlines the methods for systematically reviewing and synthesising evidence of screening strategies for type 2 diabetes mellitus and their effect on health outcomes associated with the disease. The potential impact of this systematic review is improved evidence-informed decision-making for policies and practice for screening of type-2 diabetes.

Systematic review registration

PROSPERO CRD42020147439
Towards secure and network state aware bitrate adaptation at IoT edge
Authors: Zeng Zeng , Che Hang , Miao Weiwei , Huang Jin , Tang Hao , Zhang Mingxuan , Zhang Shaqian
Published: July 2020

Video streaming is critical in IoT systems, enabling a variety of applications such as traffic monitoring and health caring. Traditional adaptive bitrate streaming (ABR) algorithms mainly focus on improving Internet video streaming quality where network conditions are relatively stable. These approaches, however, suffer from performance degradation at IoT edge. In IoT systems, the wireless channels are prone to interference and malicious attacks, which significantly impacts Quality-of-Experience (QoE) for video streaming applications. In this paper, we propose a secure and network-state-aware solution, SASA, to address these challenges. We first study the buffer-level constraint when increasing bitrate. We then analyze the impact of throughput overestimation in bitrate decisions. Based on these results, SASA is designed to consist of both an offline and an online phase. In the offline phase, SASA precomputes the best configurations of ABR algorithms under various network conditions. In the online phase, SASA adopts an online Bayesian changepoint detection method to detect network changes and apply precomputed configurations to make bitrate decisions. We implement SASA and evaluate its performance using 429 real network traces. We show that the SASA outperforms state-of-the-art ABR algorithms such as RobustMPC and Oboe in the IoT environment through extensive experiments.
Low-temperature large-area fabrication of ZnO nanowires on flexible plastic substrates by solution-processible metal-seeded hydrothermal growth
Authors: Yoo Kangeun , Lee Wonseok , Kang Kyungnam , Kim Inhwan , Kang Daehun , Oh Dong Kyo , Kim Min Cheol , Choi Hyunsik , Kim Kwangjun , Kim Minwook , Kim Jeong Dae , Park Inkyu , Ok Jong G.
Published: July 2020

We have developed the low-temperature conformal ZnO nanowire fabrication on flexible plastic substrates by utilizing the solution-processible metal seed-assisted hydrothermal ZnO crystallization. Structural evolution of ZnO nanowires controlled by major parameters involving growth temperature, growth time, and seed coating condition, has been systematically investigated towards uniform and large-area growth of conformal ZnO nanowires. Direct ZnO nanowire growth on flexible plastics without undergoing the high-temperature seed sintering has been realized by developing the low-temperature Ag-seeded hydrothermal ZnO nanowire growth. The nanoporous Ag layer favorable for ZnO crystal nucleation and continued nanowire growth can be reduced from the Ag ion solution coating at the temperature as low as 130 °C. This tactfully enables the selective hydrothermal growth of ZnO nanowires on the Ag patterns on flexible plastics. Such an all-solution-processible low-temperature fabrication protocol may provide an essential and practical solution to develop many diverse applications including wearable and transparent electronics, sensors, and photocatalytic devices. As one example, we demonstrate that a transparent UV sensor can be devised based on the ZNW growth on the Ag micromesh electrode.
The influence of simultaneous lateral grafting on clinical outcomes following one-stage implant placement: a cross-sectional analysis
Authors: Ramanauskaite Ausra , Schwarz Frank , Begic Amira , Parvini Puria , Galarraga-Vinueza Maria Elisa , Obreja Karina
Published: July 2020

Background

To investigate the influence of lateral bone augmentation procedures performed simultaneously with implant placement on peri-implant health or disease.

Material and methods

A total of 232 patients showing the same type of a two-piece implant placed either simultaneously with lateral bone grafting using a bovine bone mineral and a native collagen membrane (n = 291 implants; test group) or at pristine bone sites without lateral bone grafting (n = 283 implants; control group) were enrolled in this cross-sectional analysis. Clinical outcomes (i.e., modified plaque index (mPI), bleeding on probing (BOP), probing depth (PD), and mucosal recession (MR)), and the frequency of peri-implant disease were evaluated after a mean follow-up period of 9.97 ± 6.55 years.

Results

No differences were found between the patients in the test and control groups for any of the parameters investigated (i.e., mPI, BOP, PD, and MR). For the implants in both groups, PD values of 4–6 mm were more frequently noted in the upper jaw. A significant correlation between increased PD values and a larger implant diameter was noted for test implant sites. A KM of < 2 mm was associated with increased MR values in both groups. The prevalence of peri-implant mucositis and peri-implantitis was 68% and 5% for the patients in the test group and 61% and 10% in the control group, respectively.

Conclusions

Simultaneous lateral grafting was associated with peri-implant tissue health and stability.
Hepatocellular carcinoma with ring calcification mimicking hydatid disease: a case report
Authors: Matsunaga Yutaro , Ariizumi Shunichi , Shibuya Go , Uemura Shuichiro , Kato Takaaki , Yazawa Takehisa , Yamashita Shingo , Omori Akiko , Higuchi Ryota , Takahashi Yutaka , Kotera Yoshihito , Egawa Hiroto , Yamamoto Masakazu
Published: July 2020

Background

Ring calcification in hepatocellular carcinoma is extremely rare. Untreated hepatocellular carcinoma occasionally includes calcified lesions. Here, we report a case of ring-calcified hepatocellular carcinoma.

Case presentation

A 60-year-old man with a hepatic tumor was referred to Tokyo Women’s Medical University Hospital. He had a history of chronic hepatitis C. Computed tomography showed a liver tumor 20 mm in diameter in segment 6 of the Couinaud classification, with ring calcification. Based on this uncommon imaging presentation and the patient’s past exposure to the definitive hosts of Echinococcus multilocularis, he was preoperatively diagnosed with echinococcosis. Partial hepatectomy was performed as a radical treatment for echinococcosis. A final diagnosis of hepatocellular carcinoma was confirmed based on pathological findings. The patient was discharged uneventfully.

Conclusion

The presentation of an extremely rare hepatocellular carcinoma with ring calcification may be disguised as hydatid disease.
Meeting report of the third annual Tri-Service Microbiome Consortium symposium
Authors: Karl J. Philip , Barbato Robyn A. , Doherty Laurel A. , Gautam Aarti , Glaven Sarah M. , Kokoska Robert J. , Leary Dagmar , Mickol Rebecca L. , Perisin Matthew A. , Hoisington Andrew J. , Van Opstal Edward J. , Varaljay Vanessa , Kelley-Loughnane Nancy , Mauzy Camilla A. , Goodson Michael S. , Soares Jason W.
Published: July 2020

The Tri-Service Microbiome Consortium (TSMC) was founded to enhance collaboration, coordination, and communication of microbiome research among U.S. Department of Defense (DoD) organizations and to facilitate resource, material and information sharing among consortium members. The 2019 annual symposium was held 22–24 October 2019 at Wright-Patterson Air Force Base in Dayton, OH. Presentations and discussions centered on microbiome-related topics within five broad thematic areas: 1) human microbiomes; 2) transitioning products into Warfighter solutions; 3) environmental microbiomes; 4) engineering microbiomes; and 5) microbiome simulation and characterization. Collectively, the symposium provided an update on the scope of current DoD microbiome research efforts, highlighted innovative research being done in academia and industry that can be leveraged by the DoD, and fostered collaborative opportunities. This report summarizes the presentations and outcomes of the 3rd annual TSMC symposium.
Successes and challenges of using a peer Mentor model for nutrition education within a food pantry: a qualitative study
Authors: Oliver Tracy L. , McKeever Amy , Shenkman Rebecca , Diewald Lisa K.
Published: July 2020

Background

Delivering nutrition education within an emergency food pantry (EFP) provides an opportunity to reach many food insecure households and underserved populations. However, little is known about using a peer mentor model, “Community Cooks,”as a modality to deliver nutrition education within this setting. This research aimed to identify the successes and challenges of using a peer mentor model within an EFP to better understand the best approaches to deliver nutrition education among community residents.

Methods

In spring 2018, semi-structured interviews were conducted with 11 peer mentors after they delivered a series of nutrition workshops to community members of the EFP. Interviews were audio-recorded and transcribed verbatim. Qualitative content analysis was used to analyze the data.

Results

All peer mentors were women over 40 years-of-age, were recruited from the EFP community; most were high school graduates and currently received some form of federal nutrition assistance. All peer mentors reported that the“Community Cooks”nutrition education program offered many benefits. Key successes of the program included serving in the role as a peer mentor was an empowering experience which gave them a sense of community, purpose, and camaraderie; 2) the nutrition education was appropriately tailored towards those living with food insecurity; 3) the recipes required minimal cooking skills and included low-cost easily accessible foods available at the EFP. Key challenges of the program were the lack of community member engagement in the nutrition education workshops.

Conclusion

Challenges continue to exist when delivering nutrition education within a community EFP setting. While the use of peer mentors to deliver nutrition education messages is promising, more research is needed to quantify the impact of using a peer mentor model in underserved and food insecure communities.
To counter the rationality of sexual violence: existing and potential policies against the genocidal use of rape as a weapon of war in the Democratic Republic of Congo
Authors: van Wieringen Kjeld
Published: July 2020

The population in the eastern Democratic Republic of Congo (DRC) has been terrorized by widespread sexual violence for decades. Local armed groups, including the government army, continue to systematically rape civilians for strategic reasons. This paper argues that the discussed genocidal functions of rape as a weapon of war in the DRC can be neutralized or ‘de-functionalized’ by providing victims and targeted communities with safe abortion, anti-retroviral medication, reconstructive surgery and awareness programmes, thereby both responding to short-term humanitarian needs of victims and the need for long-term solutions to preventing further sexual violence.
Biochemical response to cryothermal and radiofrequency exposure of the human myocardium at surgical ablation of atrial fibrillation: a randomized controlled trial
Authors: Boano Gabriella , Aneq Meriam Åström , Spyrou Giannis , Enocsson Helena , Charitakis Emmanouil , Vánky Farkas
Published: July 2020

Background

Surgical cryothermia and radiofrequency (RF) ablations for atrial fibrillation (AF) seem to result in similar sinus rhythm restoration, but the biochemical consequences of the two methods are unclear. We aimed to compare the biochemical responses to the two ablative methods in concomitant mitral valve surgery (MVS).

Methods

Sixty mitral valve surgery patients with AF were prospectively included. Forty-one patients planned for ablation were randomized to cryothermia (n = 20) or radiofrequency (n = 21) ablation and 19 served as controls. Markers for myocardial injury, inflammation, cell stress, apoptosis, and heart failure were analyzed pre- and postoperatively at different time points.

Results

Troponin T and creatine kinase isoenzyme MB (CK-MB) peak levels were significantly higher in the cryothermia group compared with the RF group (12,805 [6140–15,700] vs. 2790 [1880–4180] ng/L; P = 0.002 and 271 [217–357] vs. 79 [66–93] μg/L; P < 0.001, respectively). Both groups had significantly higher levels than the no-ablation group. There were no group differences in C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), but there were correlations between pre- and postoperative levels of both CRP (rs = 0.41, P = 0.001) and NT-proBNP (rs = 0.48, P < 0.001). Protease-activated receptor 1 (PAR-1) and heat shock protein 27 (HSP27) were significantly increased in the cryoablation group.

Conclusions

Cryoablation results in a larger myocardial injury and possibly more elevated apoptotic activity and cell stress compared with the RF technique. The type of ablation device did not have any significant influence on the postoperative inflammatory response nor on the early postoperative levels of NT-proBNP.

Trial registration

DOI:10.1186/ISRCTN14454361. Registered 16 November 2014 – Retrospectively registered, http://www.isrctn.com/ISRCTN14454361
Engaging the communities in Wuhan, China during the COVID-19 outbreak
Authors: Zhu Jie , Cai Yi
Published: July 2020

During the early stage of the COVID-19 outbreak in Wuhan, the lockdown of the densely-populated metropolis caused panic and disorderly behavior among its population. Community governance systems (CGSs) were mobilized to lead community engagement to address the challenges and issues brought about by the sudden quarantine measures, still unprecedented in any part of the world during that time. This commentary aims to describe and analyze the roles of the CGSs, its implementation of culturally-tailored strategies and the performance of new functions as called for by the outbreak. We will introduce the community governance structure which has two parallel administrative units of government including the branches of the Communist Party of China (CPC). The pandemic showed that the roles of the CGSs evolved and may continue to be improved in the future. It is important to engage the community and to have community-based approaches in addressing issues brought about by lockdowns. This community experience in Wuhan provides important lessons for the rest of the world.
A multicenter paper-based and web-based system for collecting patient-reported outcome measures in patients undergoing local treatment for prostate cancer: first experiences
Authors: Kowalski Christoph , Roth Rebecca , Carl Günther , Feick Günter , Oesterle Alisa , Hinkel Andreas , Steiner Thomas , Brock Marko , Kaftan Björn , Borowitz Rainer , Zantl Niko , Heidenreich Axel , Neisius Andreas , Darr Christopher , Bolenz Christian , Beyer Burkhard , Pfitzenmaier Jesco , Brehmer Bernhard , Fichtner Jan , Haben Björn , Wesselmann Simone , Dieng Sebastian
Published: July 2020

Purpose

To give an overview of the multicenter Prostate Cancer Outcomes (PCO) study, involving paper-based and web-based collection of patient-reported outcome measures (PROM) in patients undergoing local treatment for prostate cancer in certified centers in Germany. The PCO study is part of the larger Movember-funded TrueNTH Global Registry. The article reports on the study’s design and provides a brief progress report after the first 2 years of data collection.

Methods

Prostate cancer centers (PCCs) certified according to German Cancer Society requirements were invited to participate in collecting patient-reported information on symptoms and function before and at least once (at 12 months) after treatment. The data were matched with disease and treatment information. This report describes progress in patient inclusion, response rate, and variations between centers relative to online/paper use, and also data quality, including recruitment variations relative to treatment in the first participating PCCs.

Results

PCC participation increased over time; 44 centers had transferred data for 3094 patients at the time of this report. Patient recruitment varied widely across centers. Recruitment was highest among patients undergoing radical prostatectomy. The completeness of the data was good, except for comorbidity information.

Conclusions

The PCO study benefits from a quality improvement system first established over 10 years ago, requiring collection and harmonization of a predefined clinical dataset across centers. Nevertheless, establishing a PROM routine requires substantial effort on the part of providers and constant monitoring in order to achieve high-quality data. The findings reported here may be useful for guiding implementation in similar initiatives.