bluuebunny/crossref_metadata_2025 huggingface dataset:
Normalization of a conversation tool to promote shared decision making about anticoagulation in patients with atrial fibrillation within a practical randomized trial of its effectiveness: a cross-sectional study
Authors:   Shared Decision Making for Atrial Fibrillation (SDM4AFib) Trial Investigators, Spencer-Bonilla Gabriela , Thota Anjali , Organick Paige , Ponce Oscar J. , Kunneman Marleen , Giblon Rachel , Branda Megan E. , Sivly Angela L. , Behnken Emma , May Carl R. , Montori Victor M.
Published: May 2020

Background

Shared decision making (SDM) implementation remains challenging. The factors that promote or hinder implementation of SDM tools for use during the consultation, including contextual factors such as clinician burnout and organizational support, remain unclear. We explored these factors in the context of a practical multicenter randomized trial evaluating the effectiveness of an SDM conversation tool for patients with atrial fibrillation considering anticoagulation therapy.

Methods

In this cross-sectional study, we recruited clinicians who were regularly involved in conversations with patients regarding anticoagulation for atrial fibrillation. Clinicians reported their characteristics and burnout symptoms using the two-item Maslach Burnout Inventory. Clinicians were trained in using the SDM tool, and they recorded their perceptions of the tool’s normalization potential using the Normalization MeAsure Development (NoMAD) survey instrument and verbally reflected on their answers to these survey questions. When possible, the training sessions and clinicians’ verbal responses to the conversation tool were recorded.

Results

Our study comprised 183 clinicians recruited into the trial (168 with survey responses and 112 with recordings). Overall, clinicians gave high scores to the normalization potential of the intervention; they endorsed all domains of normalization to the same extent, regardless of site, clinician characteristics, or burnout ratings. In interviews, clinicians paid significant attention to making sense of the tool. Tool buy-in seemed to depend heavily on their ability to see the tool as accurate and “evidence-based” and their perceptions of having time in the consultation to use it.

Conclusions

While time in the consultation remains a barrier, we did not find a significant association between burnout symptoms and normalization of an SDM conversation tool. Possible areas for improving the normalization of SDM conversation tools in clinical practice include enabling collaboration among clinicians to implement the tool and reporting how clinicians elsewhere use the tool. Direct measures of normalization (i.e., observing how often clinicians access the tool in practice outside of the clinical trial) may further elucidate the role that contextual factors, such as clinician burnout, play in the implementation of SDM.

Trial registration

ClinicalTrials.gov, NCT02905032. Registered on 9 September 2016.
Access to routinely collected health data for clinical trials – review of successful data requests to UK registries
Authors: Lensen Sarah , Macnair Archie , Love Sharon B. , Yorke-Edwards Victoria , Noor Nurulamin M. , Martyn Meredith , Blenkinsop Alexandra , Diaz-Montana Carlos , Powell Graham , Williamson Elizabeth , Carpenter James , Sydes Matthew R.
Published: May 2020

Background

Clinical trials generally each collect their own data despite routinely collected health data (RCHD) increasing in quality and breadth. Our aim is to quantify UK-based randomised controlled trials (RCTs) accessing RCHD for participant data, characterise how these data are used and thereby recommend how more trials could use RCHD.

Methods

We conducted a systematic review of RCTs accessing RCHD from at least one registry in the UK between 2013 and 2018 for the purposes of informing or supplementing participant data. A list of all registries holding RCHD in the UK was compiled. In cases where registries published release registers, these were searched for RCTs accessing RCHD. Where no release register was available, registries were contacted to request a list of RCTs. For each identified RCT, information was collected from all publicly available sources (release registers, websites, protocol etc.). The search and data extraction were undertaken between January and May 2019.

Results

We identified 160 RCTs accessing RCHD between 2013 and 2018 from a total of 22 registries; this corresponds to only a very small proportion of all UK RCTs (about 3%). RCTs accessing RCHD were generally large (median sample size 1590), commonly evaluating treatments for cancer or cardiovascular disease. Most of the included RCTs accessed RCHD from NHS Digital (68%), and the most frequently accessed datasets were mortality (76%) and hospital visits (55%). RCHD was used to inform the primary trial (82%) and long-term follow-up (57%). There was substantial variation in how RCTs used RCHD to inform participant outcome measures. A limitation was the lack of information and transparency from registries and RCTs with respect to which datasets have been accessed and for what purposes.

Conclusions

In the last five years, only a small minority of UK-based RCTs have accessed RCHD to inform participant data. We ask for improved accessibility, confirmed data quality and joined-up thinking between the registries and the regulatory authorities.

Trial registration

PROSPERO CRD42019123088.
Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial
Authors: Hansen Maria Swennergren , Vestermark Marianne Toft , Hölmich Per , Kristensen Morten Tange , Barfod Kristoffer Weisskirchner
Published: May 2020

Background

An individualized treatment algorithm (Copenhagen Achilles Rupture Treatment Algorithm (CARTA)) based on the ultrasonographic appearance of an acute Achilles tendon rupture has been developed aiming to select the correct patients for operative and non-operative treatment. The objective of this study is to investigate if this individualized treatment algorithm gives a better functional outcome than treating all patients either operatively or non-operatively per default.

Methods/design

This study is conducted as a multicenter, three-armed randomized controlled trial. Participants are included from four hospitals in Denmark and randomized 1:1:1 to one of three parallel groups: 1) Intervention group—participants are treated according to an individualized treatment algorithm; 2) Control group A—participants are treated non-operatively; 3) Control group B—participants are treated operatively. The individualized treatment algorithm for the intervention group is based on an ultrasonographic examination; tendon overlap and elongation below 7% is to be treated non-operatively, while no tendon overlap and/or elongation above 7% will be treated operatively. Over a period of 3 years, 300 participants will be included. The primary outcome is the heel-rise work test at 12 months post-injury. Secondary outcomes are tendon elongation, the Achilles tendon Total Rupture Score (ATRS), the rate of re-ruptures, and other complications. The primary analysis will be conducted as an intention-to-treat analysis.

Discussion

This trial will indicate if treatment of acute Achilles tendon rupture can be individualized based on elongation and tendon overlap. It is hypothesized that different patients will benefit from different treatments instead of offering all the same treatment.

Trial registration

ClinicalTrials.gov,NCT03525964. Registered 16 May 2018.
Study on a susceptible–exposed–infected–recovered model with nonlinear incidence rate
Authors: Chen Lijun , Wei Fengying
Published: May 2020

A stochastic susceptible–exposed–infected–recovered (SEIR) model with nonlinear incidence rate is investigated. Under suitable conditions, existence and uniqueness of a global solution, stationary distribution with ergodicity, persistence in the mean, and extinction of the disease are obtained. Numerical simulations and conclusions are separately carried out at the end of this paper.
The association between FTO rs9939609 gene polymorphism and anthropometric indices in adults
Authors: Mehrdad Mahsa , Fardaei Majid , Fararouei Mohammad , Eftekhari Mohammad Hassan
Published: May 2020

Background

Fat mass and obesity-associated gene (FTO) is the most studied obesity-related gene up to date. We aimed to assess anthropometric indices in carriers of FTO rs9939609 polymorphism with overweight across Iranian population (Shiraz) to find out the associations of this polymorphism with obesity indices.

Methods

This was a cross-sectional study conducted on 198 overweight healthy adults aged 20-45 years old. We assessed the body composition of the participants using bioelectrical impedance analyzer. In addition, we measured the waist circumference (WC) and hip circumference (HC). Waist to hip ratio (WHR) and waist to height ratio (WHtR) were also calculated by equations. The participants’ genotype was determined by ARMS-PCR. Also, data analysis was performed using SPSS software version 20 and R software version 3.6.2.

Results

The mean values of body mass index (BMI) and age of the participants were 26.93 ± 1.13 kg/m2 and 33.33 ± 6.35 years old, respectively. Homozygous carriers of A-allele had significantly higher values for BMI (0.60 kg/m2, p = 0.026), WHR (0.04 unit, p = 0.003), and WHtR (0.02 unit, p = 0.030) than the homozygous carriers of T-allele. Individuals with AA genotype had greater WC (2.66 cm, p = 0.042, and 4.03 cm, p = 0.002), fat mass (2.24 kg, p = 0.004, and 3.02 kg, p = 0.001), and trunk fat (1.53 kg, p = 0.001, and 2.08 kg, p = 0.001) compared to those with AT and TT genotypes, respectively. Interestingly, after adjustment of the confounders, significant associations were observed among rs9939609 polymorphism and BMI, Wt, WC, trunk fat percentage, WHR, and WHtR.

Conclusions

A-allele of the FTO rs9939609 polymorphism was indicated to be associated with greater general and central obesity in adult population of Shiraz, Iran.
Further rejection of the cybercrime hypothesis
Authors: Farrell Graham , Birks Daniel
Published: May 2020

We recently rejected the hypothesis that increases in cybercrime may have caused the international crime drop. Critics subsequently argued that offenders switched from physical crime to cybercrime in recent years, and that lifestyle changes due to ‘leisure IT’ may have caused the international crime drop. Here we explain how the critics misrepresented our argument and do not appear to introduce anything new.
Behavioral and electrophysiological evidence for a neuroprotective role of aquaporin-4 in the 5xFAD transgenic mice model
Authors: Abe Yoichiro , Ikegawa Natsumi , Yoshida Keitaro , Muramatsu Kyosuke , Hattori Satoko , Kawai Kenji , Murakami Minetaka , Tanaka Takumi , Goda Wakami , Goto Motohito , Yamamoto Taichi , Hashimoto Tadafumi , Yamada Kaoru , Shibata Terumasa , Misawa Hidemi , Mimura Masaru , Tanaka Kenji F. , Miyakawa Tsuyoshi , Iwatsubo Takeshi , Hata Jun-ichi , Niikura Takako , Yasui Masato
Published: May 2020

Aquaporin-4 (AQP4) has been suggested to be involved in the pathogenesis of neurodegenerative diseases including Alzheimer’s disease (AD), which may be due to the modulation of neuroinflammation or the impairment of interstitial fluid bulk flow system in the central nervous system. Here, we show an age-dependent impairment of several behavioral outcomes in 5xFAD AQP4 null mice. Twenty-four-hour video recordings and computational analyses of their movement revealed that the nighttime motion of AQP4-deficient 5xFAD mice was progressively reduced between 20 and 36 weeks of age, with a sharp deterioration occurring between 30 and 32 weeks. This reduction in nighttime motion was accompanied by motor dysfunction and epileptiform neuronal activities, demonstrated by increased abnormal spikes by electroencephalography. In addition, all AQP4-deficient 5xFAD mice exhibited convulsions at least once during the period of the analysis. Interestingly, despite such obvious phenotypes, parenchymal amyloid β (Aβ) deposition, reactive astrocytosis, and activated microgliosis surrounding amyloid plaques were unchanged in the AQP4-deficient 5xFAD mice relative to 5xFAD mice. Taken together, our data indicate that AQP4 deficiency greatly accelerates an age-dependent deterioration of neuronal function in 5xFAD mice associated with epileptiform neuronal activity without significantly altering Aβ deposition or neuroinflammation in this mouse model. We therefore propose that there exists another pathophysiological phase in AD which follows amyloid plaque deposition and neuroinflammation and is sensitive to AQP4 deficiency.
Causal relations on a cline of explicitness: an SFL perspective
Authors: Othman Waleed
Published: May 2020

This paper is an attempt to categorize cause-effect relations in English in terms of explicitness on the basis of realisation and choice. Specifically, making use of SFL’s concept of grammatical metaphor and the dimension of delicacy, I suggest that cause-effect relations can be placed on a cline with respect to how explicitly they encode logico-semantic meaning.
Bioethanol from hydrolyzed Spirulina (Arthrospira platensis) biomass using ethanologenic bacteria
Authors: Werlang Eliana B. , Julich Jennifer , Muller Maria V. G. , de Farias Neves Fabio , Sierra-Ibarra Estefanía , Martinez Alfredo , Schneider Rosana de C. de S.
Published: May 2020

Photosynthetic microorganisms are considered excellent feedstock for biofuel production in developing biomass production technologies. A study was conducted to evaluate ethanol production with the sequential enzymatic saccharification and fermentation of Arthrospira platensis (Spirulina) biomass with the metabolically engineered Escherichia coli strain MS04. A. platensis was cultivated semicontinuously in an open raceway pond, and the carbohydrate content was determined to be as high as 40%. The enzymatic saccharification was designed to release the maximum amount of glucose. After 40 h of enzymatic saccharification, 27 g L−1 of monosaccharides was obtained. These slurries were fermented with ethanologenic bacteria, achieving 12.7 g L−1 ethanol after 9 h of fermentation, which corresponds to 92% conversion yield of the glucose content in the hydrolysate, 0.13 g of ethanol per 1 g of Spirulina biomass and a volumetric productivity of 1.4 g of ethanol L−1 h−1. Therefore, we conclude that it is possible, in a short time, to obtain a high ethanol yield corresponding to 160 L per ton of dry biomass with a high productivity.
True cicadas (Cicadidae) as prey for the birds of the Western Palearctic: a review
Authors: Pons Pere
Published: May 2020

Background

True cicadas (Cicadidae) are large and temporarily abundant insects. Their availability may produce demographic and behavioural effects on bird populations, as happens with forest avifauna feeding on periodical cicadas in North America. In Europe, the Near East and North Africa, knowledge of cicada predation by birds is sparse.

Methods

To help fill this gap, I consulted Cramp’s Birds of the Western Palearctic, conducted a search of online databases and used search engines to generate a database of Western Palearctic birds known to eat cicadas.

Results

A total of 105 species (16% of those occurring in the region) belonging to 13 orders, and comprising 20 of the 33 passerine families, were found to consume cicadas. I estimated that 69 of these bird species are known to consume cicadas within the limits of the Western Palearctic. Many terrestrial birds predate on cicadas, preferably on adults. Avian predators include cuckoos, owls, bee-eaters, woodpeckers, falcons, reed-warblers, larks, crows and jays, buntings, shrikes, pipits and wagtails, flycatchers and chats, tits, sparrows, leaf-warblers, starlings, warblers and thrushes, but also terns and gulls. Nymphs are consumed by some passerines, owls and herons. Cicadas can make up as much as 70% of food items delivered to nestlings. Analysis of stomach contents and neck collar samples are the most common methods used in diet studies.

Conclusions

Available knowledge is biased towards species that have been more intensively studied, and often lack proper quantification of prey items. More studies about the relative importance of cicadas as prey for birds in the Western Palearctic are needed. I suggest using non-invasive studies based on pellets and droppings and prioritizing declining bird species.
Optimization of [18F]PSMA-1007 PET-CT using regularized reconstruction in patients with prostate cancer
Authors: Trägårdh Elin , Minarik David , Brolin Gustav , Bitzén Ulrika , Olsson Berit , Oddstig Jenny
Published: May 2020

Background

Prostate-specific membrane antigen (PSMA) radiotracers such as [18F]PSMA-1007 used with positron emission tomography-computed tomography (PET-CT) is promising for initial staging and detection of recurrent disease in prostate cancer patients. The block-sequential regularization expectation maximization algorithm (BSREM) is a new PET reconstruction algorithm, which provides higher image contrast while also reducing noise. The aim of the present study was to evaluate the influence of different acquisition times and different noise-suppressing factors in BSREM (β values) in [18F]PSMA-1007 PET-CT regarding quantitative data as well as a visual image quality assessment.

We included 35 patients referred for clinical [18F]PSMA-1007 PET-CT. Four megabecquerels per kilogramme were administered and imaging was performed after 120 min. Eighty-four image series per patient were created with combinations of acquisition times of 1–4 min/bed position and β values of 300–1400. The noise level in normal tissue and the contrast-to-noise ratio (CNR) of pathological uptakes versus the local background were calculated. Image quality was assessed by experienced nuclear medicine physicians.

Results

The noise level in the liver, spleen, and muscle was higher for low β values and low acquisition times (written as activity time products (ATs = administered activity × acquisition time)) and was minimized at maximum AT (16 MBq/kg min) and maximum β (1400). There was only a small decrease above AT 10. The median CNR increased slowly with AT from approximately 6 to 12 and was substantially lower at AT 4 and higher at AT 14–16. At AT 4–6, many images were regarded as being of unacceptable quality. For AT 8, β values of 700–900 were considered of acceptable quality.

Conclusions

An AT of 8 (for example as in our study, 4 MB/kg with an acquisition time of 2 min) with a β value of 700 performs well regarding noise level, CNR, and visual image quality assessment.
Impact of the Bayesian penalized likelihood algorithm (Q.Clear®) in comparison with the OSEM reconstruction on low contrast PET hypoxic images
Authors: Texte Edgar , Gouel Pierrick , Thureau Sébastien , Lequesne Justine , Barres Bertrand , Edet-Sanson Agathe , Decazes Pierre , Vera Pierre , Hapdey Sébastien
Published: May 2020

Purpose

To determine the impact of the Bayesian penalized likelihood (BPL) reconstruction algorithm in comparison to OSEM on hypoxia PET/CT images of NSCLC using 18F-MIZO and 18F-FAZA.

Materials and methods

Images of low-contrasted (SBR = 3) micro-spheres of Jaszczak phantom were acquired. Twenty patients with lung neoplasia were included. Each patient benefitted from 18F-MISO and/or 18F-FAZA PET/CT exams, reconstructed with OSEM and BPL. Lesion was considered as hypoxic if the lesion SUVmax > 1.4. A blind evaluation of lesion detectability and image quality was performed on a set of 78 randomized BPL and OSEM images by 10 nuclear physicians. SUVmax, SUVmean, and hypoxic volumes using 3 thresholding approaches were measured and compared for each reconstruction.

Results

The phantom and patient datasets showed a significant increase of quantitative parameters using BPL compared to OSEM but had no impact on detectability. The optimal beta parameter determined by the phantom analysis was β350. Regarding patient data, there was no clear trend of image quality improvement using BPL. There was no correlation between SUVmax increase with BPL and either SUV or hypoxic volume from the initial OSEM reconstruction. Hypoxic volume obtained by a SUV > 1.4 thresholding was not impacted by the BPL reconstruction parameter.

Conclusion

BPL allows a significant increase in quantitative parameters and contrast without significantly improving the lesion detectability or image quality. The variation in hypoxic volume by BPL depends on the method used but SUV > 1.4 thresholding seems to be the more robust method, not impacted by the reconstruction method (BPL or OSEM).

Trial registration

ClinicalTrials.gov, NCT02490696. Registered 1 June 2015
The feasibility and acceptability of an early intervention in primary care to prevent chronic fatigue syndrome (CFS) in adults: randomised controlled trial
Authors: O’Dowd Hazel , Beasant Lucy , Ingram Jenny , Montgomery Alan , Hollingworth Will , Gaunt Daisy , Collin Simon M. , Horne Sarah , Jones Beth , Crawley Esther
Published: May 2020

Background

Chronic fatigue syndrome (CFS, also known as myalgic encephalomyelitis (ME)) is defined as fatigue that is disabling, is accompanied by additional symptoms and persists for ≥ 4 months. Treatment of CFS/ME aims to help patients manage their symptoms and make lifestyle adjustments. We do not know whether intervening early in primary care (< 4 months after onset of fatigue) can prevent the development of CFS/ME.

Methods

This was a feasibility randomised controlled trial with adults (age ≥ 18 years) comparing usual care with usual care plus an early intervention (EI; a combination of psycho-education and cognitive behavioural therapy, CBT). This study took place in fourteen primary care practices in Bristol, England and aimed to identify issues around recruitment and retention for a full-scale trial. It was not powered to support statistical analysis of differences in outcomes. Integrated qualitative methodology was used to explore the feasibility and acceptability of recruitment and randomisation to the intervention.

Results

Forty-four patients were recruited (1 August 2012–November 28, 2013), falling short of our predicted recruitment rate of 100 patients in 8 months. Qualitative data from GPs showed recruitment was not feasible because it was difficult to identify potential participants within 4 months of symptom onset. Some referring GPs felt screening investigations recommended by NICE were unnecessary, and they had difficulty finding patients who met the eligibility criteria. Qualitative data from some participant interviews suggested that the intervention was not acceptable in its current format. Although the majority of participants found parts of the intervention acceptable, many reported one or more problems with acceptability. Participants who discontinued the intervention or found it problematic did not relate to the therapeutic model, disliked telephone consultations or found self-reflection challenging.

Conclusions

A randomised controlled trial to test an early intervention for fatigue in adults in primary care is not feasible using this intervention and recruitment strategy.

Trial registration

International Standard Randomised Controlled Trials, ISRCTN72645894. Retrospectively registered on 17 May 2013
In silico and in vitro analysis reveal multi-target anti-hyperglycaemic properties of gedunin, a limonoid from neem (Azadirachta indica)
Authors: Mazumdar Suchismita , Marar Thankamani , Patki Jyoti , Devarajan Shine , Zambare Vyankatesh , Swami Dayanand
Published: May 2020

Background

Insulin secretion and insulin related pathways have been the prime targets in the treatment of diabetes for a long time. However, recently a lot of attention is being directed towards addressing hyperglycaemia as the main perpetrator of the symptoms in this metabolic disorder. This new treatment approach also involves greater inclination to plant derived therapeutic agents for their safety and probable minimal side effects. The objective of the present study was to scientifically elucidate the potential of gedunin (a limonoid from Neem tree) as an anti-hyperglycaemic agent.

Methods

The effect of gedunin on pancreatic and salivary amylase activity and glucose transport across yeast cell membrane was tested at three different concentrations (5 μM, 10 μM and 20 μM) using known inhibitor acarbose as the standard. Multiple Ligand Simultaneous Docking was used to study the interaction of gedunin with salivary and pancreatic amylase and determine binding affinity and specificity of this interaction.

Results

The in vitro results documented a steady, linear pancreatic alpha amylase (ovine) inhibition in a concentration dependent manner with gedunin showing lower IC50 value of 20.25 μM against acarbose (IC50 = 31.12 μM) a known enzyme inhibitor used as standard in the present study. The inhibition of salivary amylase by gedunin was also distinct. Yeast cell glucose uptake studies revealed remarkable inhibition of glucose absorption at 10 μM and 20 μM concentration of gedunin (5.45% and 13.87% respectively with respect to control). Corroborating the in vitro findings even in the docking studies gedunin exhibited higher docking score (− 8.12 Kcal/mol) and higher enzyme inhibition potency (Ki = 1.12 μM) with human pancreatic amylase-substrate complex as compared to acarbose (docking score-5.24 Kcal/mol, Ki = 110.8 μM). The studies further suggested a non-competitive, mixed kind of inhibition by gedunin. As evident from this current in vitro study, gedunin had shown significant inhibition of alpha amylases and glucose uptake at much lower concentration (5, 10 and 20 μM) than previous studies where the concentrations used were (20.7–124.3 μM).

Conclusion

This study lays strong evidence to the rationale of gedunin being an important lead compound to developing a promising hyperglycaemic agent, simultaneously targeting glucose absorption in the intestine and enzymatic digestion of polysaccharides.
Identification of risk factors for post-induction hypotension in patients receiving 5-aminolevulinic acid: a single-center retrospective study
Authors: Yatabe Tomoaki , Karashima Takashi , Kume Motohiko , Kawanishi Yu , Fukuhara Hideo , Ueba Tetsuya , Inoue Keiji , Okuhara Yoshiyasu , Yokoyama Masataka
Published: May 2020

Background

5-Aminolevulinic acid (5-ALA) is useful as a photodynamic agent, but its use commonly leads to hypotension. Although avoiding a mean arterial pressure (MAP) < 60 mmHg is important, the incidence of MAP < 60 mmHg when using 5-ALA is unclear. Therefore, we conducted a retrospective study to assess the incidence of post-induction hypotension and identified risk factors of this phenomenon.

Methods

One-hundred and seventy-two consecutive patients who underwent transurethral resection of the bladder tumor or craniotomy with the use of 5-ALA were enrolled. The primary outcome was the incidence of post-induction hypotension, defined as MAP < 60 mmHg during the first 1 h after anesthesia induction. We divided participants into the normal blood pressure group (group N) and the hypotension group (group L).

Results

The incidence of post-induction hypotension was 70% (group L = 121, group N = 51). Multivariate analysis revealed that female sex was an independent factor of post-induction hypotension (odds ratio [OR] 3.95; 95% confidence interval [CI] 1.21–12.97; p = 0.02). Systolic blood pressure < 100 mmHg before anesthesia induction and general anesthesia were also identified as significant independent factors (OR 13.30; 95% CI 1.17–151.0; p = 0.04 and OR 25.84; 95% CI 9.80–68.49; p < 0.001, respectively).

Conclusions

The incidence of post-induction hypotension was 70% in patients using 5-ALA. Female sex, systolic blood pressure < 100 mmHg before anesthesia induction, and general anesthesia might be independent factors of post-induction hypotension when using 5-ALA.
The responsiveness of goal attainment scaling using just one goal in controlled clinical trials: an exploratory analysis
Authors: McGarrigle Lisa , Rockwood Kenneth
Published: May 2020

Background

Goal Attainment Scaling (GAS) is an individualized outcome measure that allows the setting of personalized treatment goals. We compared the responsiveness of GAS when individuals set only one goal instead of the recommended three or more goals.

Methods

We conducted exploratory analyses on data from two randomized controlled trials: the Video-Imaging Synthesis of Treating Alzheimer’s Disease (VISTA) (n = 130); and the Mobile Geriatric Assessment Team (MGAT) (n = 265). Independent t-tests and standardized response means (SRMs) were used to assess responsiveness of one- vs. multiple-goal GAS.

Results

In VISTA, clinician-rated multiple-goal GAS detected higher goal attainment in the intervention group (p = 0.01; SRM = 0.48). One-goal GAS, whether rated by patients or by clinicians, did not detect differences in goal attainment between groups (patient: p = 0.56, SRM = 0.10; clinician: p = 0.10, SRM = 0.29). In MGAT, multiple-goal GAS (outcome goals: p < .001, SRM = 1.29; total goals: p < .001, SRM = 1.52) and one-goal GAS (outcome goals: p < .001, SRM = 0.89; total goals: p < .001, SRM = 0.75), detected significantly higher goal attainment in the intervention group.

Conclusion

One-goal GAS detected significant change in response to a patient-centred, multi-domain care initiative. As such, in similar contexts, one-goal GAS may be an effective means of optimizing personalization and improving GAS feasibility through reduced administration time. However, it is not yet clear if one-goal GAS is responsive in the context of a pharmacological intervention and further research is recommended.
First light microscopy and ultrastructural description of Mesocoelium sociale (Luhe, 1901) Odhner, 1910 (Trematoda: Mesocoeliidae) in Bufo regularis from Egypt
Authors: Thabit Hasnaa , Khalifa Refaat
Published: May 2020

Background

Mesocoeliidae is a common parasite of the small intestine of amphibians and reptiles. From Egypt, only Mesocoelium monas (Rudolphi C., Berolini 811 (1819)) (Freitas JF, Revista Brasiliera de Biologia 18:171-174, (1958)) was reported and described by (Saad AI et. al., J Egypt Ger Soc Zool 33: 219-234, (2000)) from the small intestine of the Egyptian toads Bufo regularis from Aswan Governorate, Upper Egypt, and the molecular characterization of the same parasite was reported by (Mansour MFA et. al., Egypt. J. Biol. (Zool.),10:(1)1-8, (2014)) without any morphological description from the same final host. The present study aimed to detect the prevalence and the characteristic morphological features of mesocoeliid parasites of the Egyptian toads Bufo regularis.

Methods

Toads were collected from Assiut and Giza Governorates during the autumn of 2018. They were dissected and examined by a dissecting microscope for intestinal parasites. The collected trematodes were fixed, stained, dehydrated, cleared, and mounted. Photomicrographs were taken and parasite measurements were determined. Some of the identified worms were prepared for scanning electron microscope for studying their ultrastructure.

Results

Mesocoelium sociale was detected from the small intestine of 14 out of 51 toads Bufo regularis (27.5%) with worm burden (10–30 worms per host). Detailed morphometric characteristic features of the parasite were described by a light microscope. Scanning electron microscopy showed many fine ultrastructure details in the present study and confirmed the light microscopic description.

Conclusion

Mesocoelium sociale (Luhe M, Centralblatt für Bakteriologie Parasitenkunde und Infektionsk-rankheiten, 30, 166-177, (1901)) (Odhner T., Res. Swedish Zool Exped Egypt iv, (23a), 1–166, (1910)) is recorded for the first time from Egypt as a trematode parasite of the Egyptian toads’ Bufo regularis and described by a light microscope. In addition, it is described for the first time worldwide by scanning electron microscopy.
Comparative study on the specimen thickness measurement using EELS and CBED methods
Authors: Heo Yoon-Uk
Published: May 2020

Two thickness measurement methods using an electron energy loss spectroscopy (EELS) and 10a convergent beam electron diffraction (CBED) were compared in an Fe-18Mn-0.7C alloy. The thin foil specimen was firstly tilted to satisfy 10a two-beam condition. Low loss spectra of EELS and CBED patterns were acquired in scanning transmission electron microscopy (STEM) and TEM-CBED modes under the two-beam condition. The log-ratio method was used for measuring the thin foil thickness. Kossel-Möllenstedt (K-M) fringe of the $$ \mathbf{13}\overline{\mathbf{1}} $$131¯ diffracted disk of austenite was analyzed to evaluate the thickness. The results prove the good coherency between both methods in the thickness range of 72 ~ 113 nm with a difference of less than 5%.
Early Impact of COVID-19 on the Conduct of Oncology Clinical Trials and Long-Term Opportunities for Transformation: Findings From an American Society of Clinical Oncology Survey
Authors: Waterhouse David M. , Harvey R. Donald , Hurley Patricia , Levit Laura A. , Kim Edward S. , Klepin Heidi D. , Mileham Kathryn Finch , Nowakowski Grzegorz , Schenkel Caroline , Davis Courtney , Bruinooge Suanna S. , Schilsky Richard L.
Published: May 2020

The coronavirus disease 2019 (COVID-19) pandemic has disrupted all aspects of clinical care, including cancer clinical trials. In March 2020, ASCO launched a survey of clinical programs represented on its Cancer Research Committee and Research Community Forum Steering Group and taskforces to learn about the types of changes and challenges that clinical trial programs were experiencing early in the pandemic. There were 32 survey respondents; 14 represented academic programs, and 18 represented community-based programs. Respondents indicated that COVID-19 is leading programs to halt or prioritize screening and/or enrollment for certain clinical trials and cease research-only visits. Most reported conducting remote patient care where possible and remote visits and monitoring with sponsors and/or contract research organizations (CROs); respondents viewed this shift positively. Numerous challenges with conducting clinical trials were reported, including enrollment and protocol adherence difficulties with decreased patient visits, staffing constraints, and limited availability of ancillary services. Interactions with sponsors and CROs about modifying trial procedures were also challenging. The changes in clinical trial procedures identified by the survey could serve as strategies for other programs attempting to maintain their clinical trial portfolios during the COVID-19 pandemic. Additionally, many of the adaptations to trials made during the pandemic provide a long-term opportunity to improve and transform the clinical trial system. Specific improvements could be expanded use of more pragmatic or streamlined trial designs, fewer clinical trial–related patient visits, and minimized sponsor and CRO visits to trial programs.
Two Case Reports of Upper Extremity Venous Thrombosis From Midline Catheter Placement in Pregnancy
Authors: Viviani Chiara , Fierro Giulia , Milan Barbara , Ongaro Laura , Piccoli Valentino , Luca Lorini Ferdinando
Published: May 2020

Midline catheters are often inserted in pregnant women for whom a prolonged hospital stay is anticipated to facilitate the administration of medications and for blood sampling. Midline catheters compared with peripheral intravenous catheters are associated with fewer venipunctures and scheduled line changes. We present 2 cases of pregnant women with no personal or family history of thrombosis who underwent midline catheter insertion and developed venous thromboembolism of the upper extremity requiring anticoagulation therapy. Studies are needed to evaluate the safety profile of midline catheters in pregnancy.
Spastic Cerebral Palsy Pain Improvement With Propofol: A Case Report
Authors: Martinez Valéria , Lansaman Thibaud , Guichard Leah
Published: May 2020

Propofol is a sedative and a hypnotic agent used in the induction and maintenance of general anesthesia. Propofol also relaxes skeletal muscles. It has been used successfully to treat local or diffuse muscular rigidity from various etiologies. Propofol also provides modulation of pain processing and perception. Our case report describes a 25-year-old patient with painful spastic cerebral palsy, who experienced prolonged improvement of his symptoms after treatment with propofol. The patient has received 13 administrations of propofol with similar efficacy each time.
Use of Augmented Reality During Inhaled Induction of General Anesthesia in 3 Pediatric Patients: A Case Report
Authors: Libaw Justin S. , Sinskey Jina L.
Published: May 2020

Preoperative anxiety is common in children undergoing surgery and general anesthesia (GA). Augmented reality (AR), an interactive technology that superimposes computer-generated information on the real-world environment, can be a valuable tool to address preoperative anxiety. We describe 3 cases where AR was successfully used as a distraction technique in pediatric patients during induction of GA. Patients and parents were satisfied with the experience and described less patient anxiety as compared to previous inductions. AR can be beneficial as an adjunct or alternative to existing pharmacologic and behavioral distraction techniques for preoperative anxiety.
Neuraxial Morphine–Induced Hypothermia After Cesarean Delivery Managed With Nalbuphine: A Case Report
Authors: Bernstein Kyra , Landau Ruth
Published: May 2020

Neuraxial morphine–induced hypothermia has been reported as a relatively rare complication, with the successful use of naloxone and lorazepam to reverse symptoms. We report a case of intrathecal morphine–induced hypothermia with profuse sweating, intractable nausea, and vomiting in a primigravid woman undergoing cesarean delivery in the setting of preeclampsia. All symptoms rapidly resolved after a single dose of intravenous nalbuphine. Because nalbuphine has a long track record of safe use on labor and delivery units, it is an attractive and novel choice for treatment of neuraxial morphine–induced hypothermia.
Sovereign Dispossession
Authors: O’Hara Daniel T.
Published: May 2020

The large historical transformation from a culture of work and achievement to one of consumption and pleasure, in progressively extreme and democratically available forms, finds its expression in the finest details of fictional, literary artistry. Thomas Mann’s development of the psychological romance, the modern psychomachia, of narration amid the personae of character, narrator (and what kind of narrator), implicated author, and a newly activated and yet indulgently consuming reader, participates in a widespread game of aesthetic interpellation that leads to what contemporary theorists such as Slavoj Žižek and Robert Pfaller term the interpassive subject. As we have seen in Mann’s career and our epoch, the creative images of voice, the critical terms of self-narration, mark the phases of this movement from literature as traditionally understood to the apocalyptic expenditure of all cultural capital without return, either explosively or by playing out the string.
A Little Muzhik, Muttering to Himself
Authors: Robbins Bruce
Published: May 2020

The night before her suicide, Anna Karenina has a strange nightmare about a muzhik, or former serf, who speaks French and is doing something with a piece of iron. Given the place of class in the novel, if mainly on the Levin side rather than the Anna side, critics of Tolstoy have said less than might have been expected about the simple fact that this is a wealthy woman dreaming uneasily about a poor man. This essay attempts an interpretation of the dream, which Anna shared, more or less, with Vronsky, relating it both to Anna Karenina as a whole and to the general issue of the marginal existence of the poor in novels by, for, and about their social superiors. Reference is made to Gabriel García Márquez’s One Hundred Years of Solitude (1967), John James Bezer’s Autobiography of One of the Chartist Rebels of 1848, Edmund Wilson’s 1942 novella, “The Princess with the Golden Hair,” and Jacques Rancière’s The Philosopher and His Poor.
Restless Flying, A Black Study of Revolutionary Humanism
Authors: Judy R.A.
Published: May 2020

This is an expository essay of “restless flying,” the terms of which are gleaned from engagement with two poetic lines. One is from Aimé Césaire’s 1956 poem, “Le verbe marronner.” The other is from the tenth-century Abbasid poet al-Mutanabbī’s qaṣīda, لااحترا مه سيل ءاش يئاقب (“Baqā’ī šā’ laisa hum irtiḥālan,” “My Constant Wish Is They Not Be Departing”), apropos the literary and political work of twentieth-century Tunisian thinker Mahmud al-Mas‘adī. Both the flight and its exposition belong to what J. Kameron Carter and Sara Jane Cervenak call “the Black Outdoors,” invoking in part Michel Foucault’s notion of “the thought of the outside,” whereby the domineering speaking subject of knowledge disappears in the infinite boundedness of language. Restless flying, it is argued, is elemental of what I term poiēsis in black, referencing a set of practices-of-living articulating conceptions of humanity that are appositive to the anthropology of “Man” concomitant with capitalist modernity.
Three Phrases of History
Authors: Gourgouris Stathis
Published: May 2020

This essay takes as point of departure three phrases by Marx, Heidegger, and Benjamin in order to restage Aristotle’s notion of zōon politikon as a way of rethinking humanism as a radical political project for our times. At the same time, it reconfigures ontological questions of human-being through a consideration of human animality beyond the traditional divide between nature and culture.
Nâzım Hikmet and the Prose of Communism
Authors: Ertürk Nergis
Published: May 2020

“Socialism,” Régis Debray has written, “was born with a printers’ docket around its neck. . . . Book, school, newspaper: for the party militant, the greatest emphasis lay on the third.” This essay addresses the imagination of an underground press in the Turkish communist Nâzım Hikmet’s autobiographical novel Life’s Good, Brother, published posthumously in 1964. Taking into consideration Nâzım’s recently published correspondence and reports in the Turkish Communist Party (TKP) archive, it aims to move beyond the perfunctory, generalizing study of the relation between Nâzım’s literary aesthetics and revolutionary activism, suggesting that V. I. Lenin (more than Vladimir Mayakovksy) was a key influence on his literary writings. I argue that this novel, about the failure of a group of Turkish communists to establish an effective underground press, should be read alongside a report titled “Newspaper: A Collective Organizer,” which Nâzım submitted to the TKP in 1925. If Nâzım closely followed Lenin’s 1901 pamphlet “Where to Begin” and 1902 booklet What Is to Be Done? in his youthful writings, I suggest that in Life’s Good, Brother, he broke with Lenin and with his own earlier formulations. The novel’s imagination of a nonteleological revolutionary temporality and of a discontinuous, transnational communist writing may be understood as anticipating and interrupting the “postcommunism” of our own time.
The Anthropologist, the Moralist, and the Diplomat
Authors: Blok Anders
Published: May 2020

This guest column asks how Bruno Latour has contributed to any present and future refiguring of relations between the sciences and the humanities. To answer the question, it traces three select and shifting figures of knowledge by means of which Latour himself has been charting his progress—from the anthropologist, charged with unraveling techno-scientific networks, to the moralist, participating in the parliament of nature, to the diplomat, negotiating the moderns’ many modes of existence. Rather than a neat blueprint for carving up the knowledge space, this essay argues, Latour leaves us with “an ethos of knowledges that verges on a chaos of in-disciplines.” The essay concludes, however, that Latour’s “in-disciplinary” thinking is and will likely continue to be an important resource for explorations into the uncertain, “nonmodern” erritories that Latour has so valuably observed.
Introduction
Authors: Fliche Benoît
Published: May 2020

Exopraxis—a term for religious practices in places of worship associated with a religion not one’s own—is often associated with heteropraxis, a term for unorthodox religious practices. Heteropraxes, which may be shared by members of more than one religion, can diverge so widely from the orthopraxy and even orthodoxy of a dominant religion that government authorities will make strenuous attempts to suppress them. In Muslim Turkey, a growing proportion of the supporters of Sunni orthodoxy regard the veneration of certain trees, stones, natural springs, and resting places of saintly persons and relics as forms of idolatry (şirk), heresy (bid’at), or superstition (hurāfe). Alevi heteropraxis at such sites of wild piety are often accompanied by Sunni exopraxis. Heteropraxis and exopraxis do not everywhere or completely overlap, argues this introduction to a cluster of articles on exopraxis, but exopraxis is generally tolerant of, if not drawn to, heteropraxis.
Dilemmas of Sharing Religious Space
Authors: Boissevain Katia
Published: May 2020

Christianity has a long presence in the Maghreb, dating back to Roman imperial times. Eventually it became a mostly Muslim region, but in the late nineteenth century, the Roman Catholic Church embarked on a vast mission of church building, in part to assist the French colonial endeavor. In Tunisia, political independence in 1956 was accompanied by a further reinvigoration of Christianity, and, over the last twenty years, conversion to Christianity (mainly in the form of evangelical and neo-evangelical Protestantism) has been on the rise. Beginning in 2003, workers and students from sub-Saharan Africa have contributed to the growth of both Catholic and Protestant churches in Tunis. This article analyzes the ways in which various Christian groups organize and articulate their religious practice and proselytization in ritual spaces that are sparse and must be shared in contemporary Tunisia.
RNA genome conservation and secondary structure in SARS-CoV-2 and SARS-related viruses: a first look
Authors: Rangan Ramya , Zheludev Ivan N. , Hagey Rachel J. , Pham Edward A. , Wayment-Steele Hannah K. , Glenn Jeffrey S. , Das Rhiju
Published: May 2020

As the COVID-19 outbreak spreads, there is a growing need for a compilation of conserved RNA genome regions in the SARS-CoV-2 virus along with their structural propensities to guide development of antivirals and diagnostics. Here we present a first look at RNA sequence conservation and structural propensities in the SARS-CoV-2 genome. Using sequence alignments spanning a range of betacoronaviruses, we rank genomic regions by RNA sequence conservation, identifying 79 regions of length at least 15 nt as exactly conserved over SARS-related complete genome sequences available near the beginning of the COVID-19 outbreak. We then confirm the conservation of the majority of these genome regions across 739 SARS-CoV-2 sequences subsequently reported from the COVID-19 outbreak, and we present a curated list of 30 “SARS-related-conserved” regions. We find that known RNA structured elements curated as Rfam families and in prior literature are enriched in these conserved genome regions, and we predict additional conserved, stable secondary structures across the viral genome. We provide 106 “SARS-CoV-2-conserved-structured” regions as potential targets for antivirals that bind to structured RNA. We further provide detailed secondary structure models for the extended 5′ UTR, frameshifting stimulation element, and 3′ UTR. Lastly, we predict regions of the SARS-CoV-2 viral genome that have low propensity for RNA secondary structure and are conserved within SARS-CoV-2 strains. These 59 “SARS-CoV-2-conserved-unstructured” genomic regions may be most easily accessible by hybridization in primer-based diagnostic strategies.
UPDATES: COVID-19
Authors: Allaway Tom
Published: May 2020

NICE publishes COVID-19 rapid guidelines: gastrointestinal and liver conditions treated with drugs affecting the immune response
DOXYCYCLINE
Authors: Rees Sharon
Published: May 2020

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #doxycycline