bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives of general practitioners and nursing staff on acute hospital transfers of nursing home residents in Germany: results of two cross-sectional studies
Authors: Fassmer Alexander Maximilian , Pulst Alexandra , Spreckelsen Ove , Hoffmann Falk
Published: February 2020

Background

Visits in emergency departments and hospital admissions are common among nursing home (NH) residents and they are associated with significant complications. Many of these transfers are considered inappropriate. This study aimed to compare the perceptions of general practitioners (GPs) and NH staff on hospital transfers among residents and to illustrate measures for improvement.

Methods

Two cross-sectional studies were conducted as surveys among 1121 GPs in the German federal states Bremen and Lower Saxony and staff from 1069 NHs (preferably nursing staff managers) from all over Germany, each randomly selected. Questionnaires were sent in August 2018 and January 2019, respectively. The answers were compared between GPs and NH staff using descriptive statistics, Mann-Whitney U tests and χ2-tests.

Results

We received 375 GP questionnaires (response: 34%) and 486 NH questionnaires (response: 45%). GPs estimated the proportion of inappropriate transfers higher than NH staff (hospital admissions: 35.0% vs. 25.6%, p < 0.0001; emergency department visits: 39.9% vs. 20.9%, p < 0.0001). The majority of NH staff and nearly half of the GPs agreed that NH residents do often not benefit from hospital admissions (NHs: 61.4% vs. GPs: 48.8%; p = 0.0009). Both groups rated almost all potential measures for improvement differently (p < 0.0001), however, GPs and NH staff considered most areas to reduce hospital transfers importantly. The two most important measures for GPs were more nursing staff (91.6%) and better communication between nursing staff and GP (90.9%). NH staff considered better care / availability of GP (82.8%) and medical specialists (81.3%) as most important. Both groups rated similarly the importance of explicit advance directives (GPs: 77.2%, NHs: 72.4%; p = 0.1492).

Conclusions

A substantial proportion of hospital transfers from NHs were considered inappropriate. Partly, the ratings of possible areas for improvement differed between GPs and NH staff indicating that both groups seem to pass the responsibility to each other. These findings, however, support the need for interprofessional collaboration.
Validity of self-reported and objectively measured sedentary behavior in pregnancy
Authors: Barone Gibbs Bethany , Paley Joshua L. , Jones Melissa A. , Whitaker Kara M. , Connolly Christopher P. , Catov Janet M.
Published: February 2020

Background

Sedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy.

Methods

This cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson’s r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods.

Results

Fifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54–0.66 and ICC = 0.52–0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r < 0.5 and ICC < 0.3 vs. activPAL SED, with lower agreement during the 2nd and 3rd trimesters, and performed poorly in Bland-Altman analyses. SED% from the modified SB2D performed best of the self-reported instruments with modest mean differences, r ranging from 0.55 to 0.60, and ICCs from 0.31–0.33; though, limits of agreement were greater than ±35%. Significant trends in activPAL SED were observed across increasing tertiles of SB2D SED in the 1st and 3rd trimesters (both p ≤ 0.001), but not the 2nd trimester (p = 0.425); and for PPAQ SED in the 1st and 2nd trimesters (both p < 0.05), but not the 3rd trimester (p = 0.158). AcitvPAL SED and SED% increased significantly across tertiles of GT3X SED and SED% as well as SB2D SED% (all p-for-trend ≤ 0.001).

Conclusions

Compared to activPAL, waist-worn GT3X produced moderate agreement, though similar mean estimates of SED across pregnancy. Self-report questionnaires had large absolute error and wide limits of agreement for SED hr./day; SB2D measurement of SED% was the best self-report method. These data suggest activPAL be used to measure SED when possible, followed by GT3X, and – when necessary – SB2D assessing SED% in pregnancy.

Trial registration

www.clinicaltrials.govNCT03084302 on 3/20/2017.
Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
Authors: Muluneh Atalay Goshu , Animut Yaregal , Ayele Tadesse Awoke
Published: February 2020

Background

All pregnancies are at risk and have to be attended by skilled professionals. In Ethiopia however nearly half (45.7%) of the women were giving birth at home after antenatal care (ANC) visits in which skilled professionals were not available. Therefore, the aim of this study was to assess spatial clustering and the determinant factors of home delivery after antenatal care visits in Ethiopia.

Methods

A case control study was conducted on 2110 mothers who gave birth at home after ANC (cases), and 2510 mothers who gave birth at health institutions after attending ANC (controls), based on EDHS 2016 data. As per the recommendations of the DHS program, we weighed the data before analysis. ArcGIS 10.3 was used to show spatial pattern and SaTScan™ 9.4 to identify significant clusters. Stata 14 was used for data cleaning, weighing, and the analysis of the determinant factors. Bi variable and multi variable multilevel mixed effect logistic regression was fitted. Finally, the Log-likelihood ratio (LLR) and Relative risk with p-value of spatial scan statistics and AOR with 95% CI for significant determinant factors were reported.

Results

Home delivery after ANC was spatially clustered in Ethiopia (Moran’s Index = 0.91, p-value< 0.01). Attending, 1–3 ANC visits (AOR = 1.41, 95%CI: 1.17–1.71), no information about birth preparedness plan (AOR = 2.21, 95%CI: 1.83–2.69), pregnancies wanted later (AOR = 1.55, 95%CI: 1.20, 2.06), not having health insurance (AOR = 2.16, 95% CI: 1.29, 3.62), Muslim (AOR = 1.57, 95% CI: 1.13, 2.19) and protestant (AOR = 1.72, 95%CI: 1.16, 2.42) religions were positively associated with home delivery; While being rich (AOR = 0.42, 95%CI: 0.32–0.54), middle wealth index (AOR = O.66, 95%CI: 0.51, 0.86), primary education (AOR = 0.45, 95%CI: 0.36–0.55), secondary education (AOR = 0.11, 95%CI: 0.07–0.16), above secondary education (AOR = 0.06, 95%CI: 0.03–0.11) were negatively associated.

Conclusions

Home delivery after ANC follow ups was spatially clustered. Socio-demographic, health service and pregnancy related factors determined the prevalence of home delivery after antenatal care visits. Strengthening women’s education, ANC visit, giving more information about birth preparedness plan, and improving family wealth are vital to reduce home delivery after antenatal care visits.
Urban-rural disparity in lower extremities amputation in patients with diabetes after nearly two decades of universal health Insurance in Taiwan
Authors: Li Chung-Hao , Li Chia-Chun , Lu Chin-Li , Wu Jin-Shang , Ku Li-Jung Elizabeth , Li Chung-Yi
Published: February 2020

Background

To assess the prevalence of urban-rural disparity in lower extremities amputation (LEA) among patients with diabetes and to explore whether patient-related or physician-related factors might have contributed to such disparity.

Methods

This was a population-based study including patients with diabetes aged ≥55 years from 2009 to 2013. Among them, 9236 received LEA. Data were retrieved from Taiwan’s National Health Insurance (NHI) claims. A multiple Poisson regression model was also employed to assess the urban-rural difference in LEA prevalence by simultaneously taking into account socio-demographic variables and density of practicing physicians.

Results

Between 2009 and 2013, the annual prevalence of LEA declined from 30.4 to 20.5 per 10,000 patients. Compared to patients from urban areas, those who lived in sub-urban and rural areas suffered from a significantly elevated prevalence of LEA, with a prevalence rate ratio (PRR) of 1.47 (95% CI, 1.39–1.55) and 1.68 (95% CI, 1.56–1.82), respectively. The density of physicians who presumably provided diabetes care can barely explain the urban-rural disparity in LEA prevalence.

Conclusions

Although the universal health insurance has largely removed financial barriers to health care, the urban-rural disparity in LEA prevalence still exists in Taiwan after nearly two decades of the NHI program.
Remineralising effect of 45S5 bioactive glass on artificial caries in dentine
Authors: Wu Qiong , Mei May Lei , Wu Xin , Shi Shuya , Xu Yuting , Chu Chun Hung , Chen Yaming
Published: February 2020

Background

This study investigated the remineralisation effect of bioactive glass on artificial dentine caries.

Methods

Dentine disks with artificial caries were treated with bioactive glass (group BAG), casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) (group CPP-ACP), sodium fluoride glycerol (group F) or deionized water (group W). All disks were subjected to pH cycling for 28 days subsequently. The topography, microhardness and remineralisation depth of the dentine carious lesion were assessed by atomic force microscopy (AFM), microhardness testing and confocal laser scanning microscope (CLSM), respectively.

Results

AFM images indicated mineral depositions on the surface of the carious lesion in group BAG. The changes of Vickers hardness number (ΔVHN, mean ± SD) after pH cycling were 9.67 ± 3.60, 6.06 ± 3.83, 5.00 ± 2.19 and − 1.90 ± 2.09 (p < 0.001) in group BAG, group CPP-ACP, group F and group W, respectively. The remineralisation depth (mean ± SD) of the carious lesion in group BAG, group CPP-ACP, group F and group W were 165 ± 11 μm, 111 ± 11 μm, 75 ± 6 μm and 0 μm (p < 0.001), respectively.

Conclusion

Bioactive glass possessed a promising remineralisation effect on artificial dentine caries and could be a therapeutic choice for caries management.
Finding common ground: meta-synthesis of communication frameworks found in patient communication, supervision and simulation literature
Authors: Links Matthew Jon , Watterson Leonie , Martin Peter , O’Regan Stephanie , Molloy Elizabeth
Published: February 2020

Background

Effective communication between patients-clinicians, supervisors-learners and facilitators-participants within a simulation is a key priority in health profession education. There is a plethora of frameworks and recommendations to guide communication in each of these contexts, and they represent separate discourses with separate communities of practice and literature. Finding common ground within these frameworks has the potential to minimise cognitive load and maximise efficiency, which presents an opportunity to consolidate messages, strategies and skills throughout a communication curriculum and the possibility of expanding the research agenda regarding communication, feedback and debriefing in productive ways.

Methods

A meta-synthesis of the feedback, debriefing and clinical communication literature was conducted to achieve these objectives.

Results

Our analysis revealed that the concepts underlying the framework can be usefully categorised as stages, goals, strategies, micro-skills and meta-skills. Guidelines for conversations typically shared a common structure, and strategies aligned with a stage. Core transferrable communication skills (i.e., micro-skills) were identified across various types of conversation, and the major differences between frameworks were related to the way that power was distributed in the conversation and the evolution of conversations along the along the path of redistributing power. As part of the synthesis, an overarching framework “prepare-EMPOWER enact” was developed to capture these shared principles across discourses.

Conclusions

Adopting frameworks for work-based communication that promote dialogue and empower individuals to contribute may represent an important step towards learner-centred education and person-centred care for patients.
“Evaluation of a best practice approach to assess undergraduate clinical skills in Paediatrics”
Authors: Stollar Fabiola , Cerutti Bernard , Aujesky Susanne , Nendaz Mathieu , Galetto-Lacour Annick
Published: February 2020

Background

The Objective Structured Clinical Examination (OSCE) has been used in pediatrics since the 1980s. Its main drawback is that large numbers of children are needed to make up for the fatigue factor inherent in prolonged testing periods. Also, examinations mainly include children between 7 and 16 years old. We describe the summative examination used in our institution to evaluate medical students’ clinical competencies in pediatrics with realistic available resources and for a wider age-range. We also evaluated different factors known to influence medical students’ performances.

Methods

This retrospective, descriptive, observational study evaluated the 740 distinct pediatric examination results of fourth-year medical students over 5 years. Their summative examination combined two different assessment methods: a structured real-patient examination (SRPE) using standardized assessment grids for the most frequent pediatric diagnoses, and a computer-based written examination (CBWE).

Results

Our approach defined an appropriate setting for some key elements of the educational objectives of pediatrics training, such as balancing the child–parent–pediatrician triangle and the ability to interact with pediatric patients, from newborns to 16-year-old adolescents, in a child-friendly fashion in realistic scenarios. SRPE scores showed no associations with students’ degrees of exposure to specific lecture topics, vignettes, or bedside teaching. The impacts of clinical setting, topic, and individual examiners on SRPE scores was quite limited. Setting explained 1.6%, topic explained 4.5%, and examiner explained 4.7% of the overall variability in SRPE scores.

Conclusions

By combining two different assessment methods, we were able to provide a best-practice approach for assessing clinical skills in Pediatrics over a wide range of real patients.
Raising awareness about microbial antibiotic resistance in undergraduate dental students: a research-based strategy for teaching non-laboratory elements of a microbiology curriculum
Authors: Veses Veronica , del Mar Jovani-Sancho Maria , González-Martínez Raquel , Cortell-Ballester Isidoro , Sheth Chirag C.
Published: February 2020

Background

Resistance to antimicrobial agents has become a problem in modern society. Antibiotic resistant bacteria undermine the prevention and treatment of infections. Undergraduate dental students in Europe are required to receive information in aspects of microbiology relevant for dental practice, including oral microbial pathogens and resistance mechanisms against antimicrobial compounds. The objective of this study was to implement a research-based strategy to aid the understanding of the increase in antimicrobial resistance in undergraduate dental student training. The primary outcome of this project is the efficacious delivery of the learning objectives.

Methods

Ten volunteer undergraduate student “ambassadors” were recruited to manage the project with assistance from lead academics. Student ambassadors were a source of peer learning for their colleagues. The project consisted of three phases: Pre-project preparation (in which the ambassadors received special instruction and training); Practical experience (in which the ambassadors worked with volunteer student colleagues to carry out the project); Public presentation of results (in which ambassadors presented study results at a scientific conference of their choosing).

Results

A total of 1164 students volunteered for the project, corresponding to an average participation rate of 76.4% students per year of the course. Following final debriefing, student participants and ambassadors were strongly positive in their evaluation of the achievement of 8 key student learning objectives. The results demonstrate that most volunteers improved their knowledge related to antimicrobial resistance mechanisms in microbiology. Additional benefits of participation in this project included an improvement in dental knowledge and ethics in biomedical research for the student volunteers, whilst the student ambassadors reported improved knowledge about critical thinking and study design, as well as a deeper understanding about microbiological analysis methods.

Conclusions

To the best of our knowledge, this the first instance of the application of project-based methodologies to the teaching of a traditionally non-laboratory component of a subject taught in the dentistry curriculum. Results from both students and ambassadors highlighted the increase in dental knowledge and an increased awareness of antimicrobial resistance as the key outcomes of this project.
Will applications on smartphones allow a generalization of telemedicine?
Authors: Allaert F. A. , Legrand L. , Abdoul Carime N. , Quantin C.
Published: February 2020

Background

Telemedicine is one of the healthcare sectors that has developed the most in recent years. Currently, telemedicine is mostly used for patients who have difficulty attending medical consultations because of where they live (teleconsultation) or for specialist referrals when no specialist of a given discipline is locally available (telexpertise). However, the use of specific equipment (with dedicated cameras, screens, and computers) and the need for institutional infrastructure made the deployment and use of these systems expensive and rigid. Although many telemedicine systems have been tested, most have not generally gone beyond local projects.

Our hypothesis is that the use of smartphones will allow health care providers to overcome some of the limitations that we have exposed, thus allowing the generalization of telemedicine.

Main body

This paper addresses the problem of telemedicine applications, the market of which is growing fast. Their development may completely transform the organization of healthcare systems, change the way patients are managed and revolutionize prevention. This new organization should facilitate the lives of both patients and doctors.

In this paper, we examine why telemedicine has failed for years to take its rightful place in many European healthcare systems although there was a real need. By developing the example of France, this article analyses the reasons most commonly put forth: the administrative and legal difficulties, and the lack of funding. We argue that the real reason telemedicine struggled to find its place was because the technology was not close enough to the patient.

Conclusion

Finally, we explain how the development of smartphones and their current ubiquitousness should allow the generalization of telemedicine in France and on a global scale.
Usefulness of day 7 lumefantrine plasma concentration as a predictor of malaria treatment outcome in under-fives children treated with artemether-lumefantrine in Tanzania
Authors: Kilonzi Manase , Minzi Omary , Mutagonda Ritah , Baraka Vito , Sasi Philip , Aklillu Eleni , Kamuhabwa Appolinary
Published: February 2020

Background

Day 7 plasma lumefantrine concentration is suggested as a predictor for malaria treatment outcomes and a cut-off of ≥ 200 ng/ml is associated with day 28 cure rate in the general population. However, day 7 lumefantrine plasma concentration can be affected by age, the extent of fever, baseline parasitaemia, and bodyweight. Therefore, this study assessed the usefulness of day 7 lumefantrine plasma concentration as a predictor of malaria treatment outcome in under-fives children treated with generic or innovator drug-containing artemether-lumefantrine (ALu) in Tanzania.

Methods

This study was nested in an equivalence prospective study that aimed at determining the effectiveness of a generic ALu (Artefan®) in comparison with the innovator’s product (Coartem®). Children with uncomplicated malaria aged 6–59 months were recruited and randomized to receive either generic or innovator’s product. Children were treated with ALu as per World Health Organization recommendations. The clinical and parasitological outcomes were assessed after 28 days of follow up. PCR was performed to distinguish recrudescence and re-infections among children with recurrent malaria. Analysis of day 7 lumefantrine plasma concentration was carried out using a high-performance liquid chromatographic method with UV detection.

Results

The PCR corrected cure rates were 98.7% for children treated with generic and 98.6% for those treated with the innovator product (p = 1.00). The geometric mean (± SD) of day 7 plasma lumefantrine concentration was 159.3 (± 2.4) ng/ml for the generic and 164 (± 2.5) ng/ml for the innovator groups, p = 0.87. Geometric mean (± SD) day 7 lumefantrine plasma concentration between cured and recurrent malaria was not statistically different in both treatment arms [158.5 (± 2.4) vs 100.0 (± 1.5) ng/ml, (p = 0.28) for generic arm and 158.5 (± 2.3) vs 251.2 (± 4.2) ng/ml, (p = 0.24) for innovator arm]. Nutritional status was found to be a determinant of recurrent malaria (adjusted hazardous ratio (95% confidence interval) = 3(1.1–8.2), p = 0.029.

Conclusion

Using the recommended cut-off point of ≥ 200 ng/ml, day 7 plasma lumefantrine concentration failed to predict malaria treatment outcome in children treated with ALu in Tanzania. Further studies are recommended to establish the day 7 plasma lumefantrine concentration cut-off point to predict malaria treatment outcome in children.
Successful pre-operative local control of skin exposure by sarcoma using combination of systemic chemotherapy and Mohs’ chemosurgery
Authors: Hoshi Manabu , Iwai Tadashi , Oebisu Naoto , Nakamura Hiroaki
Published: February 2020

Background

Sarcomas sometimes invade the skin and become exposed, producing malignant wounds characterized by bleeding, exudate, odor, and infection. Malignant cutaneous sarcomas are generally incurable and ultimately impair patients’ quality of life. Mohs’ chemosurgery is a previously published technique for chemical fixation of a cutaneous tumor and subsequent excision.

Case presentation

We present the case of a 44-year-old man with an undifferentiated pleomorphic sarcoma arising in the right chest wall and rupturing through the skin. The tumor manifested as a malignant wound with ulceration, bleeding, exudate, and a strong odor. Treatment with systemic chemotherapy and Mohs’ chemosurgery was initiated. After repeated courses, the tumor demonstrated significant shrinkage. We were then able to perform wide resection and reconstruction with a rectus abdominis musculocutaneous flap. Pathologic examination of the resected specimen confirmed negative margins.

Conclusions

Mohs’ chemosurgery with concurrent systemic chemotherapy is an effective and reliable treatment option for achieving pre-operative local control of sarcomas that rupture through the skin.
Is enhancing the professionalism of healthcare providers critical to tackling antimicrobial resistance in low- and middle-income countries?
Authors: Khan Mishal S. , Bory Sothavireak , Rego Sonia , Suy Sovanthida , Durrance-Bagale Anna , Sultana Zia , Chhorn Sophea , Phou Socheata , Prien Chanra , Heng Sotheara , Hanefeld Johanna , Hasan Rumina , Saphonn Vonthanak
Published: February 2020

Background

Healthcare providers’ (HCPs) professionalism refers to their commitment and ability to respond to the health needs of the communities they serve and to act in the best interest of patients. Despite attention to increasing the number of HCPs in low- and middle-income countries (LMIC), the quality of professional education delivered to HCPs and their resulting professionalism has been neglected. The Global Action Plan on Antimicrobial Resistance (AMR) seeks to reduce inappropriate use of antibiotics by urging patients to access antibiotics only through qualified HCPs, on the premise that qualified HCPs will act as more responsible and competent gatekeepers of access to antibiotics than unqualified HCPs.

Methods

We investigate whether weaknesses in HCP professionalism result in boundaries between qualified HCPs and unqualified providers being blurred, and how these weaknesses impact inappropriate provision of antibiotics by HCPs in two LMIC with increasing AMR—Pakistan and Cambodia. We conducted 85 in-depth interviews with HCPs, policymakers, and pharmaceutical industry representatives. Our thematic analysis was based on a conceptual framework of four components of professionalism and focused on identifying recurring findings in both countries.

Results

Despite many cultural and sociodemographic differences between Cambodia and Pakistan, there was a consistent finding that the behaviour of many qualified HCPs did not reflect their professional education. Our analysis identified five areas in which strengthening HCP education could enhance professionalism and reduce the inappropriate use of antibiotics: updating curricula to better cover the need for appropriate use of antibiotics; imparting stronger communication skills to manage patient demand for medications; inculcating essential professional ethics; building skills required for effective collaboration between doctors, pharmacists, and lay HCPs; and ensuring access to (unbiased) continuing medical education.

Conclusions

In light of the weaknesses in HCP professionalism identified, we conclude that global guidelines urging patients to only seek care at qualified HCPs should consider whether HCP professional education is equipping them to act in the best interest of the patient and society. Our findings suggest that improvements to HCP professional education are needed urgently and that these should focus not only on the curriculum content and learning methods, but also on the social purpose of graduates.
Identification and evaluation of risk of generalizability biases in pilot versus efficacy/effectiveness trials: a systematic review and meta-analysis
Authors: Beets Michael W. , Weaver R. Glenn , Ioannidis John P. A. , Geraci Marco , Brazendale Keith , Decker Lindsay , Okely Anthony D. , Lubans David , van Sluijs Esther , Jago Russell , Turner-McGrievy Gabrielle , Thrasher James , Li Xiaming , Milat Andrew J.
Published: February 2020

Background

Preliminary evaluations of behavioral interventions, referred to as pilot studies, predate the conduct of many large-scale efficacy/effectiveness trial. The ability of a pilot study to inform an efficacy/effectiveness trial relies on careful considerations in the design, delivery, and interpretation of the pilot results to avoid exaggerated early discoveries that may lead to subsequent failed efficacy/effectiveness trials. “Risk of generalizability biases (RGB)” in pilot studies may reduce the probability of replicating results in a larger efficacy/effectiveness trial. We aimed to generate an operational list of potential RGBs and to evaluate their impact in pairs of published pilot studies and larger, more well-powered trial on the topic of childhood obesity.

Methods

We conducted a systematic literature review to identify published pilot studies that had a published larger-scale trial of the same or similar intervention. Searches were updated and completed through December 31st, 2018. Eligible studies were behavioral interventions involving youth (≤18 yrs) on a topic related to childhood obesity (e.g., prevention/treatment, weight reduction, physical activity, diet, sleep, screen time/sedentary behavior). Extracted information included study characteristics and all outcomes. A list of 9 RGBs were defined and coded: intervention intensity bias, implementation support bias, delivery agent bias, target audience bias, duration bias, setting bias, measurement bias, directional conclusion bias, and outcome bias. Three reviewers independently coded for the presence of RGBs. Multi-level random effects meta-analyses were performed to investigate the association of the biases to study outcomes.

Results

A total of 39 pilot and larger trial pairs were identified. The frequency of the biases varied: delivery agent bias (19/39 pairs), duration bias (15/39), implementation support bias (13/39), outcome bias (6/39), measurement bias (4/39), directional conclusion bias (3/39), target audience bias (3/39), intervention intensity bias (1/39), and setting bias (0/39). In meta-analyses, delivery agent, implementation support, duration, and measurement bias were associated with an attenuation of the effect size of − 0.325 (95CI − 0.556 to − 0.094), − 0.346 (− 0.640 to − 0.052), − 0.342 (− 0.498 to − 0.187), and − 0.360 (− 0.631 to − 0.089), respectively.

Conclusions

Pre-emptive avoidance of RGBs during the initial testing of an intervention may diminish the voltage drop between pilot and larger efficacy/effectiveness trials and enhance the odds of successful translation.
C-reactive protein derived from perivascular adipose tissue accelerates injury-induced neointimal hyperplasia
Authors: Chen Jia-Yuan , Zhu Xiao-Lin , Liu Wen-Hao , Xie Yong , Zhang Hai-Feng , Wang XiaoQiao , Ying Ru , Chen Zhi-Teng , Wu Mao-Xiong , Qiu Qiong , Wang Jing-Feng , Chen Yang-Xin
Published: February 2020

Aim

Inflammation within the perivascular adipose tissue (PVAT) in obesity plays an important role in cardiovascular disorders. C-reactive protein (CRP) level in obesity patients is significantly increased and associated with the occurrence and progression of cardiovascular disease. We tested the hypothesis CRP derived from PVAT in obesity contributes to vascular remodeling after injury.

Methods

A high-fat diet (HFD) significantly increased CRP expression in PVAT. We transplanted thoracic aortic PVAT from wild-type (WT) or transgenic CRP-expressing (CRPTG) mice to the injured femoral artery in WT mice.

Results

At 4 weeks after femoral artery injury, the neointimal/media ratio was increased significantly in WT mice that received PVAT from CRPTG mice compared with that in WT mice that received WT PVAT. Transplanted CRPTG PVAT also significantly accelerated adventitial macrophage infiltration and vasa vasorum proliferation. It was revealed greater macrophage infiltration in CRPTG adipose tissue than in WT adipose tissue and CRP significantly increased the adhesion rate of monocytes through receptor Fcγ RI. Proteome profiling showed CRP over-expression promoted the expression of chemokine (C-X-C motif) ligand 7 (CXCL7) in adipose tissue, transwell assay showed CRP increased monocyte migration indirectly via the induction of CXCL7 expression in adipocytes.

Conclusion

CRP derived from PVAT was significantly increased in HFD mice and promoted neointimal hyperplasia after vascular injury.
The permissive role of TCTP in PM2.5/NNK-induced epithelial–mesenchymal transition in lung cells
Authors: Liu Li-Zhong , Wang Menghuan , Xin Qihang , Wang Bowen , Chen George G. , Li Ming-Yue
Published: February 2020

Background

Translationally controlled tumor protein (TCTP) is linked to lung cancer. However, upon lung cancer carcinogens stimulation, there were no reports on the relationship between TCTP and lung cell carcinogenic epithelial–mesenchymal transition (EMT). This study was designed to investigate the molecular mechanism of regulation of TCTP expression and its role in lung carcinogens-induced EMT.

Methods

To study the role of TCTP in lung carcinogens [particulate matter 2.5 (PM2.5) or 4-methylnitrosamino-l-3-pyridyl-butanone (NNK)]-induced EMT, PM2.5/NNK-treated lung epithelial and non-small cell lung cancer (NSCLC) cells were tested. Cell derived xenografts, human lung cancer samples and online survival analysis were used to confirm the results. MassArray assay, Real-time PCR and Reporter assays were performed to elucidate the mechanism of regulation of TCTP expression. All statistical analyses were performed using GraphPad Prism version 6.0 or SPSS version 20.0.

Results

Translationally controlled tumor protein and vimentin expression were up-regulated in PM2.5/NNK-treated lung cells and orthotopic implantation tumors. TCTP expression was positively correlated with vimentin in human NSCLC samples. Patients with high expression of TCTP displayed reduced overall and disease-free survival. TCTP overexpression could increase vimentin expression and promote cell metastasis. Furthermore, PM2.5/NNK stimulation brought a synergistic effect on EMT in TCTP-transfected cells. TCTP knockdown blocked PM2.5/NNK carcinogenic effect. Mechanically, PM2.5/NNK-induced TCTP expression was regulated by one microRNA, namely miR-125a-3p, but not by methylation on TCTP gene promoter. The level of TCTP was regulated by its specific microRNA during the process of PM2.5/NNK stimulation, which in turn enhanced vimentin expression and played a permissive role in carcinogenic EMT.

Conclusions

Our results provided new insights into the mechanisms of TCTP regulatory expression in lung carcinogens-induced EMT. TCTP and miR-125a-3p might act as potential prognostic biomarkers and therapeutic targets for NSCLC.
Association between personal values in adolescence and mental health and well-being in adulthood: a cross-cultural study of working populations in Japan and the United States
Authors: Watanabe Kazuhiro , Kawakami Norito , Nishi Daisuke
Published: February 2020

Background

For promoting mental health and well-being of individuals, it is important to investigate its association with personal values. However, in Eastern Asian countries, no study has yet investigated the association between personal values in adolescence and mental health and well-being in adulthood. To fill that research gap, we conducted a cross-sectional study based on two online surveys of working populations in Japan and the United States.

Methods

A total of 516 workers from each of the two countries, aged 30–49 years, completed a questionnaire that measured personal values in adolescence, current psychological distress, health-related quality of life, and subjective well-being (satisfaction and happiness). Personal values were measured by items based on Schwartz’s theory of basic values and people’s commitment to those ten values. Multiple group path analysis was performed to examine the associations between personal values in adolescence and health-related outcomes, grouped by country.

Results

Care, graduating from school, and commitment to values were associated with better mental health and well-being in Japanese participants. Belief and challenging were associated with better mental health and well-being in US participants. On the other hand, financial success was associated with poor mental health and well-being in Japanese participants. Avoiding causing trouble and positive evaluation were associated with poor mental health and well-being in the US participants.

Conclusions

Certain personal values and commitment to those values in adolescence may be associated with mental health and well-being in adulthood. To address the limitations of this study, future studies should use a longitudinal design and investigate the interactions among the types of personal values and commitment to the values.
Bayesian approach for analysis of time-to-event data in plant biology
Authors: Humplík Jan F. , Dostál Jakub , Ugena Lydia , Spíchal Lukáš , De Diego Nuria , Vencálek Ondřej , Fürst Tomáš
Published: February 2020

Background

Plants, like all living organisms, metamorphose their bodies during their lifetime. All the developmental and growth events in a plant’s life are connected to specific points in time, be it seed germination, seedling emergence, the appearance of the first leaf, heading, flowering, fruit ripening, wilting, or death. The onset of automated phenotyping methods has brought an explosion of such time-to-event data. Unfortunately, it has not been matched by an explosion of adequate data analysis methods.

Results and discussion

In this paper, we introduce the Bayesian approach towards time-to-event data in plant biology. As a model example, we use seedling emergence data of maize under control and stress conditions but the Bayesian approach is suitable for any time-to-event data (see the examples above). In the proposed framework, we are able to answer key questions regarding plant emergence such as these: (1) Do seedlings treated with compound A emerge earlier than the control seedlings? (2) What is the probability of compound A increasing seedling emergence by at least 5 percent?

Conclusion

Proper data analysis is a fundamental task of general interest in life sciences. Here, we present a novel method for the analysis of time-to-event data which is applicable to many plant developmental parameters measured in field or in laboratory conditions. In contrast to recent and classical approaches, our Bayesian computational method properly handles uncertainty in time-to-event data and it is capable to reliably answer questions that are difficult to address by classical methods.
Integrated quality evaluation strategy for multi-species resourced herb medicine of Qinjiao by metabolomics analysis and genetic comparation
Authors: Li Zeyun , Du Yue , Yuan Yongliang , Zhang Xiaojian , Wang Zhengtao , Tian Xin
Published: February 2020

Background

Quality evaluation of multi-species resourced herb medicine (MSRHM) is a main problem for quality control of herb medicine. Current quality evaluation methodology lost consideration of species discrepancy. New quality evaluation strategy for MSRHM is in urgent need. Qinjiao, a representative MSRHM, originated from Gentiana macrophylla Pall., Gentiana straminea Maxim., Gentiana crassicaulis Duthie ex Burk. or Gentiana dahurica Fisch., has been used as an important herb medicine over 2000 years for expelling wind-dampness and relieving impediment pain. However, quality evaluation among species has never been revealed. The current work proposes an integrated quality evaluation strategy for MSRHM of Qinjiao, which may promote innovation of quality control of MSRHM.

Methods

In this work, 58 batches of Qinjiao covering 4 species were collected. Genetic comparative analysis based on ITS2 sequence was conducted. Metabolomics analysis based on TOF–MS and NMR spectrum were carried out. Compounds underlying species differences were identified and their discrepancies among species were investigated by ANOVA analysis and multivariate analysis.

Results

Four species of Qinjiao can be authenticated by ITS2 sequence comparation. Metabolomics analysis by TOF/MS and NMR revealed chemical discrepancies among species of Qinjiao. Maximum discrepancy was present between Gentiana crassicaulis Duthie ex Burk. and Gentiana dahurica Fisch. Chemical difference among species were tentative explored. For TOF–MS profiling, 28 constituents were tentative identified, 17 of which were further confirmed by standards. For 1H-NMR profiling, signals from 5 compounds were assigned. Contents discrepancies were investigated by ANOVA analysis. It seems that (seco)iridoids like loganic acid, gentiopicroside or swertiamarin were richer in specie of Gentiana crassicaulis Duthie ex Burk., while flavonoid (morroniside) and triterpenoids (roburic aicd, ursolic acid, oleanolic acid, β-sitosterone) were richer in specie of Gentiana dahurica Fisch. The current research demonstrates that metabolite profiling based on both UPLC/Q-TOF MS and 1H-NMR coupled with ITS2 sequence comparation can be a powerful tool for quality investigation of MSRHM of Qinjiao.

Conclusions

A comprehensive quality evaluation strategy for MSRHM was proposed by integrating UPLC-Q-TOF–MS, NMR based metabolic analysis and ITS2 sequence genetic comparation. The proposed quality evaluation strategy shall promote innovation of quality control of traditional Chinese medicine.
Prenatal genetic analysis and differential pregnancy outcomes of two de novo cases showing mosaic isodicentric Y chromosome
Authors: He Si , Xi Hui , Chen Jing , Wang Dan , Pang Jialun , Hu Jiancheng , Liu Qin , Jia Zhengjun , Wang Hua
Published: February 2020

Background

Fetal cells collected from the amniotic fluid of two pregnant women indicated sex chromosome abnormalities. Therefore, we performed G-banded chromosome karyotype analysis, single nucleotide polymorphism array (SNP array), fluorescence in situ hybridization (FISH), and sequence-tagged sites (STS) analysis of the Y chromosome to determine the rare molecular genetics of the two fetuses.

Case presentation

The karyotypes of the fetuses from patients 1 and 2 were mos 45,X[92]/46,X,+idic(Y)(q11.21)[8] and mos 45,X[20]/46,X,+idic(Y)(q11.223)[80], respectively. Fetus 1 had a 7.76 Mb deletion in Yq11.222q11.23 and a 15.68 Mb duplication in Yp11.2q11.21. Fetus 2 had 21 Mb of repetitive segments in Yp11.3q11.223. Azoospermia factor (AZF) detection by STS analysis revealed a missing AZFb+c region in fetus 1 and three functional AZF regions in fetus 2. The isodicentric Y chromosome (idic (Y)) in both fetuses arose de novo. The pregnancy of patient 1 was terminated, whereas the fetus of patient 2 was delivered and is now 10 months old with normal appearance and growth.

Conclusion

A combination of technologies such as chromosome karyotyping, FISH, SNP arrays, and STS analysis of the Y chromosome is important in prenatal diagnosis to reduce birth defect rates and improve the health of the Chinese population.
Time periodic Navier–Stokes equations in a thin tube structure
Authors: Juodagalvytė R. , Panasenko G. , Pileckas K.
Published: February 2020

The time periodic Navier–Stokes equations are considered in the three-dimensional and two-dimensional settings with Dirichlet boundary conditions in thin tube structures. These structures are finite union of thin cylinders (thin rectangles in the case of dimension two), where the small parameter ε is the ratio of the hight and the diameter of the cylinders. We consider the case of finite or big coefficient before the time derivative. This setting is motivated by hemodynamical applications. Theorems of existence and uniqueness of a solution are proved. Complete asymptotic expansion of a solution is constructed and justified by estimates of the difference of the exact solution and truncated series of the expansion in norms taking into account the first and second derivatives with respect to the space variables and the first derivative in time. The method of asymptotic partial decomposition of the domain is justified for the time periodic problem.
Exact solutions to the nonlinear equation in traffic congestion
Authors: Li Cheng , Cao Damin , Du Qing
Published: February 2020

In this paper, the KdV-mKdV equation is obtained via the reductive perturbation method which can be applied to model the traffic flow. To overcome the shortcomings of the traditional KdV-mKdV equation, the original equation is converted into a space-time fractional equation, which is decreased to a common differential equation by using fractional complex transformation. All possible exact solutions are given through the entire discrimination gadget for polynomial method. In particular, the corresponding options are resembled for the specific parameters to show that each answer in the classification can be realized. And the numerical simulations in the paper additionally confirm this conclusion.
Preparation of the standard cell lines for reference mutations in cancer gene-panels by genome editing in HEK 293 T/17 cells
Authors: Suzuki Takayoshi , Tsukumo Yoshinori , Furihata Chie , Naito Mikihiko , Kohara Arihiro
Published: February 2020

Background

Next Generation Sequencer (NGS) is a powerful tool for a high-throughput sequencing of human genome. It is important to ensure reliability and sensitivity of the sequence data for a clinical use of the NGS. Various cancer-related gene panels such as Oncomine™ or NCC OncoPanel have been developed and used for clinical studies. Because these panels contain multiple genes, it is difficult to ensure the performance of mutation detection for every gene. In addition, various platforms of NGS are developed and their cross-platform validation has become necessity. In order to create mutant standards in a defined background, we have used CRISPR/Cas9 genome-editing system in HEK 293 T/17 cells.

Results

Cancer-related genes that are frequently used in NGS-based cancer panels were selected as the target genes. Target mutations were selected based on their frequency reported in database, and clinical significance and on the applicability of CRISPR/Cas9 by considering distance from PAM site, and off-targets. We have successfully generated 88 hetero- and homozygous mutant cell lines at the targeted sites of 36 genes representing a total of 125 mutations.

Conclusions

These knock-in HEK293T/17 cells can be used as the reference mutant standards with a steady and continuous supply for NGS-based cancer panel tests from the JCRB cell bank. In addition, these cell lines can provide a tool for the functional analysis of targeted mutations in cancer-related genes in the isogenic background.
Nonlinear beamforming for enhancement of 3D prestack land seismic data
Authors: Bakulin Andrey , Silvestrov Ilya , Dmitriev Maxim , Neklyudov Dmitry , Protasov Maxim , Gadylshin Kirill , Dolgov Victor
Published: February 2020

We have developed nonlinear beamforming (NLBF), a method for enhancing modern 3D prestack seismic data acquired onshore with small field arrays or single sensors in which weak reflected signals are buried beneath the strong scattered noise induced by a complex near surface. The method is based on the ideas of multidimensional stacking techniques, such as the common-reflection-surface stack and multifocusing, but it is designed specifically to improve the prestack signal-to-noise ratio of modern 3D land seismic data. Essentially, NLBF searches for coherent local events in the prestack data and then performs beamforming along the estimated surfaces. Comparing different gathers that can be extracted from modern 3D data acquired with orthogonal acquisition geometries, we determine that the cross-spread domain (CSD) is typically the most convenient and efficient. Conventional noise removal applied to modern data from small arrays or single sensors does not adequately reveal the underlying reflection signal. Instead, NLBF supplements these conventional tools and performs final aggregation of weak and still broken reflection signals, where the strength is controlled by the summation aperture. We have developed the details of the NLBF algorithm in CSD and determined the capabilities of the method on real 3D land data with the focus on enhancing reflections and early arrivals. We expect NLBF to help streamline seismic processing of modern high-channel-count and single-sensor data, leading to improved images as well as better prestack data for estimation of reservoir properties.